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Health Literacy: Is there an app for that?

May 27, 2014

This week May 28, 2014 at 9 pm ET, the Canadian Physiotherapy Association’s Manager of Policy and Government Relations, Kate Rexe (@CPA_Kate) will moderate the #hcsmca discussion. Kate Rexe is an engaged advocate of public health care and has been working in health policy and promoting knowledge exchange for the last 12 years.

By Kate Rexe (@CPA_Kate

head shot Kate Rexe

Kate Rexe


Choosing Wisely

I was excited when the Choosing Wisely Canada campaign launched in April 2014. Modeled after the American Choosing Wisely initiative by the ABIM in 2012, this campaign educates physicians and patients about unnecessary tests and encourages patients to make informed choices. I believe this is a critical step towards improved health literacy because it gives patients and providers the evidence necessary to start conversations about tests and treatments. Why is this important? Because we’ve always been taught to trust the recommendations made by our doctors, surgeons, nurses, and other health care professionals. We often swallow their advice because we are taught to have faith in their education and the healthcare system. However, physicians and patients alike need to understand that more care, more tests, and more treatment doesn’t always equal better care.

With the notion of “choosing wisely” in mind, I recently decided to question a diagnostic test ordered for my 3-year old daughter. This decision fell outside of the Choosing Wisely resources, but was in keeping with the spirit of the campaign. Based on the evidence and previous conversations with the team of specialists that have cared for her since birth, I asked if we could forego the invasive procedure as I didn’t believe it would offer any new insight into her development. The doctor agreed, but my anxiety related to questioning and cancelling the test remains. While logic reassures me I made the right decision, I feel like I have interfered with a system designed to provide the best quality care for my daughter.

I am not a health professional, but a professional working in health policy. With over a decade of experience, including seven years on a hospital research ethics board, I would argue I have a high level of health literacy. So I can’t help but wonder: if I am feeling like I’ve made a mistake in questioning the physician and the system, how do other healthcare consumers feel? And, more pointedly, is access to information leading to more informed consumers, or more troublesome patients?

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Moving beyond the medical model
There are solutions to common health challenges that both improve quality of life and reduced reliance on diagnostic imaging, unnecessary tests and treatments. These solutions are often based on interprofessional collaboration, which promote the engagement of the right professional at the right time to provide the right care. For example, in 2013 the Canadian Physiotherapy Association (@PhysioCan) released a series of fact sheets highlighting the Value of Physiotherapy in many areas from cardiovascular rehabilitation, to musculoskeletal conditions, to managing chronic disease. The reality is physiotherapy has a significant long-term impact on health because it focuses on a patient’s function and quality of life. The result is not only improved patient outcomes, but a broader impact on population health because physiotherapists promote the adoption of healthy behaviours, work to prevent chronic disability and support self-management strategies to prevent the occurrence of acute events over time. Unfortunately, primary health care is organized in such a way that physiotherapists are not often the first point of access for a patient. This is why it is critical to balance health literacy and consumer choice with system change.

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Is social media the answer?
Social media can be a great equalizer for the consumers of health care. The rising use of information technology, regardless of socioeconomic status and even for the aging population, demonstrates the possibilities and solutions for sharing information for the prevention and promotion of health, as well as mechanisms for managing complex chronic disease.

But, does the availability of information lead to more informed choice? Dr. Google opens up a world of diagnoses and access to health information that drives consumer demand, but is not always based on sound evidence. Targeted social media campaigns can help raise awareness and ask important questions to increase health literacy. But, one could argue the proliferation of health information can cause confusion for the average consumer. If health professionals are providing information, how do we increase the confidence of patients to question the prescription of tests and treatments?

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How do we better support consumers of health care?
If social media is an opportunity to engage citizens in more informed choice about healthcare, tests and treatment, there must be a way to evaluate the differences in the evidence that is circulated to consumers. Expanding health literacy to include access to other health professionals in the diagnosis and treatment of common problems would be a logical next step for the Choosing Wisely Canada campaign. While the campaign provides an excellent example of guidelines for ordering tests, it needs to go one step further to identify how a range of solutions are available to improve a patient’s quality of life.

For the #hcsmca chat on May 28, 2014 at 9 pm ET, we will be discussing the following topics exploring the role of social media in helping patients and clinicians make wise choices when it comes to diagnostic tests and images.

  • T1: Can social media help patients and clinicians choose wisely when it comes to diagnostic imaging? #CWC 
  • T2: Are patients ready to question doctor’s orders when it comes to prescribed tests?
  • T3: Can social media help promote access to the right professional at the right time?
  • T4: Is access to information leading to more informed consumers, or uncooperative patients?

Read the May 28th transcript.

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