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Are We Asking the Right Questions?

Experts weigh in on why patients don't always get the right care – and what we can do about it
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We’ve all been there. Sitting in a cold exam room, tense and nervous, perhaps embarrassed in one of those awkward gowns. Not understanding what the doctor is saying—or even knowing what to ask.

Not knowing how to make informed healthcare choices can take a toll—physical, financial, emotional—even professional.

And the numbers don’t lie. Compared to people with higher health literacy, patients with low health literacy have:

  • 40% higher risk of going to the ER
  • 55% higher risk of hospitalization from asthma
  • 3 times more heart failure hospitalizations
  • 3 times higher odds of needing to go back to the hospital in patients over age 64
  • Higher risk of early death from heart failure and other causes
  • Low health literacy costs the US up to $238 billion a year.

In our 2016 webinar, “Why Health Literacy Matters to Your Business,” leading experts Cynthia Baur, PhD, Endowed Professor and Director of the University of Maryland’s Horowitz Center for Health Literacy, and Dr. Russell Rothman, MD, MPP, Director of the Center for Health Services Research at Vanderbilt University, discussed with EdLogics moderator and population health expert Fred Goldstein how, by focusing on statistics, we may be missing the bigger picture.

Here’s just a small part of what they had to say:

Looking at the wrong problem

Fred Goldstein: Given all of the statistics, what are some of the key reasons patients with lower health literacy experience poorer health and require more care?

Dr. Baur: One of the things I like people to think about is even the framing of that question. Because you are right about the data that’s been collected on people’s experiences and outcomes with getting healthcare services. But that approach of looking at people’s health literacy levels and the use of emergency services and what-not—many times, that approach puts the blame on them. Because it makes them seem like they’re doing things that are inappropriate or costing the system or themselves more money.

Systems on top of systems

Dr. Baur: The reality is that we live in a very complex set of health systems. There are multiple healthcare systems. There’s the public health system. There’s the educational system which influences people’s knowledge and skills about health. So all of those different systems are part of that larger environment in which people are trying to get information and services. …

Health literacy has really been an issue that’s been out there for a while. The data have been accumulating about these costs. We’re at a point where people are taking a step back and saying, if you want patient-centered or person-centered health and healthcare, you really have to look at what people’s experiences with these systems are. You have to look at the challenges they face and the demands being placed on them to try to get information and services. And that will lead us toward looking at organizational practices, system redesign, and ways that will make it easier for people to get what they need.

Lost in the maze

Dr. Rothman: Poor health literacy is a common problem. We know that over 90 million Americans have basic or below basic skills and over 110 million have only basic or below basic quantitative skills, which can make it very challenging in our very numbers-focused healthcare environment.

Even people with good health literacy skills can now struggle to navigate what’s become a very complex healthcare system. Trying to figure out how to take their medicines, how to follow a good diet, how to follow up specific recommendations from providers—even just navigating

where to go in the hospital, or how to get to appointments, or how to navigate insurance—it’s all become very complex. The amount of time patients have to interact with their doctors or other clinicians whether it’s at a clinic or even in the hospital—it’s very short.

The bottom line

Dr. Rothman: There are real opportunities for us to improve how we provide health information to patients and families to help them to improve their health.

Watch the entire webinar for more from other experts, including  former US Health and Human Services Secretary, Governor Tommy Thompson

The information and opinions attributed to Drs. Baur and Rothman are their opinions only and do not necessarily represent the views of their affiliated organizations, including the University of Maryland, Centers for Disease Control and Prevention, and Vanderbilt University Medical Center.

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Thomas M. Chamberlain, PharmD, is Founder and CEO of EdLogics, an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government entities...read more

Win-Win: How Healthcare Gamification Helps Companies and Employees

Playing to learn is one path toward improved health literacy—and lower healthcare costs.
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In 2012, Tom Chamberlain, PharmD, founded EdLogics, our gamified health education platform. Recently he shared how he first got the idea from working with patients, and the results so far.

Let’s start with your background. You began your career as a pharmacist, right?

Right. As a PharmD and an entrepreneur, I’ve been involved in starting and growing a number of companies, all of them focused on healthcare education and improving the utilization of healthcare services. My primary objective has always been to improve clinical outcomes and reduce healthcare costs for consumers and payors of healthcare services.

And how did you get the idea for EdLogics?

