The Difference Between Patient Education and Health Literacy

June 13, 2017 - Patient education and health literacy are two key concepts in patient engagement and chronic care management. Healthcare experts strive to improve patient health knowledge, asserting that knowledgeable patients are more engaged in shared decision-making and self-management.

Because patient education and health literacy are so closely related, their overlapping definitions begin to blend together. In reality, patient education and health literacy are two separate sides of the same coin and require a thorough understanding from clinicians.

Healthcare professionals must understand the differences between the two and the ways in which these two concepts relate to fully deliver meaningful patient education that drives health literacy.

Using patient education to drive patient care

Patient education is the practice of informing patients about their health, wellness, treatment plans, potential outcomes, and other information critical to the patient experience.

The goal of patient education is to instill a sense of autonomy in the patient and to equip her with the knowledge necessary to make her own healthcare decisions.

As a result, healthcare experts have hailed patient education as a critical aspect of shared decision-making and chronic care management.

Patients who fully understand their current wellness levels, their treatment options, and the potential consequences of each treatment option are well-prepared to offer input into how to carry onward with their care, said Peter Goldbach, MD, in a past interview with PatientEngagementHIT.com.

“Sometimes what gets lost is the fact that the patient you’re working with may not really understand their condition,” said Goldbach, who is Chief Medical Officer of patient education company Health Dialog. “It’s very confusing to be a patient and it takes the provider a while to arrive at a diagnosis. But eventually providers need to share that diagnosis with the patient, let them understand it, and have a chance to let it sink in.”

Research shows that patient education efforts can help increase the occurrence of shared decision-making. One tool from the University of California San Francisco (UCSF), called PREPARE For Your Care, explained complicated health concepts in plain language. This increased the frequency of shared decision-making by 35 percent.

Healthcare professionals must determine the best patient education strategies for their specific populations. Many industry experts laud the patient teach back method during which providers explain a concept to patients and ask patients to explain the concept in return.

If patients can successfully and clearly communicate a piece of information using their own words, providers can conclude that patients understand the concept. Patients who repeat information in their own words tend to absorb information faster than patients who just listen.

Other healthcare professionals rely on patient data access to help improve patient education. A recent OpenNotes study showed that patients who can view clinician notes and offer feedback can better participate in their own health. OpenNotes also helped improve patient safety.

Clinicians can also tap into external resources to help deliver patient education. According to MedlinePlus, a part of the National Institute of Health and National Library of Medicine, healthcare professionals can use pamphlets, printouts, videos, models, props, podcasts, charts, or peer groups to improve patient education.

Providers should employ each tactic based upon a patient’s personal preferences.

Patient education helps improve health literacy

The CDC defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.”

In essence, health literacy is the end goal to strong patient education. Providers who successfully educate their patients will help patients better understand their own health, allowing patients to interact with the healthcare industry in the following ways:

• Find information and services
• Communicate their needs and preferences and respond to information and services
• Process the meaning and usefulness of the information and services
• Understand the choices, consequences and context of the information and services
• Decide which information and services match their needs and preferences so they can act

Digital health literacy is closely related to health literacy and refers to a patient’s ability to use health technology to interact with their own health and the healthcare system at large. Digital health literacy may impact a patient’s ability to obtain and use the patient portal and EHR, for example.

Healthcare professionals have yet to develop a gold standard for assessing patient health literacy levels, although the need is increasingly pressing. As healthcare becomes more patient-centered, providers will need to know how much education patients need to fully empower and engage patients.

Some industry experts have developed upcoming patient health literacy assessments. University at Albany researcher Jennifer Manganello, PhD, MPH, has created one tool that can assess teen health literacy in under 30 seconds.

Patients view a list of 10 health-related words in 30 seconds and read them out loud. Clinicians assign a score based on how the patient pronounced the word, according to Manganello, who is also an associate professor in the Health Policy, Management & Behavior department at the University at Albany.

“Although this tool does not fully measure all concepts related to health literacy, such as getting health information and thinking critically about it, it does provide a simple way to identify those teens who may require more support to understand health information,” Manganello explained.

Research published in the Journal of Medical Internet Research suggested that patients who use the internet more frequently also have higher health literacy. The research team recommended that clinicians ask patients about their internet usage to help predict their patient education needs.

A separate study also published in JMIR indicated that patients who manage a chronic condition, have more experience with the healthcare industry, and who have higher educational attainment tend to have higher health literacy.

However, clinicians should note that chronic care management patients likely accumulate this health literacy through years of industry involvement and patient education from their providers.

It’s not likely there will ever be a one-size-fits-all guide to identifying a patient with high health literacy. As a result, clinicians must integrate strong patient education strategies into all of their patient engagement efforts.

Healthcare providers can improve patient activation and ultimately drive person-centered care by offering all patients the chance to improve their health literacy.