How digital health literacy intersects with custom software development

The Innovation Hub (iHub) at Boston’s renowned Brigham Health supports clinicians, researchers and administrators aiming to transform digital health ideas into real-world solutions. Structured as an advisory service, iHub provides feedback and guidance on digital health concepts at all stages of development.

iHub’s track record includes fully formed and validated solutions such as Twiage, a platform that streamlines workflows and accelerates care for EMS and emergency department teams; Herald Health, which pushes actionable data to care providers within existing workflows and data streams; and BrainSpec, which enables “virtual biopsies” using magnetic resonance spectroscopy.

Now, as digital capabilities expand and become standard across healthcare services, iHub recognizes that new opportunities affect an array of end-users from employees to patients and visitors. Mark Zhang, DO, MMSc, iHub’s medical director, recently addressed the 2022 Health & Digital Literacy Convergence Summit and shared how his organization’s work carries over to the design of inclusive healthcare applications.

Starting with patients and stakeholders

“Like most large, matrixed health systems, a lot of the work we do doesn’t happen in a vacuum,” explained Zhang. “We engage with many stakeholders in order to make large projects function.”

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At the top end of a development opportunity, iHub collaborates with colleagues in Brigham’s patient engagement and education group. Instructions and information intended for external audiences are custom translated into appropriate native languages. Concurrently, designers convey how people will use the application, ensuring that information flows and pathways are clear, understandable and accessible.

“Some of these solutions might require alternative pathways for folks who may not be comfortable with a web-based program — whether that’s due to a technical or physical limitation or just a preference,” Zhang noted. “We make sure that our tools have natural ‘outs’ for that percentage of the population.”

During new project development

When engaged in a new project, iHub interacts with a patient and family advisory council (PFAC) — comprised of current and former patients, family members and caregivers — who work together to advance best practices.

“We need end-user input from the get-go. We’re looking for design signals to see how they move through a process,” said Zhang. “When we hear that a pathway isn’t working, or the flow is not appropriate, that’s where we make adjustments. The PFAC helps us design while addressing issues at the outset. Also, as we release the solution and iterate, PFACs will have an important say in conversations moving forward.”

Deploying a digital gateway

At Brigham, the biggest change in patient education over the past 10 years has been the adoption of a digital gateway that delivers targeted information directly to the patient. 

“We’re not relying on a large packet of paper presented to the patient upon discharge,” Zhang pointed out. “Instead, the information is affiliated with the patient’s profile in our Patient Gateway. It’s not yet as structured as it could be, but it’s a huge shift. If a patient has a question or wants to reach out to the clinical team, he or she can do that through our application and get a quick response. Our emphasis in on decreasing barriers of engagement and creating pathways for further education and clarity.”

Emerging opportunities for digital health literacy

As Brigham examines emerging opportunities to enhance health literacy, iHub anticipates other avenues of growth enabled by technology. Potential applications may use artificial intelligence and natural language processing to help summarize complex conversations between patients and caregivers and to bring just-in-time and point-of-care knowledge to the bedside. 

“Medical trainees are digitally native. It’s part of their natural workflow,” commented Zhang. “They no longer need to rely on memorization. They can now look up something on the spot.” Additionally, through the power of video, if someone needs a refresher on a seldom-used procedure, they can find it. What’s more, virtual and augmented reality bring new possibilities in procedure simulation and conveying empathy for the patient.

In the end, Brigham and similar organizations want to engage patients, caregivers and visitors with digital tools that mimic what has become expected in non-healthcare environments. “What’s coming is the ability to distribute digital interventions that might live outside our existing infrastructure and create a feedback loop so that the clinician knows — within current workflows — whether the patient is engaged,” concluded Zhang. “We’re trying to thread that needle to make sure stakeholders and end-users get what they need.”

Frank Irving is a Philadelphia-based content writer and communications consultant specializing in healthcare, technology and sports.