Page 31 - Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

HeALtH LiteRACY, eHeALtH, AnD CoMMUniCAtion

To achieve this vision requires a transformation of the Arizona Med-
icaid health care system. Necessary components of this transformation
will include the widespread adoption of interoperable health information
technology (HIT), electronic health information exchange, and electronic
health records that are transferable and transportable either through the
patient or through electronic means. Furthermore, there must be greater
use of Web-based clinical and patient decision-support tools that use a
common health data set and evidence-based references. Such a system
would enable Medicaid to use the data in its files to provide clinical
decision tools that allow physicians to see the individual patient episode
of care or care plan and also make it possible for AHCCCS to aggregate
this information for a broader perspective of the health of the Medicaid
population. Finally, the system needs internet and communication tools
that support the delivery of personalized health information and health
literacy competency for Medicaid beneficiaries.
Ratzan and Parker defined 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 deci-
sions” (Ratzan and Parker, 2000). Improving health literacy levels will
help create informed and activated AHCCCS members. To design inter-
ventions aimed specifically at improving health literacy, AHCCCS identi-
fied several skill sets inherent in the broad definition of health literacy.
One such set of skills is functional health literacy skills, the basic read-
ing and writing skills necessary to understand and follow simple health
information. Another skill set is interactive health literacy skills which are
more advanced than basic skills and include the ability to interact with a
system that is providing personalized health information, not just general
health information. This set also includes the cognitive and interpersonal
skills needed and the confidence necessary for interacting or partnering
with a clinical professional.
Critical thinking skills are another component of health literacy. These
skills involve the ability to analyze and make value-based choices when
presented with alternative possibilities—the choice between medications
with different side effects, for example, or the choice of surgery versus
longer-term medical intervention. Finally, there are focused health literacy
skills that are more specialized and that involve the knowledge and abil-
ity to engage in consumer-directed care by performing defined patient
self-care management support tasks and wellness activities. These skills
will be increasingly important as people move more into home-based and
community-based care.
AHCCCS has a Medicaid Transformation Grant to develop new
eHealth tools to improve health literacy. During Phase I of the grant, the
objective will be to reconfigure available technology. This will be accom-

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