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Case Management

Do We Understand One Another?

February 1, 2009

ArrayExploring the Importance of Health Literacy

In describing the fragmentation of today’s health care system, Helen Osborne, the president of Health Literacy Consulting, relates the story of an elderly patient in need of hip replacement surgery. The man’s primary care physician referred him to a specialist to conduct the procedure. Following the surgery, however, the man experienced an infection. So he visited a doctor who specialized in such an intricate matter, and the doctor soon concluded that he would need a new replacement. There would be a separate specialist, of course, to take care of that.

For the care of one joint, the man was shuttled through the hands of three doctors. With such highly specialized and often splintered care, the average consumer may find it difficult to track the jargon and the processes of what constitutes our modern health care leviathan — in particular during transitions of care.

“What I’m working toward is helping health professionals communicate important messages in ways patients and their families can understand,” says Osborne, who has produced several resources on the subject, including the comprehensive book Health Literacy from A to Z. “The responsibility is on the health care communicator. It’s our responsibility to not only communicate clearly but to confirm that the message was correctly understood.”

Exploring the importance of health literacy The National Library of Medicine estimates that one-third of the adult population has limited health literacy. This blockage of understanding is associated with poor health, which can affect the following areas.

PREVENTIVE SERVICES.

Those with low health literacy skip preventive measures like flu shots and mammograms.

CHRONIC DISEASE.

Those with low health literacy are not only more likely to have chronic conditions like high blood pressure, diabetes, asthma and HIV/AIDS but are less likely to manage them effectively.

HOSPITALIZATIONS AND ER USE.

Those with low health literacy are more likely to make preventable hospital visits and to utilize emergency services.

HEALTH CARE COSTS.

Because of a lower utilization of preventive services, those with low health literacy incur greater costs to the health care system.

health literacyhelth li-t( )r -se n: the ability to understand health information and to use that information to make good decisions about your health and medical care
FOSTERING AWARENESS.

With lives and dollars at stake, it is important for care providers to be clear in their delivery and presentation of health information.

“To me, health literacy is really about mutual understanding,” Osborne says. While she believes that there has been a seismic shift of responsibility onto patients and families, the care provider is not excluded from addressing health needs in an understandable way. The need, in fact, has increased. Attending to the following questions will create a smoother line of communication.

Is the information appropriate for the user? Age, language, literacy skills and social and cultural diversity will be paramount concerns to creating a viable message.

Is the information easy to use? Plain language and the use of familiar examples to explain complicated medical practice or terminology are two methods of increasing the level of understanding.

Are you speaking clearly and listening effectively? Open-ended questions will force patients to respond with more than a “yes” or “no.” Asking a patient to restate the information they received is another effective option.

 


For more information about health literacy, visit the National Library of Medicine online at www.nlm.nih.gov/medlineplus/healthliteracy.html. Helen Osborne offers a free newsletter, podcasts and more tips and information on her website at www.healthliteracy.com.

Continue learning about health literacy online. Visit the Case In Point website to earn CE credits and to bolster your individual state of practice at www.caseinpointmagazine.com

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