The Role of Healthcare Payers in Digital Health Literacy Jessica Carreño Louro Project Manager, AIM

Why are we different? Who we are? 59 members from 29 countries in Africa, LA and of course Europe. National healthcare funds and healthcare mutuals. What do they all have in common? non-profit (benefits if any are reinvested in improving services or lowering premium) Democratically managed Based on solidarity (no risk selection + mission of public interest) Responsibility to finance healthcare in a sustainable way but also and above all to look after citizens’ health and well-being.

Determinants of digital health literacy Capacity to understand Access to Information Situational and personal determinants Different factors which influence health literacy and we’ll see what healthcare payers can/could do on each of them + end with some final concerns not to be overlooked.

Healthcare payers’ role Providing high quality and easily accessible information themselves Providing guidance on how and where to find trustful information from other sources Access to information access to information – Health insurers have the role to make high quality information more easily accessible for their affiliates by providing the information themselves while focussing on target groups e.g. our Belgian member Solidaris have developed several apps amongst which: Comunicare: for breast cancer patients: access to information on treatments, secondary effects of medicines, recommendations and on care program through a user-friendly app. Vivoptim: program of personal attention to prevent cardiovascular risks based on patients’ behaviour. The program includes: health information, health risk assessments, community-based support. It offers patient's personal medical records, counselling, clinical analysis, and medical outcomes. Patients interact with a medical professional, have telephone access to speak with a counsellor, and can access their own data. By providing guidance on how and where to find the information (e.g. providing their members with a list of trustful sources where they can find info on a specific topic such as vaccination for example / UMU provides each of its elderly affiliate with a tablet and provides training on how to use it) Most pple use search engines to look for health related information. Yet, the trustful and high quality sources are not always the ones which appear first. As healthcare insurers we have the responsibility to lobby for trustful sources to be legally first on the one hand and on the other to work on improving our own referencing on search engines. Lobby to make trustful information more easily accessible

Healthcare payers’ role Information tailored to people’s needs and realities e.g. SVLFG online training for farmers The capacity to understand and apply that information The information will be more understandable if it is tailored to people’s needs and realities. The EU Barometer survey of 2014 shows that 50% of patients find that the information is not reliable; 48% that it is commercially oriented and 39% that it is not tailored to their needs. Health insurers work hand in hand with communities in order to properly adapt their messages to target audiences. E.g. the German Insurance Fund for Farmers, SVLFG, has worked together with the GET.ON institute in adapting their online training to farmers. The trainings help reach people suffering from stress or other mental health issues earlier and offers help online. They are adaptive, experience oriented and individualised. Guidance is offered via the phone or per video. As you see on the screen, the pictures have been adapted to the audience, just as the examples used, the language, videos, etc. We bring the horse to the water by making info accessible but we also make it drinkable and appetising.

Healthcare payers’ role Focus on vulnerable groups The potential of a settings approach (particularly in schools) Digital health literacy of medical and healthcare staff Situational and personal determinants. Low levels of digital health literacy are observed among low socio-economic groups. On the one hand, as healthcare payers, we have the responsibility, as said, to adapt our messages to our audience and to target specifically vulnerable groups. Cultural adaptation of the messages is key in their success. On the other hand, to help overcome inequities, we are convinced of the power of a settings approach. E.g. teaching kids at school (who will then show their parents). Medical and healthcare staff should also be properly trained. This is of course the case of doctors and nurses but also of health insurance staff. Higher levels of digital health literacy means higher needs of interoperability to allow to unleash the full potential of mHealth.

In optimal conditions Potential of higher levels of digital health literacy Interoperability and data protection concerns As healthcare payers, we are convinced of the potential benefits of increased levels of digital health literacy in enhancing patient engagement and in keeping patients connected to their health and wellbeing. However, governments and other stakeholders like healthcare payers need to guarantee optimal conditions which would ensure people’s privacy and the safety of their health data. We are also convinced that improving digital health literacy requires a multi-stakeholder collaboration involving governments (local; regional); schools; community centres; NGOs; Industry; healthcare staff; and of course patients and citizens themselves. We are already and willing to continue working in collaboration with other actors. Need for multi-stakeholder collaboration

Reliable / unreliable sources (EESC opinion) Labelling, accreditation procedures for health apps jessica.carreno@aim-mutual.org