Health Literacy, eHealth, and Communication Putting the Consumer First: Workshop Summary (2009) / Chapter Skim
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3 Outcomes and Challenges of eHealth Approaches: Panel 1
3 Outcomes and Challenges of eHealth Approaches: Panel 1
Pages 29-46
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From page 29... ...
Since 2004 the HHPC has been using the methods of participatory action research to develop the Digital Partners in Health Project, a health portal designed to provide culturally-relevant health information and decision support to consumers with low literacy. Building the project required information about how people of color use technology and seek health information.
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From page 30... ...
For these reasons researchers at the HHPC spent a significant amount of time collecting data using a random-digit-dial survey of 646 Harlem residents 18 years of age and older. The survey collected data on the use of and access to different types of technology as well as data on demographics, general health, and health-information-seeking behaviors.
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From page 31... ...
of Internet users also trust health-related information found on the Internet. The data also show that 63 percent of those who go to the Internet search for health information about specific diseases.
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From page 32... ...
Convenience of use was a major factor in the use of the Internet. Although participants reported enjoying the freedom that the Internet allowed, many said they had difficulty understanding 46% Non-Users Television 52% Internet Users Internet/Web 29% 71% Radio 37% 41% Newspapers/Magazines 40% 57% Family/Friends 49% 58% Health care 90% professional 94% 0% 20% 40% 60% 80% 100% FIGURE 3-1 Trust in sources of health information.
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From page 33... ...
Using these data as background for understanding community attitudes, the HHPC project set out to build a Web portal that Harlem residents would use. The conclusion was that the Web portal platform would need to do more than deliver health information, even if it were at a lower health literacy level, the portal would have to encourage a level of trust and cultural relevance as its foundation.
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From page 34... ...
This is consistent with participatory action research methods, the methods used in the HHPC approach. There are a number of mechanisms available in Web 2.0 by which the community filters material, such as community ratings.
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From page 35... ...
. A study by Baldry and colleagues showed that when health professionals actively encourage patients to view their own health records, it helps restore patient trust in the medical system (Baldry et al., 1986)
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From page 36... ...
These components offer a number of improvements over the previous system, including more comprehensive records, access to trusted patient education, engagement and action, patient safety, medication reconciliation, patient concordance, wellness reminders, decision support, communication, and patient and provider partnerships. The development of My HealtheVet has been guided by the belief that "Bar Code Medication Administration (BCMA)
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From page 37... ...
This authentication allows the veteran access to additional features, such as the ability to view medication names when ordering VA prescription refills and access to the VA medication history as an extract from the VA electronic health record. Many of the screens within My HealtheVet have printer-friendly functions.
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From page 38... ...
As mentioned previously, there is a three-tiered access to the system -- visitor, registered members, and authenticated members. There are currently 59,000 veterans who have been in person authenticated and are now able to receive VA prescription medication names as the initial extract from the electronic health record, thereby improving medication reconciliation.
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From page 39... ...
My HealtheVet also allows veterans to input information from care provided in community settings. About 40 percent of the VA population receives care outside the VA system so universal secure access to patient health information is critical to providing integrated care coordination among multiple providers.
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From page 40... ...
VA is currently in the alpha testing stage of secure messaging. The contributions of eHealth to the goals of health literacy and improving patient outcomes can be very powerful, Nazi concluded.
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From page 41... ...
For example, in San Francisco a website was established recently to evaluate police officers, but it was immediately taken down. Perhaps there are aspects of wikis that could be used to evaluate one's health care providers in terms of their sensitivity or competency in health literacy.
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From page 42... ...
On the subject of the Harlem community, a participant said that there are a variety of factors that are not directly addressed by eHealth, such as the social determinants of health, including lower education and lower employment. It seems that people are thinking that eHealth will provide a panacea to bridge the gap in health disparities.
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From page 43... ...
Knowing that veterans may not have access to a computer, the VA made sure that computers were placed in every medical center for use by veterans. Data show that while veterans access their personal health record they are also accessing the health education libraries.
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From page 44... ...
Nazi responded that this is an important research question. Because VA has a research branch, those involved in informatics at VA are pressing for a collaborative effort with VA researchers to study such questions as: Do personal health records make a difference?
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From page 45... ...
Is my blood sugar controlled? An audience member suggested that as one gains more information about one's own personal health record, there may be things in the record that one did not hear when visiting the clinician.
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