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Health IT Design Improvements for Patient Health Literacy

A vast majority of Americans have limited health literacy and poorly presented digital health information can pile on additional difficulties for end-users.

By Kyle Murphy, PhD

- Communication is essential to effective patient engagement, but patients historically have had little input into how providers present information to them.

Patient engagement needs to take into account patient health literacy

The latest work on patient health literacy by the Office of Disease Prevention and Health Promotion (ODPHP) looks to bridge information gaps between providers and patients.

The division within the Department of Health & Human Services (HHS) recently published the second edition of its guidance for healthcare organizations to consider when generating online content for patients — Health Literacy Online: A Guide to Simplifying the User Experience.

Authors of the guide highlight five health IT design tips for healthcare organizations to consider in order to improve the end-user experience:

1. Make websites responsive. Today’s users expect websites to work well on every screen they touch—whether it’s a mobile phone, a tablet, a desktop computer or other interfaces we haven’t thought of yet.

2. Start with mobile in mind. More and more users, especially low-literacy users, are accessing the web from mobile devices. Shrinking the space you have to work with at the start helps prioritize what and how you present information, while making sure the mobile experience is a simple one.

3. Write actionable content. Most web users—including those with limited literacy skills—are looking for specific information or an answer to a question.  They typically don’t stay on a page more than around 15 seconds.

4. Have users test your site with their own phones. Users are accustomed to how their smartphone or tablet is set up. When conducting usability testing you will get more accurate information if users test your site on a device they’re familiar with.

5. Use visual cues to indicate change. Show that the graphic or tool on your site has changed with visual cues.  If users can’t see changes, they’ll assume the graphic or tool isn’t working, creating frustration. Use visual cues to indicate change—the more obvious, the better.

"As content writers and developers of consumer digital health information tools, you are faced with the difficult task of imagining what your end users will find understandable and actionable," writes Acting Assistant Secretary Karen DeSalvo, MD, MPH, MSc, in the forward to the second edition. "There are a number of strategies that can help (e.g., use cases, personas, and user requirements) to make your tools more user friendly. But these strategies cannot always close the experience gap that exists between writers and developers and their end users."

As the Acting Assistant Secretary and National Coordinator notes, an increase in end-user research is important to understanding how individuals process digital health information.

"We cannot know for sure the level of health literacy of those who will visit our websites, in what context they will access them, or what device they will be using," DeSalvo maintains. "We can, however, be ready for them. We do this by designing digital health information tools that are broadly accessible and available to all Americans because they have been designed with them in mind."

As the latest edition reveals, a vast majority of Americans have limited health literacy (9 in 10) and poorly presented digital health information can pile on additional difficulties for end-users.

Especially important to the health IT design process for patients is involving these end-users in the design and testing of these tools (e.g., websites). The guide emphasizes both an end-user's ability to comprehend and apply the information she encounters in a meaningful way. What's more, it places emphasis on the role of mobile devices as a central vehicle in reaching individuals.

The guide also includes a convenient checklist for developers of patient-facing health information content.

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