Posts Tagged ‘health literacy’

Infographic: Health Literacy

May 6th, 2015 by Melanie Matthews

One in two adults can’t use a BMI chart to find a healthy weight, understand a vaccination chart and/or read a prescription label, according to an infographic by GSW on health literacy.

The infographic details examples of low health literacy and the impact it has on patients and the healthcare system.

Advancing Health Literacy: A Framework for Understanding and ActionAdvancing Health Literacy: A Framework for Understanding and Action addresses the crisis in health literacy in the United States and around the world. This book thoroughly examines the critical role of literacy in public health and outlines a practical, effective model that bridges the gap between health education, health promotion, and health communication.

Step by step, Advancing Health Literacy: A Framework for Understanding and Action outlines the theory and practice of health literacy from a public health perspective. This comprehensive resource includes the history of health literacy, theoretical foundations of health and language literacy, the role of the media, a series of case studies on important topics including prenatal care, anthrax, HIV/AIDS, genomics, and diabetes.

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STAAR’s 4 Domains of Process Improvement to Enhance Patient Health

June 18th, 2013 by Jessica Fornarotto

Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, recommends hospitals follow the four domains of process improvement from the State Action on Avoidable Rehospitalizations (STAAR) in order to improve the standards of care for each patient to prevent future health woes.

During HIN’s webinar Readmission Penalties in 2013: A Cross-Continuum Approach To Lessen the Financial Impact, Boutwell listed STAAR’s four domains, which include enhanced assessments, enhanced teaching, real-time communication and timely follow-up care.

STAAR’s four general domains of process improvement do not constitute a cookbook. We recognize that hospitals need to adapt and implement these concepts in various ways to fit their settings, whether rural, urban, academic or community hospitals.

The four major domains are an invitation to reflect. If your hospital is not providing these four elements of care for every single patient leaving your care, regardless of risk, then I invite you to reflect upon why you wouldn’t do this for everyone. Why wouldn’t we make sure that we update our standard of care as people leave our hospital ‘sicker and quicker,’ and take upon themselves a greater burden and more responsibility for after-hospital care? Why wouldn’t we improve our standard of care for everyone in these four areas? The four domains are as follows:

1. Enhanced assessment. This means that we assess patients. That’s what we do in the hospitals; that’s what nurses, doctors and therapists do all the time. But this is the concept of expanding that view, especially of our frequent flyers or our frail patients to the big picture. What is the longitudinal care need beyond the acute episodic presenting need?

2. Enhanced teaching and learning. This is a change from putting packets of information on meal trays to using the three or four days of the hospitalization as a learning opportunity. Identify who is the right learner, because it’s not always the patient. Engage in that health literacy-appropriate teachback technique to convey the key elements — not the entire 85-page booklet on heart failure but the key elements of self-management as the patient transitions from our setting to the next setting.

3. Real-time communication. This is communication both to the receiving providers as well as better updates in communication to the patients and family members. It can’t be okay for us to have rounds at 7:00 or 8:00 in the morning and then tell the patient to call their daughter because they are being discharged at 2:00. This is the experience of many of our patients still. Keeping people updated as to their care plan and their after-hospital care needs is something that we identified as a major theme in many root cause analyses of early readmissions.

But even more to the point around real-time communication is that we’re still not doing a great job in letting the outpatient providers know that their patients are being admitted and discharged and defining the reasons for their hospital stay. What was their course treatment? What were the new results and what medicines were they prescribed? Root cause analyses from every community across the United States now find that real-time communication with their receiving providers is still lacking.

4. Ensuring that there is timely post-acute care follow-up. This will vary based on patient risk, but if your patient is moderate or high-risk, a call to their doctor’s office and an appointment in one to two weeks is not going to do it anymore. We have so much data. If you run your own hospital’s data as to the average time between discharge and readmission, you will find that 25 percent of your readmissions are coming back within three to four days, and 50 percent are coming back within seven to 10 days. We need to get touch points. It doesn’t need to be a follow-up appointment; there are many good models of phone calls, visiting nurses, lay-care providers, etc. We need to follow up with patients to make sure that when they get home, they understand their plan of care, they get their medications and they are not confused.

