Helen Osborne: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 conversations with some really amazing people.

Today, I’m talking with Laurie Myers, who is the Global Health Literacy Director for Merck & Company. In his role, Laurie leads the company’s health literacy efforts worldwide.

Her leadership has helped to improve patient communications in medication labeling, packaging, clinical trial materials, lay summaries, patient education and more.

Laurie presents this work at conferences around the world and has authored numerous papers about all these many accomplishments.

Welcome to Health Literacy Out Loud, Laurie.

Laurie Myers:Thank you, Helen. It’s an honor.

Helen Osborne:I’ve met you at conferences. I’ve heard about your great work. I really wanted to bring your voice to Health Literacy Out Loud.

I think what most intrigues me is when you present about these very big, global accomplishments or what you’ve done within Merck. You’re still just one person. How did all this get started? How did one person make this worldwide difference?

Laurie Myers:First of all, let me start by saying, officially, I’m one person. The progress we’ve made is dependent upon so many champions across the company, so it’s very important.

I started about nine years ago. I had never heard the words health literacy. Eight years ago, my manager came to me and said, “Would you be willing to help work on multi-cultural marketing for a couple of months while I hire somebody?” I said, “Sure.”

People much smarter than me said, “There’s an incredible need to address health literacy.” I said, “What’s that?”

Helen Osborne:You said, “What’s health literacy?”

Laurie Myers:Correct. “What’s health literacy?”

Helen Osborne:That was its origins. Why did it stick with you? This was just going to be temporary.

Laurie Myers:I had spent the first 28 years of my life working in the field of developmental disabilities, so the idea of bringing a voice of those who are potentially slightly less empowered to the table to meet their needs just resonated with me.

Also, like many of us, we all have stories. I have a graduate degree in Healthcare Management. My daughter had surgery to remove a birthmark on her leg maybe 10 years ago and they told me to limit her activity. My children play many sports, so, to me, that meant, “Don’t go to travel soccer practice.” It didn’t mean, “Sit on the sofa.”

Long story short, at the end of the day, she was too active. Her leg bled, and she needed another surgery.

Helen Osborne:Oh my goodness.

Laurie Myers:I think every one of us, including those of us at Merck, has a story like that, that we can relate to. It felt like a very universal issue.

Helen Osborne:Wow. I’m getting that. It seems like happenstance. Your company said, “We need someone to do this.” You said, “Fine.” You had training and experience in a not obviously related field, but you made the connection and that personal one.

I come to it the same way. A lot of reasons come together. I think many of us in the field do that. Somehow, when it originated from many different ways, health literacy doesn’t let go. We keep doing it. You’ve been doing it nearly 10 years. I’ve been doing it 20. It just stays inside.

Let’s move forward. Thanks for sharing the origin. Now you have this role. It’s gone on for more months. It’s gone on for years. How did you start making a difference within Merck, which is a giant corporation? How did you make a health literacy difference there?

Laurie Myers:I think the most important thing is understanding that health literacy is really aligned to the mission and the purpose of your company.

Our mission is Patient First. There’s a quote about putting the patient first. Regardless of where you are in the world, it’s hanging in the office building. That was the first thing. I think you have to be in an environment where patient is at the center.

The second part of it is that you really need sponsorship. You have to listen. A theme you would hear throughout all of this is the importance of listening, listening to patients, lawyers or people who have to make this happen. Understanding how health literacy will make what they do even better is really an important part.

Helen Osborne:Those are the people you are working for and with on a regular basis including regulators, scientists, administrators and all. They’re your audience in many ways. I think you need to make a compelling case.

I’m interested in what you said you need. Sponsorship, what’s that?

Laurie Myers:Sponsorship really has to do with helping senior leadership at the highest level understand why health literacy is important to what we do.

How I’ve done that . . . I do not have a background, for instance, in clinical trials, but what I do is I meet with a person and say, “Here’s health literacy.” I share my story and I say, “Please tell me what you do,” and I learn.

Then my question is, “Do you see any relevance of health literacy to what you’re doing?” Every time, people do. We see the opportunity to improve communications with patients in so many ways.

