Measuring Health Literacy: What, So What, Now What?/media/Files/Activity Files... · Measuring...
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Measuring Health Literacy: What, So What, Now What?
Ruth M. Parker, M.D.Professor of MedicineEmory University School of Medicine
What?
• H.L. is fundamental to health reform, timely
• H.L. reflects dual nature of communication
• “What gets measured gets done”... Cocotas
So What?
• Individual—used to describe prevalence/associations (last 15 years) REALM, TOFHLA
• Community —geo-coding map
• Population - NAAL
Measures ofSkills and Ability
300 studies - health material demand exceeds ability
CAHPS and HCAHPS – under development
? What are the essential skills across life-span for successfully navigating/ engaging in health?
? Do health systems reflect health literacy within organizational infra-structure?
Measures of Demands/Complexity
Back to Cocotas…
What gets measured gets done….
Putting health literacy on the agenda builds demand for measurement and action.
Organizational Infra-structure…where is health literacy?
HealthPartners (George)
PILL (AHRQ/RWJF)
Health plan audit tool (AHIP/RWJF)
? The Medical Home - What is the infrastructure for a health literate medical home?
• Broad agreement that h.l. occurs when skills/ability are aligned with demands/ complexity
• Measures reflect dual nature▫ Goal is for all to “be” health literate▫ Indicators reflect progress toward goal of
aligning skills with demand
• HHS -- create ongoing national data repository of health literacy skills/ability
• HHS -- make available tract level data map of entire country detailing skills/ability
• In clinical practice, promote “universal precautions” rather than individual skill testing
Measures ofSkills and Ability
• CMS and health plans develop meaningful metrics of “health literate” care and service providers• models, demonstrations• incentives for early adopters
• NIH, professional societies define essential “need to know to do” for health. Be clear, use baby steps.
Demands/Complexity
Measure it…“what gets measured gets done”
• Incorporate health literacy into HP 2020• Link to national efforts to measure health
quality, disparities, and cost