residents
TRANSCRIPT
Andrea KenyonDirector of Public Health and Community OutreachDirector, PhillyHealthInfo.org
Introduction to Patient Health Information Resources
St. Francis Hospital, Family Practice Residency
December 17, 2009
This project has been funded in whole or part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No 05-0684”
Located: 19 South 22nd Street, Center CityOnline: www.collegeofphysicians.org
• Founded in 1787• Non profit cultural and educational organization• Mission: Advancing the cause of health while
upholding the ideals and heritage of medicine.
Programs:• Improving the health of the public through
PhillyHealthInfo.org• Historical Medical Library• Mütter Museum• Lectures, symposia
PhillyHealthInfo.org Project Goals2. Empower citizens of the Philadelphia region to make better
informed health decisions and to raise awareness of the health issues most affecting this region.
2. By providing access, via the web, to credible heath information and relevant health resources within the Philadelphia region, PHI enables individuals, families and communities to take greater responsibility for their health.
ObjectivesAt the end of this session you will be able to:
Demonstrate a basic understanding of health literacy and its importance in patient decision making regarding their health
Understand the health information characteristics of patients
Appreciate the important role the Internet can play in educating and empowering individuals to take charge of their health
Identify and use consumer focused resources offered by the National Library of Medicine
Help patients use the Internet as a health resource
Health literacy is the degree to which individuals have the capacity to obtain, process,
and understand basic information and services
needed to make appropriate health decisions.
Source: Healthy People 2010
IOM Report 2004
AMA Report 2007
Joint Commission Report 2007
2003 NAAL:Percentage of Adults in Each Literacy Level
Source: National Center for Education Statistics, Institute for Education Sciences
The Bottom Line
• Only 12% of adults have Proficient health literacy.
• 36% of adults (77 million people) have Below Basic or Basic health literacy.
So what?
Poor health literacy affects people’s ability to:
• Navigate
• Share
• Engage
• Adopt
• Act
• Poorer health knowledge• Poorer health status• More hospitalizations and readmissions• Higher health care costs• Quality of care threatened
The Impact of Low Literacy on Health
Who is at risk?
• Older
• Poor
• Education level
• Minorities
• LEP
You Can’t Tell by Looking….
“People of all literacy levels can have low health literacy.” - Ask Me 3™
Don’t Ask…Don’t Tell
Common Clues of Low Literacy
• Asking staff for help• Making excuses• Noncompliance with
medication, etc.• Postponing decision making• Watching others • Medication review is
problematic
What we have here is a failure to communicate
Checklist for Patient Understanding
At the end of each office visit, a patientshould be able to answer these questions:
What health problems do I have & what should I do about them?
Where do I go for tests, medicines & appointments?
How should I take my medicine?
Other instructions
Next steps
All patients (regardless of literacy level)
prefer easier to read materials
Health Literacy Resources
http://www.healthliteracynow.org/
http://www.clearhealthcommunication.com
http://www.hrsa.gov/healthliteracy/training.htm
http://www.nlm.nih.gov/medlineplus/healthliteracy.html
http://www.npsf.org/askme3/
http://www.ahrq.gov/qual/pillcard/pillcard.htm
http://www.ahrq.gov/questionsaretheanswer
Before 1972- PaternalismDoctors told patients what they wanted patients to know and what they wanted them to do
1972 AHA Patient Bill of Rights“The patient has the right and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information about his or her diagnosis, treatment, and prognosis.”
Doctors are part of the team - and so is the patient
Patient is asked to make decisions about their own health care process
Where do patients get the tools to make these decisions?
Health InformationSeeking Trends
60% of American Internet users have searched for health information on the Internet
53% of people with chronic conditions have searched for health information on the Internet
42% of all adults say they or someone they know has been helped by health information found on the internet.
3% say they or someone they know has been harmed by health information found on the internet.
Source: Pew Internet & American Life Project Online Health Search November 16, 2009
The “Google Doctor’s Office” is never closedIncreasingly expect to have access to information 24/766% of health searches start at a search engine½ search for someone other than themselvesWomen more likely to conduct health searches than men
Today’s E-patient52% of internet users watch videos online59% consulted blog comments, doctor reviews or podcasts20% use social network sites20% posted comments, reviews, photos, audio or video
ChallengesOnly 25% check the source and date of online health information “always” or “most of the time”
Reality: 75% (85 million Americans) check the source and date “only sometimes,” “hardly ever,” or “never” !!!
Overwhelmed by information and choices
Lack of evaluation skills
Either they trust information found on the Internet too much or not at all
Digital and Technological Divides remain
Age Related Characteristics
Teens• A different “digital divide” • No critical thinking• Accept information w/o regard for authority• Rank graphics over authority of the site
Baby Boomers• Health seeking online – they rank on top• Have children and serve as caregivers for aging parents• They don’t know they are old!!
Seniors• Multiple conditions• Many medications• Cognitive, cision and hearing changes• Those who are computer savvy go online regularly and 66% seek health information
Top health searches via Search Engines 2009
AOL#1????LupusDiabetesPregnancyDepression
Google#1HeartWeb MdWalgreensHerpes
“ On the Internet, nobody knows you’re a dog . . .”
Doctor E-Patient Relationship
Survey of 1,050 U.S. physicians showed that physicians welcomed patients who brought accurate, relevant online information to their appointments and felt it was beneficial to their health outcomes.
Conversely - physicians felt that when patients brought in inaccurate information it harmed the quality of care and the physician-patient relationship.
Source: J Medical Internet Research 2003 5(3):e17 E. Murray et al
Do you think that physicians comply with a patient request to do an inappropriate clinical intervention based on inaccurate online information to avoid jeopardizing patient satisfaction and the doctor-patient relationship?
National Library of MedicineDedicated to serving the health information needs of librarians, health care professionals, educators and consumers throughout the United States.
National Network of Libraries of Medicine (NN/LM) Network of 5,000+ medical libraries, public libraries, academic and special libraries, clinics, public health departments and community and faith based organizations.
MedlinePlus - http://medlineplus.gov
ClinicalTrials.gov - http://clinicaltrials.gov/
AIDSinfo - http://www.aidsinfo.nih.gov/
Dietary Supplements Labels Database - http://dietarysupplements.nlm.nih.gov/
Tox Town - http://toxtown.nlm.nih.gov/
Household Products Database - http://householdproducts.nlm.nih.gov/
Haz-Map - http://hazmap.nlm.nih.gov/
Genetics Home Reference - http://ghr.nlm.nih.gov/
PhillyHealthInfo.org - http://phillyhealthinfo.org/
Go Local Delaware - http://medlineplus.gov/delaware
Thank you to:
Barbara J. Henry, MLS, AHIP Community Health LibrarianWilmington HospitalMedical & Community Health Libraries
Contacts:
Andrea KenyonProject Director, [email protected] x 237
Jon GoffWebsite Manager, [email protected] x 221