The path to digital health literacy

That digital health could transform the way we care for people with long-term conditions is undeniable. Utilising that potential depends not just on providing the technology, but also the skills required to use it.

Health Literacy Month, which ran throughout October, promoted the importance of providing understandable health information. But what is sometimes overlooked is accessible health information.

It doesn’t matter how well an app or email-based patient support programme is written or presented — if the intended recipient leaves the phone in a drawer or the messages languishing in a dusty inbox, the programme will fail.

Health system savings

According to NHS England’s national medical director, the traditional model of outpatient care is no longer fit for purpose.

In the foreword to a Royal College of Physicians report that describes a healthcare system familiar across industrialised countries, Professor Stephen Powis called on the NHS to embrace digital health.

“The vast majority of patient interactions with secondary care are through outpatient clinics,” he said, adding that the various parts of the outpatient journey do not always deliver the “best experience”.

“The too-often uninformative appointment letters; the wait for the appointment; the journey, often at inconvenient times, which can be a major source of stress for older patients; the waiting around in clinic; and, in some cases, the repetition of the entire process when the referral was misplaced or a visit to another specialty is required.

“It’s hard to imagine there is no room for improvement,” Prof Powis wrote.

And then there’s the cost implications of this messy patient journey. At a time when health systems are experiencing ever higher costs, simple technology platforms can deliver huge, welcome savings.

One such example is a new NHS app, MyCare, which allows people to book outpatient appointments “at the touch of a button”, and instantly generates an appointment letter.

It is set to save just one hospital trust more than £1million in postage, stationery and admin in 2018/2019.  With the NHS spending around £150million a year on stamps alone, the possible savings are astronomical.

Age-related accessibility

Reducing the burden of treatment for people living with long-term conditions is a laudable aim and one the health and pharmaceutical sector is working to achieve through its use of technology. But we also need to consider the “end user”.

In the UK, 58 per cent of people aged 60 and over are living with at least one long-term condition compared to 14 per cent of those under 40. In the United States, 60 per cent of those aged over 65 had at least one chronic condition in 2012.

Older people, then, are among those who stand to gain the most from digital health initiatives such as MyCare.

Yet, figures show that 59 per cent of Americans aged between 65 and 69 have a smart phone, a figure that drops to just 17 per cent in the 80-plus age group.

Location-related accessibility

Another group who would stand to benefit from Skype clinics, telephone appointments and app-based symptom trackers are those who live in remote or rural areas. Long round trips for medical appointments can be expensive, time consuming and stressful.

As a report published by the United States Department of Agriculture last month stated, the benefits of telehealth may be “greater where remoteness and provider shortages can make accessing healthcare difficult”.

But the same report found rural residents were less likely to engage in “telehealth”, described as health services and activities conducted via the internet, than their urban counterparts.

Just seven per cent of rural residents engaged with online health maintenance programmes, compared to 11 per cent of urban residents. And whereas 2.5 per cent of those living in urban areas used online health monitoring platforms, this figure was just 1.3 per cent in rural areas.

Digital upskilling to utilise potential

Of course, these statistics relate to the general population, not just those with long-term conditions.

They do, however, highlight the need to ensure the often-expensive digital initiatives we are rolling out are accessible.

In the US, the Patient Empowerment Network runs the Digital Sherpa Program. It consists of a hands-on workshop, delivered by a volunteer, which shows people with cancer how to access available online resources.

The sessions are patient-led but might include explaining how and where to find health and disease information or how to connect with other patients.

It works. In feedback, nine out of 10 patients said they had learned about the internet and social media and 97 per cent said the workshop had been beneficial to them and their cancer journey.

This kind of upskilling is just one example of a simple and cost-effective way to ensure everyone, particularly those who stand to gain the most, reap the benefits of digital health.

Digital health literacy

Ultimately, if digital health initiatives are not accessible, it doesn’t matter how well intentioned or well put together they are, they will not be used.

And in a time of beyond-the-pill pharma activity, unusable digital health information isn’t worth the pixels its written on.