Many Canadians have low health literacy and may not understand the link between health information and how it informs their care choices: more than 60% of Canadians and 88% of seniors are estimated to have less than adequate health literacy skills (for example, not understanding the link between smoking and certain cancers). Canadians also lack health technology literacy – the awareness of available new technologies that can help them make appropriate health decisions by offering greater access to their own health data and additional services.
Why is this important?
Awareness needs to increase in the Digital Health community. We need to anticipate how patients’ low health literacy will need to be considered in the design and implementation of digital health tools, and in the liberation of their data. We will need to understand and present data in better ways to patients to help increase their literacy and understanding. “Data dumping” (quantity and technology) does not equal “patient access to data” (user experience and improved outcomes).
Low health literacy means poorer health – and greater costs to health care systems. Canada is a geographically large country with an aging population and diverse health needs. We cannot afford a health literacy gap that enables higher rates of chronic illness or longer wait times than necessary for faster treatment. Nor can we afford poor health technology literacy that prevents people from taking advantage of new patient tools and innovations across Canada like virtual visits with a doctor or faster electronic consults with a specialist.
Beyond the smart watch: more education and more access
Canadians are keen to use new consumer technologies to help them adopt better lifestyles. This is a great first step. The time is right to make Canadians aware of emerging and evolving health apps, consumer information and virtual technologies, but which ones?
Awareness starts by building a dialogue with care providers before using any technology and avoiding any that may be passing fads. Reputable education about where technology can help and where it can hinder is important.
People move from awareness to knowledge and developing skills by first understanding the benefits of health literacy, the “what’s in it for me?”. Technology can help patients move from understanding these benefits to the next stage of taking action, the “now what
do I need to do about it?” Action unleashes the true benefits of technology-supported health literacy. It can remove barriers to change. It can harness artificial intelligence. It can incorporate learning adaptive technology with the potential to nudge human behaviour.
The power of data, and how to get more of it into the hands of Canadians so they can make informed choices
Technology empowers people to become partners in their own health and when they see improvements totheir health informed by their data, their belief systems change based on their growing health literacy. Our data starts with the information we collect in our smartphones and fitness trackers and expands to include the images, notes, and clinical documents existing in a myriad of systems scattered across the health space. But data needs context, and must be curated for understanding, sifted for consumption, and interpreted so that it makes sense. Artificial intelligence and machine learning tools will soon make this easier, but patients today still need advice from a trusted health practitioner who can interpret and contextualize.
Clinicians understand that data generates information; that information fuels knowledge and insight; and that insight is the key to better care decisions. The bottom line? 99.99% of the time, we are responsible for our own care. Data gives us knowledge and helps us make better choices. With better choices we can change disease behaviours, self-actualize and activate.
Access to health data is key to improving health literacy, and new technologies are needed to make that possible. There is still much to do in order to facilitate access to health data for Canadians. Data liberation is the present call to action for the digital healthcare community.
So, what do we do now?
Digital tools are available to enhance care, from smart watches to interactive websites. Often these are adopted, but then used inconsistently. They do not always lead to an improvement in literacy or a change in health. Their impact is not always measured. They are not all well-designed and are often sales-driven instead of driven by people’s health needs. This must change. Creative co-design (with the patients who use the tools) and measurement of outcomes must be built into new health technology, along with consistency and standardization supported by communities of practice and knowledge.
As tools evolve to become health- related instead of disease-related, they can grow to support learning and skills development, consider cultural competencies in design (i.e. comic books for diabetes management for children and storytelling verbal learning in aboriginal communities), and include a plan for scale and spread.
The world is increasingly leveraging virtual care tools and we have been slow to adopt this in medicine, despite the positive effect that access to modern communication technology can have on health literacy. We are just scratching the surface with viewing online tests results, communicating with care providers through emails, and video consultations. Using these tools contributes even more data, the natural extension of which is the power to be found in socializing and sharing this knowledge. Socially shared medical insight is bringing the collective voice to individuals and we grow smarter together. Witness the impact of platforms like PatientsLikeMe.com, where patients learn positively from one another using shared information, interpretation, and insights to improve their health.
While we have made great strides in Canada around increasing access to information and care through digital health technologies, and have no doubt helped build health literacy, we have more to do, both as patients and as providers. Clinicians and health tech implementers should maintain a relentless focus on getting information and insight into the hands of patients. We must always ask ourselves: Is health information technology helping or hindering? Patients need to build awareness of new self-management technologies and virtual tools that grant better, faster access to care and to their own health data. Our next jump in literacy starts there.