Health Literacy

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Addressing Health Literacy in Care Coordination Emily Fisher Access to Care Coordinator - Columbus Public Health


Objectives • Care coordination, patient engagement and health literacy • What are we working on? • What lessons have we learned? • How do we continue this work? • Shared Learning – Q&A – Group Discussion

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Question‌

Plain Language Policy?

Teach Back Training?

Do you or your organization take steps currently to promote or improve health literacy?

Universal Precautions?

Ask Me 3?

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Health Literacy and Care Coordination Care coordination: Organizing of patient care activities and sharing information to achieve safer and more effective care. Patient engagement: A patient's knowledge, skills, ability and willingness to manage their own health and care with interventions designed to increase activation and promote positive patient behavior. Health Literacy: The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.(1)

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Health Literacy Low health literacy is more prevalent among: – Older adults – Minority populations – Those with low socioeconomic status – Medically underserved Patients with low health literacy have difficulty: – Finding doctors and seeking preventive health care – Filling out health forms – Sharing their health history – Knowing the connection between risky behaviors and health – Managing chronic health issues – Understanding directions on medicine(2)

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What Gets In The Way of Care? What affects the ability to grasp and remember information? – Fear – Pain – Language – Culture – Stress – Medications City of Columbus • Columbus Public Health


Engagement and Literacy Enhancing patient-centered communication: – Plain language (verbal and written) – Confirming understanding (Teach Back) – Interpretation and translation

Results Greater patient satisfaction

Enabling shared decision-making: – Working together to make decisions – Selecting tests, treatments and care plans that balances risks/expected outcomes with patient preferences and values. – Clinicians and patients sharing the best available evidence when making decisions.(3)

Adherence to treatment plan Increased health literacy Improved health outcomes

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Why Do We Focus on Health Literacy?

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What have we learned?


The Cycle… Care Coordination

I understand the information and can act on it.

Health Literacy

My needs are being met and I’m connected.

Patient Engagement

I have a say and I’m being heard.

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The Layers‌

Patients and Consumers

Providers

Organizations

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Patients and Consumers Health Health Literacy Literacy Cultural & Conceptual Knowledge

Listening

Oral Literacy

Speaking

Reading

Writing

Numeracy

Print Literacy

4: Health Literacy – Cliff Coleman, MD - Evidence Based Best Practices, Oregon Health & Science University

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Providers

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Clear Communication

---5 IOM Crossing the Quality Chasm, 2001

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Organizations

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Local Improvements


The Landscape

Statewide collaborative of caregivers and health professionals working together to improve health communication between those seeking health care and those providing it.

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Local Coalition Work

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Local Assessments

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Internal Improvements • • • • • • • •

Phone systems Signage Paperwork Policies Staff Training QI Projects Cross-Departmental Collaboration Streamline referrals City of Columbus • Columbus Public Health


Recent Outreach Initiatives

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What Barriers Exist? • Limited funding, capacity • Competing demand • Lack of awareness for Universal Precautions • Federal and state changes to health coverage/care • Leadership and staff buy-in City of Columbus • Columbus Public Health


Future Efforts • Health literacy in ESL • Education: – Transportation – ACA and Medicaid – Coverage to Care – Prescription 101 – Local Health Issues

• Staff Training City of Columbus • Columbus Public Health


Shared Learning and Discussion


Shared Discussion • What role do you think health literacy plays in care coordination? • What challenges do you think exist for health literacy in care coordination? • How can you incorporate health literacy into your work to improve care coordination? City of Columbus • Columbus Public Health


Thank you!

Emily Fisher – Access to Care eefisher@columbus.gov 614-645-1244


References 1. 2. 3. 4. 5.

6.

https://health.gov/communication/literacy/ https://www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/index.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006571/ https://www.legacyhealth.org/~/ media/Files/PDF/Conference%20materials/Health%20Literacy%202016/Coleman.pdf http://www.nationalacademies.org/hmd/~/ media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%2 02001%20%20report%20brief.pdf www.ohiohealthliteracy.org

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