Chapter 20 Supporting ConsumerInformation and Education Needs
Objectives• Define health literacy and eHealth.• Explore various technology-based approaches to consumer health education.• Identify barriers to us of technology and issues associated with health-related consumer education.• Imagine future approaches to technology- supported consumer education.
Introduction• The challenge for consumers and health care professionals alike is the proliferation of information on the Internet and the need to learn how to recognize when information is accurate and useful for the situation at hand.• We will explore consumer information and education needs and how technology may help to meet those needs, and at the same time create ever increasing demands for health related information.
Consumer Demand for Information• More and more people, in a trend known as consumer empowerment, are interested in taking control of their health and are not satisfied being dependent on a health care provider to supply them with information.• The Pew Internet and American Life Project survey report of 2006 (Fox 2006) indicates that 8 in 10 of Americans who are online have searched for health information.
Consumer Demand for Information• Pew survey does not reflect the health information needs or demands of those who are not online. – The digital divide is the term used to describe the gap between those who have and those who do not have access to online information. – Grey Gap - A term used to reflect the age disparities in computer connectivity; there are fewer persons over age 65 who use computer technology than those in younger age groups.
Consumer Demand for Information• Missen and Cook (2007), discuss the potential impact that technology based health information dissemination can have on the know-do gap in developing countries. – The Internet connections in developing countries are widely scattered and may not be efficient/sufficient for viewing health care information. – The know-do gap reflects the fact that solutions to global health problems exist but are not implemented in a timely fashion because of the lack of access to important health information.
Health Literacy and EHealth Initiatives• The goal of health literacy for all is one that is widely embraced in many sectors of health care, and a major goal of Healthy People 2010 and continued in the health communication and health information technology objective of Healthy People 2020 .• Those of us who have been practicing for some time recognize that informed patients have better outcomes and pay more attention to their overall health and changes in their health than those who are poorly informed.
Health Literacy and EHealth Initiatives• Healthy people 2010 defines health literacy as, "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions“(para.2).• The eHealth Initiative (eHI) was developed to address the growing need for managing health information and to promote technology as a means of improving health information exchange, health literacy and health care delivery.
Health Care Organization Approaches to Education• One approach is to have patient education information stored electronically so that changes can be made as needed or information can be better tailored to the specific patient situation and then printed out and reviewed with the patient.• Many HCO’s sponsor health promotion education classes as a way of marketing their facilities and showcasing some of their expert practitioners.
Health Care Organization Approaches to Education• HCO’s are now also taking advantage of the fact that patients and families are captive audiences in waiting rooms and promote education via pamphlet distribution, health promotion programs broadcast on TV, and health information kiosks.• One caution, however, is that just because the information is made available does not mean that people will participate or that they will understand what they have experienced.
Dynamic Web Sites of Organizations• Most offer physician search capabilities, e- newsletters, and call-center tie-ins.• Must be a sincere commitment to keeping information current and easily accessible.• Web designers must pay particular attention to the aesthetics of the site, the ease of use, and the literacy level of those in the intended audience.
Promoting Health Literacy in School Aged Children• Promoting health literacy in school aged children presents special challenges to health educators. – e-health programs need to be developed specifically to appeal to the generational (highly connected and computer literate) and cultural needs of this group.• The Children’s Nutrition Research Center has responded to these challenges by supporting the development of nutrition education programs as interactive computer games, video games, and cartoons referred to as ‘edutainment’ (Flores 2006).
Promoting Health Literacy in School Aged Children• Donovan (2005) describes an Interdisciplinary WebQuest designed to appeal to older school aged children. – The Quest is interdisciplinary in that it requires reading comprehension, critical thinking, presentation, and writing so that core skills and health literacy skills are learned in a single assignment.
Promoting Health Literacy• Nurses and other health care providers need to embrace the Internet as a source of health information for patient education and health literacy.• Patients are increasingly turning there for ‘instant’ information about their health maladies.
Patient Education• The Health on the Net (HON) Foundation Survey (2005) describes the certifications and accreditation symbols that identify trusted health sites.• The HONcode and Trust-e were identified as the two most common symbols that power users look for.
Patient Education• The Pew Internet Survey (2006) indicates that nearly 75% of online searchers do not check the date or the source of information they are accessing on the web and 3% of online health seekers report knowing someone who was harmed by following health information found on the web.
Patient Education• The US National Library of Medicine and the National Institutes of Health sponsor MedlinePlus a web site that has a tutorial for learning how to evaluate health information as well as an electronic guide to web surfing that is available in both English and Spanish.
Future Directions• Audio and video podcasts may become more commonplace in health education and be provided as free downloads from the websites of HCOs.• Voice recognition software used to navigate the Web may reduce the frustration and confusion associated with attempting to spell complex medical terms.• Multiple language access to health information and decision-support tools.
Future Directions• Interactive Behavior Change Technology (IBCT) for diabetes management (Piette 2007) – The goal is to improve communication between patients and health care providers and provide educational interventions to promote better disease management between visits. – Use a combination of electronic medication reminders, meters that track glycemic control longitudinally, and personal digital assistant–based calculators to promote behavioral interventions necessary to better manage the diabetes.
Information Prescriptions (D’Alessandro, 2010)• Direct patients and families to credible websites: – government and HCO websites• Suggest wikis and blogs that may help with understanding their health issues or share information with and seek support from others who have similar issues.• “Information prescriptions are prescriptions of focused, evidence-based information given to a patient at the right time to manage a health problem” (p. 81).
Thought Provoking Questions1. How do you envision technology enhancing patient education in your setting?2. Formulate a plan evidencing a potent patient education episode on MRSA. Provide a rationale for each approach and describe a tool you would use to educate the patient and his/her family.