To Put “Care” into Healthcare
Part 1
As of today there are 1047 articles on the coronavirus on Wikipedia alone. On top of that there are thousands upon thousands of questions, websites, documentaries and videos on the coronavirus. There is no dearth of resources when it comes to the literature engulfing COVID-19. Actually there is no dearth of resources when it comes the literature surrounding almost any ailment. The problem is we don’t know how many of these resources are accurate or precise. The problem is that we don’t have the knowledge to differentiate between hoax and health.
What is the problem?
The problem isn’t the lack of communication — in fact there are videos, literature, scientific studies, and articles. In the era of mass communication, the problem lies in miscommunication. This problem isn’t novel; the lack of proper medical information has been a common theme in modern medicine. This has consequently led to lower health literacy rates. Health literacy refers to an individuals ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. That is the official definition, but in reality there is no set definition on health literacy. Allow me to elaborate.
In the era of mass communication, the problem lies in miscommunication.
Why is Health Literacy a Problem?
There is no government based health policy surrounding any metrics related to health literacy. This means there are no defined guidelines around what it means to be able to read and understand; the reading level threshold has not been identified. This is an obvious issue, one that is more prominent in this current climate. Statistics show that the inability to understand medical information is associated with higher morbidity levels at the individual and societal level. Poorer health literacy contributes to poorer health, which impacts an individual’s health more than an individual’s socioeconomic background, age, background, or ethnicity. These factors are known as the social determinants of health. The less educated people are, the more likely they are to get ill, in fact an individual with poor health literacy is two times more likely to die from an illness. But what does that mean for the health care system? It means unnecessary costs.
The less educated you are, the more likely you are to die.
When people don’t know why they are sick and what they are sick from, they are more likely to go the emergency room. If you have ever been to the emergency room in any hospital you must be familiar with families entering emergency rooms for the common cold or flu. The key word here is “common.” There are many “common” issues and ailments that people go the emergency room for, costing them on average 16.3 hours in the waiting room, and costing the government 18 billion dollars.
It’s not the flu that costs our systems 18 billion dollars; it’s poor health literacy. There are a lack of resources that are easy to navigate and comprehend which have cost people time, money, illnesses, and trust in the healthcare system.
Most health professionals usually communicate health information with their patients. Communication with patients is important, but comprehension is far more necessary for communication to be effective. Health care professionals are meant to provide care, and care should extend beyond a stethoscope and a prescription. Health literacy should be an active and exercised component of healthcare because it is this “common” knowledge that will help a patient make the right choices that extend beyond a hospital. Again, allow me to elaborate.
As a science student I have the knowledge to understand what bronchitis means, to the common public this is less than common knowledge. The term “itis” refers to inflammation. The term “bronchiole” refers to a tube that connects your throat to your lungs, where gas exchange can occur. Bronchitis is the inflammation of the lining in the bronchiole tubes. You can imagine how difficult it can be to breathe with bronchitis; the lining is inflamed so gas exchange cannot occur as easily. Now you, the reader knows that “itis” means inflammation. You can easily carry forward this information to another medical term, such as colitis — “itis” means inflammation and “col” is colon, translating to “inflammation of the colon.” I have not only explained what bronchitis, I have given you the power to take this knowledge home. Information like this provides a patient with the proper understanding of their body, and I think that’s quite necessary.
How do we solve this problem?
Health literacy can be broken down into three levels, the individual level- understanding your own health, the professional level — health care professionals explaining health information, and at the system level — increasing signage and educational material at a systematic level. Professionals hold the most amount of medical knowledge, but what use is knowledge that cannot be distributed? As Einstein once said, “if you can’t explain it simply, you don’t know it well enough.” We know that our health care professionals know “it” well enough, so perhaps we should know focus on the explaining part. This is as important as knowing the information, studies show that out of 197 serious medical safety issues, 127 has root causes in failure to communicate and 26 had root causes in patient education. So how do we solve this?
If you can’t explain it simply, you don’t know it well enough.” — Albert Einstein
A Few Recommendations
Well, one recommendation would be the tried and tested teach back technique. The teach back technique is one of the best learning methods. Here is how it works. Once the health care professional explains the patient’s condition, the patient explains it back. Simple. The health care professional can recognize whether the patient actually understands their ailment and if there are any gaps in their learning.
The next recommendation would be modifying the written information. We know that many times a patient’s visits don’t stop at their family physicians clinic; rather there are many patients that travel from one physician to another, and from one specialist to another. What remains constant between these physicians is paperwork. So it is blatantly obvious that the written component also needs modification. The suggestion here is to provide two pieces of paperwork, one that explains the medical terminology to another healthcare professional, this already exists in our system. The second paper should explain the medical terminology to the patient. This encourages better delivery of information between not only patients and physicians, but family caregivers as well — another constant between physicians and patients.
By communicating and ensuring comprehension, medical professionals can get a further insight into their patient’s understandings, which can help to collect data and develop signage for patients.
What does this all mean?
Like most sectors, healthcare is also in need of data. Data can allow systems to implement change or remove programs that are ineffective, all creating a more cost effective system and quality based system. The main recommendation here is to define health literacy. What does comprehension really mean; how do we determine which language to use? By understanding the general public’s personal reading and writing levels, the Ministry of Health or institutions can develop signage’s or posters that speak to the general public.
The main recommendation is to define the health literacy
Of course this list of recommendations aren’t conclusive, or limited and nor do they tackle the problem of health literacy fully. But I think it is important to aim for healthcare that is both informative and comprehendible. Care should not be limited to the four walls of a hospital. Care is about the kind of response one provides to another. To put care into healthcare means to provide an education. It means to help individuals look for signs and symptoms that are high risk versus low risk. It means to make “common” knowledge more common so less people end up in emergency rooms. It means to take an active part in preventative health rather than responsive health. It means to give people the right to know about their body’s. It means to create a more holistic, transparent and engaging relation between the patient, the professional, and the healthcare system. It means to provide care well beyond a stethoscope and a prescription.
To put “care” into healthcare means to provide an effective education.
