"Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions
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Is Sitting the New Patient Communication Strategy for Nurses?

Is Sitting the New Patient Communication Strategy for Nurses? | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[USA]

Nurses sitting down during patient communications raised patient satisfaction from the 9th to the 43rd percentile.

 

By Sara Heath

 

"April 26, 2017 - Nurses can add an easy-to-implement patient communication strategy to their tool belts, according to a recent study. Research published in the Patient Experience Journalshows that nurses who sit down when communicating with patients yield higher patient satisfaction scores.

 

The research team developed the strategy, called the Commit to Sit initiative, by looking at evidence-based communication approaches.

 

“Qualities that show active listening include being eye level, making eye contact, and undistracted conversation,” the researchers reported. “In the acute care setting, the majority of the patients are lying in a hospital bed, making sitting the most logical and non-threatening way to communicate.”

Dig Deeper

 

Sitting, as opposed to standing, while communicating with patients makes patients perceive that nurses are spending more time talking to them. Studies show that patient perceptions of time spent with them is tied to a positive patient experience.

 

The research team deployed the strategy in a 19-bed unit inside a larger hospital in Texas. The team measured initiative success using the Press Ganey Satisfaction survey, looking specifically at the overall nurse communication composite score, as well as scores for treating patients with courtesy and respect, listening carefully, and explaining concepts understandably.

 

At the end of the nearly seven-month study, nursing communication and satisfaction scoresrose from the 9th percentile to the 43rd percentile. While these results fell short of the research team’s goal of the 60th percentile for nursing communication, it still marked a considerable improvement, the team said.

 

However, the road to communication improvement was not easy, the researchers reported. In the first months of the study, researchers and nursing participants saw little to no difference in patient satisfaction, despite concerted efforts in Commit to Sit. Nurses reported sitting with all of their patients, but only 40 percent of patients and families perceived these efforts.

 

Midway through the study, nursing leaders prompted nurses to explicitly ask if they could sit with patients and families before starting health conversations. This gentle approach reinforced nurse efforts, the researchers found.

 

“Incorporating the word ‘sit’ made an impact as the feedback received during clinical leader rounds was more equivalent to the number of patients the team reported sitting with,” the researchers said. “This may be logically explained as patients make a conscious decision whether a nurse may sit with them at that time or not, increasing their ability to recollect when asked by leaders.”

 

Nurses also presented some resistance to Commit to Sit, especially with regard to extremely sick patients relegated to contact isolation. The researchers targeted nursing education toward safety protocol in those instances, instructing nurses to use disposable pads for sitting or to wear extra protective garments where necessary.

 

These findings have positive implications for nursing practice and patient-provider communication improvements, the researchers said. Commit to Sit presents a simple fix that can improve patient experience, a key factor in patient-centered care models.

 

“Implementing the Commit to Sit initiative provided nurses the opportunity to learn something unique about each patient to share during report to help foster relationships even through shift change,” the researchers said. “Utilizing Commit to Sit to connect with patients, demonstrating caring beyond the patient’s medical diagnosis, positively impacts the patient experience.”

 

Additionally, these findings are key for nurses, who play an integral role in improving the patient experience through communication. Nurses usually spend the most time communicating with patients and are in charge of alleviating patient concerns and communicating health information clearly to help patients become activated in their care.

Going forward, nurses should continue the Commit to Sit agenda, the researchers concluded. Nurses may also consider using their sitting time to learn more about their patients, building a stronger relationship that can eventually lead to higher patient experience scores."

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Could Patient-Provider Relationships Reduce Provider Burnout?

Seventy-nine percent of physicians say patient-provider relationships lead to job satisfaction, but limited time for relationship-building is causing provider burnout.

 

September 18, 2018 - Focusing on patient-provider relationships and strategies to address the social determinants of health could help reduce provider burnout, but current care models do not always allow for that, according to the Physicians Foundation’s Biennial Survey of America’s Physicians.

 

The survey, conducted by Merritt Hawkins on behalf of the Physicians Foundation, included responses from nearly 9,000 physician respondents from different specialties and facility types.

 

On the whole, the survey painted a picture of an industry plagued by provider burnout, with 78 percent of respondents saying they experience provider burnout to some extent. Inefficiency of EHR use is the leading source of burnout, the survey revealed.

 

Focusing on patients could be the key to reducing that physician burnout, respondents said. Seventy-nine percent of physicians said patient relationships are their greatest source of job satisfaction, a finding that is consistent with previous surveys.

 

“What attracts most physicians to medicine is the unique nature of the physician/patient relationship, a fact confirmed by this survey,” the survey authors stated. “The majority of physicians submit to the grueling and expensive grind that is medical education and training primarily in order to play a positive role in the lives of other human beings.”

 

READ MORE: How Does Provider Burnout Impact Patient Care Quality, Care Access?

 

However, current healthcare models do not allow for this type of patient relationship-building, the survey showed. About one-quarter (23 percent) of physician time is spent on non-clinical documentation. As value-based care models continue to take hold in the industry, physicians are inundated with care quality reporting that gets in the way of their patient interactions.

 

What’s more, a larger proportion of providers don’t believe value-based care models and subsequent quality reporting has an impact on patient care. Although 47 percent of respondents have their payments tied to value-based care models, only 18 percent think quality metrics are beneficial to patients.

Instead, more than half of physician respondents said quality reporting gets in the way of patient care.

 

Extensive care quality reporting is contributing to physician burnout, which in turn is leading to an increased risk of a physician shortage. Currently, 80 percent of physicians are at capacity or overextended. That trend could get worse as more physicians plan to decrease their roles in the medical industry as a result of burnout.

 

Forty percent of respondents said they are considering retiring or cutting back hours in the next three years, up from 36 percent in the 2016 survey. Forty-six percent of respondents said they want to change career paths.

 

READ MORE: Clinician EHR Demands Detract from Patient-Provider Relationship

 

“The primary public policy and healthcare concern attached to low physician morale is the prospect of physicians modifying their practice styles in ways that reduce patient access, or the prospect that physicians will abandon patient care roles or leave medicine altogether,” the report pointed out.

 

The social determinants of health (SDOH), or the lifestyle and societal factors that influence patients’ ability to achieve wellness, are also top-of-mind for physicians, the survey showed. Eighty-eight percent of physicians said their patients experience at least one social determinant of health. Only 1 percent of physicians said none of their patients experience the SDOH.

 

Healthcare organizations and physicians are working to address the social factors, but, again, demanding documentation requirements are getting in the way. The prevalence of SDOH and limited resources to address them may be contributing to physician burnout, the survey authors suggested.

 

“It is sobering to consider the extent to which physicians indicate that poverty, lack of education and other social disorders are affecting their patients,” the report noted. “As referenced above, low levels of physician morale and high burnout are attached to feelings of powerlessness and lack of control, which may result when physicians are unable to materially help patients due to their life circumstances.”

 

Specifically, SDOH and their impact on patient care outcomes – regardless of treatment quality – could add to that feeling of powerlessness, according to Walker Ray, MD, chair of the Physicians Foundation’s Research Committee.

 

READ MORE: Effective Nurse Communication Skills and Strategies

 

“It is distressing that such a high number of patients are dealing with one or more social situations that are detrimental to their health,” Ray said in a statement. “These challenges directly impact a physician’s ability to deliver effective care, and the cost implication of these issues is enormous. Such social determinants as they relate to healthcare have been a critical focus of the Foundation for years, and we have made concerted efforts to address these vital issues with partners across the U.S.”

 

Physicians also experience issues with their patients directly, the survey found. For example, 31 percent of physicians said their patients do not follow their treatment plans.

 

“In some cases, patients may be unable to adhere to treatment plans, which may include diet improvements, exercise and other lifestyle choices, due to their social circumstances, including poverty and others referenced above,” the survey authors explained. “Some patients simply choose not to follow their physician’s advice.”

