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24-02-2013 | Article

A model for patient engagement, the “blockbuster drug of the century”


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medwireNews: Medical providers should assume that all patients are at risk for neither understanding their health conditions nor knowing how to deal with them, say experts.

Erring on the side of caution when it comes to patient literacy should coincide with health organizations ensuring patient understanding at all levels of planning and operation of diagnosis and treatment, they comment.

To address the 88% of Americans who are not competent enough to navigate the health system and act on health information, a Health Affairs study posed a model for clinical encounters to ensure that patients understand the medical information presented to them, which would enable taking action in an educated and effective manner.

"It's not really the fault of the individual, it's more about the complexity of the healthcare system and the information that we provide," Linda Harris, senior health communication advisor at the Department of Health and Human Services, told medwireNews. "If you think about how complicated medical terminology is and how little we really try to translate that information into actionable guidance, then that disconnect is pretty apparent. Almost all of us have less health literacy than our providers."

One remedy that Harris and colleagues suggest is a common health literacy improvement strategy based on two-way communication called the "teach-back." After conveying information as clearly as possible to a patient, doctors would ask the patient to teach it back to demonstrate understanding and retention. This feedback would help patients and providers achieve a shared understanding.

"There's not a lot of training in medical schools for how to communicate with patients," Harris said. "When you don't provide that feedback loop, it could actually lead to a lot of unforeseen mistakes that actually add time and costs to the healthcare process."

The responsibility for communicating with the patient would fall to the entire health organization so that, for example, the receptionist and nurse practitioner also confirm a patient's comprehension, limiting the burden on doctors who often have limited time and resources.

Harris's model would also have patients help define quality by gauging their perspectives and criticism. "Feedback on a regular basis from a patient would really move us forward in holding organizations accountable for doing the right thing," Harris explained.

Patient surveys, for instance, would gauge the level of involvement that providers allow in decision making or how engaged staff are in confirming their understanding.

By Peter Sergo, medwireNews Reporter