Page 40 - Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

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

oveRvieW oF iSSUeS

Out in the field, talking with leaders at the state, local, and national
level about eHealth and health technology, people find that there is little
awareness of the problems associated with low health literacy. The first
step, then, must be an educational effort to raise awareness. Once aware-
ness has been raised, efforts must focus on figuring out how to tackle the
remaining issues.
Looking at the drivers of health IT, one might be able to make a busi-
ness case for health literacy. In 2008, for example, analysts expect that $1.8
billion will be spent on chronic care management, most of which will be
paid for by health plans or employers. Connecting consumers who have
chronic conditions to e-learning systems built to address low health lit-
eracy issues—systems such as the one described by Rodgers—could offer
a compelling business case for health literacy.
Another participant asked Rodgers how AHCCCS made the business
case for developing its eHealth system and how it addressed issues of lia-
bility, privacy, and confidentiality. Rodgers responded that AHCCCS ana-
lyzed the potential return on investment and found that it is about $144
million a year. This is achieved on the provider side primarily through
reduction of lab duplication, reduction in emergency room visits by pro-
viding patients with alternative sources of care, and reduction in x-rays
by deploying images to where patients go for care.
On the consumer side the key element is compliance. There is signifi-
cant variation in how well patients comply with physicians’ instructions.
It is difficult to see beyond the basic compliance issue because more data
are needed—for example, data on whether patients are taking their medi-
cations. It is expected that the system will allow providers to track various
kinds of compliance (e.g., whether patients pick up their medications or
keep their health care appointments). Once data are available, personal-
ized interventions can be developed—it will not work to implement the
same intervention for everyone because the reasons for noncompliance
are not uniform.
A participant asked if the speakers could elaborate on what Web 2.0 is.
Norman responded that it reflects a shift in technology to more consumer-
driven content. When the World Wide Web was first introduced, for exam-
ple, in order to create a Web page, one had to know some programming
language and HTML (HyperText Markup Language). With Web 2.0 tech-
nologies anyone, even those with no technical skill, can post on the Web
with, for example a wiki (essentially an editable Web page) or a social net-
working Web page like Facebook. One does not need to understand any
of the technology. Rodgers said that the great potential for health care is
that patients with special health care needs can communicate with others
who have the same needs, so that they can learn from each other. This is
an entirely new way of providing coaching and obtaining support.

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