“Siri, what do my lab results mean?”

Overcoming the Literacy Burden Using Voice-Mediated Interfaces

The literacy and numeracy burden represents one of the major barriers to engaging patients in their health. Efforts to offer patients open access to their data afford those who are health literate an empowering opportunity. However, patients who struggle with literacy and numeracy may not benefit. Poor literacy itself it is a risk factor for poor health outcomes. Though current representation of health data relies on text-based tools, I wonder if patients are more comfortable with having verbal conversations about their health. The application of voice activated interfaces or so called “digital assistants” has the potential to change the way patients, especially those with low health literacy and numeracy engage and relate to their health information.

The low health literacy and numeracy levels in the US are striking with only 12% of US adults scoring in the highest literacy levels and only 9% scoring in the highest numeracy levels. According to the CDC, literacy is defined as “understanding, evaluating, using, and engaging with written text to participate in the society, to achieve one’s goals and to develop one’s knowledge and potential.” While, numeracy is “the ability to access, use, interpret, and communicate mathematical information and ideas, to engage in and manage mathematical demands of a range of situations in adult life.” Patients with low health literacy and numeracy have lower use of preventive health services and self reported health status, but higher difficulty with chronic disease management and higher health resource utilization (e.g., preventable hospital admissions, emergency department services use, etc.). Though the ultimate solution would address broader educational challenges in the US, a different presentation of health information could be transformative for our patients.

In our current efforts, data is provided to patients by means of paper-based results letters or information packets, patient portals, or online text-based content. Yet these mediums rely heavily on the assumption of health literate patients. Video provides a way to overcome some of the challenges of literacy and numeracy, but falls short on its ability to provide information when the patient needs it. The creation of voice-mediated interfaces, like Siri, Amazon Echo and Google Now, could offer patients the ability to review their health information and literally ask questions about their lab tests, their diseases, and their health. The challenge will be to assess whether providing information using this medium makes any difference in their understanding and use of health resources.

The dream of using our voice to obtain information digitally and navigate user interfaces is certainly not new, but its use as a vehicle to overcome the health literacy and numeracy burden would be.