Health Literacy Month came and went during this fall in the month of October. But what exactly is “health literacy” and why is it important for healthcare’s future?
Nanci Reiland, Assistant Professor of Nursing at Lewis University, and also a consultant for the Will County Health Department’s Community Health Center, says this is all about better two-way communication between the doctor and the patient.
“You need to be literate to understand a book you’re reading. Well, you need to be health literate to fully comprehend how your healthcare applies to your situation,” Reiland explained. “It’s a matter of understanding your body, any diagnosis you might have, and what various numbers mean or don’t mean.”
“Unfortunately,” Reiland continued, “many people are way behind in understanding the entire concept of their health care. It’s estimated that only 12 percent of the U.S. population would qualify as health literate.”
Reiland says that two main ingredients to health literacy are “plain language” on the part of the healthcare provider, and “self-management” on the part of the patients. Another ingredient she would love to see added is better education for future “young adults.”
The term “plain language” comes from the Plain Writing Act, passed in October of 2010. It was a U.S. Government effort requiring federal agencies to use “clear government communication that the public can understand and use.”
“After the act was passed,” Reiland recalled,” federal departments dealing with medical issues, such as the Centers for Disease Control, were then required to follow those regulations. Then, the entire medical profession started realizing, ‘hey, wait a minute, maybe we should be looking into this as well.’ That goes for speaking plainly as well as writing plainly.”
The main goal, Reiland says, is for doctors, nurses, and health care providers to use more common language and less technical terms, and therefore encourage more two-way communication between the caretaker and the patient. “It’s also a matter of encouraging the patients to better advocate for their own health, and to create a better doctor-patient relationship,” Reiland said. “What you want to avoid is the patient simply being told what to do, and then leaving the office with or without understanding the full situation. A more engaged patient is better able to make decisions that will impact their health.”
“These days,” Reiland also pointed out, “patients can google absolutely anything. So they might go home, type in the name of whatever condition they have been diagnosed with, find just any article, and say, ‘okay, I’m going to handle it this way. But is the article legitimate and with the right information? If the health provider and patient have a good relationship, the patient can be comfortable sharing what they have read. And then the doctor or nurse can let them know if what they have read is legitimate and could possibly be part of their plan.”
This, Reiland says, is where “self-management” comes in. And in order to work properly it requires initiative from the doctors and nurses as well as the patients. “The doctor or nurse needs to be willing to talk substantially with the patient, and take a little more time than what he or she might be used to. After they have explained the treatment plan to the patient, the doctor or nurse needs to essentially ‘interview’ the patient and ask them to repeat what they have just been told. In other words, ‘tell me what I just told you.” We need to assume low health literacy, and never just think that a patient understands everything and walks out of the office confident of the treatment plan.”
“There are a couple of side issues here,” Reiland explained further. “First, insurers need to be willing to pay for this extra discussion time; and doctor’s offices need to adjust their scheduling to allow it to happen. Second, we realize that there are cultural differences that can cause issues with this. For example, some cultures might not encourage eye contact with those considered in authority. That can hurt the communication, or give the impression of the patient being disinterested. Also, in some cultures, it might be normal for the patient to nod his or her head, but that does not necessarily mean that they understand the diagnosis or the treatment plan.”
What is the best way to set up the future of improved health literacy? Reiland believes a great place to really make a difference is in the schools. For example, a law in Illinois requires Consumer Education to be taught to high school students before graduation. But Reiland says, how about a requirement for Healthcare Education?
“It should be all about helping these students’ transitions into young adulthood,” Reiland said. “I have met many young adults in their 20s, who no longer have their parents calling the shots, who seem completely lost. It would be great to teach them more about how to manage health insurance, what a good blood pressure reading is, how to know when to see a healthcare provider, what ideal blood sugar levels are and why. Good ‘numeracy skills’ are also important, such as how to measure medication. Simply put: teaching them the importance of understanding their genetic information, what certain numbers mean, and what to look for.”
“Life, health, and healthcare are all becoming more complex; and it seems hard to take as good care of ourselves as we used to,” Reland said, “especially when it comes to being active. We’ve slipped into an era where people often approach the doctor thinking ‘I know my habits have impacted my health, but please fix what is wrong with me.’ It is also more complicated and decentralized today with all of the specialists. This can be very discouraging. But with better health literacy, the patient can take more control of things, in both a proactive and reactive way.”
Another factor of the future that could help for overall health literacy, as well as making things more convenient, is the patient portal. Patient portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals.
The idea of the patient portal, Reiland says, is to have all of a patient’s information available at one online location. They will see their long term and short term medical history: from vaccination records, to the results of recent bloodwork, to when follow-up visitations are recommended with all of your doctors. “I’ve seen so many parents,” Reiland recalled, “trying to locate their child’s information. By using the patient portal, and understanding the numbers and test results, they will have more information at their fingertips and a more secure feeling of being in control.” The patient portal sign up is already available at the Will County Community Health Center by going to www.nextmd.com
. If it is your first time on the site, click the blue bar in box on the right that reads “I am new here.” You will then be able to establish a user name and password, and begin your usage of the patient portal for personal medical information.
Reiland says despite the amount of work that needs to be done, the goal of having health literate patients in the majority rather than the minority is something that can be done. “Health literacy is really a personal responsibility on everyone’s part,” Reiland concluded. “The medical field needs to provide support and assistance to make it happen. Then, the patients have to want that understanding and control of their healthcare. It’s a two-way street. It starts with health professionals, and it starts with patients as well.”