Helen: Welcome to Health Literacy Out Loud. I’m Helen Osborne, president of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.

In these podcasts, you get to listen in on my conversations with some really remarkable people—hearing what health literacy is, why it matters and ways every one of us can help improve health understanding.

Today I’m talking with Pamela Kelly, who is director of Partnerships & Initiatives at Health Literacy Missouri, or HLM.

Since joining HLM in 2012, Pam has been reinventing what it means to be a health communications leader in the 21^st century marketplace. Pam leads HLM’s statewide business development efforts and has succeeded in strengthening strategic partnerships with clients across the private and public sectors. Her work has already had a significant and measureable impact on health in Missouri. Welcome, Pam.

Pam: Thank you, Helen. I’m excited to be here.

Helen: For years, I have been encouraging health literacy advocates to consider the business side of what we do. That is your focus and expertise. Tell everyone and remind me, why do we need to pay attention to business?

Pam: That’s a great point. Health literacy is at an intersection between health, education and business, and it involves more than just reading ability. It has so many dimensions including what it means to be able to read, understand and communicate important medical health information.

Right now we’re seeing a critical intersection where health literacy is becoming central to the way that healthcare systems and health businesses are doing what they need to do in order to prioritize quality, cost containment, safety and really involving patients in healthcare decisions.

Helen: You raise so many key points. I’m a clinician, and many of our listeners probably are clinicians or public health specialists, but you’re talking about healthcare systems and businesses. Can you give us an example of those bigger groups that are now interested in health literacy?

Pam: Absolutely. Helen, we’re talking about groups such as large, global pharmaceutical companies who have really taken a priority stand when it comes to health literacy simply because they are looking at those audiences that have to be able to utilize and understand their medical information.

They have to understand their medications and how to use those properly to avoid critical problems when taking their medicine, like overdoses which can cause huge complications and horrible side effects for the patient.

Helen: You’re talking on a huge level with international pharmaceutical companies. Bring this down just a notch because maybe all of our listeners don’t have influence globally, although hopefully some of them do. Where else does health literacy matter?

Pam: Health literacy matters basically in everything that we do every day. Health literacy matters in our local workplaces and health and wellness programs to understand the health information that goes along with using those programs. It matters in our health insurance and our school systems.

Helen: Health literacy matters in all of those areas that may not be where we as practitioners are based. What can we be doing about it or what should be considering as we move forward in the 21^stcentury?

Pam: You make a very good point about where practitioners are based. We have the school health nurses that are based in the schools. We have industrial health nurses who are stationed in health and wellness programs. This is the whole point about a disruptive innovation. We have to think beyond healthcare systems, look at where people are at and reach them in those healthcare settings.

Helen: You used a new term for me and maybe many of our listeners. It’s “disruptive innovation.” What is it?

Pam: Everyone has their own take on disruptive innovation, but for us here at Health Literacy Missouri, it’s about helping to create a new market and value for those who are in an existing market. We basically disrupt an existing market and provide value in a way that they are able to reach their audiences in a new and different way.

Helen: Can you give an example?

Pam: Absolutely. For the healthcare system, to get back to our traditional practitioners, it’s really been focused on physician’s care. It’s the physician working with the patient but ultimately deciding what’s best for that patient.

Now we’re seeing a huge disruption in how care is being provided and delivered in the healthcare system in the fact that patients now have responsibility for being a part of that decision-making process.

Helen: That’s a disruption, like it or not, that came along with healthcare reform.

Pam: Absolutely.

Helen: That’s a disruption. What’s the innovation?

Pam: The innovation is how we communicate. It used to be that you could just change the readability and hope that informed health communication and the patient understood what was going on.

Now, it’s so much more than that. It’s about understanding cultural nuances and different subsets of the population. It’s about how to reach low-literacy patients in how they learn and take in information. It’s both science and art put together.

Helen: I love that. I use that term too, that what we do is a science and art. It’s just not a manual that says, “This is what you do and this will always work.” There’s a real creative dynamic aspect to it. It sounds like you’re very much focused on that.  

We talked about the big picture. You put this into context. You explained the terms and all those great health literacy principles. Let’s move forward. What can we do?

Pam: We talk about this from a business proposition. We’re trying to help our clients and partners in the field provide usable content and services to the audiences that they serve.

There are some things that we can do. First, we can really help our clients determine who their audiences are. The second step is being a co-creator with your client. Instead of you providing solutions for your client, you really want them on board creating content with you.

What I mean by this is that you want to have them invested in that service or product because it’s critical to how they disseminate it and who they’re disseminating that information to. Whether it’s to their staff, employees, clients or consumers, you want them involved in that process.

It’s not a flat, PowerPoint type presentation that they can show to staff or clients anymore. It’s really about creating content, services, products, or whatever it is you do that really reach people where they are. It’s very interactive and should be very dynamic.

Helen: I’m going to put you on the spot, Pam. You talked about some big examples like these global pharmaceuticals, and then you talked about a much more local example like a school nurse. Can you give us examples of what you mean about creating interactive, dynamic products that reach people where they’re at? You can give us an example at a great big level and at a much more local level.

