Nearly 9 out 10 Adults May Lack the Skills Needed to Manage their Health and Prevent Disease

What is health literacy?

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.¹

Health literacy is dependent on individual and systemic factors:

• Communication skills of lay persons and professionals
• Lay and professional knowledge of health topics
• Culture
• Demands of the healthcare and public health systems
• Demands of the situation/context

Health literacy affects people's ability to:

• Navigate the healthcare system, including filling out complex forms and locating providers and services
• Share personal information, such as health history, with providers
• Engage in self-care and chronic-disease management
• Understand mathematical concepts such as probability and risk

Health literacy includes numeracy skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills. Choosing between health plans or comparing prescription drug coverage requires calculating premiums, copays, and deductibles.

In addition to basic literacy skills, health literacy requires knowledge of health topics. People with limited health literacy often lack knowledge or have misinformation about the body as well as the nature and causes of disease. Without this knowledge, they may not understand the relationship between lifestyle factors such as diet and exercise and various health outcomes.

Health information can overwhelm even persons with advanced literacy skills. Medical science progresses rapidly. What people may have learned about health or biology during their school years often becomes outdated or forgotten, or it is incomplete. Moreover, health information provided in a stressful or unfamiliar situation is unlikely to be retained.

Why is health literacy important?

Only 12 percent of adults have Proficient health literacy, according to the National Assessment of Adult Literacy.  In other words, nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease.  Fourteen percent of adults (30 million people) have Below Basic health literacy.  These adults were more likely to report their health as poor (42 percent) and are more likely to lack health insurance (28 percent) than adults with Proficient health literacy.⁶

Low literacy has been linked to poor health outcomes such as higher rates of hospitalization and less frequent use of preventive services (see Fact Sheet: Health Literacy and Health Outcomes). Both of these outcomes are associated with higher healthcare costs.

Key research study findings on the relationship between health literacy and health outcomes:

http://www.health.gov/communication/literacy/quickguide/factsliteracy.htm

Use of preventive services

According to research studies, persons with limited health literacy skills are more likely to skip important preventive measures such as mammograms, Pap smears, and flu shots.¹ When compared to those with adequate health literacy skills, studies have shown that patients with limited health literacy skills enter the healthcare system when they are sicker.²

Knowledge about medical conditions and treatment

Persons with limited health literacy skills are more likely to have chronic conditions and are less able to manage them effectively. Studies have found that patients with high blood pressure,³ diabetes,^3-5 asthma,⁶ or HIV/AIDS^7-9who have limited health literacy skills have less knowledge of their illness and its management.

Rates of hospitalization

Limited health literacy skills are associated with an increase in preventable hospital visits and admissions.^10-13 Studies have demonstrated a higher rate of hospitalization and use of emergency services among patients with limited literacy skills.¹²

Health status

Studies demonstrate that persons with limited health literacy skills are significantly more likely than persons with adequate health literacy skills to report their health as poor.^10, 12 14

Healthcare costs

Persons with limited health literacy skills make greater use of services designed to treat complications of disease and less use of services designed to prevent complications.^1, 11-13 Studies demonstrate a higher rate of hospitalization and use of emergency services among patients with limited health literacy skills.^10-13 This higher use is associated with higher healthcare costs.^15 16,

Stigma and shame

Low health literacy may also have negative psychological effects. One study found that those with limited health literacy skills reported a sense of shame about their skill level.¹⁷ As a result, they may hide reading or vocabulary difficulties to maintain their dignity.¹⁸

Partner with mHealth Games to promote health literacy and begin improving health outcomes today!

Body Computing Conference 2013: Dermtap Harnesses Photo Sharing for Dermatology and Digital Doctoring

Stanford dermatology resident and founder of Medable, Dr. Michelle Longmire, took the stage at the USC Body Computing Conference to demonstrate Dermtap. Dermtap is a fully HIPAA-compliant mobile app for secure and safe image storing and sharing. With Dermtap, Dr. Longmire’s primary goal is to make “digital doctoring” a reality, enabling digital communication between patients and providers.

Currently, many physicians take photos of interesting pathology for sharing and teaching, but this practice creates a complex situation when it comes to patient privacy and intermingles medical and recreational photos. That’s where Dermtap comes in.

With Dermtap, a dermatologist can snap photos of interesting pathology and store these photos within the app’s servers, completely independent of your personal library.

Each case can have up to 5 photos, and each photo can be anonymized by covering up eyes or identifying features. With every photo, you can then share access to established teams (your group practice, for example), specific colleagues, or to any contact in your phone’s address book.

