Abstract
BackgroundInterventions to define medical jargon have been shown to improve electronic health record (EHR) note comprehension among crowdsourced participants on Amazon Mechanical Turk (AMT). However, AMT participants may not be representative of the general population or patients who are most at-risk for low health literacy.ObjectiveIn this work, we assessed the efficacy of an intervention (NoteAid) for EHR note comprehension among participants in a community hospital setting.MethodsParticipants were recruited from Lowell General Hospital (LGH), a community hospital in Massachusetts, to take the ComprehENotes test, a web-based test of EHR note comprehension. Participants were randomly assigned to control (n=85) or intervention (n=89) groups to take the test without or with NoteAid, respectively. For comparison, we used a sample of 200 participants recruited from AMT to take the ComprehENotes test (100 in the control group and 100 in the intervention group).ResultsA total of 174 participants were recruited from LGH, and 200 participants were recruited from AMT. Participants in both intervention groups (community hospital and AMT) scored significantly higher than participants in the control groups (P<.001). The average score for the community hospital participants was significantly lower than the average score for the AMT participants (P<.001), consistent with the lower education levels in the community hospital sample. Education level had a significant effect on scores for the community hospital participants (P<.001).ConclusionsUse of NoteAid was associated with significantly improved EHR note comprehension in both community hospital and AMT samples. Our results demonstrate the generalizability of ComprehENotes as a test of EHR note comprehension and the effectiveness of NoteAid for improving EHR note comprehension.
Highlights
Access to and demand for heath information has led to a greater focus on patient-centered care [1,2]
Use of NoteAid was associated with significantly improved electronic health record (EHR) note comprehension in both community hospital and Amazon Mechanical Turk (AMT) samples
While prior work has shown that more active involvement by patients can lead to better outcomes [3,4] and that patients are more proactive than ever in seeking out health information [5,6], challenges remain for patients with low health literacy
Summary
Access to and demand for heath information has led to a greater focus on patient-centered care [1,2]. The National Assessment of Adult Literacy estimates that approximately 36% of Americans have health literacy levels rated as “basic” or “below basic” [7]. This estimate, combined with the finding that physicians often overestimate the health literacy of their patients [8,9], shows that there is a gap between patient desire for health information and their ability to understand it. This gap can lead to adverse effects for patients as well as higher costs for health care centers [10-16]. AMT participants may not be representative of the general population or patients who are most at-risk for low health literacy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