 

Limited patient treatment adherence could be a significant source of physicians’ feelings of powerlessness, as well.

 

The report did find some highlights to the patient-provider relationship. For example, physicians are increasingly using telehealth technology to expand patient care access. Currently, 18 percent of physicians have adopted telehealth into some of their healthcare practice.

Going forward, it will be essential for medical industry leaders to help physicians overcome the burdens that are impacting their job satisfaction. Creating more space for better patient-provider relationships and making it easier for physicians to address societal factors could help physicians regain control of their own jobs and reduce provider burnout.

 

“As the patient population continues to grow and to age, and as societal problems such as poverty and drug abuse pose mounting healthcare challenges, it is vital that physicians remain engaged and committed to the practice of medicine,” the report concluded. “Physician satisfaction and physician practice patterns are matters of public health and should be considered as a part of any comprehensive policy to ensure patient access to timely, quality care.”

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The surprising barrier to ensuring patients get their flu shots | FierceHealthcare

The surprising barrier to ensuring patients get their flu shots | FierceHealthcare | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[USA]

"On the heels of one of the worst flu seasons on record, a new study published in the Journal of the American Medical Association identified one of the biggest barriers preventing patients from receiving their flu shot: the time of day the patient sees their doctor.

Researchers from the University of Pennsylvania observed 11 primary care clinics over a three-year period and found flu vaccination orders dropped throughout the day, from 44% at 8 a.m. to 32% by 4 p.m.

“Primary care physicians often fall behind schedule as the clinic day progresses, and this tendency may lead to rushed visits, decision fatigue and suboptimal care,” the authors of the study wrote.

 

It's a timely finding, as the next flu season looms and health officials have begun urging patients to get their flu vaccinations in the coming days and weeks. The Centers for Disease Control estimated the flu was at epidemic levels for 16 consecutive weeks in the 2017-2018 flu season and 700,000 were hospitalized due to symptoms associated with the flu. The agency is already warning about another potentially nasty flu season, CNBC reported.

 

During the 2016-2017 flu season—the third year of the study—the researchers wrote that three physician practices utilized a “nudge" when it came to vaccines. Medical assistants received a prompt in a patient’s electronic health record to ask patients about a flu shot upon check-in. Prior to the nudge, primary care physicians had to manually check a patient’s EHR to see if they were due for a flu shot.

 

Those intervention practices saw a nearly 20% increase in flu shots ordered compared with the preintervention period. However, researchers found the vaccination rate still suffered a decline throughout the day, the authors wrote.

 

The study reported a 9.5-percentage point increase in vaccination rates at clinics using the nudge. The CDC and the Healthy People 2020 initiative set a target flu vaccination rate of at least 70% for all individuals aged 6 months and older. Data from the CDC showed less than half the population received a flu shot during the 2016-2017 season.

 

CDC's data indicates only 38.6% of the general population was vaccinated by November 2017.

 

In a commentary piece about the study also appearing in JAMA this month, Suchitra Rao and co-author Ann-Christine Nyquist cautioned against the reliance of nudges in EHRs. The authors wrote that decision fatigue could be replaced with alert fatigue, and cited other studies that have shown clinicians often ignore nudges, especially when the prompts are considered a lower priority.

 

The University of Pennsylvania team echoed the point within the study and noted that intervention practices set prompts to only appear for medical assistants, which yielded higher vaccination rates over trials that did not distinguish between medical assistants and physicians. 

 

“This design increased clarity in who was responsible for addressing the alert and reduced the burden on physicians,” the study authors wrote.

And while the authors said more work is needed to address the time-of-day variations for vaccination rates, the study concluded that :well-designed nudges may be a promising approach to improve medical decision-making behaviors."

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Call a doctor a doctor: Despite objections to the term ‘provider,’ it persists | FierceHealthcare

Call a doctor a doctor: Despite objections to the term ‘provider,’ it persists | FierceHealthcare | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[USA]

"Somewhere along the way, doctors became “providers.”

And while some physicians have raised objections, the term provider is still being used—and it still doesn’t work, says Jennifer Weiss, M.D., an orthopedic surgeon, in a post on KevinMD.

“Calling medical doctors 'providers' does more than inflict eco-injury. It actually reduces morale, worth, purpose and results in already overworked doctors finding less meaning in the work that they do,” says Weiss.

 

In the corporate world, the pendulum is swinging back to using job titles that actually define an employee’s role accurately. But the trend hasn’t found its way into the medical world, Weiss says. Instead, the word provider, a term that doesn’t reflect a person’s training or tasks, has come into fashion.

 

The term was adopted by federal law in the early 1970s and by its definition can include everyone from a doctor of medicine or osteopathy to a nurse practitioner or clinical social worker.

 

It’s not just doctors who should be bothered by the term, Weiss says, arguing there is nothing “mid-level” about a so-called mid-level provider who works long shifts and takes care of sick patients.

 

“The whole term (any way you put it) doesn’t work and needs to be changed,” she says. “...Why is anyone on a medical staff still being termed “provider” if we know that titles matter, are used to accurately reflect a person’s role within a company and lead to better overall engagement in the workplace? It’s not only nonsensical, but it’s also detrimental,” she says.

 

In fact, healthcare professionals have different training, knowledge and clinical experience. In the shift to team-based care, members have different roles and responsibilities based on their specific competencies."

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Texthelp - Interview with Prof. Don Nutbeam on #healthliteracy

[UK] [AUSTRALIA] [WORLD]

"The World Health Organisation defines Health Literacy as “the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”

Recently, we had the privilege of meeting Health Literacy expert Professor Don Nutbeam and discussed the fundamentals of this definition."

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Dr Google in the ED: searching for online health information by adult emergency department patients | The Medical Journal of Australia

Dr Google in the ED: searching for online health information by adult emergency department patients | The Medical Journal of Australia | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[AUSTRALIA]

 

"Abstract
Objective: To determine the prevalence, predictors, and characteristics of health-related internet searches by adult emergency department (ED) patients; to examine the effect of searching on the doctor–patient relationship and treatment compliance.

Design: A multi-centre, observational, cross-sectional study; a purpose-designed 51-item survey, including tools for assessing e-health literacy (eHEALS) and the effects of internet searching on the doctor–patient relationship (ISMII).

Setting, participants: 400 adult patients presenting to two large tertiary referral centre emergency departments in Melbourne, February–May 2017.

Outcome measures: Descriptive statistics for searching prevalence and characteristics, doctor–patient interaction, and treatment compliance; predictors of searching; effect of searching on doctor–patient interaction.

Results: 400 of 1056 patients screened for eligibility were enrolled; their mean age was 47.1 years (SD, 21.1 years); 51.8% were men. 196 (49.0%) regularly searched the internet for health information; 139 (34.8%) had searched regarding their current problem before presenting to the ED. The mean ISMII score was 30.3 (95% CI, 29.6–31.0); searching improved the doctor–patient interaction for 150 respondents (77.3%). Younger age (per 10-year higher age band: odds ratio [OR], 0.74; 95% CI, 0.61–0.91) and greater e-health literacy (per one-point eHEALS increase: OR, 1.11; 95% CI, 1.06–1.17) predicted searching the current problem prior to presentation; e-health literacy predicted ISMII score (estimate, 0.39; 95% CI, 0.20–0.39). Most patients would never or rarely doubt their diagnosis (79%) or change their treatment plan (91%) because of conflicting online information.

Conclusion: Online health care information was frequently sought before presenting to an ED, especially by younger and e-health literate patients. Searching had a positive impact on the doctor–patient interaction and was unlikely to reduce adherence to treatment."

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What Role Do Call Centers Play in Patient Communications?

[USA]

Call centers are essential to patient care access and satisfaction. How are organizations driving call center strategy to achieve those goals?

