Can Technology Improve Health Literacy?

Abstract

Nearly nine out of 10 Americans have low health literacy skills [1]. This is a significant public health concern, as a low health literacy level can negatively impact an individual's ability to navigate the healthcare system, manage chronic diseases, follow a healthy diet, monitor medication, and read educational materials [2-4]. This raises the question: How can we minimize the potentially negative impact of low health literacy on health outcomes? The 2013 Institute of Medicine (IOM) report on health literacy identified technology as a key facilitator in bridging the gap between literacy and health outcomes [5]. Perhaps technology can provide some answers. Health literacy is defined by the IOM as: " the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions " [2]. Low health literacy is a stronger predictor of health than age, income, employment status, education level, or race [6]. Health literacy is comprised of numerous skills, including reading and writing (print literacy), basic mathematical calculations (numeracy), and learning and speaking (oral literacy) [2]. To this basic definition, one can also add Electronic Health (eHealth) literacy skills, which are defined as: " The ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem " [7]. Computer and technology literacy is a component of eHealth related to the use of these mediums to search for and use health information or to solve health-related problems [7]. eHealth literacy, computer literacy specifically, are increasingly important constructs given the rapid development of computer-and cell phone-mediated health programs. In the United States, an estimated 85% of adults and 95% of adolescents 12-17 years old use the Internet [8,9]. Almost three-quarters (71%) of adults have used the Internet to search for health-related information and 21% have used some form of technology to track health information [10,11]. [10,11]. Most adults (91%) and 78% of adolescents in the US aged 12-17 years own a cell phone and 55% and 47%, respectively own a Smartphone [8,9]. As of 2012, 19% of cell phone users indicated they downloaded an app to help manage or track their healthcare [12]. Internet and cell phone usage is increasing around the world, and particularly in developing countries [13]. In 2008, developing countries accounted for 52% of the share of Internet users; in 2013, that number rose to 65% [13]. Cell phone usage has seen even greater growth. In 2005, developing countries accounted for 55% of cell phone subscriptions worldwide; as of 2013 that number was over 77% [13]. The Internet and cell phones are poised to provide worldwide access to healthcare information.