Page 57 - 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

complexity involved. There is a complementary project that will link the
portal to a more traditional personal health record that has the traditional
functions such as patient reminders and prescription refills. There will
also be point-of-care patient education.
The portal, however, provides very different kinds of content—in
particular, more actionable content. When a doctor tells a patient to con-
trol his or her blood pressure, for example, the “how to do it” is the part
that is often missing and, furthermore, is very community-specific. The
portal is a place to go to hear about what others have tried to do, what
they have done or could not do, as well as a place to join groups or start
groups aimed at accomplishing specific things.
One participant commented that the statistics provided on the num-
ber of people who have access to and use the Internet are encouraging.
She then asked Kukafka if, when conducting the telephone survey, the
interviewers probed those individuals who do not have a computer or
did not use the Internet in order to determine what the barriers to use
were? And, if so, will the project begin to address some of those issues?
Kukafka responded that the interviewers did probe and that some of the
information on barriers was presented. Fear of pornography and fraud
was actually of higher importance than being able to understand the
information. Will the project be able to do something about all the bar-
riers? The answer is no. What the project can do is encourage discourse
among the participants during which the barriers might emerge and can
then be discussed.
In terms of such barriers as having to wait in long lines at the library
to use the computer or having only limited hours when the library is
open, the hope is that the community will begin to build capacity in order
to reduce some of those barriers. One of the most interesting comments
about the portal was “This is not a website, it’s an action, it is activism.”
The portal can assist a ground-up effort and provide the platform for
discourse and activism out of which change will occur.
On the subject of the Harlem community, a participant said that there
are a variety of factors that are not directly addressed by eHealth, such as
the social determinants of health, including lower education and lower
employment. It seems that people are thinking that eHealth will provide
a panacea to bridge the gap in health disparities. But how likely is it that
that will really happen? Isn’t it necessary to address the broader social
determinants of health and not depend on eHealth bridging the gap?
Kukafka responded that empirical evidence will be necessary to deter-
mine the degree to which the Harlem approach is successful. It is likely
that there will be early adopters, as in the diffusion of any technology, but
there will be people who have significantly more barriers to adoption, and
it is doubtful that 100 percent of the population will be reached.

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