Health literacy: Rethinking patient communications in China
Healthcare companies in China would benefit strategically from improving the health literacy of their patients and those who they serve, says Efen Huang
 |
| Correct medicine: Communications boost needed |
|
 Global healthcare companies can expand their efforts to include the creation and provision of resources to help patients navigate through often confusing and conflicting healthcare information
|
|
Incidents of patients causing public disturbances in hospitals and assaulting healthcare workers have peppered news reports in China recently.
In June 2009, more than 80 doctors from a hospital in Fujian staged a sit-in, demanding the municipal government prosecute individuals involved in a hospital disturbance incidence that left several doctors and hospital workers injured.
According to a separate news report, 96% of doctors in China have experienced various degrees of patient-instigated disturbances at work.
This crisis in physician-patient relations invites a rethinking of the patient healthcare communication currently practiced by global healthcare companies in China.
An overhaul of the thinking processes guiding current patient communication endeavors would offer an opportunity to strongly position these companies as a vital and beneficial force in enabling more constructive and productive physician-patient communication.
A casual survey of patient communication activities by global healthcare companies in China suggests that most programs follow a standard formulation of promoting disease and therapy awareness, a classic push strategy in marketing communication.
Wider communications
The task of supporting doctors’ communication with patients or helping patients to access resources for treatment management remain mostly cosmetic through patient leaflets, hotlines, and website communication.
Efforts to improve hospital management through sponsoring hospital directors’ attendance in management courses have not appeared to translate into a more efficient and convenient care experience for patients.
Such a standard formulation fails to address a current gap in healthcare communication in China: the lack of an enabling communication system that promotes patient health literacy.
According to the World Health Organization, health literacy involves "the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health.”
The US Department of Health and Human Services further defines the term to include an individual's "ability to negotiate complex health care systems. Health literacy requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations."
Patient healthcare communication organized along the line of promoting health literacy coincides with one of the Chinese government's priorities in its medical reforms.
During an Asia-Pacific regional ministerial meeting on the theme of "Promoting Health Literacy" held April 29-30 in Beijing this year, China's Minister of Health Chen Zhu commented that his ministry "attaches great importance to health literacy" and listed the ministry's issuance of "Health Literacy for Chinese Citizens basic knowledge and skills" and the publication of "66 Articles of Health" in 2008 as examples of his ministry's commitment in this area.
Test programmes
Test pilot programs launched in 2008 to improve health literacy have yielded positive results with the media reporting that a second-tier city close to Shanghai achieved a 25% improvement in residents' health literacy.
In comparison to the skills and knowledge required for improving patient health literacy, the current promotion of the disease and therapy awareness approach, at best, mostly follows the framework of social marketing.
Under this framework, marketing tactics are used to encourage specific behavioral goals such as seeking treatment or choosing appropriate therapy, which in turn would yield a greater social goal such as improved health outcomes for patients and the greater population.
However, as Routao Wang of Beijing’s Union School of Public Health points out, social marketing communication schemes are ineffective in promoting critical health literacy that involves a perspective with the emphasis on empowerment and self-efficacy.
The work required to help patients and the public to develop skills to negotiate complex healthcare systems or the skills for analytical decision-making is largely unaddressed within a social marketing scheme.
A communication program organized around the perspective of promoting health literacy would involve an overhaul of the guiding assumptions driving the present communication practices at these global healthcare companies.
Instead of limiting communication efforts to providing information to patients guided by the assumption that patients are under-informed,global healthcare companies can expand their efforts to include the creation and provision of resources to help patients navigate through often confusing and conflicting healthcare information.
Similarly, in addition to providing doctors with the latest medical information, healthcare companies can create resources for hospitals and doctors to help them better manage the experience of care for patients.
Re-examination
A health literacy-guided communication programme would involve a re-examination of the roles of patients and physicians in the process of communicating health care issues.
It would involve patients having access to resources for learning skills to manage the complexity and uncertainty of medical scientific information and to participate in the therapy decision-making process.
It would involve resources outside of the current physician-patient model to facilitate and enable the processes of health communication, especially given that many doctors at large hospitals in China have only a few minutes to consult with each patient.
It would also provide the how-tos for patients to develop empowerment and self-efficacy and resources for doctors and medical personnel to facilitate the healthcare communication process.
Studies suggest that changes to communication processes and the underlying assumptions in patient and physician roles in health management improve health outcomes for patients.
According to a study in the U.S. , patients who are actively engaged as "co-producers" and experts in their diabetic and weight-loss management achieved significantly better health outcomes than their counterparts in the study.
Separately, a study in Austria also concluded that greater patient involvement through a "patient-centric" model resulted in better health outcome efficiency and greater patient satisfaction with their care.
In both cases, additional communication resources were employed that allowed patients to enjoy greater latitude in exercising their decision-making capability in their health care management.
Some would argue that the dire state of physician-patient relations in China is attributable to more fundamental and deep-rooted economic distortions than a mere case of poor communication resources and processes.
However, while the government engages in an ambitious medical reforms plan to address the underlying economic distortions, private healthcare enterprises can play a vital role by reorganizing their current patient communication practices to enable patients to exercise greater empowerment and self-efficacy.
Many global healthcare companies are already expanding aggressively into rural markets in China in response to the government's planned medical reforms, either as pharmaceutical companies expanding into generic pharmaceuticals, IT companies expanding into medical information, or medical diagnostics expanding into community hospitals.
The state of physician-patient relations as well as the fragile state of trust in the quality of community doctors calls for a revamped patient healthcare communication model.
Just as continuing medical education has been a valuable strategic platform for global companies operating in China, a patient communication approach aimed at improving health literacy also offers a strategic opportunity for companies to participate as a beneficial force, enabling more constructive and harmonious physician-patient relations in China.
Efen Huang is the founder of Rewire Mind and has been consulting with Ruder Finn Asia on healthcare communication for several years
|
