Digital Health Literacy: Why It’s Important and How to Improve It

What are the consequences of low digital health literacy?

Low digital health literacy can carry with it several consequences. Primarily, it can deepen health inequities in an increasingly digitized healthcare landscape. Patients who do not know how to use digital health tools, don’t see the importance of those tools, or can’t access those tools in their preferred language, ultimately won’t use them.

And that puts them at a disadvantage for patient engagement and health improvement.

Take, for example, the telehealth boom that happened during the COVID-19 pandemic. Healthcare professionals lauded telehealth as filling in care access gaps, particularly for patients managing a chronic illness, but that technology wasn’t accessed equally by all patient populations.

Folks living in rural areas, low-income people, and even some racial groups were less likely to use telehealth than their urban, high-income, or White peers.

In April 2022, researchers from the All of Us Research Program reported that digital health literacy keeps many low-income patients from using patient engagement technologies like wearables. Wearables are instrumental in facilitating All of Use research priorities. Ensuring traditionally underserved patients who mostly visit federally qualified health centers (FQHCs) have access is key to participation and research diversity.

While most experts recommend healthcare providers use omnichannel and multimodal patient engagement strategies—ones that leverage multiple types of technology options and some low-tech tactics, too—it will also be critical for clinicians to assess and support digital health literacy.

In doing so, clinicians assure every patient has the equal potential to utilize patient engagement technologies, ultimately supporting health equity.

Screening for digital health literacy

Just as providers screen for regular health literacy, they should also screen for digital health literacy, the Telehealth Equity Coalition advised. Asking patients about broadband access and reliability is not enough, TEC added. Instead, providers should be asking patients if they already own a device that can host a patient engagement app, if they use email, if they know how to download an app, or if they know how to browse or change camera settings.

These skills might not be a requirement for every patient engagement technology; conversely, some patient engagement technologies might require other skills. However, providers should flag a patient who doesn’t use email, for example, because that might signal limited tech-savvy in other areas, too.

Selecting the right patient engagement technology

Healthcare organizations should also be mindful of the types of patient engagement technologies they adopt. Most healthcare organizations have a patient portal with an intuitive user interface that resembles those of other tools patients might use in other aspects of their lives.

But patient engagement technology adoption usually doesn’t end there. Having consumer-facing tools, like online appointment scheduling, patient education, and patient outreach systems that interoperate with the patient portal and other provider systems, will be paramount. This will streamline the experience for patients and cut down on confusion.

Promoting technology adoption

Clinicians should also make sure that patients understand the importance of using a digital health tool. Healthcare experts have long recognized the power of provider testimony in increasing patient portal adoption; providers who advocate for other digital devices, like patient engagement apps, will likewise drum up more adoption.

Providers discussing patient engagement technology use with patients may consider:

• Why the tool will improve health
• How to use the tool
• Security considerations

Patients trust their providers, and if a provider says a tool is safe and effective for managing health, a patient will be more likely to use it.

Notably, a provider should show the patient how to use the tool; this is the same as providing patient education about care management. Walking the patient through how to use a remote patient monitoring device will increase the odds that patients continue use.

That demonstration should also emphasize privacy and security, two key factors for patients considering health IT adoption. Providers can discuss how secure a technology option is and how it protects patient information. As more patients connect health IT to their smartphone apps, providers may consider discussing how third-party programs not covered by HIPAA carry their own risks.

Helping patients select online sources

Digital health literacy moves beyond knowing how to use a medical device; it also includes online medical research. In the age of Dr. Google, healthcare providers need to be mindful of how their patients engage with online research and give patients the skills to parse out reliable and unreliable information.

That will be especially critical in light of the pandemic, during which medical misinformation abounded.

According to NIH, providers should:

• Help patients with online search
• Help patients navigate online webpages
• Review online credibility
• Outline other resources other than online search

When instructing patients about how to do an online search, providers should advise patients about specificity. What age is the patient? Their gender? What are all of their symptoms, not just one? Adding specificity to online search increases the odds that the patient will find accurate and reliable results.

Once on an informational webpage, providers can instruct patients to review bolded headlines, utilize page search, and read content before clicking on hyperlinks.

Finally, providers should give patients the skills to assess website credibility. Websites with many commercial ads or promotions or old publishing datelines may not have reliable information. Patients may also check out the website’s “about us” page to check for certain biases.

Of course, search engines are not the only place patients can get medical information, and providers should remind them of that. Patients should check their own after-visit summaries, prescription requests, provider communications, and patient portals to see if they can find information there.

Digital health navigators, coaching

According to the Telehealth Equity Coalition, health navigators, health coaches, and community health workers are excellent for supporting digital health literacy. These individuals usually have the trust of patients through shared lived experiences. Community health workers also have the training to understand digital health tools, giving them both the social capital and the technical know-how to teach digital health literacy.

Healthcare organizations may consider partnering with community organizations, like the library, to implement digital health literacy training programs. The All of Us Research Program said local libraries can provide reliable WiFi that enables digital health use. Librarians are research experts and can help advise patrons on how to check for reliable information sources.

Digital health literacy will be essential as healthcare increasingly embraces technology. Although some patients may still choose to use low-tech patient engagement strategies—it could simply be their preference—healthcare providers should implement a digital health literacy plan to make sure health IT is an option for everyone. In doing so, organizations can ensure equal opportunity to reap the rewards of patient engagement technology.