 

September 04, 2018 - Call centers are beginning to fulfill growing and more diverse functions in healthcare organizations, delivering on both internal and patient communication needs, according to a recent Spok survey.

 

The survey of about 400 healthcare professionals revealed that organizations are using their call centers to respond to changing industry forces. Between organizational consolidation and a focus on positive patient experiences and communications, call centers have come to the forefront.

 

“As the sheer volume of communication rises, it’s no surprise that complexity increases as well,” the survey authors wrote. “Regulatory considerations, increasing consolidation of healthcare entities, growing pressures for value-based care, the proliferation of technology, and a constantly mobile staff all add to the challenge of reliably connecting people with the critical information they need.”

Call centers are no longer the “answer and transfer” sites in which patients would call and then be redirected to another hospital service line. Instead, call center operators are in charge of numerous tasks ranging from patient communications to relaying information to providers.

 

Sixty-two percent of organizations are responding to these diverse demands by putting a call center strategy into place. One-quarter of respondents do not have a call center strategy in place, while 15 percent said they were not sure.

 

READ MORE: Centralized Appointment Scheduling Aids Patient Experience

 

These strategies are not new, the survey found. Half of organizations have had a call center strategy in place for one to five years, while 19 percent have had call center strategies for over five years.

 

Although organizations have maintained their call center strategies for some time, these protocols are not static, the survey found. Healthcare organizations have been agile in responding to industry forces that change patient and provider needs inside of call centers.

 

Sixty-four percent of organizations said emerging technologies have changed their call center strategies. Fifty-seven percent said they have responded to new organizational goals, and 51 percent said they have reworked their strategies as a result of vendor consolidation.

Other common catalysts of strategy change include emerging or evolving roles in healthcare, transformation in clinical communications, and improved call center auditing.

 

Healthcare organizations view their call center strategies as key enterprise improvements, the survey continued.

 

READ MORE: 3 Steps to Improving Appointment Scheduling for Patients

 

Forty-eight percent of organizations consider their strategies an enterprise-wide transformation, while 27 percent say it’s a technology project, 12 percent say it’s a communication project, and 10 percent say it’s enterprise consolidation. This reflects that organizations are asking their call centers to do more, to be the face of the organization, and to be skilled communicators, the survey authors posited.

 

“We think this signals a recognition that contact center roles and functions are a key part of a hospital/health system’s overall strategic plan, not confined to communications policies and procedures,” the survey authors stated. “We may further surmise that contact centers are becoming an agent of change (as opposed to a recipient of change) for an organization.”

 

As a result, organizations are tapping experts from departments outside of the call center to lead call center strategy. While operators and other call center staffers are the biggest part of strategic planning teams, organizations also include vendors and consultants (48 percent) and hospital IT departments (36 percent) on the team.

 

Other strategic team members include clinical leadership, telecom departments, physicians, nurses, and parent organizations, although these stakeholders are less common.

 

In fact, there is an important technology thread that ties together all call center overhauls and strategies, the survey revealed. Fifty-seven percent of organizations said their IT departments are in charge of call center improvement projects. And as noted above, IT innovations are often the catalyst for call center optimization.

 

READ MORE: Seamless Appointment Scheduling Fuels Patient Satisfaction

 

About three-quarters of respondents said they use quality management and analytics software in their call centers.

And as far as hardware goes, organizations use a litany of different technologies such as mobile devices (80 percent), in-house or on-site pagers (79 percent), building WiFi (79 percent), and wide-area encrypted pagers) 62 percent).

 

Additionally, about 60 percent of organizations are focused on both integrating new digital devices into their call center strategies and administering on-call schedules. Another 36 percent of organizations are looking to improve communication between the call center staff and care teams.

 

In fact, IT evolutions could be the future of call centers, organizations reported in open-response portions of the survey. Organizations are looking ahead to addressing the consolidation of systems and internal programs, implementing new technologies, and achieving two-way communication between call center teams and clinical teams.

 

“Healthcare organizations are well aware they operate in the midst of relentless change. Regulatory changes, consolidations of healthcare entities, proliferation of technology, and a constantly mobile staff all contribute complexity to communication workflows,” the report concluded.

 

“It’s clear from the survey that the transformations are not yet complete. Most respondents list an abundance of processes and issues that need continued attention, as well as plenty of future opportunities to be addressed.”

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How Does Provider Burnout Impact Patient Care Quality, Care Access?

[USA]

Provider burnout affects clinicians at 83 percent of healthcare organizations. How does this impact patient care quality?

 

September 06, 2018 - Provider burnout has reached staggering levels, leaving healthcare professionals to consider the impacts the issue will have on patient care quality and care access.

 

“The health care environment—with its packed work days, demanding pace, time pressures, and emotional intensity—can put physicians and other clinicians at high risk for burnout,” according to the Agency for Healthcare Research and Quality (AHRQ). “Burnout is a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment.”

 

And as providers face more occupational stressors – new technology, shifting workloads, changing payment models – provider burnout is becoming more common and more detrimental.

 

A 2018 report from NEJM Catalyst found that provider burnout is a problem at 83 percent of healthcare organizations.

Burnout is not only applicable to physicians, but to other healthcare professionals, as well, the report found.

 

Seventy-eight percent of registered nurses feel burnout, while 64 percent of advanced practice registered nurses and 56 percent of clinical leaders feel the same.

 

READ MORE: Why Quality Measures Must Reflect Patient Values, Care Experience

 

But how does this impact patient care? Does an overworked provider deliver the same care quality to her patients? And do swaths of providers retiring or cutting their hours impact patient access to care? Below, PatientEngagementHIT.com 

outlines how provider burnout impacts patients."

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Public health working to fight misinformation through trust, relationships: Facts not enough

Public health working to fight misinformation through trust, relationships: Facts not enough | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[USA]

"Despite best public health efforts, misinformation about health can spread wildly — often faster than factual information. It is a problem public health both recognizes and is struggling near-constantly to combat.

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Negative language in patient records can affect care

Negative language in patient records can affect care | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[USA]

"The words that health providers use in medical records may alter patient care, a May study in the Journal of General Internal Medicine finds.

In the study, more than 400 physicians in training, including medical students and residents, read one of two chart notes about a hypothetical patient with sickle cell disease. One set of chart notes used stigmatizing language, such as doubting the patient’s pain, portraying the patient in a negative light and implying that the patient was uncooperative. The physicians in training were then surveyed about their attitudes and treatment plan for the patient, a 28-year-old black man with vaso-occlusive crisis, a painful condition common among people with sickle cell disease.

Physicians in training who read the chart notes with stigmatizing language, such as “narcotic dependent,” were more likely to have a negative attitude toward the patient and use a less aggressive treatment plan. Participants who read the vignette with neutral language had a more aggressive pain management plan.

Physicians who identified as black had more positive attitudes toward the patient overall, as did medical students.

While medical education sometimes encourages providers to quote a patient’s own words in records, the practice raised concerns for some respondents, who felt it was used to denote low socio-economic status or untruths. As such, the practice deserves a “more nuanced analysis of its potential role,” the researchers said.

“There is growing evidence that the language used to communicate in health care reflects and influences clinician attitudes toward their patients,” Anna Goddu, a Johns Hopkins University School of Medicine student who co-authored the study, said in a news release. “Medical records are an important and overlooked pathway by which bias may be propagated from one clinician to another, further entrenching health care disparities.”

The experiment highlighted what is important to include in patient medical records, according to the study.

“This record may be the only source of information a new clinician has about some patients,” lead study author Mary Catherine Beach, MD, MPH, professor of medicine at the Johns Hopkins University School of Medicine, said in a news release. “We have to question the assumption that the medical record always represents an objective space.”

For more information, visit https://link.springer.com/article/10.1007%2Fs11606-017-4289-2.

Copyright The Nation’s Health, American Public Health Association

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Doctors told to ditch Latin and use 'plain English'

Doctors told to ditch Latin and use 'plain English' | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

[UK]

Video: "Doctors must learn a new skill - writing letters that are easier for patients to understand, guidelines say."

