Seeing Eye to Eye
Improving Eye Health Literacy through Better Patient-and-Doctor Communication
Can clinics cater to a better opportunity for health education? How can we nurture health literacy during a patient journey? Seeing Eye to Eye is a project that has produced educational and communicative tools for patient health literacy within clinical settings and health consultations.
Through theoretical research, active surveys and personal accounts of patients, it has shown that patient support and patient health literacy influence positive patient outcomes. While local healthcare and clinics already provide patient-centred care and enable trust from patients, strong patient health literacy is not enabled in these settings. Could we activate health literacy strongly such that long-term benefits and improved patient outcomes are enabled?
As doctors are the main stakeholder in a patients' journey, we need to ensure that they would be equipped for patients to understand eye health. Present communication barriers -- like language barriers, a lack of time and the mismatch of eye health knowledge from doctor to patient -- also obstruct patients from comprehending eye health matters well. Therefore, how might we design a universal language between doctor and patient to enable improved patient outcomes through adequate and informed health literacy?
There are many methods of communication in the world of literacy. However, visual comprehension and interactive education can be a universal language to break communication barriers between patient and doctor. These tools introduce topics about eye health and knowledge of different conditions, aiming to simplify and provide valuable information for patients to comprehend complex ideas. Each are catered for different parts of the consultation between doctor and patient to support both parties through communication and a better understanding of eye health.
Framework
Literacy does not produce outcomes alone. Through my theoretical research, I found patient support to be a strong, valid factor for patients; patient-centred care and patient trust were often supported to allow patients to feel seen and understood before being influenced to ideal patient outcomes.
These three pillars would work together to create patient satisfaction and engagement towards their health, thus creating an ideal patient outcome. As doctors are the main stakeholder in a patients' journey, we can percieve that a doctors' communication may be the one to cater these three pillars. My research conducted then worked to percieve this theory in practice.
Research
Research was conducted through three different methods: 1) Quantitative survey and data analysis, 2) Behaviour Observation and Ethnography, 3) Interviews with Relevant Stakeholders.
First was to understand patient perceptions. I created a two-by-two matrix and invited over 123 individuals to place a sticker on a spot that best identified with their perceptions. Through collecting 25 different rationales as well, I came to understand that most patients already trusted Singapore's local clinics. When in need of medical aid, patients would seek a clinic for medical aid. More participants also placed their sticker towards lower perceived health literacy and this became a gap to focus onto. The image below were the results.
Secondly, to see the theory of how a doctors' communication drives patients and their health outcomes, I also sat into 3 different doctors' clinics with over 38 patients to identify if these three pillars of health knowledge, patient-centred care and patient trust were activated. From this research, I found that patient-centred care and patient trust were easily and consistently activated, but patient health knowledge was not.
Lastly, to understand if health knowledge shared from doctors was comprehended well, I accompanied several first-time patients around the clinic. One patient had strong personal purpose and activated strong health literacy, while another was puzzled at her referral to the hospital clinic and did not activate health literacy strongly. This was not the fault of her or her doctor, but simply that neither party was equipped enough to activate it.
Through engaging with both patients and doctors, a key insight that I discovered was that ophthalmologists and patients saw the eye much differently: doctors imagined a cross section with much detail into its anatomy, while patients simply saw the front view and whether it was working as intended. Thus, bridging this gap of perspective was important for a patient-centred view on eye health literacy.
Methodology
Through studying different communication methods, my methodology was inspired from childrens' books: utilising pop-ups and moving pictures to introduce topics for learning and simplify complex concepts.
Deliverables
1. Communication Cards
Good communication comes good diagnosis. These Communication Cards have visuals depicting different types of vision loss. They can be used as a visual reference to describe symptoms and facilitate communication without the use of spoken language.
2. 3-Layered Eye Illustration
First-time patients may find difficulty comprehending eye anatomy like an ophthalmologist does. To bridge the patient and doctor perspective, these illustrations allow doctors to demonstrate the delayering of the skin, shifting from the front of the eye to the cross section and bringing attention to the eyes’ anatomy.
3. Cataract’s Progression
Cataracts involve the whitening of the lens within the eye. This tool facilitates interactive education for intuitive understanding, allowing doctors to demonstrate the progression of cataracts and actively invite patients to interact with the slider.
4. Glaucoma’s Progression
Glaucoma causes a permanent loss of one’s peripheral vision. This tool allows doctors to demonstrate its progression and for patients to intuitively understand its impact. Doctors may facilitate this by placing this tool in front of a patient’s eye and pulling the lever.
5. Cataract Phacoemulsification
Visual supplementation for procedure councelling helps increase patients’ knowledge and preparedness for treatments. This pamphlet can be used to better understand the process ofphacoemulsification, a common cataract surgery. Align the clear sheets with the eye for Steps 1 and 2, then pull the tab for Step 3.
6. Diagnosis Booklets and Flash Cards
Patients need valuable and bite-sized information to their situation. Doctors can provide curated booklets and flash cards to each patient before they leave the clinic to allow them to a review what they learned from their consultation and a reminder of their chosen care plan.