Medical Weak Link

As most of you know, I have been regularly writing about the various initiatives involving electronic health records (EHRs). EHR advocates claim that they are necessary to empower consumer-driven health care.

One of the assumptions, however, is that consumers are medically literate - which is a problem if they are in fact illiterate. Articles in the New York Times and Baltimore Sun (registration may be required) this week highlight the problem.

As reported in the Sun in a study conducted by Northwestern University's Feinberg School of Medicine, for patients over 65,

Almost 40 percent of those deemed medically illiterate died during the study, compared with 19 percent of those who were literate. Factoring in health at the outset and other variables, medically illiterate patients were 50 percent more likely to die than the others.

The medical literacy problem has been recognized for over a decade (here, here and here), but EHR advocates nor designers have yet to address it directly. If EHRs are ever going to be truly effective, how the information contained within them is going to be communicated to patients, especially those illiterate or literate but with little medical knowledge will have to be solved.

Maybe Apple should look into this problem, since they seem pretty good at the person- machine interface.


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Robert Charette
Spotsylvania, Va.
Willie D. Jones
New York City