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Why healthcare needs 'patient leaders' to make new solutions work

Why healthcare needs 'patient leaders' to make new solutions work | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

"While leading the health practice at Yahoo, Jack Barrette made a discovery that changed the course of his career.

 

In the early 2000s, Mr. Barrette — former president of a consumer health strategy consultancy and former health and medicine lead at an online marketing firm — was tasked with building Yahoo's health presence. As part of his effort to expand the company's healthcare reach, he jumped headfirst into Yahoo Groups, a platform where users convened to discuss issues ranging from music to politics to sports. He wanted to understand what made the search engine's users tick.

 

There, Mr. Barrette discovered thousands of online discussion boards dedicated to healthcare, where passionate users would steer discussions on medical conditions, provide health advice and offer support to one another. "I found a relatively small, but passionate, group of consumers who were helping thousands of others by leading health groups and answering questions," Mr. Barrette said during an interview with Becker's Hospital Review.

 

Mr. Barrette dubbed these users "patient leaders," and in 2007 he founded WEGO Health, a company centered on the idea healthcare organizations need these advocates to inform improvements to the care delivery process.

 

"A patient leader is someone who uses their health journey to educate others and raise awareness," explained Mr. Barrette, who now serves as CEO of WEGO Health. "We've been successful in recruiting more than 100,000 patient leaders to WEGO Health by demonstrating our commitment to building their visibility, getting them in front of the industry and ensuring they receive compensation for their time and expertise."

 

Today, WEGO Health connects its network of patient leaders with hospitals, health startups and drugmakers to ensure these organizations incorporate the patient perspective into the design, development and promotion of their products and services.

 

Mr. Barrette spoke with Becker's Hospital Review about why this patient-driven innovation is essential for organizations seeking success in today's healthcare landscape.

 

Editor's note: This interview has been edited for length and clarity.

 

Question: What surprised you most about working in the healthcare industry?

 

Jack Barrette: The disconnect between the industry's goal to improve the patient experience and its failure to make greater strides. Health systems, in particular, have genuine incentives — financial and otherwise — to become truly patient-centered organizations. Getting there requires a commitment to human-centered design, yet most health systems continue to innovate for patients, instead of with patients. The key is to include patients throughout the development lifecycle — it's not enough to get their input at the beginning and then at the end.

 

Q: What are some challenges you've seen for hospitals looking to engage patients in their healthcare?

 

JB: A big challenge is doctors and care providers have too little time to connect with their patients, and that is only amplified once the patient walks out the door. Hospitals have struggled to put systems and tools in place that can bridge the engagement gap between visits. Patient portals help only marginally, if at all. We believe health systems could better collaborate with patient leaders to help on this front, especially with significant challenges in the industry related to self-management, medication adherence and behavior change.

 

Q: WEGO Health's work revolves around the idea of "patient-driven innovation." How do you define patient-driven innovation, and how can the concept help hospitals today?

 

JB: Patient-driven innovation is what happens when you bring patients to the table as peers, as co-creators and fellow collaborators. There's plenty of evidence to support the fact that hospitals uncover new solutions to improve the patient experience when patients are actively involved in a human-centered design process. At WEGO Health, we connect healthcare companies to our network of patient leaders, most of whom are hyper-connected through online patient communities and social media networks.

 

Q: What opportunities do you see for hospitals to include patients in the development of new programs and technologies?

 

JB: At WEGO Health, we see an opportunity for hospitals to involve patients in every phase of the process, from patient journey mapping and personal development to design sprints, user testing and content development. One of our hospital clients recently discovered unmet needs for its epilepsy patients by bringing a patient expert with epilepsy into the design thinking process very early on. The patient is now a member of the advisory board and is as integral to the design process as the clinicians, researchers and health IT team.

 

More articles on patient engagement:
5 consumer thoughts on healthcare providers' patient engagement
Patients don't care if physicians have tattoos or piercings, study finds
Apple's App Store turns 10 — Here are 4 ways it's tackled healthcare


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Creating a Shared Playbook: How technology can improve understanding for the whole care team, patients included

Creating a Shared Playbook: How technology can improve understanding for the whole care team, patients included | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it
How does technology augment health literacy and engagement? 

The science of patient engagement is continuing to mature; access to the tools is always getting better. Ideally, we want to make those as personal as possible by having a deep understanding of what’s important to individuals and their disease states. We want to understand how each person can be best engaged so they can participate.

At the same time, new tools can help us collect information from patients to add to the knowledge base (such as their personal experience with the suggested treatments). Patient-reported outcomes can be systematically collected and incorporated into the knowledge-base. All of those things, even though they’ve been discussed for decades, are still at their earliest stages. The technology is evolving to make them possible and scalable.
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Using social media to understand health risks and deliver health interventions at scale


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Beginner's guide to establishing social media presence for health education

This presentation was given during the Track 2: Social Media in Medical Education of the 4th Philippine Healthcare and Social Media Summit 2018 in Grand Regal …

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TED-Ed video: How does your body process medicine? - Céline Valéry

TED-Ed video: How does your body process medicine? - Céline Valéry | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it
Have you ever wondered what happens to a painkiller, like ibuprofen, after you swallow it? Medicine that slides down your throat can help treat a headache, a sore back, or a throbbing sprained ankle. But how does it get where it needs to go in the first place? Céline Valéry explains how your body processes medicine.
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CONTINUITÉ des SOINS : Ce que les patients et les soignants attendent d'une transition de soins

CONTINUITÉ des SOINS : Ce que les patients et les soignants attendent d'une transition de soins | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

"Cette étude d’une équipe de soignants du Boston Medical Center (BMC) s’est penchée, pour la première fois sur ce que les patients et les soignants attendent du système de santé, ou en pratique des organisations, pendant une transition de soins. Alors que les hôpitaux, en particulier, travaillent continuellement à améliorer ces transitions, en sortie d’hospitalisation par exemple, et vers des établissements de soins ou le domicile, on n’a rarement interrogé sur le sujet les patients et les soignants. Pour la première fois à grande échelle, les chercheurs se sont penchés sur ce que les patients et les soignants attendent des fournisseurs pendant une transition de soins. L’étude, présentée dans les Annals of Family Medicine révèle que les attitudes attentionnées, la responsabilité du système de santé et la continuité des soins sont les souhaits et objectifs prioritaires des groupes étudiés.

 

Le Dr Suzanne Mitchell qui est médecin en médecine familiale et en soins palliatifs au BMC, pense que les services fournis durant ces transitions sont très insuffisants en regard des besoins : « Les systèmes de santé doivent apprendre à mieux préparer les patients et les soignants à concevoir et mettre en place des outils accessibles permettant d’assurer un soutien continu entre l'hôpital et le domicile, pour une transition sécuritaire et favorable au rétablissement de chaque patient ».

 

Son équipe a mené une étude qualitative par interviews de 248 patients (PT) et soignants (CG : care givers), menés en face face et en groupe dans 6 centres médicaux. Les patients participants étaient sortis de l’hôpital au cours des 90 derniers jours. L'équipe a compilé cette information qualitative pour déterminer quelles valeurs et quels services de santé les participants, patients et soignants souhaitaient et pour développer un modèle conceptuel montrant comment les services de transition des soins et le comportement du système ou de l’établissement sont liés pour atteindre ces résultats.

 

3 grands objectifs ressortent, la responsabilisation, la continuité des soins et les attitudes attentionnées et valent pour les patients comme pour les soignants. Si ces 3 conditions sont réunies, les soins sont alors considérés comme d’excellente qualité et dignes de confiance. Si les organisations prestataires ne parviennent pas à atteindre ces résultats, les soins sont considérés comme dangereux et laissent aux patients comme un sentiment « d’abandon ». Au-delà, l’étude montre que ces résultats médiocres entraînent de la méfiance, de l'anxiété et de la confusion, parfois des conflits, une surutilisation évitable de certains soins de santé et des retards, des coûts ou des résultats de santé aggravés."

