Plain language sets the stage for clear communication
An interview with Sherry Sanderford, Communications Director at Aetna, on how Aetna focuses on health literacy and plain language communications.
Dodge: Why is health literacy such an important issue?
Sherry: A variety of studies point to a real problem with health literacy in our country. A study by the U.S. Department of Education and National Institute of Literacy earlier this year showed that one out of five Americans reads below the 5th grade level. But we know from our own reviews that many healthcare materials are written above the 10th grade reading level. That is a huge disconnect. Literacy and health literacy impact the quality of care people receive, their ability to act on health care instruction and their overall wellness. For example, patients with low health literacy have an increased risk of hospitalization. They are also more likely to make errors when dealing with their medication or treatment options.
This is also a serious issue for our industry because health care is undergoing so much change. Healthcare reform is impacting the way that people access care and purchase health insurance. It’s putting much more responsibility in the hands of consumers. People need to understand their health care needs and how health insurance works in order to purchase the right plan. And when they need care, they need to understand how to access the right care, at the right time and place.
Dodge: What is Aetna doing to address the issue of health literacy?
Sherry: This is an area that we are extremely passionate about. In 2006, we created a health literacy workgroup. It consists of volunteers that champion the issue, spreading awareness of it across our company through education and programs. The team includes marketing and communications professionals as well as clinicians.
A plain language program was also developed to help ensure that our communications are written simply and plainly. We set a standard that all member (consumer) communications were to be written at a 5th grade level. Business-to-business and provider communications couldn’t exceed a 9th grade level. Anyone responsible for writing or communications at Aetna must take a special training class that helps them meet these standards.
We also try to make this effort engaging and fun. On our employee intranet, we run articles about health industry jargon. Then we give employees different options to use instead. I think what is most amazing is that this effort to communicate clearly and effectively has really become a core part of our culture. Often, our customer service professionals are the ones sending in suggestions about jargon we need to quash.
Dodge: What are Aetna’s goals around health literacy and clear communication?
Sherry: Our goals are fairly simple. We want people to understand the information that we provide to them—the first time they read it. Then we want them to be able to act on this information. Whether that’s taking their medication on time, scheduling a doctor’s visit or choosing the right health plan. We even teamed up with the Financial Planning Association to develop a public education program and website to do just that. This website explains health care terms and helps people understand the world of health benefits.
Dodge: Are you aware of other best practices or efforts in the healthcare industry that are making an impact on health literacy?
Sherry: One important effort in 2010 was the U.S. Department of Health & Human Services’ national action plan to improve health literacy. And an organization that advocates for clear communications is The Center for Plain Language. They have an annual awards ceremony where they rate communications based on clear language and simple design. We get really excited when our work is recognized.
Dodge: Are there any quick tips for writing “plain language” that you can share with us?
Sherry: One easy thing to remember is to always check your reading level. In most cases, you can do this right in your word processing software through the spell check feature. There are also free tools online.
Next comes the hard part—editing your communications to match the right reading level. I have a few tricks that I use. These are ones we share with employees.
• Write the way you speak.
• Address the needs of the reader.
• Focus on one topic.
• Anticipate reader questions.
• Use short words.
• Use familiar words.
• Write short sentences.
• Avoid jargon.
• Use an active voice.
• Use personal pronouns.
• Use informative headings.
• Use lists (bullets).
The best tip that I can provide is to put yourself in your audience’s shoes. Are they going to understand what pre-certification means? If not, is there a better word—like approval?
It’s important to understand that writing in plain language isn’t about “dumbing things down.” It’s about communicating effectively. If your audience doesn’t understand what it reads, then you haven’t communicated. Simple communication is very effective.
The reading level of this blog post is 8.1.