I just learned that October is Health Literacy Month, via an article entitled “Hospital discharge summaries are a health literacy issue” (a guest post by another physician) published on the KevinMD.com blog.
(Background: this article had originally been posted on another blog called Engaging the Patient, sponsored by Emmi Solutions, a healthcare communications firm which is promoting Health Literacy Month.)
The first paragraph described a patient as being a very elderly Filipino woman, and the article went on to explain how she had suffered some serious adverse effects because there was a problem with how her Rx medicines had been prescribed. Turned out that two of her meds had been combined into a single pill, a fact that was not apparent from the patient’s medication list.
But I was left wondering why the patient’s ethnicity was mentioned at all, since there was no discussion of any relevance to her health issues nor about if she had limited English skills, which also does not automatically track with ethnicity. So I was surprised to read the following conclusion to the case study:
My hope is that this case illustrates the ways in which we might address health literacy issues using fail-proof systems-based approaches, rather than narrowly focusing our efforts on how we can build our patients’ capacity to interact with the health care system. Yes, teaching this patient to be a more fluent reader and to understand her prescription labels would have been ideal.
And we should have taught her to be more engaged and given her a phone number that she could call post-hospitalization to reach a Tagalog-speaking provider with questions about her discharge instructions or medications. But while we are working on engaging her with her care and teaching her to read prescription labels and providing enhanced communication support, let’s do what we can to “fix” the health literacy problem without involving Ms. Reyes at all.
Somehow the author made a non sequitur jump to depict the patient as Limited English Proficient (LEP), but never once spoke of utilizing the services of an interpreter at the hospital or if any instructions had been translated for the patient. It was likewise not mentioned that a pharmacist could have played an important role in the case. Seemingly this young physician knew nothing of the duties of the hospital to ensure communication between providers and patients, and is disseminating this scenario as typical.
So a response was in order. I’m happy to say that my comments on the article were accepted for posting, and hope they will help make a dent.
My message for Health Literacy Month is that we need to seize the teachable moments.