 
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"PoP1 - Power of the Patient: What is an “e-Patient” anyway? Tune in and hear from “e-Patient” Dave deBronkart

"PoP1 - Power of the Patient: What is an “e-Patient” anyway? Tune in and hear from “e-Patient” Dave deBronkart | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

What is an “e-Patient” anyway? Tune in and hear from “e-Patient” Dave deBronkart as he defines this space and outlines what you can expect with his new podcast and even how to become empowered in your own healthcare. Dave will share what we all need to know to get the best medical care without going broke or getting killed in the process. In this inaugural episode, listen as Dave tells his own story and how he got to where is he today – helping others!"

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Is Social Media Useful in Understanding Side Effects?

Is Social Media Useful in Understanding Side Effects? | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

“Oh god, I really hate you prednisone, I can’t sleep because of you.” It’s only 66 characters long, but Twitter messages like this one may become a critical tool for understanding and reporting a drug’s side effects in the future.

As people have become more and more comfortable sharing personal information online, including personal health information, pharmacoepidemiologists — the health care professionals who closely track a drug’s benefits and side effects in the general population — now see social media sites like Twitter and Facebook as vast troves of data about prescription drug use in America.

It would be an understatement to say that traditional systems for reporting drug side effects, including the FDA’s MedWatch program, are failing. One of the larger published papers to look at the problem, a review of 37 studies from 12 countries, found that adverse effects of prescription drugs were underreported 94% of the time, meaning that a patient experienced a drug side effect but it was not reported to the appropriate local, regional or national drug safety surveillance systems.

The study, published in 2006 in Drug Safety, found that the problem was even more pronounced for common, less serious side effects — that is, the side effects patients are most likely to experience are the ones that are least likely to be reported. Severe or serious adverse effects of drugs were reported 80% of the time, compared to 95% for more common side effects.

The Problem of Unreported Side Effects to FDA

Earlier this year, researchers at the University of Manchester in the UK published a study using social media to understand drug side effects that may help solve many of these problems. Using natural language processing software, the investigators searched Twitter for posts that mentioned side effects from prednisone, a very commonly prescribed glucocorticosteroid.

When they looked at the most frequently mentioned side effects, they weren’t surprised to find weight gain near the top. But insomnia, the side effect most often found in the initial analysis, is not generally considered by doctors to be a significant side effect of prednisone.

“Insomnia doesn’t really feature in much of the medical literature,” said Rikesh Patel, MRCP (Member of the Royal College of Physicians, the UK equivalent of MD in the US), the study’s lead author and a fellow in rheumatology at the University of Manchester. “For example, we don’t routinely recommend that patients take their steroid therapy in the morning versus evening, and actually that might be a reflection that there is little known about insomnia and its relationship to steroid therapy.”

There are several reasons for the discrepancy between side effects reported on social media and those reported through the traditional adverse event surveillance system, the FDA’s MedWatch program.

Have a comment? Post a message on our Facebook page or message us on Twitter @Med_Shadow

Perhaps the most important is that the traditional system of reporting a side effect is laborious. It requires filling out a multipage form, which busy physicians often don’t have the time to do.

“In clinical practice, it’s not viable to do that for every single side effect,” said Dr. Patel. “So you get skewed reporting in which only the most serious and rarer side effects come up in that system.”

On social media, patients may be more candid, or confessional, as well as more likely to report the side effects that are affecting their quality of life.

“We found that patients more often report side effects that are particularly troublesome,” Dr. Patel explained. “And when people talk about side effects, it’s the less severe side effects that are reported on social media.”

So, in some ways social media may present a more accurate view of how prescription drugs are negatively affecting patients’ day-to-day lives. However, despite the advantages, social media is not a magic bullet.

A More Candid View of Side Effects

“Patients may be more candid on social media, but then there is the added layer of privacy protections on the various platforms that limit comprehensive data collection,” said Michael S. Sinha, MD, JD, MPH, a postdoctoral fellow in the Program On Regulation, Therapeutics, and Law (PORTAL) at Brigham and Women’s Hospital and Harvard Medical School, Boston, and lead author of a study looking at how social media can be used to tell patients about important FDA drug safety messages.

Nor does Dr. Sinha believe that patients should be using social media sites to learn about a prescription drug’s side effects.

“I suspect that a social media approach to drug side effect reporting is not ready for prime time,” he said. “Patients are better off communicating with their health care providers directly about side effects as opposed to posting on social media or mining those sites for information.”

While Dr. Sinha acknowledged that side effects are rarely reported to the FDA MedWatch program, the ones that are provide much-needed information that social media simply cannot collect. “Simply put, researchers and regulators need far more information about drug use and side effects than can be reported in a single social media post or series of posts.”

In the future, it is likely that big-data approaches that include monitoring social media for drug side effects will likely complement existing, more in-depth approaches.

“In the process of consenting a patient when you start them on any drug, you want to tell them about serious side effects because those are the red flags that you need to look out for,” Dr. Patel said. “Maybe [this] would be captured in a traditional approach. But you also want to tell them about side effects that happen to people very commonly…and that’s something that’s just not captured using a spontaneous pharmacovigilance system.”

 

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What Consumer Characteristics Predict High Health Literacy?

What Consumer Characteristics Predict High Health Literacy? | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

June 10, 2016 - Patients who manage chronic illnesses, have more experience with the healthcare industry, and higher education levels tend to have higher health literacy, says a recent article in the Journal of Medical Internet Research.

Lead researcher Mary Zide, MLIS, PhD, along with her research team, sought to examine patterns in health literacy administering a crowd-sourced survey. The survey, which garnered 500 responses, specifically focused on patient health literacy with regard to managing lung cancer.

The survey showed that patients managing chronic illnesses tended to be more health literate and better understand healthcare terminology.

However, chronic illness status was not the only predictor of better health literacy. Characteristics such as education level, time spent online, income, smoking habit, sex, and patient portal use habits also predicted health literacy.

Characteristics such as time spent online and education level may have resulted in higher health literacy because of better general health knowledge, Zide and colleagues posited.

READ MORE: How Social Media Can Improve Public Health, Patient Education

Interestingly, the research team also suggested that some of these characteristics may have overlapped to create patients with higher health literacy. The survey showed that patients with higher levels of educational attainment were also more likely to be managing a chronic illness.

A patient’s knowledge of their own illness, combined with their general knowledge produced by their education level, may have created a patient with higher health literacy.

“In our work, it may be that the higher performance we observed relates to higher levels of educational attainment, as those respondents reporting chronic illness in our survey more frequently had Associate, Bachelor’s, and Master’s degrees than those reporting no chronic illness (14.6% vs 12.9%, 39.8% vs 36.8%, and 9.7% vs 8.8% respectively),” Zide and colleagues said.

The researchers also focused on perceptions of patient portals, adding survey questions regarding patient satisfaction with the technology.

Patients with chronic illnesses tended to have better perceptions of patient portals, potentially because patients managing a chronic illness may spend more time using a portal, and therefore are more familiar with the technology.

READ MORE: Can Online Articles Improve Patient Education, Engagement?

Females were also more likely to view the patient portal more favorably, specifically with regard to usability. On a Likert scale question asking respondents to rate portals’ ease of use, females averaged a score of 5.32 out of ten versus males’ 4.97 out of ten.

This trend, too, could be credited to more frequent use of the patient portal.

“While use does not equal preference, positive ratings may be influenced by the higher use of portals we observed in this survey (19.7% of women had used a portal over ten times, compared to 14.3% of men), which is consistent with higher eHealth resource use observed in women,” Zide and the research team explained.

