Helping Your Patients Make Sense of the mHealth Marketplace

One of my favorite developments within the Florida Society of Health-System Pharmacists (FSHP) has been membership’s growing interest in informatics. Of course, there are FSHP members who have been active in informatics for 20+ years, but the increased focus on it in the last 5 or so has been particularly encouraging.

To that end, I was asked to present this year at FSHP Annual on one of my favorite topics – patients’ use of mobile health (mHealth) apps to enhance their self-management. The expanded slide deck from my FSHP presentation is below. 


How easy is it to read dietary supplement patient leaflets?

One of the aspects of information quality that is still very much an imperfect science is readability.  There are a handful of established tools to evaluate it, with the Flesch Kincaid Grade Level (FKGL) being the best known.  The FKGL is simple and thus limited.

I first met Qing Zeng when I was giving a poster presentation during Mednet in Toronto in 2006 (Mednet later morphed into Medicine 2.0).  We exchanged some ideas and our business cards, and that was it for awhile.  We reconnected at AMIA and formally explored some research ideas.  One area of potential collaboration revolved around a tool her group was developing called the Health Information Readability Analyzer (HIReA).

Fast forward to today.  The paper resulting from that initial collaboration was just published in the Journal of Alternative and Complementary Therapies.  In it, we used HIReA and FKGL to evaluate the readability of patient and professional leaflets.  We focused on leaflets of dietary supplements (e.g. ginseng, fish oil, SAMe) used in a common (i.e. diabetes) and less prevalent (i.e. chronic fatigue syndrome) condition.  The patient-targeted leaflets ended up being much more difficult to read than their desired level by both measures.  Part of this may be due to the fact that the leaflets were not created specifically for consumers, they were just scaled down versions of leaflets originally tailored for clinicians and researchers.  Hopefully our results will help provide some guidance as more patient-targeted health information is created, as well as serve as an introduction of HIReA in a broader forum.


Note:  If anyone happens to get a glimmer of recognition from the name HIReA, this was also the tool later used to assess the readability of the top 50 prescribed drugs in Wikipedia presented at Medicine 2.0 in 2009 and later at other venues.  Our JACM article goes in-depth about the HIReA tool and will likely address many of the questions people have had about it at the various presentations in conjunction with the Wikipedia study.


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Meet the Consumer Health Informatics Subspecialty!

Pharmacy is a profession in healthcare.  Pharmacy informatics is a specialty within this profession. It is not yet one of the recognized specialty areas by the Board of Pharmaceutical Specialties, but it is a specialty nonetheless.  Consumer health informatics is a subspecialty within informatics, and can be integrated with pharmacy or any other profession in healthcare.  My path has led to immersion in the possibilities associated with consumer health informatics.

Consumer health informatics (CHI), like medical informatics, health informatics, and pharmacy informatics, suffers from a bit of an identity crisis – or at least a lack of consensus terminology.  The two working definitions for CHI that I am particular to are:

“…analyses consumers’ needs for information; studies and implements methods of making information accessible to consumers; and models and integrates consumers’ preferences into medical information systems.”

British Medical Journal article by Eysenbach

“…studies from a patient/consumer perspective the use of electronic information and communication to improve medical outcomes and the health care decision-making process.”

American Medical Informatics Association’s

CHI Working Group

One of the most attractive elements of CHI was also summarized quite nicely in the review by Eysenbach:

“Consumer informatics stands at the crossroads of other disciplines, such as nursing informatics, public health, health promotion, health education, library science, and communication science…it is paving the way for health care in the information age.”

There is much to appreciate in the inherent collaborative and participatory nature of the CHI subspecialty.  Because of its characteristics, aspects of Web 2.0/social media are also frequently included under the CHI umbrella.  The interdisciplinary approach of CHI was born out of necessity and offers the chance to capitalize on the strengths of multiple professions and ultimately improve outcomes.  I look forward to exploring the promise of CHI and its potential impact on the constantly changing world of healthcare.


[Note: Thanks to Chad Hardy (@pillguy) for the invitation as a blog contributor at]