That doesn’t mean we’re perfect. We’re far from perfect, but you have to dream big and keep going and realize that you don’t need perfect to make progress.

Helen Osborne:You’ve got so many great things that you’re doing. It sounds like you’re doing this health literacy stuff, you believe it and that’s not going away. You’ve identified senior leaders, departments and organizations who need a greater understanding of health literacy.

It sounds like you’re bringing that together, but you’re also listening to their needs, so that’s making their personal relevance, just like you had your own. Is that a model?

Laurie Myers:Yes. I think Part 2 of that is that they then lead the implementation of health literacy within their area.

Helen Osborne:You’re not doing all that. They’re doing that.

Laurie Myers:Correct. What my role is, is almost a coach. They say, “I do see relevance.” Then I help to share some best practices across the company and really what we’ve learned from patients. I can’t tell you enough how important that is.

Then they identify a person within their group to really be a champion and implement it. That’s the only way that I’m able to work in so many different ways with so many different people.

Helen Osborne:I’m really getting it. It’s like you’re giving them that part to hang onto, letting them know that this really matters and giving them the facts and the tools. Then helping them take it from there. Rather than this being Laurie doing all this, you’re helping them get to where they need to go. Correct?

Laurie Myers:Absolutely. For instance, Health Literacy Media, who’s been an important partner to us for many years, actually trained over 450 people last year on health literacy on the principles in the morning and then spent the afternoon working through some of their materials. It’s something that they really own.

One thing that’s really critical as a lesson for others who are thinking about health literacy in a large company is the importance of having legal sponsorship.

The first question I get when I speak at conferences is really, “How do your lawyers let you do that?”

Helen Osborne:I get those questions too. Like, “Great idea. What about those lawyers?”

Laurie Myers:I think from the beginning that’s actually . . . We have had one lawyer in particular who I call my health literacy lawyer. Now there are many lawyers who believe this, and in fact, most.

The first thing you need to show them is that you understand both the spirit and the letter of all rules and regulations. Then show them an example of how you’ve applied health literacy to something that respects that and that’s also more patient-friendly.

Then that gives you the opportunity, once you’ve demonstrated you understand their world and you respect it, to politely question some things. Is this a legal requirement? There are many things we can’t change because we’re required. Or is it how we’ve always done things?

When you open that conversation, it’s amazing how you’ve done many things for many years that really are open to applying health literacy principles.

Helen Osborne:It’s that difference and I hear that, and I see that over and over. How much is a legacy part of the way you do business? “We’ve always done it this way. Therefore, we need to keep doing it this way,” but it sounds as though you frame that question in a much more open way.

Laurie Myers:I think the question was, “Is this a legal requirement or is this how we’ve always done it?” Important to that is listening to patients.

For instance, one of the projects I’ve spent a long time working on is developing our patient labeling for new molecules to apply health literacy principles.

Once, I was listening to a woman who had low health literacy. English was her second language. She read it and she started crying. I watched. She said, “I read this, and not only do I understand it, but if there was a side effect and something was going wrong, not only would I know, but I’d know what to do.”

If you play that for people for 30 seconds, they say, “Oh my goodness. We need to be thinking about health literacy.” It doesn’t mean we’re perfect, but it means we’re trying.

Helen Osborne:It sounds like you’re bringing in the person part, reminding us why we all do this work. In so many ways, Laurie, this goes right back to your health literacy origin story and how for you it came from many components. It sounds like that’s what you’re encouraging others to do and then make it their own with some guidance.

Many of our listeners to the podcast, probably most, are not in big companies like you. What have you learned by making a difference within an organization that others might apply to their own settings?

Laurie Myers:I think there are many lessons. One is to dream big. You have to believe that it’s possible, and if you don’t, it will never happen. As impossible as it seems, you can change a culture, whether it’s with a 10-person company or a much larger one.

I think the second thing is resilience, to not give up. You will have fantastic days when you can’t believe that things actually are approved, and you will have days that you’ll say, “Shucks. I wish we had been able to make more progress there.”

Helen Osborne:I’m so glad you said that, because when people listen to somebody like you or they’re at a conference, a person standing up in front of everybody, or maybe on a podcast, it seems like it’s all good news and this was pretty easy and you can just do it.

