The push is on to make all Americans “well-informed, savvy users of health care.” That makes perfect sense for the 12 percent of us who have what experts call health literacy. But where will it leave the 77 million American adults with poor health literacy, meaning they have difficulty with common health tasks like following instructions on a drug label or on a standard childhood immunization schedule? The solution could be in the palms of their hands.
The Pew Research Center estimates that 92 percent of Americans owned cellphones in 2015, including 68 percent who had smartphones. Those numbers were consistent across demographic groups including ethnic minorities, who are disproportionately affected by low health literacy. By creating easily understood health information that is accessible on a smartphone or other internet-connected device, we could provide real-time, relevant, and accurate information to the vast majority of Americans.
One of the many advantages of digital tools is that they can be personalized. Today’s technology is smart enough to deliver to individuals the right information at the right time in the most effective manner. Because these tools are extremely flexible, they could easily incorporate educational features, communication functions, health checklists and guidance, price comparisons, and more. The possibilities for digital tools in addressing health literacy are endless.
Digital technologies can also teach us about health literacy and improve our ability to convey essential information to various populations. They automatically log usage and collect data. And they’ll be able to see what percentage of consumers are using the tool, how they’re using it, and where there are consistent stopping points. This information will let researchers and policymakers analyze how well health literacy programs work and, if needed, quickly provide updates to improve them.
Why does this matter? Low health literacy has been linked to increased hospitalizations, increased use of emergency care, lower use of mammography and other screening tools, and poorer ability to interpret health messages.
Researchers at George Washington University’s Milken Institute School of Public Health estimated that the annual cost of low health literacy ranges from $106 billion to $238 billion. That ballooned to $1.6 trillion to $3.6 trillion when the researchers accounted for the future costs of low health literacy that result from current actions or lack of action. To put those numbers into perspective, the estimated cost of the Affordable Care Act in 2016 was $110 billion, meaning that tackling health literacy could cover its costs.
The US government has tried to improve health literacy in the past. The Department of Health and Human Services, for example, launched the National Action Plan to Improve Health Literacy in 2010 in coordination with the Centers for Disease Control and Prevention’s Health Literacy Action Plan. Despite the good intentions of these programs, measurable results from them are slim — some resources are available for organizations interested in making health information more accessible, and the CDC now follows a “plain writing” policy, but that’s about it.
Improving health literacy can’t be achieved by a single stakeholder. Physicians must take steps to ensure that their patients have access to useful, accurate, and relevant information related to the patient’s visit, procedure, or diagnosis. Pharmacists must properly communicate medication schedules, interactions, and procedures for refilling medications. Health plans have a responsibility to help their members understand their benefits and use them to their full potential. Legislators need to offer incentives so these stakeholders will make health literacy a priority.
The first step, of course, is getting all stakeholders to commit to improving health literacy and to invest in the tools that will provide ubiquitous access to information regardless of age, education, income level, or ethnicity. The health care industry can’t expect consumers to take on more accountability without proper knowledge, so it is critical that they engage with digital health innovators to build the right digital health tools to bridge the literacy gap.
If improved health literacy can lead to better use of health insurance benefits, better outcomes, and reduced costs, what are we waiting for?
Ahmed Albaiti is president and CEO of Medullan, a company that provides innovative technology solutions to the health care and life sciences industries. Before that he led the clinical research enterprise information technology group at Partners HealthCare Systems in Boston.