Although the survey showed that chronically ill patients viewed the portal better than their peers, it showed one significant commonality between the two: one third of patients are put off from patient portals due to security concerns.

Zide and colleagues noted that these security concerns may be a significant barrier to patient portal adoption because they directly affect patient satisfaction.

READ MORE: Internet Familiarity Tied to Patient Digital Health Literacy

“Security has also been a concern,” the researchers said. “This common theme suggests that eHealth users may associate eHealth tools with a lack of security. This concern has the potential to impact portal use, as it would likely limit satisfaction and perceived usability and, thus, feasibility.”

Patient portal security concerns are a common issue, as the researchers noted. However, leading healthcare organizations have made efforts to ensure that these tools be secure.

The Office of the National Coordinator for Health Information Technology (ONC) has released information regarding the technical safeguards necessary for protecting patient portal data:

To make sure that your private health information is safe from unauthorized access, patient portals are hosted on a secure connection and accessed via an encrypted, password-protected logon.
EHRs also have an “audit trail” feature that keeps a record of who access your information, what changes were made, and when.


Although patient portals use safeguards, there are other safety tips you should follow when accessing the patient portal. Always remember to protect your username and password from others and make sure to only log on to the patient portal from a personal computer or secure computer.


The Department of Health and Human Services has also made clear HIPAA guidelines regarding patient portals. These guidelines spell out who and who is not allowed to access EHR-tethered health data.

Although HIPAA is a set of guidelines, rather than some sort of physical protector of health data, these provisions act as a legal standard that guides health data into the correct hands.

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New Tool Assesses Teen Patient Health Literacy in 30 Seconds

New Tool Assesses Teen Patient Health Literacy in 30 Seconds | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

"May 08, 2017 - Pediatric clinicians can now assess adolescent patient health literacy in under 30 seconds using a new tool developed by researchers from the University at Albany.

Created by Jennifer Manganello, PhD, MPH, the tool addresses a knowledge gap about health literacy in pediatric and adolescent healthcare. Although it is common knowledge amongst most clinicians that teenagers are largely unable to understand their own health, diagnoses, and other critical information, there is little headway on a solution.

“Numerous studies have indicated low health literacy is linked to negative health outcomes in adults. However, limited research has been done on adolescents,” Manganello said in a press release. “[The tool] offers researchers and clinicians a brief screening tool that can be used to quickly assess adolescent health literacy in a variety of settings."​

 

“There is much less research on teens than on adults, which is one of the reasons why this tool is so important,” Manganello continued in email correspondence with PatientEngagementHIT.com. “However, with the limited research we have, it appears that low health literacy is related to outcomes such as poor asthma management and limited understanding of how to use products containing acetaminophen.”

 

Manganello, who is an associate professor in the Health Policy, Management & Behavior department at the University at Albany, created Rapid Estimate of Adolescent Literacy in Medicine, shortened to REALM-TeenS.

 

READ MORE: Five Best Practices for Improving Patient Health Literacy

 

REALM-TeenS is a condensed version of another health literacy assessment, REALM-Teen. The fundamental difference is the time needed to complete either assessment.

Developed in 2006 by Terry Davis of the Louisiana State University Health Sciences Center, REALM-Teen asks patients to read out loud a list of 66 health-related words within three minutes. REALM-TeenS shortens that list to 10 health-related words in 30 seconds.

 

Tested words include terms such as “diabetes,” “asthma,” “exercise,” and “bronchial.”

 

Both assessments look at how many words adolescent patients can pronounce correctly within the allotted timeframe. If the patient struggles to pronounce several words, it is likely she is unfamiliar with it and needs more education in that area, Manganello reasoned.

 

“Although this tool does not fully measure all concepts related to health literacy, such as getting health information and thinking critically about it, it does provide a simple way to identify those teens who may require more support to understand health information,” Manganello explained.

 

READ MORE: How Digital, Health Literacy Drives mHealth Patient Engagement

 

REALM-TeenS is nearly as accurate as its more extensive predecessor, Manganello said. She compared past research about REALM-Teen with results using her own tool and found that REALM-TeenS was 92 percent as successful as the long-form counterpart.

 

Knowing that the quicker tool is nearly as effective as the more extensive assessments is key, Manganello said. Not a lot of clinicians actually test for patient health literacy because assessments can take too long or get in the way of other appointment priorities.

 

“We understand that researchers and health professionals often have a very limited amount of time to ask questions and collect their information,” Manganello acknowledged. “Our new tool makes it easier. Identifying low health literacy in adolescents can be useful for tailoring important health information, medication instructions, and follow-up support.”

 

Additionally, this tool is more conducive to assessing overall patterns in teen health literacy.

 

“Current recommendations suggest that health providers use 'universal precautions' to make information easy to understand for all patients as opposed to screening individual patients,” Manganello noted. “However, this tool will be useful for those who want to look at overall rates of low health literacy for adolescents in a practice or find out how low health literacy relates to certain health conditions or behaviors.”

 

READ MORE: How Hospitals Can Raise Patient Satisfaction, CAHPS Scores

 

It’s important to diagnose teen health literacy so clinicians can improve patient understanding but also so clinicians can make health information more navigable and easy to comprehend.

 

Perhaps the issue is not that patients lack the ability to understand health concepts, Manganello posited. Instead, the challenge may be that information is too complex to understand.

 

“One thing to remember is that health literacy is viewed as a combination of an individual’s skills and the complexity of the information or health care environment they need to navigate,” Manganello explained.

 

“While we need to think about innovative ways to improve health literacy for teens, another option is to focus on how we can help make the information and system easier to understand,” she continued. “For instance, many recommend that providers use the teach back method to ensure patients have clearly understood the information they are told.”

 

Healthcare professionals need to offer more support to their patients to facilitate patient understanding. Educational resources and an explanation of how various structures – related to both physical health and the healthcare industry as a whole – may be helpful for ensuring patients are well-equipped to navigate the system on their own.

 

“While many think of health literacy as the ability to read and understand health information, it goes beyond that,” Manganello concluded.

 

“Health literacy also includes skills such as numeracy, clear communication with providers, and the ability to obtain, understand, and think critically about health information,” she said. “An understanding of how to navigate the health system is important as well, which includes knowing the difference between a primary care provider and a specialist, for instance.”

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The Difference Between Patient Education and Health Literacy

The Difference Between Patient Education and Health Literacy | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

USA

June 13, 2017 - Patient education and health literacy are two key concepts in patient engagement and chronic care management. Healthcare experts strive to improve patient health knowledge, asserting that knowledgeable patients are more engaged in shared decision-making and self-management.

 

Because patient education and health literacy are so closely related, their overlapping definitions begin to blend together. In reality, patient education and health literacy are two separate sides of the same coin and require a thorough understanding from clinicians.

 

Healthcare professionals must understand the differences between the two and the ways in which these two concepts relate to fully deliver meaningful patient education that drives health literacy.

 

Using patient education to drive patient care

 

Patient education is the practice of informing patients about their health, wellness, treatment plans, potential outcomes, and other information critical to the patient experience.

 

READ MORE: Patient Education Reduces Costs, Boosts Asthma Outcomes

 

The goal of patient education is to instill a sense of autonomy in the patient and to equip her with the knowledge necessary to make her own healthcare decisions.

 

As a result, healthcare experts have hailed patient education as a critical aspect of shared decision-making and chronic care management.

 

Patients who fully understand their current wellness levels, their treatment options, and the potential consequences of each treatment option are well-prepared to offer input into how to carry onward with their care, said Peter Goldbach, MD, in a past interview with PatientEngagementHIT.com.

 

“Sometimes what gets lost is the fact that the patient you’re working with may not really understand their condition,” said Goldbach, who is Chief Medical Officer of patient education company Health Dialog.

“It’s very confusing to be a patient and it takes the provider a while to arrive at a diagnosis. But eventually providers need to share that diagnosis with the patient, let them understand it, and have a chance to let it sink in.”

