Health Literacy and the College Student: Impact of a Medical Terminology Course on Intention to Use a Personal Health Record

摘要

Context: To examine the effect of a college level medical terminology course on students’ comfort level with using the Internet for information about health, and ultimately his/her decision to use a personal health record (PHR) to collect, maintain and share information with health care providers.Methods: An online survey tool was used to gather information about willingness to use a PHR as well as perceived health literacy levels at the conclusion of the course. Students were asked specifically if the medical terminology course provided the necessary skills to comfortably interpret health information they find online. An index was created to delineate perceived high literacy level versus low literacy level based upon survey responses.Results: Eighty percent of students perceived their health literacy level to be “high” near the conclusion of the medical terminology course. In addition, a desired health outcome of willingness to adopt a PHR was confirmed with 68% of students indicating their agreement. However, the age group that indicated the least interest was the 18-19 year olds, with 63% expressing willingness to use a PHR.Conclusions: As health information accessibility increases and patient engagement becomes more important for incentive payment reimbursement, providing tools such as a medical terminology course could improve adolescent and young adult self-confidence in interactions with health providers. Encouragement and education about the benefits of PHR adoption may improve overall engagement and health outcomes. Patient participation incentives may improve interest as well.Implications and Contribution: Patient engagement in medical care is challenging in adolescents and young adults. Our research found that 18-25 year olds were least likely to use a personal health record. Improving education about maintenance of health information may increase commitment to prevention and treatment, and will likely impact overall health status. Context The American Recovery and Reinvestment Act of 2009 (ARRA) included the Health Information Technology for Economic and Clinical Health (HITECH) financial incentive programs for physician based and hospital electronic health record (EHR) implementations. One component of the HITECH Act will require patient engagement through portals and other means of secure messaging between patients and physicians to earn reimbursement as part of meaningful use requirements in the coming years. The meaningful use criteria are used to gauge whether a provider is using the EHR to the extent required for financial subsidy programs provided by Medicare and Medicaid [1], and engaging 5% of patients is one of these requirements [2]. As a result of this legislation and general trends in information governance, the availability of health data to patients will become more commonplace as well.At the center of this communication is a personal health record (PHR) that could be part of a physician’s EHR, or wholly maintained by the patient. The PHR contains health related information, which aids in healthcare decision making [3]. The resulting link between the patient and physician can improve communication and promote engagement in the healthcare process [4,5].As the population becomes aware of this increased access to information and seeks additional information online prior to and after an encounter with their doctor, concerns arise about the individual’s ability to comprehend sometimes technical jargon found online [6]. Misunderstanding of medical terms can cause fear and anxiety in patients who are unfamiliar with this complex language and is an indication of poor health literacy [7]. Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” [6]. To further investigate the concept of health literacy and willingness to adopt a personal health record, Bandera’s framewor