Health Literacy Past, Present, and Future: Workshop Summary (2015) / Chapter Skim
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6 Looking to the Future
6 Looking to the Future
Pages 67-80
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From page 67... ...
The four panelists were Betsy Humphreys, deputy director of NLM; Winston Wong, medical director for Community Benefit and director of Disparities Improvement and Quality Initiatives at Kaiser Permanente; Steven Teutsch, adjunct professor at the Fielding School of Public Health at the University of California, Los Angeles; and Michael Wolf, professor of medicine and learning sciences at the Feinberg School of Medicine at Northwestern University. THE ROLE OF TECHNOLOGY IN HEALTH LITERACY1 Davis started the discussion by asking Betsy Humphreys about the role that technology might play in health literacy over the next decade, and her response was that technology, if done correctly with input from users, could make a significant impact on the integration of health literacy into all of health care by making the job of being a patient easier.
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From page 68... ...
The only way to counter this type of misnformation is to make sure that the i public agencies and foundations that produce high-quality health information for the public do so from the start in a way that is interesting, engaging, understandable, and accessible, or as she put it, "to make it easier to find the good stuff than it is the bad stuff." Going forward, NLM's main role in health literacy will be to organize all of the great information that is coming out at the appropriate literacy level and to help make it available in multimedia formats that communicate in ways that the written word cannot. Another role will be to make research available on what works and what does not in terms of technologies for disseminating health information and to do so not just for the public, but
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From page 69... ...
Davis asked Humphreys if she thought print medical journals would still be available in 2024, to which Humphreys replied that she does not think those would still exist in 2024. What will develop, though, are more avenues for personal interactions with vulnerable populations to help them understand health information, and that this is a role in which libraries excel today.
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From page 70... ...
Davis then asked Teutsch about the importance of trust when it comes to public health information, particularly with regard to vaccination. He explained that in California, parents can opt out of having their children vaccinated based on personal beliefs, and the problem is that too many personal beliefs about vaccination are formed based on misinformation being promulgated by blogs and celebrities that some members of the public consider more credible than health care and public health professionals.
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From page 71... ...
Davis agreed that a tipping point in that regard may be at hand and that those attending and participating in this work are in a position to help get the nation on the other side of that tipping point. RESEARCH ON HEALTH LITERACY3 Turning to the matter of health literacy research, Davis asked Michael Wolf if he believed, as she does, that the field may have lost its creative spark and is too focused on securing research funding rather than on thinking about problems and meaningful ways to address them.
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From page 72... ...
One benefit from this is that an increasing number of studies and grants that he reviews, whether they come from a health literacy researcher or not, include health literacy as a covariant factor in models designed to study some other health determinant. That is an important development, said Wolf, because it means that people are measuring the impact of health literacy on a wide variety of outcomes.
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From page 73... ...
Over the past decade, however, place has become as important a part of the discussion of health equity as race, and there is the awareness that a person's zip code is a more important determinant of health than his or her genetic code. To the point that Teutsch made about the physical environment, place matters as a proxy for understanding the social determinants of health in terms of whether 4 This section is based on the comments of Winston Wong, medical director for Community Benefit and director of Disparities Improvement and Quality Initiatives at Kaiser Permanente, and the statements are not endorsed or verified by the IOM.
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From page 74... ...
Wong referred to this last idea as "fate happens," and he said there is a new appreciation for how fate, as determined by where someone lives, can have a disproportionate impact on the burden of disease and the development of chronic disease. The question for health care providers, then, is how to interface with all of these elements and by extension to determine how health literacy fits into an honest discussion of how individuals understand their health and how they understand the value proposition for making changes that improve their health.
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From page 75... ...
Ultimately, he said in closing, it will be necessary to have measures that health care organizations can use to determine if the money they are investing in crisis-oriented, intensive chronic care centers is providing real value for the individuals and purchasers of health care in terms of preventing high-cost intensive medical therapies. DISCUSSION George Isham started the open discussion period by asking Wolf to describe a research agenda around measuring and describing complexity, and specifically, how it might be possible to engage in all of the many aspects of complexity in terms of the universal precautions approach or a tailored approach to help people help themselves.
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From page 76... ...
Yvette Morello with the March of Dimes noted that organizations such as hers are also sharing information with people that they call consumers because they are not providing direct care or giving medical advice. She encouraged the research community to work with other organizations that are communicating with consumers outside of the actual clinical setting.
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From page 77... ...
Ruth Parker asked the panel to talk about what cost, transparency, and value-based care might look like in 2024 and how it might affect vulnerable populations and what role health literacy might play in providing value-based care. Teutsch replied that from a population health perspective, there is a major move afoot to look at the economic and health returns of interventions outside of health care, such as early childhood development and education programs, in terms of their health impacts and overall value.
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From page 78... ...
Teutsch added that the ability to understand value comes from being an educated consumer, for which health literacy plays an obvious role. Wilma Alvarado-Little, asked if it is really known how consumers want to get their health information.
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From page 79... ...
Wolf said that companies such as Microsoft and Google are trying to change the equation by developing applications that give patients ownership over their health information. Today, he added, pharmacists and physicians alike do not have a good idea on how to provide information using technology in ways that would be useful to them and their patients, and that this is in part a failure of the health literacy community to help providers know how to get information into the hands of those who need it.
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From page 80... ...
Something as simple as being able to provide information about what standard evidence-based guidelines do exist and incorporate them into a clinical care system linked to the electronic medical record is a real challenge, not from a technical viewpoint but from an adoption viewpoint. He did think that at a minimum it should be possible to codify standard guidelines and make them available to both physicians at the point of care and to their patients.
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