Our world has been radically transformed by digital technology – smartphones, tablets, and web-enabled devices have transformed our daily lives and the way we communicate. Medicine is an information-rich enterprise. A greater and more seamless flow of information within a digital healthcare infrastructure, created by electronic health records (EHRs), encompasses and leverages digital progress and can transform the way care is delivered and compensated.

With EHRs, information is available whenever and wherever it is needed through a virtual representation of our health identity. In actuality, EHRs are problematic versions of our alternate identities that have real-life consequences for our health and digital literacies. A key challenge in this is that individuals do not have the literacy skills necessary to take advantage of the growth in online health information to improve their health care.

Health literacy has been defined as the ability to obtain, communicate, process, and understand health information, and use that information to make good decisions about health and medical care (Brach, et al., 2012). Tens of millions of Americans currently have little or no health literacy skills leading to unhealthy lives, chronic illness, ineffective medical care, unnecessarily poor outcomes, and high rates of mortality. Health care literacy will enable individuals to make appropriate health care decisions and lifestyle choices. Tens of millions of Americans have little or no health literacy skills leading to unhealthy lives, chronic illness, ineffective medical care, unnecessarily poor outcomes, and high rates of mortality.

Adults, aged 18-30 use the Internet as a primary information resource when seeking solutions to a health-related problem (Estabrook, Witt, & Rainie, 2007). On a typical day in 2006, 8 million American adults searched for information about health topics (Fox, 2006), and this number continues to rise exponentially (Rideout, Foehr, & Roberts, 2010). As they consume information, individuals do not often query search engines (Kuiper & Volman, 2008); read search results (Henry, 2006); evaluate multiple sources (Jewitt, 2008); and integrate what they learn (Rouet, 2009).    

Another challenge is that fundamental assurances of privacy, security, and trust are at risk as individuals may often be unaware of the existence of their EHR, or how to negotiate this virtual record. Continued failure to address issues of health care literacy will lead to a “cascade of suboptimal outcomes, including a reduced ability to interpret labels and health messages, limited ability to take medications appropriately, lower likelihood of receiving preventative care, more hospitalizations, greater use of emergency care, and–among elderly people–worse overall health status and higher mortality rates” (Koh, Berwick, Clancy, Baur, Brach, Harris, & Zerhusen, 2012). 

Within this new landscape for learning, researchers cannot assume users have the ability to navigate digital texts and virtual worlds. Currently, there is a critically large and growing gap between the quality of the health care delivery system and the ability of individuals to understand and use the information and tools they are given (Gazmararian, Curran, Parker, Bernhardt, & DeBuono, 2005). There is a need for future research in which individuals need to evaluate online health information, synthesize what they learn, and communicate a plan of action aimed at improving their health care and quality of life.

It is essential that patients and consumers understand that good health care and wise life choices are their responsibility and should be made with the advice and guidance of their doctors. This responsibility is made even more challenging given the credence that patients and consumers give to the ubiquitous nature of health care information available on the Internet. 

Brach, C., Keller, D., Hernandez, L. M., Baur, C., Dreyer, B., Schyve, P., … & Schillinger, D. (2012). Ten attributes of health literate health care organizations. Washington, DC: Institute of Medicine of the National Academies.

Estabrook, L., Witt, E., & Rainie, L. (2007). Information searches that solve problems.

Fox, S. (2006). Online health search 2006. Pew Internet & American Life Project.

Gazmararian, J. A., Curran, J. W., Parker, R. M., Bernhardt, J. M., & DeBuono, B. A. (2005). Public health literacy in America: an ethical imperative. American journal of preventive medicine, 28(3), 317-322.

Henry, L. A. (2006). SEARCHing for an answer: The critical role of new literacies while reading on the Internet. The reading teacher, 59(7), 614-627.

Jewitt, C. (2008). Multimodality and literacy in school classrooms. Review of research in education, 32(1), 241-267.

Koh, H. K., Berwick, D. M., Clancy, C. M., Baur, C., Brach, C., Harris, L. M., & Zerhusen, E. G. (2012). New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’. Health Affairs, 10-1377.

Kuiper, E., & Volman, M. (2008). The Web as a source of information for students in K–12 education. Handbook of research on new literacies, 5, 241-266.

Rideout, V. J., Foehr, U. G., & Roberts, D. F. (2010). Generation M [superscript 2]: Media in the Lives of 8-to 18-Year-Olds. Henry J. Kaiser Family Foundation.

Rouet, J. F. (2009). Managing cognitive load during document-based learning. Learning and Instruction, 19(5), 445-450.

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