Building the Case for Health Literacy Proceedings of a Workshop (2018) / Chapter Skim
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5 Adopting Health Literacy in an Organization
5 Adopting Health Literacy in an Organization
Pages 43-60
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From page 43... ...
Chris Carlson, senior vice president for consumer and customer experience at UnitedHealthcare Shared Service Operations, then spoke about his organization's experience with developing and adopting a health literacy plan. Jennifer Dillaha, medical director for immunizations and medical advisor for health literacy and communication at the Arkansas Department of Health, described how her organization adopted health literacy as part of the department's strategic plan.
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From page 44... ...
In some cases, these individuals were employed as full-time health literacy change leaders, while others spent half or less of their time on health literacy after somewhat grudgingly being given permission to do so. The organizations varied in size, how long they had been working on and had a person in charge of health literacy, and the populations they served.
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From page 45... ...
Carol has a "backhoe" at her disposal because the leaders of her organization have made health literacy a priority: they named an executive sponsor and champion, created a taskforce, ensured she has access to senior leaders, developed supportive policies and mandates, allocated resources, and created a health literacy office with organization-wide reach. As a result, Carol has been able to make widespread progress in spreading and embedding health literacy through the organization.
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From page 46... ...
The strategies they most commonly tried included linking health literacy to other initiatives, focusing on cost savings and return on investment, presenting statistics on health literacy, and relaying stories of patient experiences to engage both the hearts and heads of organizational leaders. Of note, only one interviewee mentioned using important legal, regulatory, and compliance issues to justify addressing health literacy to leaders.
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From page 47... ...
In short, said Carlson, trust begets engagement, and in the same way, health literacy equals engagement when it is done right. The unique thing about health care, he added, is that no matter what part of the health care system someone interacts with, the experience of health care is emotional, which makes establishing trust even more important.
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From page 48... ...
The company's internal research estimates that transforming a low health literacy community to a higher literacy level would affect medical costs, including an estimated 10 percent drop in emergency department visits and 18 percent decrease in hospitalizations. As an example of the type of educational work his team does internally, he explained how UnitedHealthcare trains its pharmacy advisors who work with a Medicare population by putting them in real-life situations.
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From page 49... ...
Another component of that initiative improved adherence to treatment plans by offering clear directions in simple language both in direct conversation on the phone or in the service environment or via digital tools such as a mobile app or patient portal. These tools helped the company's advocates talk to members using plain language, not the benefit structure language that exists in some health industry documents.
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From page 50... ...
SOURCE: As presented by Chris Carlson at Building the Case for Health Literacy: A Workshop on November 15, 2017.
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From page 51... ...
Service agents have been trained in spoken word health literacy and changing the way they listen to and talk with consumers to provide positive, clear, personal, and compassionate messages. Introduction of financial literacy practices are helping consumers understand cost and benefit options, including proactive alerts and personalized videos, and the company now solicits communication preferences to help address personal situations, such as the need for documents in large print or in alternate languages.
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From page 52... ...
"That costs money," said Carlson. "Every time somebody calls us, it costs us $15 and it takes time out of the caller's day." Because of this incident, UnitedHealthcare has now instituted a health literacy control point and includes a plain language explanation via a cover letter, as well as a Web link to more information, that can help reduce member anxiety and increase understanding.
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From page 53... ...
Out of that meeting came the Partnership for Health Literacy in Arkansas, which became the health literacy section of the 3 This section is based on the presentation by Jennifer Dillaha, medical director for immuni zations and medical advisory for health literacy and communication, Arkansas Department of Health, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 54... ...
What the coalition discovered over time was that low health literacy is more than a literacy problem and that it cannot be solved with more health information. They also learned that individual patients are not the only ones with low health literacy -- the health care system, including the public health system, has a health literacy problem, too.
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From page 55... ...
Every objective related to each of these goals now includes a health literacy component, Dillaha explained. "This was made possible because we had support from the highest levels at the health department to make health literacy an important part of what we do," said Dillaha, echoing what Riffenburgh and Carlson said about the importance of having support from the highest levels of an organization.
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From page 56... ...
Sisters United, a program developed by the ADH's Office of Minority Health and Health Disparities and supported by the Region VI Southwest Regional Health Equity Council, is another successful infant mortality reduction program. Sisters United trains members of African American sororities to go into the communities and use health literacy
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From page 57... ...
Dillaha said she recognizes the ADH is not likely to get many additional resources to conduct health literacy activities, so efforts to improve health literacy must be implemented by using current resources differently. Perhaps the biggest challenge she has faced has been acquiring funding for staff with time dedicated to working on increasing health literacy capacity throughout the health department.
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From page 58... ...
His organization, for example, has spent the past 2 years focusing on net promoter score, a management tool that can be used to gauge the loyalty of a firm's customer relationships. In his opinion, measuring health literacy itself is missing the mark because that is not the direct issue that concerns most health system leaders. Michael Villaire from the Institute for Healthcare Advancement asked Riffenburgh how the health literacy leaders in "tunnel and teaspoon" organizations evaluated themselves and their activities to even maintain the little support they received from their health systems.
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From page 59... ...
In fact, her professional experience before starting her doctoral program was that she worked in an organization dominated by nurses, and since her health literacy initiative was in a different area, the nurses were not interested, and she could not get any traction for her program. Jennifer Pearce asked Carlson if UnitedHealthcare had plans to use health literacy interventions to bridge the divide between insurer and provider.
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From page 60... ...
She then recounted that three of the people she interviewed from "tunnel and teaspoon" organizations said their organizational leaders had each called health literacy "fluff." With leadership like that, it is not hard to see why people experience burnout, she added. Ruth Parker from the Emory University School of Medicine commented that using health literacy to drive retention as an outcome makes good sense, and she asked Carlson how the company sees health literacy relating to consumer health activation and engagement, which could also be used to build the case for health literacy.
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