Content of Care

Functioning like a spell-checker, the program, accessing a glossary of 10,000 interchangeable terms, scans medical literature for readability and literacy; upon finding less-than-literate words or terms, it highlights and simplifies those words with alternatives. With a fast-growing client base dominated by HMOs, managed care providers, hospitals and insurers, the market’s embrace of the product is one sign of growing industry awareness, but as Aracely Rosales, HLI’s chief content expert and multilingual director, says, simplifying healthcare language is just the first step.

“More than just words and knowing how to read, health literacy involves a number of additional skills, including listening, analyzing and decision making,” says Rosales, a nationally recognized leader in cross-cultural health communications who also serves as president of Philadelphia, Pa.-based Plain Language and Culture, Inc., a consortium of literacy, language and communication specialists dedicated to clear, plain language communications. “It’s about delivering information to patients, or end-users, at a level they want, is important to them, and that they can fully understand, so they can take care of themselves.”

When Rosales, a former teacher, fled her native Guatemala for the U.S. in 1981, she spoke no English; she remembers well the difficulties of trying to explain her child’s medical condition to a clinician. “Negotiating the healthcare system and health information is complex at every stage, especially for immigrants,” she says. “Responsibility is increasingly put in the hands of the consumer, yet people fearing the system avoid the system, waiting until they are so sick that they require emergency care. It’s a vicious cycle.”

By emphasizing plain language in patient brochures, plan materials, prescriptions and all other consumer touchpoints, the cycle can be broken. California-based Kaiser Permanente, for example, is a recognized managed care provider taking steps toward greater linguistic and cultural competence in healthcare.¹¹ Through patient and provider education materials developed by leading health literacy experts, the NPSF’s “Ask Me 3” program promotes three essential questions that patients should ask their providers in every healthcare interaction.¹²