 

Research shows that patient education efforts can help increase the occurrence of shared decision-making. One tool from the University of California San Francisco (UCSF), called PREPARE For Your Care, explained complicated health concepts in plain language. This increased the frequency of shared decision-making by 35 percent.

 

READ MORE: How Does Patient Health Literacy Affect Digital Health Use?

 

Healthcare professionals must determine the best patient education strategies for their specific populations. Many industry experts laud the patient teach back method during which providers explain a concept to patients and ask patients to explain the concept in return.

 

If patients can successfully and clearly communicate a piece of information using their own words, providers can conclude that patients understand the concept.

Patients who repeat information in their own words tend to absorb information faster than patients who just listen.

 

Other healthcare professionals rely on patient data access to help improve patient education. A recent OpenNotes study showed that patients who can view clinician notes and offer feedback can better participate in their own health. OpenNotes also helped improve patient safety.

 

Clinicians can also tap into external resources to help deliver patient education. According to MedlinePlus, a part of the National Institute of Health and National Library of Medicine, healthcare professionals can use pamphlets, printouts, videos, models, props, podcasts, charts, or peer groups to improve patient education.

 

Providers should employ each tactic based upon a patient’s personal preferences.

 

READ MORE: The 3 Building Blocks Supporting Patient Engagement Strategies

 

Patient education helps improve health literacy

 

The CDC defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.”

 

In essence, health literacy is the end goal to strong patient education. Providers who successfully educate their patients will help patients better understand their own health, allowing patients to interact with the healthcare industry in the following ways:

 

  • Find information and services

 

  • Communicate their needs and preferences and respond to information and services

 

  • Process the meaning and usefulness of the information and services

 

  • Understand the choices, consequences and context of the information and services

 

  • Decide which information and services match their needs and preferences so they can act

 

Digital health literacy is closely related to health literacy and refers to a patient’s ability to use health technology to interact with their own health and the healthcare system at large. Digital health literacy may impact a patient’s ability to obtain and use the patient portal and EHR, for example.

 

Healthcare professionals have yet to develop a gold standard for assessing patient health literacy levels, although the need is increasingly pressing. As healthcare becomes more patient-centered, providers will need to know how much education patients need to fully empower and engage patients.

 

Some industry experts have developed upcoming patient health literacy assessments. University at Albany researcher Jennifer Manganello, PhD, MPH, has created one tool that can assess teen health literacy in under 30 seconds.

 

Patients view a list of 10 health-related words in 30 seconds and read them out loud. Clinicians assign a score based on how the patient pronounced the word, according to Manganello, who is also an associate professor in the Health Policy, Management & Behavior department at the University at Albany.

 

“Although this tool does not fully measure all concepts related to health literacy, such as getting health information and thinking critically about it, it does provide a simple way to identify those teens who may require more support to understand health information,” Manganello explained.

 

Research published in the Journal of Medical Internet Research suggested that patients who use the internet more frequently also have higher health literacy. The research team recommended that clinicians ask patients about their internet usage to help predict their patient education needs.

 

A separate study also published in JMIR indicated that patients who manage a chronic condition, have more experience with the healthcare industry, and who have higher educational attainment tend to have higher health literacy.

 

However, clinicians should note that chronic care management patients likely accumulate this health literacy through years of industry involvement and patient education from their providers.

 

It’s not likely there will ever be a one-size-fits-all guide to identifying a patient with high health literacy. As a result, clinicians must integrate strong patient education strategies into all of their patient engagement efforts.

 

Healthcare providers can improve patient activation and ultimately drive person-centered care by offering all patients the chance to improve their health literacy.

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WhatsApp, doc? Social media becomes a new platform for medical advice

WhatsApp, doc? Social media becomes a new platform for medical advice | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it

When you fall ill or want to seek medical advice, who do you turn to? Your family doctor or the neighbourhood medico, of course. But, experts say, you may now have another option: social media.

WhatsApp, Twitter and Facebook, among others, are helping doctors to reach out to patients, guide them for treatments, provide counselling post-surgery and create close-knit support communities, as more Indians join social media platforms.

Representational image. AP

"We are frequently using WhatsApp, Skype and Viber to reach out to patients. Currently, we have over 180 patients connected via WhatsApp and over 30 through Skype who are receiving online rehabilitation training," says Dr H.S. Chhabra, medical director and chief of spine service at the Indian Spinal Injuries Centre in New Delhi.

At present, there are 143 million social media users in India, including 25 million in rural India. By 2020, India will have at least 1.4 billion mobile subscribers, according to a latest report by Swedish communication technology and services provider

 

The medical trend has been catching up fast with the Indian health providers. Take the case of Anil Kalra, (name changed) 27, who was diagnosed with a severe spinal cord injury in December 2012. After the surgery at the Indian Spinal Injuries Centre, he underwent rehabilitation for four months.

While recovering, doctors provided him health tips post-surgery via skype for 45 minutes daily for six weeks. After the online counselling period, Kalra is a happy man now. "Kalra's case demonstrates the importance of internet and social media platforms," Dr Chhabra told IANS.

Dr Archana Dhawan Bajaj, gynecologist and obstetrician at New Delhi-based Nurture IVF Centre, has been using social media platforms for patients' benefit. "I use Twitter, FaceBook and YouTube to have a constructive dialogue with my patients. Social media is enabling collaborations in the context of health care which is essential in promoting awareness via sharing testimonies, providing support and advocating best health practices," Dr Bajaj said.

The power of social networking in medicine should not be underestimated. "Many patients are joining us via social media. Many of them have received key knowledge about their ailments and possible treatments on Facebook and WhatsApp," says Dr S.S. Sibia, medical director at the Sibia Medical Centre in Ludhiana that is famous for non-invasive treatments for various diseases.

This has saved many lives, he adds.

At Max Super Speciality Hospitals in New Delhi, WhatsApp has connected several breast cancer patients with specialists who are available for counselling round the clock.

"We have radiation oncologists and onco-surgery specialists on the WhatsApp group. So if a patient posts a query, whichever expert is available to answer at that time, addresses the query," said Dr Anupama Hooda, director (medical oncology) at Max Hospitals.

At times, patients share general health tips, anecdotes and organise activities like yoga with group members.

"We have more than 75 active members on WhatsApp and are strict about the content being posted. It is not an entertainment group - it's only for support purposes," Dr Hooda emphasises.

 

In a recent survey involving 2,250 people in the US, nearly 57 percent said they were interested in using Facebook and e-mails to reach out to doctors for managing health better.

Nearly 46 percent of patients wanted to use e-mail to track their health progress, said the survey from Johns Hopkins' Bloomberg School of Public Health, published in the Journal of General Internal Medicine.

 

"We do use social media to counsel our patients and take queries from post-surgery long-distance patients to resolve their concerns," comments Dr Deep Goel, director (department of bariatric and gastrointestinal onco-surgeon) at BLK Super Speciality Hospital.

"We also have a WhatsApp group of our bariatric patients who remain in touch with surgeons and dietitians," he informs.

Social media's use in health care is limited in India, though.

"Social media can be a double-edge sword for health experts because communication over e-mails and instant messaging may not provide the complete profile of the patient," Dr Hooda emphasises.

"Drug prescription and final diagnosis should be done only after a thorough physical examination," Dr Goel stresses.

Social media, however, is a great platform to understand the epidemiology of diseases.

Moreover, social media can play a pivotal role in bridging the gap between doctor and patients.

"Facebook and Twitter can play a major role in mending the increasing distrust between the patients and their doctors," say the experts.

According to Dr Samir Parikh, director (mental health and behavioural science) at Fortis Hospitals, social media is helping provide emotional and practical resources to patients and creating awareness about other health-related issues.

"Social media is also breaking stereotypes, giving lifestyle and health tips, facilitating behaviour changes and, ultimately, helping people lead healthier and safer lives," Dr Parikh says.