Other physicians that have been invited to access your case can contribute comments, or suggest diagnoses. The app intelligently provides a list of proposed diagnoses at the top of the comments with the ability for participants to vote for each diagnosis via a “like” button. One of my favorite features of the app is the fact that typing a diagnosis within the comment box’s free text instantly brings up an auto-fill list of diagnoses. This simplifies spelling (which can be a problem with many dermatological conditions) and also helps update the list of proposed diagnoses.  A simple and effective way to best understand the app is to watch the brief video located on their website.

As one would expect, patient privacy and security is a continual theme addressed effectively throughout the application. In order to successfully register as a provider, you must produce a valid NPI number. Furthermore, as mentioned above, every photo uploaded can be de-identified via censoring. Also, after a certain amount of inactivity, the app requires a password, preventing others from accessing your patient’s photos.

When signing up for the Dermtap service, there is a separate process for registration as a patient and as a provider. In the public beta version currently available on the app store, the registration process for patients is still restricted to an invite-only basis. Dr. Longmire explained to me that they plan to roll out the patient portion of the service in its next phase, which will facilitate patient-provider communication and sharing of photos.

With my brief time using the app, I have been thoroughly impressed with the simple and clean user interface. The bright colors and flat design fit right in with the recently introduced iOS 7. The app flows smoothly, and does not appear to “jump” around and does not have any noticeable lag, which commonly occurs with apps that heavily rely on the cloud. The ability to view multiple (up to 5) images within one case is also quite useful, as it provides additional perspectives on the progression of a disease, which is crucial for an accurate diagnosis.

Most exciting of all, this clean and highly functional user interface is based on the Medable platform, which Dr. Longmire created as a tool to help other medical professionals make their app ideas a reality. The Medable platform is fully HIPAA compliant, features care collaboration between patients and providers, and supports image storing/sharing. For those of us who might not be dermatologists, her vision is that Medable can be the backbone for other mobile apps tailored for other needs or specialties. Dermtap shows us that digital doctoring for dermatologists is already here, and its Medable backbone promises that digital doctoring for the rest of us is not far behind.

App Store Link – Join the Beta Test. If you are interested in using Dermtap in your practice as a tool for patient image storage and sharing, please contact them at hello@dermtap.com.

This article is part of iMedicalApps’ coverage of the 7th annual Body Computing Conference, hosted by the USC Body Computing Center, which took place on October 4th, 2013.  The event showcases the cutting edge of digital health, in partnership with industry leaders and venture capitalists in biotechnology, telecommunications, entertainment, and design.

  http://www.imedicalapps.com/2013/10/body-computing-conference-2013-dermtap/

Telemedicine conference speakers say technology to connect patients, doctors is "effective and efficient" | jacksonville.com

By Charlie Patton

Telemedicine, the delivery of health care services using technology such as video conferencing, is “a cost-effective, hassle free and patient centered” approach to health care.

That’s the message State Rep. Cary Pigman and a dozen other speakers delivered Tuesday during the 2013-2014 Telemedicine Public Policy Symposium, held at the Mayo Clinic’s Jacksonville campus.

The symposium was hosted by State Rep. Mia Jones of Jacksonville and by Pigman, an emergency physician. After the conference, Jones said she and Pigman plan to co-sponsor a bill that would require Medicaid and private insurers in Florida to reimburse health care providers who treat patients using telemedicine. Currently, 21 states have such legislation.

Telemedicine “is effective and efficient,” said Anne Burdick, the associate dean for Telehealth and Clinical Outreach at the University of Miami Miller School of Medicine. “It should be reimbursed.”

“So much of what we do in health care is directed toward rescue,” Pigman said. “This would enable [physicians] to do more maintenance and preservation.”

Jeff Wacksman, practice operations director for Mobile Physician Services, which provides in-home visits to homebound patients in the Tampa Bay area, noted that 5 percent of Medicaid patients account for 54 percent of Medicaid spending.

One major reason the care of those patients is so expensive is that “they are accessing health care at its most expensive point” by showing up often in emergency rooms.

Providing new ways for such people to access health care could save a lot of money, he said. In fact, if the law were changed to allow homebound patients anywhere in the state to be treated in their homes using telemedicine approaches, the state could save billions, Wacksman said.

Toree Malasanos, a pediatric endocrinologist who is director of the Florida Initiative in Telehealth and Education at the University of Florida, said that using telemedicine techniques to treat kids with diabetes at a clinic in Daytona Beach had resulted in a 70 percent drop in emergency room visits and an 88 percent decrease in hospitalizations.

Telemedicine conference speakers say technology to connect patients, doctors is "effective and efficient" | jacksonville.com