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The Virtue and Value of Patient Empowerment and Health Literacy amidst Healthcare Reform

 
Knowledge is Empowerment

Patient empowerment and health literacy are important and valuable attributes for both patients and healthcare providers in today's changing healthcare system which emphasizes quality improvement in healthcare, improved population health and reduced healthcare costs.

Patient empowerment is a key component of healthcare reform in that it is the development of the ability to understand and participate in one's healthcare and health management so as to bring about improvements in both while at the same time reducing healthcare costs.  

Because the current fee-for-service healthcare provider reimbursement system is currently in the process of transitioning from a volume-based system to a value-based one in which the value-based parameters are quality of care and costs, patient empowerment and health literacy are valuable to both patients and healthcare providers.  

Health literacy,which is the ability of patients to understand health-related information and use that information to make informed decisions, has been well-recognized by many in the healthcare community as a valuable cofactor for the delivery of quality health care.  The patient-related reason is that health literacy begets greater patient adherence to treatment instructions and better treatment outcomes. The provider-related reason is that the ability to make correct diagnoses and provide effective treatment are in large part determined by the quality of the information provided by patients, in spite of all of the diagnostic technology at our disposal.

The latter fact is supported by a study performed in the early 1990s in which internal medicine physicians performed evaluations outside of the hospital on patients with undiagnosed medical problems then compared the rate of diagnostic accuracy of the three diagnostic modalities that physicians use, i.e., the patient history, physical examination and diagnostic testing. The study showed that of the three categories of information relied on  the history alone resulted in the correct diagnosis being made 76% of the time compared to accuracy rates of 12% and 11% when doctors relied on only the physical examination and diagnostic testing respectively.

Another study published in an August 2011 edition of the Journal of the American Medical Association which compared the relative importance of the patient history, physical examination, and diagnostic tests showed conclusively that hospitalized patients in the study were accurately diagnosed most often when doctors relied on the history alone or the history in conjunction with the physical examination findings and/or test results. Conversely, the study showed that when physicians relied on the physical exam or test results solely or in combination accurate diagnoses were made in only a small percentage of the patients.

The quality of healthcare received by patients is oftentimes determined to a great degree by the quality of the information they provide. Proficient health literacy usually results in more accurate and relevant information which translates into more accurate diagnoses as well as timelier and more appropriate treatment.      

Additionally, proficient health literacy resulting from patient empowerment reduces healthcare costs by decreasing overreliance on medical technology, unnecessary duplicate testing and costly errors resulting from actions based on incorrect or insufficient information.

As healthcare reform and healthcare payment reform continue to evolve, the value and importance of patient empowerment are likely to increase. Therefore, patients and patients' caregivers should take the necessary steps to acquire a degree of health literacy to assume the increased patient responsibility accompanying the forces of reform.    

This article is for informational purposes only and is not intended to be legal advice or a substitute for medical consultation with a qualified professional. If you are seeking legal advice or are unsure about your medical condition you should consult an attorney and/or physician.

The author is a board-certified intenist with more than 30 years of patient contact.

Victor E. Battles, M.D.
Sept. 21, 2013

For patient empowerment resources visit Proactive Health Outlet.

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