The proliferation of consumer-facing technology and personal health information technology has grown steadily over the past decade, and has certainly exploded over the past several years. Many people have embraced smartphones and wearable health-monitoring devices to track their fitness and personal health information. Providers have made it easier for patients and caregivers to access health records and communicate through online patient portals. However, the large volume of health-related information that these devices can generate and input into a health record can also lead to an increased amount of confusion on the part of users and caregivers. The Institute of Medicine convened a workshop to explore health literate practices in health information technology and then provide and consider the ramifications of this rapidly growing field on the health literacy of users. Health Literacy and Consumer-Facing Technology summarizes the discussions and presentations from this workshop, highlighting the lessons presented, practical strategies, and the needs and opportunities for improving health literacy in consumer-facing technology.

Informed consent - the process of communication between a patient or research subject and a physician or researcher that results in the explicit agreement to undergo a specific medical intervention - is an ethical concept based on the principle that all patients and research subjects should understand and agree to the potential consequences of the clinical care they receive. Regulations that govern the attainment of informed consent for treatment and research are crucial to ensuring that medical care and research are conducted in an ethical manner and with the utmost respect for individual preferences and dignity. These regulations, however, often require - or are perceived to require - that informed consent documents and related materials contain language that is beyond the comprehension level of most patients and study participants. To explore what actions can be taken to help close the gap between what is required in the informed consent process and communicating it in a health-literate and meaningful manner to individuals, the Institute of Medicine's Roundtable on Health Literacy convened a one-day public workshop featuring presentations and discussions that examine the implications of health literacy for informed consent for both research involving human subjects and treatment of patients. Topics covered in this workshop included an overview of the ethical imperative to gain informed consent from patients and research participants, a review of the current state and best practices for informed consent in research and treatment, the connection between poor informed consent processes and minority underrepresentation in research, new approaches to informed consent that reflect principles of health literacy, and the future of informed consent in the treatment and research settings. Informed Consent and Health Literacy is the summary of the presentations and discussion of the workshop.

Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults - 90 million people - have inadequate health literacy to navigate the health care system. Implications of Health Literacy for Public Health is the summary of a workshop convened by the Institute of Medicine Roundtable on Health Literacy in November 2013 that focused on the implications of health literacy for the mission and essential services of public health. The workshop featured the presentation of a commissioned paper on health literacy activities under way in public health organizations. Other presentations examined the implications of health literacy for the mission and essential services of public health, for example, community health and safety, disease prevention, disaster management, or health communication. This report includes the commissioned paper and summaries of the workshop presentations.

“Health literacy is the ultimate global currency of health and well-being. Without health literacy, medicine fails, public health fails, and people pay the cost for these failures with their lives. As this book goes to press, the world is confronted by the COVID-19 pandemic. Improving health literacy becomes increasingly important if we are to successfully confront the challenges that stress our systems of medicine and public health like never before.” (Richard H. Carmona, M.D., M.P.H., FACS, former Surgeon General of the United States, in his foreword to this book.) Two years ago, HTI published the book Health Literacy: New Directions in Research, Theory and Practice. Together with that earlier volume, this book: Health Literacy in Clinical Practice and Public Health: New Initiatives and Lessons Learned at the Intersection with other Disciplines, strives to enumerate and expand our understanding of the multidisciplinary connections which underpin the field of health literacy. The book’s balance between research and practice is a response to the feedback the editors received about the previous publication, which focused more on HL theory and research. With reports of specific health literacy research initiatives and interventions, particularly in clinical practice and public health, the book covers contemporary health literacy research and practice and is divided into three sections. Section one explores health literacy’s capacity to foster progress in clinical practice and public health; section two provides insights into health literacy initiatives and lessons learned from diverse healthcare stakeholders; and section three examines health literacy’s similarities with – and differences from – related health research disciplines. The book sets the practice and research of health literacy on an evidence-based, thoughtful, effective, efficient, and applied course. As Dr Richard Carmona says in his foreword: “It is enthusiastically recommended for all health and medical practitioners and researchers.”

This book's focus is on the decisions taken in consultations between health care patients and professionals. Clinician- patient partnerships in health care decisions are increasingly advocated. Evidence- based patient choice describes a model of health care in which the evidence-based approach can integrate with the promotion of consumer choice. The book examines the traditional approach and the changing experience and expectations of consumers. It describes with many clinical examples and patient narratives how to practice evidence-based patient choice, and explores the ethical, sociological and economic issues raised. It also addresses the future modifications to professional training and organisational change which are required if evidence-based patient choice is to become the norm and speculates about what is likely to be achieved in the next few years. The book provides a summary of current perspectives in this area, which will be of interest to consumers, their representative groups, and to professionals in practice and training alike. From the foreword by Richard Grol: 'An enormous challenge lies before us. In this new and challenging field Evidence-based patient choice is manna from heaven. It summarises the current state of knowledge about these new patient involvement approaches. It is by far the most comprehensive account of scientific and ethical thinking about patient choice at this moment. And, it manages to show us the way to a potential future: health care provision where patients and professionals operate as real partners with shared goals...'

To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today's complex modern health systems. This information may be provided in a variety of forms â€" ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations.

The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities. To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the National Academies of Sciences, Engineering, and Medicine convened a public workshop on building the case for health literacy. This publication summarizes the presentations and discussions from the workshop, and highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy.