One of the questions explored by „The Digital Patient” is how to promote health literacy in the digital age. To deepen our understanding of the various issues associated with this question, we interviewed Professor Michael Mackert from the University of Texas. Together with his colleagues, Mackert recently carried out a study exploring the impact of low health literacy among citizens on how they use digital health information. The findings show that patients with low health literacy are generally less healthy and have more difficulty with digital solutions, particularly when it comes to protecting their privacy and preparing information. This risk of a new digital divide is considerable. The study’s findings were published in 2016 in the Journal of Medical Internet Research. In the following interview, the study’s author, Prof. Mackert, discusses the lessons we can draw from these findings.  

Why could be we be facing a new digital divide when it comes to citizens’ knowledge about health information and making decisions about healthcare?

Prof. Michael Mackert

Mackert: “Roughly one-third to one-half of all adults in the United States struggle with health information, and international stats are roughly comparable. While internet access itself is more even than it used to be, developers of health technology who aren’t familiar with issues related to health literacy could be making design decisions that create barriers to usage for these lower health literate populations.“

How can we increase the quality of information and the usability of health information technology even for citizens with low health literacy?

Mackert: “There are design guidelines for creating materials that work for lower health literate audiences, such as using plain language whenever possible. A pressing need as I see it would be creating similar guidelines specifically focused on technological innovations. E-health provides new opportunities for overcoming some of those communication barriers, but developers and those designing the technology need to be more aware of how they can do this better.”

Which “homework” do developers, health insurers and policymakers still have to do to avoid a digital divide around the usage of health Information Technology?

Mackert: “I think it’s an awareness issue, first and foremost. Healthcare providers more than ever understand issues related to health literacy and the importance of clear and simple communication. The same kind of awareness campaign to even help them understand the issues is a crucial first step.”

What do the results of your research mean for establishing trust in health information technology without losing citizens’ concern over privacy issues out of sight?

Mackert: “I think it highlighted the problem related to trust, but I don’t know that it provides solutions yet. I would argue more investigation is needed to understand the sources of those distrust to help guide work to address them.”

What role would you wish for health information technology to play in the future when it comes to citizens’ health literacy?

Mackert: “I think e-health provides opportunities not available in other media for providing important health information in novel and engaging ways. It’s an essential tool to addressing health disparities, and if it’s done well it can help people who struggle with health information and those who are quite savvy. No one asks for more complicated health information.”

Prof. Michael Mackert is doing research on health literacy at the University of Texas. His focus is on the design of health information that is of particular benefit to people with low health literacy.

This interview draws on the “Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide” (Mackert et al., 2016) publication.

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