Dullabh and June Eichner. The goal of the guide is to assist developers, the people who are creating new software programs, to become more aware of and more knowledgeable about health literacy issues. For purchasers, the guide includes a checklist of things they should look for when evaluating whether to buy a particular HIT product.

The project first reviewed the literature, both the IT and HIT literature, to find out what was known about ways to develop health information technology so that it would be accessible to limited-literacy audiences. Project staff also looked at various products and websites such as MiVIA. Finally, project staff held discussions with individuals who develop and purchase HIT as well as with researchers involved in the evaluation of HIT for limited literacy populations.

Not surprisingly, the literature on developing accessible health information technology for limited-literacy audiences is scanty; very little has been published about the best way to proceed. As discussed in this workshop, there may not be a single “best” way; instead systems should be adapted to a particular community or population.

AHRQ views health information technology as including personal health records, electronic health records, and health information exchange. The guide covers a number of different types of technology that can be used to convey health information to various audiences, including Internet websites, touch screen kiosks, personal wireless devices (e.g., cell phones, BlackBerrys, and personal digital assistants or PDAs), and home monitoring devices.

The guide promotes the use of universal basic design principles. First, use a simple structure with clean looks that highlight important elements. Second, build well, taking advantage of the technology inherent in the application in order to give consumers choices. Finally, for Internet sites, it is important to use HTML rather than other formats because HTML is more accessible to consumers.

An example of a simple design is shown in Figure 5-1. This design, which is still in testing, is a version of an update to prevention information in healthfinder.gov, which has been attempting to find which approaches are more responsive to and work best for consumers. As can be seen, the design contains only five headings of two or three words each: (1) Eat Healthy, (2) Get Active, (3) Get Screened, (4) Quit Smoking, and (5) Watch Your Weight. Each of the subsequent Web pages takes a similarly clean approach, presenting quite a bit of information but in a clear, simple, and understandable way.

Much of the guide2 adheres to current guidelines for print materials.


The guide is called Accessible Health Information Technology (IT) for Populations with Limited Literacy: A Guide for Developers and Purchasers of Health IT. It is available on AHRQ’s National

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