Pam: Absolutely. Here at Health Literacy Missouri, one of the things that we decided on early on was that we can’t be all things to all people, so we really narrowed the focus on the services and products that we would offer.

I think that the first step for any health literacy organization is to decide what you are best at. What are you best at delivering? Then really sharpen the focus there. That’s the first step.

The second step would be to look at the content and services that you’re providing. Do they really engage and hold the listener’s or user’s attention and is there a skill-building component to it?

What we have provided from the large global pharmaceutical standpoint is a way that this particular client really needed to train up internal staff and build capacity within. When you’re global, it’s hard to go to every location and do that. What we created was a very interactive, skill-building, e-learning program that can be housed on their platform and disseminated worldwide.

Helen: That’s interesting and very timely. You talked about the 21^st century. With the e-learning platforms, you’re taking those hurdles that you know are out there. You can’t be everywhere all over the world, so how can you make it work?

Pam: Exactly. This goes back to co-creating. We really created this program to work with this client together so that we could reach specific audiences within their organization who needed to then reach their consumer base.

We had paths within this e-learning that spoke to each person and each job owner who needed to have an ownership part in creating content, so it was very tailored.

Helen: Was there any pushback from your client like, “We hired you and now you’re making us do part of the work”?

Pam: Absolutely not. They love it. These are lessons learned. We can certainly create a product for a client and not include them, but now your clients want to be included in that creation. They want a voice in what the end product looks like. It’s a great business case because they will own it, and it’s a great relationship-building opportunity between you and your client.

Helen: That’s wonderful. That’s a big example. Take us a little more locally.

Pam: I think every state has a school system where there may be a need to really help them strengthen. This goes to the business case for the school. Maybe it’s their attendance. One of the things that we looked at with our particular partner here in St. Louis was how we drill down to find out what those big attendance issues were.

Lo and behold, they were health issues. We had kids missing school because of health issues, but some of those health issues did not require a missed day. We worked with our partners here at the school system to look at how to create a health-promoting school.

This was system wide. It was where you look at putting health first because we know that health directly impacts your ability to learn and your educational outcome.

We also used the IHA book What to do When Your Child Gets Sick to train a critical group of parents who were more at risk with their students and families about how to determine when your child has a certain illness and whether or not it required missing school and connect them back into the school system.

Helen: Thank you so much, Pam. What vivid and real examples you just gave. You really are making a difference. I know that you said you’re making a difference in lives in Missouri, but it sounds a lot bigger than that.

Our listeners come from across the U.S. and around the world. What would you like to pass on to them in their work?

Pam: For our colleagues and peers out in the health literacy world, and even for organizations who are trying to figure out how to integrate health literacy within their organizations, I would list four points.

The first thing I would mention is that when you are looking at creating a health literate organization or removing those barriers, we all saw the IOM roundtable paper, but it really takes that information and operationalizes it to your organization or institution.

You can’t just do teach back, but now your forms are a barrier, or you change your forms and now way finding is a nightmare. It’s looking at a complete overview and assessment of your organization system wide. That’s the first step.

Secondly, we have to remember that health literacy is not a trait. It’s a state of mind. Literacy levels can change depending on context of the situation. When you really put all of your energy and focus on testing individuals, it’s a lot of time wasted.

You miss those opportunities to have more of a universal precautions approach because any of us can experience real health literacy at any given time.

Helen: I can relate to that one. What’s the third one?

Pam: It’s to remember that when you are thinking about who your potential prospects or partners are, you need to think outside of the traditional health systems and health-related industry.

Think about the fact that health affects us in everyday work settings. Look at all of those different external areas where you or your organization can touch health and make the most impact.

Fourth, always invest in R&D and listen to feedback from your clients. You have to continue to always innovate and redesign your techniques.

Helen: You are doing that. You are embodying that. I’ve learned so much from listening to you, Pam. I’m even more a fan of what you’re doing to bring a business mindset to what we’re doing. We need to look at the whole world around us. That way, we really can make a difference in a disruptive, but even more, an innovative way.

Pam, thanks so much for being a guest on Health Literacy Out Loud, and even more for doing all you do.

Pam: Thank you so much, Helen. It was fun.

Helen: I learned so much from Pamela Kelly about disruption and innovation and ways we can spread that health literacy message far and wide. But health literacy isn’t always so easy.

For help clearly communicating your health message, please visit my health literacy consulting website at www.HealthLiteracy.com. While you are there sign up for the free enewsletter, What’s New in Health Literacy Consulting.

NewHealth Literacy Out Loud podcasts come out every few weeks. Subscribe for free to hear them all. You can find more information, along with important links, at www.HealthLiteracyOutLoud.org.

Did you like this podcast? Even better, did you learn something new? I sure hope so. If so, tell your colleagues and friends. Together, let’s let the whole world know why health literacy matters. Until next time, I’m Helen Osborne.