Clinical summaries for hospitalised patients: time for higher standards - EHRs fall short when generating patient tools

Thanks Lisa.

Health literacy is a favorite topic of mine and I think this editorial (and the references it cites) demonstrates how difficult it is to create understandable material for patients. As health care practitioners, we do not understand what patients understand and we do not spend any time assessing comprehension.

Our patient materials are dull, verbose, jargony, and mostly inaccessible. We simply do not take health literacy into account when we provide instructions to patients, and the we wonder why things go wrong: "Only one in eight adults (12%) over age 65 appears to have
adequate health literacy skills" www.cpha.ca/uploads/portals/h-l/report_e.pdf .

The PEMAT is a very useful step forward, but must be completed along with readability assessments and we need to have the time and resources to create accessible patient materials, be they discharge summaries, educational pamphlets, followup instructions, or multimedia products.

Mike

Thanks Lisa for sharing. Could you please cross post this in the Coordination of Care Community? I think the members there would appreciate this info.

Finnie

This is an editorial by Sunil Kripilani that shares the shortcomings of discharge summaries being produced by EHRs.

Essentially, this is a call for action, for clinicians and patients to be directing IT developers on how to incorporate best practice into output design.
Summaries and reports at discharge are often not helpful for patients as they are unable to interpret the message. I have encountered many instances where patients were unable to follow the medication discharge plan, using comments "it's too many pages", "it's too confusing". He suggests using the Patient Education Materials Assessment Tool (PEMAT) as a guide to designing the organization, readability and formatting of patient take home tools.

I believe as health providers, we often know the shortcomings of the outputs from the systems that our organization uses, but feel helpless on implementing change due to the ever growing wishlist and costs associated with modifying/customizing.

There is certainly an opportunity to work together with patients, clinicians and HealthIT professionals to design an evidence-informed standardized patient take home tool (including reconciled medication plan) - that can be tested with users. Let's setup our patients for success!

Here is the editorial .

Would love to hear your thoughts and have you share your experiences.

Lisa