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Public Library Association Launches Program to Deliver Health Info

Public Library Association Launches Program to Deliver Health Info | "Global patient empowerment: health literacy, health education, ehealth literacy, public health promotion, narrative tools & social media, e-patients, patient expertise, patient advocacy, shared health decision making" by VAB Traductions | Scoop.it
The new partnership with the National Network of Libraries of Medicine is designed to train librarians to better serve patrons seeking medical guidance.
Responding to the sizable proportion of Americans who hit the library to check out health guidance instead of books, the Public Library Association is partnering with a federal agency to train librarians to better provide consumer-health information.

Earlier this month PLA announced its partnership with the National Network of Libraries of Medicine (NNLM), which supports medical libraries for a variety of institutions. PLA Deputy Director Scott G. Allen said the new initiative, called Promoting Healthy Communities, is designed to tailor medical information for librarians serving a general audience. “Public librarians are charged with helping those patrons, but they’re not taught a whole lot in library school about consumer health information or literacy,” he said. “So they sort of have to learn it on the job.”

Research suggests that those librarians have an important role to play. According to a 2010 study, 37 percent of library users, including 57 percent of seniors living in poverty, used public library computers to seek health information. But a 2013 survey of public librarians showed that a third of respondents were unfamiliar with resources that could help patrons with health-related queries.

Public librarians aren’t taught a whole lot in library school about consumer health information.
The PLA-NNLM partnership intends to address that knowledge gap in a variety of ways, including podcasts, webinars, conference sessions, and a dedicated website set to launch later this year. That site will provide information for librarians on what NNLM information is accessible, streamlined versions of that information for a consumer-health audience, and recommendations for how libraries can promote their role as a health info desk.

That streamlining and guidance is essential, Allen said, because much of the data NNLM handles is too high-level in relation to the basic consumer information that public library patrons are seeking. “Not everything [NNLM does] is relevant to a public library, so we’re trying to focus on what they do that can help public libraries,” Allen said.

However, the program addresses a wide range of needs among librarians. Training on the materials can be used by librarians seeking a credential in Consumer Health Information Specialization managed by the Medical Library Association, or the materials can be accessed a la carte based on local needs. “Some public library staff have a lot of experience with this and maybe just want to take some courses on cultural issues in healthcare, or privacy issues, or opioids,” Allen said.

PLA’s parent, the American Library Association, has partnered with NNLM before on projects like a “Health Literacy Toolkit,” which promotes libraries’ role as a repository for accurate health information. But PLA was approached by a regional office of NNLM for the more targeted outreach program. And though Promoting Healthy Communities is designed to officially last through the spring, Allen said it’s hoping to create resources that will last beyond that.

“We’re looking for other sources of support, but we’re trying to do things, such as the website, in ways that we can sustain without a lot of resources,” he said. “Every time we do a webinar in our program, or an article in our journal, it gets archived and we can refer people to it. So we do hope to continue after April.”
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4 Patient Education Strategies that Drive Patient Activation

"April 27, 2017 - As meaningful patient engagement continues to be a core priority for healthcare professionals, clinicians need a thorough understanding of patient education strategies.

Ensuring patients are knowledgeable about their healthcare is the surest method for sparking patient activation. Patients who are more knowledgeable about their health are more likely to use self-management techniques, attend their follow-up appointments, and ask their doctors questions about their care.

However, education means something different to each patient. While some patients will be receptive to educational strategies, others will need more nudging from their doctors.

Clinicians must follow a series to steps before issuing patient education materials, ensuring that the strategies employed are useful for the individual patient.

Assess patient health literacy
Before implementing any patient education techniques, clinicians must assess a patient’s current knowledge level. All educational materials will be useless if the patient does not have functional health literacy, defined as follows by the Agency for Healthcare Research and Quality (AHRQ):

“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Healthcare professionals should leverage health literacy assessments during clinical encounters, or ask patients to complete assessments prior to appointments. AHRQ has several resources for assessing patient health literacy that can be adapted for various clinical needs.

When patients have low health literacy, it is important for clinicians to address specific problem areas. Research shows that patients with low health literacy are less likely to utilize educational and other health tools than their more health literate peers.

Educational resources should begin by defining key terms and concepts. Subsequent materials can also review health information, research suggests.

Utilize patient teach-back
It is difficult to speak of patient education strategies without mentioning the teach-back method. This technique is touted by many healthcare professionals, including AHRQ.

During patient teach-back, clinicians first explain an important concept, procedure, or self-management technique to the patient. The clinician then asks the patient to repeat the lesson in his or her own words.

Asking patients to synthesize health information and repeat it in their own words will highlight whether the patients truly comprehend health information. If the patients are unable to do so, clinicians can determine new approaches to ensure the patients understand.

“The goal of teach-back is to ensure that you have explained medical information clearly so that patients and their families understand what you communicated to them,” an AHRQ guide on the subject said. “This low-cost, low-technology intervention can be the gateway to better communication, better understanding, and ultimately shared decision-making.”

Offer educational materials in patient preferred formats
There are many different tools clinicians can use to improve patient education, from digital technologies to paper handouts. To ensure that these tools are most effective, clinicians must work with patients to determine which meet both patient preferences.

According to MedlinePlus, a health information resource from the National Institute of Health and the National Library of Medicine, patient education materials include, but are not limited to, the following:

- One-on-one teaching
- Demonstrations
- Analogies
- Graphics
- Brochures or other printed materials
- Podcasts
- YouTube videos
- Videos or DVDs
- PowerPoint presentations
- Posters or charts
- Models or props
- Group classes
- Trained peer educators


Not all tools will suit all patients, so it is important for providers to engage patients in conversations about education and assess patient preferences. Clinicians and patients should both consider how patients learn best and what is most feasible to integrate into patient lifestyles.

Additionally, clinicians should be mindful of what the patient needs to know (rather than what might be nice for the patient to know), what is important to the patient, and what the patient already knows. Doing so will avoid repetitive information and information overload, MedlinePlus says.

Lean on health technology
Health IT offers patients convenience, making it easier for them to find and store educational materials.

In the case of patient portals, technology makes it easier for patients to access health information – no longer do patients have to visit health information management departments in the hospital.

Using an online interface, patient portals allow patients to access their lab results, medical histories, and a plethora of other health information.

Clinicians who use OpenNotes, a practice philosophy where clinicians digitally share their appointment notes with patients, can offer their patients in-depth and specific health advice each office visit.

Studies have shown that patients forget up to 80 percent of what their doctors tell them during appointments. OpenNotes can help remind patients of this data, boosting patient understanding of their own health.

Research has shown that patients who read, understand, and review their own health information via the patient portal are better able to engage in their health and inform their clinicians of potential treatment issues. One OpenNotes study published at the end of 2016 found that 57 percent of patient concerns with medical records resulted in actual record changes, eventually improving patient safety and health outcomes.

Healthcare professionals can also leverage mHealth tools where appropriate. These tools range from typical informative tools to more interactive apps.

Through strong engagement, mHealth apps work to inform patients of their own health conditions, and often walk patients through self-management techniques.

Clinicians must factor in patient health literacy and the effectiveness of certain apps. When apps do not include necessary information, or are above a patient’s literacy level, they are ineffective.

Ultimately, selecting a patient education strategy is going to depend on the patient. Techniques must cater not only to a patient’s health literacy levels, but also to her preferences and unique needs. When education strategies fall short of this, they will likely be less effective.

Clinicians must first engage their patients to determine the best path forward for patient education. Using shared decision-making, doctors and patients can determine which tools will be most effective in driving patient education, and eventually improve outcomes."

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ENG to FR freelance translator specialised in patient empowerment through health literacy - health education - patient education - ehealth - digital health - health IT - AI & medicine/healthcare - www.linkedin.com/in/VABtraductions