6 Data Analytics Driving Successful Population Health Management

April 2nd, 2013 by Jessica Fornarotto

population health data analytics

Webinar Replay: Achieving Population Health Management Results in Value-Based Healthcare

The development of a successful population health management (PHM) effort starts with the data and the data analysis, states Patricia Curran, principal in Buck Consultants’ National Clinical Practice. Curran describes the role of data and data analysis, the six critical PHM data areas, and the “influences” and the “influencers” that affect a population’s road to better health.

Where are we today and where do we want to be in the future? All of the data that you can gather is carefully evaluated to consider several points: the culture of the company and the employees, the business objectives, the health literacy of the population, compliance and risk scores and the utilization trends.

Data is essential to understanding the population you wish to manage and designing programs to meet the needs of a specific population. Buck Consultants takes all the raw data that we can gather, analyzes it, and transforms it into knowledge. The ‘aha’ moment is when it all comes together and we use it to build a strategy for an organization’s PHM program. It’s important to use your own data to identify the population’s specific needs and target your program to those needs. There are six areas that form the foundation for a successful PHM program:

  • Clinical data is biometric data or lab data, and possibly health risk assessment (HRA) data, that helps identify risks and cost drivers and is used to monitor the program’s success.
  • Utilization data would be the utilization patterns. For example, how are people accessing their healthcare?
  • Adherence is beginning to replace the word ‘compliance.’ This refers to how well members and providers are adhering to evidence-based medicine guidelines. Are they filling their prescriptions consistently? Are they getting preventive care?
  • Operational data is participation data, productivity data, disability data and other information that helps to monitor and develop the programs.
  • Financial data shows how this healthcare activity that you’re offering translates to dollars and opportunities for real hard dollar savings. This data is key in order to get senior management support and finances to continue the program.
  • Satisfaction data is necessary to monitor how participants and your key stakeholders view your efforts.

Part of the data analysis also includes identifying all the things that influence the decisions people are making and the influencers that are affecting what you’re trying to accomplish. For example, influencers might be spouses, family members, friends, healthcare providers, and employer management staff. Influences might be a fear of financial issues, ignorance, indifference, and inconvenience.

Take this scenario as an example: an employer may have a goal to increase the level of mammogram participation or people getting mammograms on a regular basis. They bring in a mobile unit to provide on site mammograms. But after they do this, they find that there is still no change with mammogram compliance. They will then go back to their employee population and discover that the reason they didn’t have any improvement was because the supervisors on the line didn’t allow people off the line to participate. The line supervisor is the influencer that needs to be identified and rectified before there’s going to be any change.

Infographic: The Cost of Health Literacy

December 5th, 2012 by Melanie Matthews

Individuals with low health literacy have an average annual healthcare cost of $13,000. An infographic by the Institute for Health Technology Transformation illustrates the correlation between health literacy levels and healthcare costs and quality.

Health Literacy

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11 Ways to Engage Consumers in Patient Portals

September 5th, 2012 by Patricia Donovan
patient portal

Patient portals increase engagement, support stage 2 meaningful use.

Patient portals are an ideal way to boost patient engagement, a metric getting lots of attention in stage 2 of the federal government’s incentive plan for meaningful use of EHRs. Stage 2, which will begin as early as 2014, increases health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.

Under the final rule issued last month, organizations vying for meaningful use incentives will not only have to demonstrate the availability of patient portals, but also the percentage of patients accessing health information via these channels.

There are plenty of portals already out there, but how can healthcare companies convince patients and health plan members to use the portal? Problems with portal awareness, functionality and health literacy can sink a portal project before it gets off the ground. In a Physicians Practice podcast, pediatrician Peter M. Kilbridge, a senior research director with The Advisory Board Company, suggests 11 ways to not only engage patients in portal use but also increase the likelihood they’ll return to the tool continually to manage their health:

