HJAR Jul/Aug 2021

It seems we are underutilizing technology at our fingertips to solve this. Do you think patients videoing or recording segments of appointments, with prior consent, is the simplest answer for those with the ability to do so? Technology may be one way to support patient teaching, but it is not the only option and is certainly not always a simple decision that providers should make on their own. While many patients have smart devices and may have a desire to audio or video record your instructions, there are some things to consider. First, you would need (documented) consent from everyone in the room. Do not assume that other col- leagues in the room are comfortable being recorded. And even if you are the sole pro- vider in the room and are willing to consent, recording your conversation may not align with your organization’s policies. Some may prohibit any recording in exam rooms. Oth- ers may prohibit recording of the provision of care, which could include the delivery of patient education. With these consider- ations in mind, I would encourage you to explore and understand your organization’s policies before you hit the record button or allow your patients to do so. As an alternative, you can confirm under- standing using teach-back, and then send home written information and additional reference links the patient can review later. If your patient uses your patient portal, include the information there in addition to providing hard copies. How is the increase in telehealth affecting effective communication? Recent changes in telehealth policy have facilitated numerous opportunities to pro- vide continuity of care during a pandemic and likely to reach some patients who were not receiving adequate care even pre- pandemic. To ensure that new options to deliver care and education via telehealth help address health disparities rather than contribute to them, we must consider access and skills. I do cringe a bit when I hear someone say, “Everyone has a smart- phone.”While we are much closer to 100% than we were a year or more ago, the digi- tal divide still exists, and it affects the very groups I mentioned as having health literacy challenges. Just over half of older adults has a smartphone, and home broadband is less common among the elderly, certain racial and ethnic minorities, people in rural areas and people with lower incomes. My hope is that organizations consider multiple for- mats for the delivery of patient care and education in an effort to ensure we provide those resources to those who may need them most. In addition, outreach efforts could focus on helping community mem- bers access and use digital technologies that support health, including telehealth, use of patient portals and health-promoting apps. Local public libraries and adult education providers would make logical partners for such efforts. What do you see on the horizon for health literacy? As health systems strengthen their investment in strategies to improve indi- vidual and population-level outcomes and satisfaction while curtailing growth in costs, I have already observed increas- ing awareness of the role that clear health communication plays. Somany value-based reimbursement metrics are focused on individual patient behaviors (e.g., access- ing appropriate levels of care and complet- ing preventive exams and immunizations). While information alone cannot predict or ensure a specific behavior, it is often fun- damental. As an example, a patient with congestive heart failure must understand the risks for and signs of complications and must know the appropriate action to take if those problems do arise. Poor understand- ing of any of these concepts could result in an avoidable readmission that impacts the patient’s experience and outcomes as well as the hospital’s bottom line. In addition, the nation’s attention is increasingly fixed on disparities between different population groups in health outcomes and opportunities for health improvement. COVID-19 has illuminated these gaps, and healthcare and public health systems continue to take incredible steps toward addressing them. We cannot over- look that the same groups with increased risk for limited health literacy have suf- fered disproportionately from COVID-19. The same can be said for a host of other health issues, so I suspect (and hope!) that more emphasis will be placed on addressing health literacy as we continue the pursuit of health equity. n HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2021 19