It’s so nice to hear your candor about that. There are bad days. I know I have bad days too. It’s like, “Why? Really?” Good to hear that that happens to you too.

How do you get yourself past some of those frustrating spots?

Laurie Myers:I think it actually comes back to the “dream big.” You recognize that you don’t let perfect get in the way of good. You look at the big picture. If you are making progress in the right direction, then that’s what you really need to focus on.

In our case, it’s very exciting when you see the aha moment of people across the company. I work, for instance, with our manufacturing division, and they’re engineers. When they see people with low health literacy, it moves them. That’s what keeps you going as well.

Helen Osborne:That’s what I wanted to know more about. I know this is a question I’ve dealt with a lot in my own work. It’s “What are our measures of success?”

If we go through those traditional “How many people did this?” or “How many people came to a training?” or something, that’s not always, at least in my world, the best measure of success. How do you know when some of this is working? What would be an example?

Laurie Myers:One of the things that’s very important to me is making this not just about my company, but really bringing it back to patients. One of the unique positions that someone at a large company has the opportunity to do is to potentially speak with policymakers.

For instance, in Europe, we were actually able to help shape a policy to make summaries of clinical trials more accessible to patients and reflect principles of health literacy and numeracy. That’s how it matters and why it’s beyond that.

I recognize that’s not something that everyone has the chance to do, but it’s really being engaged in external conversations. We have worked hard, for instance, to find people with low health literacy. They don’t typically volunteer to participate when they have to read information about medicine.

We’ve learned from Ruth Parker and Mike Wolfe as teams at Northwestern and Emory and also from an organization called Sommer Consulting who does the testing with people across the range of health literacy levels. They go to churches and literacy centers.

Guess what? We don’t need to be the only ones who know that. There are lessons there that can help many people. Those are kinds of practical things that I speak about at conferences and I talk to people on the phone.

It doesn’t matter if they’re other companies or healthcare. What have we learned? I’ll tell you and I’m happy to help because it’s about the patient.

Helen Osborne:It’s really interesting. I’m really getting a sense of the collaboration, the dreaming big. You now are participating in conversations about policy at an international level. It all started with one person and one situation. It’s a situation that found you rather than you finding it.

I just want to know before we close out this podcast conversation, what’s your big dream for this whole world of health literacy?

Laurie Myers:First of all, dreaming big . . . I can work many years in my career and we will never hit perfection. Nothing will ever be perfect.

I think dreaming big is about how we embed the voice of patient, including those with low health literacy who we know are at greatest risk of chronic disease.

How do we get everyone, from those doing the earliest clinical trials all the way through to packaging, to be understanding of the voice of the patient. How do we make it easier for them to do the right thing, to take our medicine safely, to understand the side effects, to understand their disease?

Again, we’re not perfect, but that’s my dream. How do we empower patients, how do we get people at our company and also how do we share what we’ve learned to help others understand it as well?

Helen Osborne:Thank you so much. I hope that this podcast conversation can help do that. To me, listening to you and hearing your story, as I do other people’s stories– there are so many stories that start with one person on the inside who makes a big difference on the out, a real inspiration.

Thank you so much, Laurie, for all you’re doing for health literacy and for sharing it with our listeners on this podcast.

Laurie Myers:You are most welcome. I listen to every podcast that you make, Helen, and it’s truly an honor to have the opportunity to chat with you, so thank you.

Helen Osborne:Thank you.

As we just heard from Laurie Myers, it is important to dream big about health literacy and all of us can make a difference. But doing so isn’t always easy. For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there, please sign up for the free monthly e-newsletter, What’s New in Health Literacy Consulting.

New Health Literacy Out Loudpodcasts come out every few weeks. Subscribe for free to hear them all. You can find us on iTunes, Stitcher Radio and the Health Literacy Out Loudwebsite, www.HealthLiteracyOutLoud.com.

Did you like this podcast? Even more, did you learn something new? Do you feel inspired to move ahead? If so, tell your colleagues and tell your friends. Together, let’s tell the whole world why health literacy matters.

Until next time, I’m Helen Osborne.

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