Huang and Hasegawa-Johnson's team investigates health literacy

ECE ILLINOIS Professor Mark Hasegawa-Johnson and Swanlund Endowed Chair Emeritus Thomas S Huang are a part of a team of researchers led by Daniel Morrow investigating the connection between health literacy and advanced age. Both Huang and Hasegawa-Johnson are affiliated with the Coordinated Science Lab.

Electronic health record portals should make it easy and convenient for patients to view the important information in their medical records. But having access to the information and understanding how to use it are two different things.

"Health literacy is an umbrella term for specific abilities involving comprehension and memory capacity," said Daniel Morrow, a professor of educational psychology and a member of the Cognition, Lifespan Engagement, Aging, and Resilience Group. "As we get older, we’re more likely to suffer from chronic illnesses, such as diabetes, hypertension, and cardiovascular disease that require us to monitor symptoms, take blood pressure, or remember medications. At the same time, we’re facing processing constraints that come with aging, like less working memory capacity. This can make self-care very challenging."

That certainly could be the case for the one in four adults over 65 years old who take five medications every day. In fact, cognitive decline may be partly responsible for the statistics that indicate that half of those older adults may not be taking their medications correctly, which can reduce the efficacy of their treatment or even threaten their safety.

But there is good news, explained Morrow. "While we find that working memory declines with age, knowledge tends to sustain or increase with age. So the hope is that as you have more experience with your illness, you develop expertise. Knowledge can compensate for the constraints of memory."

The team’s current project, which focuses on those patient health care portals, builds on that framework.

For instance, patients can log into their portal to retrieve cholesterol test results, but the numbers alone leave many older adults scratching their heads. "The goal is to improve the way numerical information is presented to patients in these portals," Morrow explains.

Together, they’re focusing on ways to make the information in the portal more usable—and that means more engaging. The modes range from the simple—a number line that is color coded in red, yellow, or green to indicate risk levels, or emoticons, like smiley or frowning faces, that quickly and easily portray your health status—to the more complex, like a computer agent (or an "avatar" as Huang and Hasegawa-Johnson call it) that is programmed to talk to you about your test results. While it wouldn’t substitute for time with a physician, it could provide the kind of conversational experience that promotes comprehension in between visits with a provider.

"What we’re doing is trying to emulate in a portal environment some of the dynamics of face-to-face communication," Morrow said. "We’re examining what could be the best way to design the computer agent to make it interactive and effective so patients can use it to make good decisions. We’re just scratching the surface of this promising idea."

The full story can be found on the Beckman Institute's website.