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Health literacy principles in telehealth

David Thompson, MD, CHC, FACEP, Chief Executive Officer and Chief Medical Officer, Health Navigator

The average person doesn’t tell their doctor they have tinnitus when their ears are ringing. And they don’t use words like “otolaryngologist” or “audiologist.” So, how can health care systems overcome problems with patient understanding? This is a real-life problem, but improving health literacy is a promising solution.

According to the Institute of Medicine, health literacy is “the ability to obtain, process and understand basic health information.” Health literacy involves a person’s general literacy – the ability to read, write and understand written text. It’s also important to consider culture and experience in the health care system.

When patients don’t understand basic health information, it can lead to costly and dangerous situations. To assess those who may encounter challenges, the National Center for Education Statistics performs a National Assessment of Adult Literacy (NAAL) every 10 years. In a time where telehealth and technology are becoming a big part of health care, it’s time to find new ways to address limited literacy.

Although more than half of adult patients have adequate health literacy, many patients struggle to understand health care. In a telehealth encounter, patients may not understand basic follow-up questions. They can also have trouble describing symptoms or understanding a doctor’s instructions. Consider these facts from the NAAL study:

  • 26 percent of people didn’t understand their appointment schedule,
  • 42 percent didn’t understand prescription instructions, and
  • 35 percent had trouble with common health tasks.

Every day, patients with limited literacy use medical call centers, online symptom checkers, and other consumer-focused e-Health technologies. But identifying health literacy challenges can be difficult in e-Health encounters because patients and clinicians aren’t face-to-face. Collecting information about the patient and listening for cues can help.

Health care providers should ask all patients if they have any questions or need help reading instructions. Written content should always be in patient-friendly language at a sixth-grade reading level. Telehealth software and symptom checkers should use plain language.

Solutions for telehealth providers

Telehealth software can be designed to effectively address patient health literacy needs. Some platforms have the ability to convert plain language into coded medical terminology, and vice-versa, which improves understanding for both patients and physicians.

Health care organizations can also use telehealth technology to train staff in plain language communication. Providers who recognize that improving health literacy can be expanded into telehealth encounters can make health care more approachable and improve patient outcomes.