  1. Make sure patients are aware of the portal. Staff should inform patients about the portal, and brochures and sign-in credentials should be readily available, recommends Dr. Kilbridge.
  2. Highlight functions patients care about, such as the ability to send secure messages or questions and schedule referrals.
  3. If patients aren’t scheduled to come in to the office for an appointment, send them an e-mail or snail mail announcement about the portal.
  4. When building a portal, it’s important that patients get there on the first try. Keep the instructions and path to the portal simple.
  5. Define the physician’s role in this process — the most important role, Dr. Kilbridge emphasizes. “Physicians have a greater ability than anyone else to influence. You must educate the physicians in proper portal use.” Even among physicians, the digital divide is great, he adds. “Show the physicians how the portal will help them — by reducing phone calls, by motivating patients to follow up on test results.” All of these benefits can improve overall clinical indicators for a practice.
  6. Encourage the healthy to use the portal. “Healthy patients will use the portal when it simplifies routine tasks, like making appointments.”
  7. Add health and wellness information, such as links to community activities such as walks or runs, that providers can point to during visits.
  8. For patients with chronic illness, offer logs for them to enter regular data, such as weight o A1C levels, and activate red flags when they reach warning levels.
  9. Pay attention to health literacy levels, making sure the information and tools available from the portal are easy to understand.
  10. Coordinate the portal with other means of patient access, such as a call center or nurse advice line. These groups can also refer patients to the portal for more information.
  11. Coordinate the portal with other communication modalities. “Some portals can be built to interact with texting,” notes Dr. Kilbridge, who estimates that about 85 percent of individuals are comfortable using texting.

What about the elderly? Will they use the portal? “There are always populations that won’t use it — minorities, elders, the less educated.”

But judging from the numbers of grandparents proudly sharing their grandchildren’s photos on social networks like Facebook, expecting them to tackle a patient portal may not be such a stretch.

10 Hallmarks of a Health-Literate Organization

August 23rd, 2012 by Jessica Fornarotto

Recorded Webinar: Patient Engagement in the Patient-Centered Medical Home — A Continuum Approach

Leadership committed to health literacy and easy access to health information are two attributes of an organizational environment that fosters health literacy, suggests a new study reported in the Institute of Medicine (IOM).

It is possible for a healthcare system to redesign its services to better educate patients in the handling of immediate health issues and also become more savvy consumers of medicine in the long run, says the University of California, San Francisco (UCSF) and San Francisco General Hospital and Trauma Center (SFGH) study. The study identified ten attributes that healthcare organizations should adopt to make it easier for people to better navigate health information, make sense of services and better manage their own health — assistance for which there is a profound societal need.

The ten attributes of a health-literate organization are:

  1. Has leadership that makes health literacy integral to its mission, structure and operations.

  2. Integrates health literacy into planning, evaluation measures, patient safety and quality improvement.
  3. Prepares the workforce to be health-literate and monitors progress.
  4. Includes populations served in the design, implementation, and evaluation of health information and services.
  5. Meets the needs of populations with a range of health literacy skills while avoiding stigmatization.
  6. Uses health literacy strategies in interpersonal communications and confirms understanding at all points of contact.
  7. Provides easy access to health information and services and navigation assistance.
  8. Designs and distributes print, audiovisual, and social media content that is easy to understand and act on.
  9. Addresses health literacy in high-risk situations, including care transitions and communications about medicines.
  10. Communicates clearly what health plans cover and what individuals will have to pay for services.

Some 77 million people in the United States have difficulty understanding very basic health information, which clouds their ability to follow doctors’ recommendations, and millions more lack the skills necessary to make clear, informed decisions about their own healthcare, said senior author Dean Schillinger, MD, a UCSF professor of medicine, chief of the Division of General Internal Medicine at SFGH, and director of the Health Communications Program the UCSF Center for Vulnerable Populations at SFGH. “Depending on how you define it, nearly half the U.S. population has poor health literacy skills. Over the last two decades, we have focused on what patients can do to improve their health literacy,” said Schillinger. “In this report, we looked at the other side of the health literacy coin, and focused on what healthcare systems can do.”

The importance of enhancing health literacy has been demonstrated by many clinical studies over the years, said Schillinger. Health literacy is linked directly to patient wellness. People who can understand their health information tend to make better choices, are able to self-manage their chronic conditions, and have better outcomes than people who do not.

Adults with low health literacy may find it difficult to navigate the healthcare system, and are more likely to have higher rates of medication errors, more ER visits and hospitalizations, gaps in their preventive care, increased likelihood of dying, and poorer health outcomes for their children.

Many health policy organizations have recognized that health literacy is not only important to people, but it can also benefit society because helping patients help themselves is a way to keep healthcare costs down. Successful self-management reduces disease complications, cuts down on unnecessary ER visits and eliminates other wasteful spending.

Click here for more information and for a complete description of the ten attributes.