Warning signs that suggest that health information may not be trustworthy are if:
- You cannot identify the author(s) or who is contributing to the page;
- There is a potential conflict of interest, such as selling a treatment;
- Information appears one sided or biased;
- Site information has not been reviewed or updated in the past year;
- The site claims 100% satisfaction and uses the word “cure” or “miracle”;
- No evidence is cited, and proof is based on testimonials; and
- Words are misspelled, grammar is poor, or “Something doesn’t seem right.”
Health Literacy Level
A provider’s assessment of a patient’s health literacy level, including demographic characteristics, knowledge of their condition and information management skills, is integral to assisting in e-health utilization.
In Title V of the Patient Protection and Affordable Care Act of 2010, health literacy is defined as “the degree to which an individual has the capacity to obtain, communicate, process and understand health information and services in order to make appropriate health decisions.” A common misconception is that health literacy is determined only by a person’s educational level and their ability to read. Health literacy is multidimensional and includes other factors, including age, gender, cultural and language barriers, illness and physical and mental limitations. In addition, health literacy encompasses the communication between the patient and all of the members of the healthcare system, including physicians and other health professionals, hospitals, insurers and pharmacies.
If learning ability is compromised, individuals may not be able to participate in shared decision making in disease management and wellness. For example, persons with limited health literacy are more likely to report their health as poor, have higher hospital admission rates, have a lesser quality of life and have earlier mortality. The report, The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy, indicates that only 12% of adults had the skills needed to effectively manage their health and prevent disease. A recent literature review indicated that major literacy issues in healthcare are ongoing.
Examples of patient behaviors that may indicate a literacy problem are:
- When asked to complete forms (either paper or using an electronic device), the information is incomplete or incorrectly answered. Patients may explain this by saying, “I forgot my glasses.”
- Individuals may demonstrate non-adherence to medication instructions or be unable to identify a medication’s name or purpose. They may use color or shape to identify medications.
- A person may frequently miss or cancel appointments. This may be related to a lack of their understanding about where to go, and appointment times and dates may not be clear to them if an electronic messaging system is used.
- Patients may react with anger or frustration when asked to do a management task they don’t understand.
- Care activities may be relegated to others with a common reply being, “My wife [friend, etc.] usually takes care of __________ [fill in any number of items here].”
By considering health literacy, clinicians can best understand and support patients by choosing the appropriate medical language to communicate with them. Staff can assist in e-health utilization, incorporate literacy principles in care activities and address office and visit procedures, including form completion, appointment reminders and transportation.