The ability of the physician to capture and share health information in the form of an electronic health record (EHR) is one half of the physician-patient dynamic. The other half is the ability of the patient to comprehend and act upon the information contained in an EHR (as well as educational resources outside of the record) in a meaningful way. A breakdown can occur between the physician and patient when the information that flows from the doctor to the layperson isn’t communicated in an understandable form — that is, the physician’s use of medical terminology doesn’t mesh with the patient’s health literacy.
In a notice published in the Federal Register, the Department of Health and Human Services has today announced an ongoing effort by the Agency for Healthcare Research and Quality (AHRQ) to gauge how well suited health education resources made available via an EHR are to the various levels of health literacy:
Electronic health records (EHRs) can help providers offer patients the right information at the right time during office visits, by directly connecting patients to helpful resources on treatment and self-management. EHRs can also facilitate clinicians’ use of patient health education materials in the clinical encounter. However, health education materials delivered by EHRs, when available, are rarely written in a way that is understandable and actionable for patients with basic or below basic health literacy—an estimated 77 million people in the United States
According to the AHRQ, the failure of providers to communicate medical information to their patients appropriately has led to “more medication errors, more and longer hospital stays, and a generally higher level of illness, resulting in an estimated excess cost for the US health care system of $50 billion to $73 billion per year.”
To mitigate these costs and improve patient outcomes, AHRQ is initiating the first phase of four-pronged effort to publish a Health Information Rating System (HIRS). Developing the HIRS is a four-pronged effort:
1. develop a valid and reliable Health Information Rating System (HIRS),
2. create a library of patient health education materials,
3. review EHR’s patient education capabilities and features, and
4. educate EHR vendors and users.
After consulting existing rating systems, evidence-based literature, and a plan of technical expects, the AHRQ is set to begin testing the HIRS on consumers. The test will begin with 48 English-speaking consumers reviewing 12 rated educational materials and end with the development of “a systematic method to evaluate and compare the understandability and actionability of health education materials.” Feedback from the consumers will inform revisions and improvements to the HIRS. Once the HIRS is finalized, AHRQ will commence reviewing patient health education materials according to the rating system.
While much of the conversation about inequality in healthcare centers on access and cost, health literacy is a reminder that having access and being able to afford care isn’t enough. “Health education materials are actionable when consumers of diverse backgrounds and varying levels of health literacy can identify what they can do based on the information presented,” notes Carolyn Clancy, Directory of AHRQ. Patients must be empowered by their providers to make healthy decisions.
EHRs have the capability to communicate information from the physician to the patient. What’s problematic is whether this information is meaningful to the end-user, the patient. Technology can only go so far before coming face to face with the human element.