• 31May

    The Case for Health Literacy – Moving from Equality to Liberation

    Excerpts from an article by National Academy of Medicine: The majority of health literacy research focuses on providing support to patients and strengthening individual health literacy skills. The work is much needed and important but places the onus or responsibility to increase health literacy solely on those who are mistreated by a complex system of policies, procedures, and institutions. Instead, as in other market-driven industries, the responsibility should fall on the companies and organizations that sell health care to maintain their margins and profits. Very few other industries could survive by providing poor communication and hard-to-understand information to their clients and consumers.


    The Equality image represents the traditional approach in health care, which turns a blind eye to health literacy and fails to address the differential impact on individuals and populations. The Equity portion of the image represents more equitable care by providing patient and caregiver supports, such as health literacy. Health literacy is a life skill that should be taught in school with reading, writing, and math. For now, it is imperative that we teach health care providers and staff to provide health literate care. It is good business to meet your customers where they are and make their experience as easy and pleasurable as possible. This is at the heart of good customer service.

    The health care system must strive to achieve the liberation represented in the third image. With liberation, complex systems and information are broken down to remove the fence blocking patients from getting what they need and truly meet patients where they are. Liberation also involves teaching health care providers to actively listen and build care that is centered around the person’s needs. We need to liberate patients, caregivers, and family members from complex information demands and confounding systems. The responsibility of the health system is to establish health literate organizations and care. That responsibility will become heightened as payment realigns from volume to value and truly incentivizes health deliverers to provide high-quality care. Ineffective communication and inefficient systems of care delivery that do not emphasize listening to and learning about a patient’s life circumstances will become a much rarer sight as the health care industry transforms its business models to thrive under these new reimbursement mechanisms.

    Moreover, the case for health literacy grows stronger every day. Those organizations and entities that embrace and adopt health literate principles early will gain a strategic advantage over the competition. Health literacy is still a relatively young field from a research perspective. However, based on the limited studies we have, plenty of preliminary evidence shows that adopting health literacy universal precautions can improve the quality of care and enhance the care experience, while reducing health costs (both for individuals and the system) and strengthening our efforts to achieve health equity [1].

    Returning to the image, there are numerous planks that need to be removed from the fence to liberate patients fully from confusion and frustration, allowing them to make informed decisions about what care to receive, how to receive it, and where and when to receive it. We need to value the knowledge of all involved: the patients as experts in their lives and the providers of care as experts in the field. We will highlight some of these planks/barriers in the remainder of this discussion paper, keeping in mind that this is just a start. Many other barriers need to be addressed before patients, caregivers, and family members will be unshackled from health literacy challenges. The responsibility of those working within the health system is to identify and remove all of these challenges. This is one way we can meet the quadruple aims to provide higher-quality care at a lower cost, while increasing the care experience for both patients and health professionals [2].

    • One systematic change starting to be addressed is the siloed delivery of health care.
    • With the Centers for Medicare and Medicaid Services ramping up the transition from volume- to value-based reimbursement will go a long way to freeing up health professionals’ time to communicate with patients in more meaningful ways. Current volume-based reimbursement actually discourages health systems from providing good communication, because if providers do not do a good job and a patient comes back, they make more money.
    • A remaining and systemic barrier in the health care system is the lack of transparency in terms of cost and quality of care.
    • Electronic Health Record (EHR) Interoperability – Numerous private companies have developed different EHR hardware and software systems that are not interoperable, and they fear that doing so would expose proprietary information that might make them lose their share of the market.

    Proposing health literacy as a key component to transition the health care industry from equality to liberation may appear radical at first. However, the changing structure of reimbursement requires that the health care industry implement a liberation business model focused on meeting patients and family members where they are as they describe their needs. We realize that changing business models is disruptive and may introduce market instability. Yet a period of disruption may signal a period of future innovation. Given the current research, we are confident that health literacy is essential to tearing down planks such as siloed delivery, volume-based reimbursement, lack of transparency, and interoperability challenges. Health care organizations and providers who are early health literate adopters will possess a significant market advantage, lower costs, increase satisfaction, improve the care experience for patients and providers, and ultimately improve the population health of the nation. Let us move forward to liberation as equal partners.

    You can read more here: https://nam.edu/the-case-for-health-literacy-moving-from-equality-to-liberation/