The More You Know: Health Care Literacy’s Impact on Return to Work

Reducing delayed recovery costs starts with ensuring equal access to health care for injured employees

A key factor in helping injured employees return to work is encouraging them to be highly active in their own recovery. This involves arming them with accurate medical information, so they can engage in their treatment.

Yet, realizing this goal is easier said than done, especially if the information isn’t presented in a way that is easily understandable. In fact, health care literacy is a major problem in the United States, with the U.S. Department of Health and Human Services reporting 1 in 3 adults has a basic or below basic level understanding of health information.

In this edition of Enlyte Executive Insights, Genex’s Helen Froehlich, SVP, Utilization Management, addresses these issues and offers solutions on how leaders can assure all injured employees are receiving equal access to health care education.

What is health care literacy and why is it a major concern in our industry?

Helen Froehlich (HF): Health care literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information to make appropriate health decisions. So, those more at risk for low-health literacy include employees in certain demographics—such as employees with limited education, chronic comorbid conditions, non-native English speakers, older workers and those living in underserved areas.

How important is health care literacy? A Genex Services patient education study found 97% of injured employees reported patient education as one of the most important factors in their ability to recover. And getting the injured employee involved in his or her own recovery is vital to a successful return to work and is a bottom-line issue for payers. When workplace injuries occur, employees can feel removed from normal work roles, activities and communication with coworkers. They may withdraw, feel helpless and become passive in their recovery. This can cause injured employees to regress into a downward spiral of noncompliance, grow more dependent on medication, feel resentment for employers and possibly seek litigation and/or long-term disability.

What major issues should leaders be aware of associated with health care illiteracy?

HF: There are several factors, but let’s start with one that all of us struggle with when it comes to receiving health care—not having enough facetime with providers. Even before the pandemic, the average visit with a physician had dropped to just six minutes. So, in the amount of time it takes to brew coffee, patients must not only understand the nuances of their injury and how it effects their overall health, but also absorb step-by-step guidance on treatment. This type of environment isn’t conducive to patient empowerment.

As a country, we’re becoming more and more diverse. Nearly 20 percent of the U.S. workforce is foreign born. Cultural differences, language barriers and a host of other social determinants can also make it challenging for injured employees to navigate their care. We’re also seeing more Americans work into their senior years, with those 55 and older making up 25 percent of the U.S. workforce. This represents a significant number of employees who may have difficulty keeping up with the ever-changing technology applied in today’s health care practices. Being able to engage in a person’s own care means he or she needs to feel comfortable communicating with the physician in an environment that supports it.

What can be done to improve health care literacy?

HF: As an industry, we need to meet injured employees where they are and give them the tools to succeed. This begins at the first report of injury, ensuring injured employees are treated with a humanistic, rather than an administrative, approach. It’s important to step back and remember that health care, let alone workers’ comp, is complex and complicated. Medical information can be difficult to understand, particularly if injured employees are distracted by fear and anxiety during medical appointments—as they contemplate their injury and how it will affect their future.

A valuable tool in meeting this goal is nurse triage services, which provide injured employees with access to a registered nurse to immediately assess the injury. Through a series of questions, the nurse can provide medically sound recommendations for the right level of care. This often results in simple self-care instruction, avoiding needless physician or emergency room visits. If treatment is required, nurse triage assists the employee in finding the right physician or facility for timely evaluation. Having an experienced health care professional to talk to immediately after injury sets a precedent for employees that the employer is on their side and is genuinely concerned about their wellbeing.

When more involved injuries occur, compassionate health professionals such as case managers provide support, guidance and education in plain language to injured employees. They are instrumental in assuring injured employees’ needs are being met by coordinating the care plan and medical appointments, and serving as the connecting piece among employee, family, clinicians, employers and claim handlers. Companies that offer case managers who are multilingual and practice cultural humility are best equipped to meet the needs of today’s diverse workforce.

Throughout recovery, case managers encourage injured employees to take an active role while setting and maintaining expectations for return to work. They partner with the injured employee in establishing functional goals. Case managers will listen to the injured employee’s needs, wants and fears and address these factors with providers. Education is a key component of the case management process. Health literacy is about a person's ability to obtain, understand, communicate and act upon information in health-related settings. When the injured employee is well informed, he or she can make better decisions and feel more in control of the situation.

Today, many workers’ comp programs have developed patient portals to provide access to reliable clinical information. These programs have progressively become tailored for the layperson to better understand more complex terms. Injured employees can then use these portals to research their condition and treatment plan. However, it’s important that these portals are specific to workers’ compensation and allow the injured employee to learn from an occupational health perspective.

What else can leaders do to increase health care literacy?

HF: Employers and workers’ comp leaders understand that the more an injured worker is invested in his or her own recovery, the more likely the individual will return in a safe and efficient manner. The pandemic has created a new importance of addressing psychosocial factors in claims management. Most employers agree that ensuring mental health needs are met is vital for employee wellness and productivity. The earlier a case manager is involved with the injured worker and all stakeholders the better. Treating the injured employee from a more wholistic approach and identifying and addressing all factors that could interfere with recovery will go a long way in assuring all injured employees have equal access to the right health care at the right time.