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

Patient empowerment and health literacy are important and valuable attributes for both patients and healthcare providers in today’s changing healthcare system which emphasizes improved healthcare quality, 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 tests 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.

Health Risks – How to Assess and What to Do

Modern life in the industrial society brings not only many benefits but troubles as well. Health risks, both physical and psychological, are among of them. There are many reasons and the following are the most serious:

Global environmental pollution;
Intense pace of life;
Lack of physical labor in daily life;
Over-population in some areas;
Informational over-load;
Continuous struggle for economic survival;
Emotional conflicts at work and home;

Health risks are subtle, most acting slowly and inconspicuously. Nature gives humans a strong sense of survival, and allows us to cope with health risks efficiently for a long period of time. However , over time, the means to cope becomes weaker and weaker and we begin losing our health.

Unfortunately, human nature being what it is, we ignore the small signs and health risk factors because we’re busy and initially they are not very noticeable. However, once these health problems grow larger and interrupt our daily life, we realize something is wrong and we have to seek professional help.

Health risks: early diagnostics.

The truth is that health risk factors are always present, but their negative effects appear much earlier than we notice consciously. Various tiny functional disturbances occur that could only be detected by means of special testing procedures. It is only with time that they become more profound and catch our attention (e.g. periodic pains, dizziness, poor sleep etc.).

A serious disadvantage of our modern healthcare system is that it treats patients with well-established common practices, such as ordering certain diagnostic tests, treating symptoms, and dispensing prescriptions – all of which is dictated by the medical insurance business. Healthcare today is not geared toward prevention. Physicians also look at statistics, such as smoking – if you smoke, you have a higher risk of heart disease or lung cancer. If your blood relatives have diabetes, you have greater odds to develop diabetes as well. Although this is all true, this approach is too abstract from the point of view of an individual human being. In other words, you may have enough health risk factors in your life to have certain diseases, but they may never occur.

A serious disadvantage of the modern healthcare system is its excessive inclination to business merits. We have to admit that such system is more targeted not to curing patients (not even mentioning about disease prevention) but to the process of treating patients in accordance with well-established common practices. The system works in such a way that a doctor is usually limited in choosing modern diagnostic and treatment means. Those means are dictated not only by medical necessity but economical expediency. This is due to involvement of medical insurance business, which does not appreciate using all variety of diagnostic and treatment means without very serious reasons, read without having known clinical symptoms manifesting certain disease.

The goal of an early detection of various health risk factors and prevention of their negative effects is becoming important and popular among healthcare professionals as soon as business organizations responsible for people’s health become aware of its importance. In other words, more and more businesses come to understanding that their employees’ health has a serious material value.

This gives us a good chance to switch to a new paradigm of domination of preventive healthcare when medical professionals will be able to use any means available to assess health risks and choose effective measures to early detect any disturbances of body functions well before their know clinical manifestation.

Health risks: tools for assessment of physiological functions.

Are there any affordable but effective and sensitive tools available to evaluate body’s physiological functions and early signs of their disturbances, which could be used for patients screening in standard healthcare practice? The answer is yes.

It is well known from medical science that most of the body’s organs susceptible to the negative influence of various health risk factors are functioning under constant regulatory control of the autonomic nervous system. Typically the autonomic regulatory function is the main target for this influence of the risk factors causing body’s stress response. Chronic exposure of the body and mind to these stressors results in failures of the complex body regulation and makes its function inadequate. Finally this leads to clinical manifestation of the symptoms typical to certain diseases.

In the past two decades the biomedical scientists have developed fairly simple yet effective methods of assessment of the body’s autonomic regulatory function using analysis of the heart rate variability (HRV). These methods utilize very simple recording of either EKG or pulse wave signal and their respective processing using special mathematical algorithms. As a result they produce data indicating the level of functional activity of the autonomic nervous system, its balance and reserve capacity. Although these methods do not produce any specific diagnostic conclusions, however their ability to quantitatively evaluate the level of the autonomic dysfunction as a result of influence of the health risk factors way earlier than any clinical symptoms occur lets us solve the problem of early detection of various functional disturbances and help the doctor taking proactive measures to fix the problem.