I was fortunate to have had the opportunity to manage my own patients during my doctor of pharmacy program and residency training. Having firsthand experience treating patients with chronic conditions like diabetes, high blood pressure, and COPD, I knew the challenges of educating and engaging patients in the self-management of their conditions. Traditional educational strategies such as pamphlets and printouts weren’t effective in teaching patients what they needed to know to improve their conditions.

For people with diabetes, testing blood sugar is a routine part of managing their condition. If you’re injecting insulin or using a pump, you may have to test several times a day. Without accurate blood sugar tests, you might not get the right amount of insulin at the right times.

If you can’t measure your blood sugar, you can’t control it. And if you can’t control your blood sugar, you raise your risk of amputations, heart attacks, blindness, erectile dysfunction, and many other problems. One immediate risk is diabetic ketoacidosis, which comes on quickly and can be fatal. Even if you survive, your ER trip will cost thousands of dollars. And it all can be avoided with appropriate education.

Many patients seem to understand how to check their blood sugar once someone shows them. But it was clear to me that most of my patients had forgotten what they’d learned by their next visit. They still weren’t retaining the information needed to manage their diabetes.

This happened over and over again – and similar scenarios occurred with a number of patients with various chronic conditions. I realized we’d never be able to help our patients if we couldn’t find a better way to teach them what to do.

Is that where health literacy comes in?

Yes, but a lot of people aren’t familiar with the term. Here’s one definition:

“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.”

Or to put it more simply:

“Health literacy means you can find and understand the information you need to make good decisions about your health.”

Low health literacy is now recognized as a critical barrier to effective and efficient healthcare. It’s an enormous problem, and the consequences are far-reaching. For instance, did you know that compared to patients with adequate health literacy, patients with low health literacy have:

  • 40% higher risk of going to the emergency room
  • 55% higher risk of hospitalization from asthma
  • 3 times more heart failure hospitalizations
  • and 3 times greater odds of 30-day readmission for patients over age 64

In fact, the cost of low health literacy in the US is somewhere between $106 billion and $238 billion per year. It’s unreal!

If we want to improve health outcomes and lower healthcare costs, we need a way to reach consumers – a way that works for them long term.

So how does EdLogics help?

Since I started working in the healthcare industry, the concept of health literacy has matured into an academic discipline. Institutions like Vanderbilt University have devoted teams of talented experts and researchers—like Russell Rothman, MD, MPP, arguably one of the top health literacy experts in the world—to help healthcare providers, employers, payors, and the public understand the implications of low health literacy—and develop effective solutions to address this major healthcare issue.

At EdLogics, we’ve teamed up with many leading academic medical centers and Centers of Excellence (CoE), as well as industry thought leaders like Dr. Rothman and former US Secretary of Health and Human Services Governor Tommy Thompson, to identify specific ways to improve health literacy.

The first step is to make learning fun and engaging. To do this, we employ and work with experienced clinicians, developers, designers, and gamification experts to create stimulating, engaging games that educate users on important health topics, from diabetes to the Zika virus, all developed with the low health literate user in mind.

To keep users coming back, we’ve developed innovative gamification and unique incentive strategies where users earn rewards by playing games and completing educational activities.

Employers can purchase a customized version of the platform, enabling employees and their families to play, learn, and win. And the cost is minimal: roughly $20 a year per family.

What have you seen so far?

I’m very proud of our platform. It’s a product that educates consumers about chronic diseases, common medical conditions, general health, well-being, medications, and how to navigate the healthcare system. We’ve heard inspiring testimonials from employers and employees, and we have impressive statistics on knowledge improvement and consumer engagement. In fact, 100% of users improve their knowledge of a given condition after completing our learning activities, and 79% of users say they will change their behavior based on what they learned.

We’re continuously making enhancements, all with a focus on improving consumer engagement. That’s the key to being able to influence positive behavior change and deliver the most important, lifesaving knowledge. Not to mention the opportunity to reduce pain and suffering – both physical and financial.

Bookmark this blog and follow us on LinkedIn and Twitter. We’ll be publishing posts on the crisis of low health literacy and how to help address it. Want to learn more? Request a demo of the EdLogics platform.

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Subscribe now. Know when we publish our latest articles on health literacy, gamification, and healthcare.

Thomas M. Chamberlain, PharmD, is Founder and CEO of EdLogics, an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government entities...read more