Keeping Health Literacy Human-Centered in an AI-Driven World

By Tiffany Vo, MPH, CHES, Patient Education Coordinator, UCI Health – Orange/Medical Center (Consultant, Lettuce Gather LLC)

In this edition of Health Literacy Voices, Tiffany Vo shares how health literacy can stay human-centered in an AI-driven world—shaping policies, education and patient care to build a more equitable, informed and compassionate health care system.

What Is Your Vision for the Field of Health Literacy?

AI has been expanding its use into the healthcare field and is projected to take over many roles. While this might be helpful in many large language models, healthcare and AI systems should continue to remain human-centered and have checkpoints for quality, accuracy, and human discernment.

There is also high interest in navigating AI use in multilingual translations at an affordable rate while maintaining the reliability of the medical translations. While many healthcare agencies and organizations are facing massive budget cuts and reduction of DEI priorities, some organizations will slip on using proper medical translation channels. This gives room for solutions moving forward—which should still include the human checkpoint to double-check the work, while using AI to reduce cost for full document translations from scratch.

Academic programs have seen reduction in student enrollment due to various factors, but the education of public health, pre-health care, paraprofessionals, and healthcare professions should still include health literacy principles. Concepts such as plain language, person-first language, and catering content to target demographics (of various ages, abilities, etc.) should be included when drafting content for patients and the public. This will help maintain the professional skills needed for human-centered work.

Advocacy and policies will need to reinforce that healthcare and health literacy remain human-centered, where AI is a supportive tool and not a replacement for the quality, safety, and compassionate perspectives brought in by human personnel. An example of this in my work has been proposing a letter to the patient at the beginning of tough-topic documents to soften the information provided while showing compassion and support to the patient.

What Are Your Greatest Concerns for the Field?

Not just in health literacy or healthcare, but at large in all industries, AI programs can be used to advance the field and reduce employee staffing costs, but will need specialized staff in both their respective specialties with AI knowledge to act as key checkpoint personnel in workflows. This will present barriers for new graduates and seasoned professionals in obtaining secure employment without both skills and experience. Additional barriers would probably be in policies at all Socioecological Model levels to support maintaining human-centered checkpoint requirements in workflows.

I also recognize that newly graduated professionals are struggling to get their foot in the door of healthcare or related public health jobs. This is in part due to the economy after the pandemic and the fast-moving AI developments, but not all hope is lost. There are several ways to boost portfolios and change perspective on options for one’s career path. Some examples I have discussed with students and hiring committee members include actual work experience in any field to show work ethic and workforce experience. Any experience in healthcare or the target industry would be nice to have, but if not, seek volunteer experiences, certifications (some are free online), AI skill development as it relates to their field of interest, and any entry-level job to get a foot in the door. I have also recommended that students with employment consider staying with the company and trying to move into management, HR, employee health, employee environmental health and safety, and other opportunities within their current employer.

Which Historical or Contemporary Figure Best Represents the Principles of Health Literacy?

Professor Temple Grandin is a contemporary figure who has shaped my perspectives on individualized therapeutic interventions, multimodal learning methods, and patient education content developed for target learners. Professor Grandin started her life as a child with mutism, diagnosed as nonverbal with brain damage (in the 1940s). Over time, with her mother’s persistence (along with other key people in her life) encouraging various learning methods to help Temple learn, she eventually surpassed the limitations put on her by society. She went on to not only complete high school but excel in university in the agricultural sciences, earning her MS in animal sciences at Arizona State University and PhD in animal sciences at the University of Illinois. She is now a renowned global speaker and has been a faculty professor at Colorado State University for over 30 years. Her achievements and story have made broad impacts on the world of autism and on families of children with learning difficulties.

My professional start in special education set my foundation for health literacy by working closely with children, adults, and families of people with varied learning needs. I am hopeful that human-centered, compassionate, and thoughtful design of patient educational content can truly impact the workflow and end users’ health outcomes. Strategic design will provide patients with education, resources, and skills for self-advocacy.

What Is the Most Misunderstood Aspect of Health Literacy?

Making content within health literacy standards is not “dumbing down” content.

Making content within health literacy standards is not “dumbing down” content. Content should be easy to understand the first time it’s read, with complementary images, diagrams, tables, and related features for reading ease for patients of broad backgrounds and comprehension abilities. Writing in plain language using person-first language has not been readily taught in foundational coursework in many health-related majors (and departments or fields like marketing or business within healthcare), which has caused dissociation from the importance of health literacy in the content workflow. Additionally, I have witnessed a prominent disconnect from staff who may have come with high language levels through their upbringing, high academic achievement, or personal bias, causing conflict when editing documents to meet patient health literacy needs.

Departments and roles that are not clinical may have a higher disconnect and lack sufficient health literacy training. This can cause issues in workflows, communications, perspective, proper terminology, and publication errors. It would be strategic to offer annual continued learning courses on the basics of health literacy concepts for all staff, as this would improve workforce knowledge and in turn the communication skills needed in a healthcare setting.

It has also been common to see clinical staff claim that certain terminology within their specialty and the patient’s treatment protocols are terms patients should already know. This is not always true, and all medical terms should be introduced with a simple version of what the term means, then the simple term should be used throughout communication to make comprehension easier for patients and their families or caregivers.

Proper use of person-first language is not readily taught in academics, and not always upheld from staff to staff, or even supervisor to staff. A person-first language knowledge gap shows when staff use language such as “diabetic patient” instead of “patient with diabetes” or “autistic person” instead of “patient with autism.” These are disrespectful ways to speak or write about patients, which could also leave room for legal issues or even lawsuits. This concept should also be included in the proposed annual staff training modules.

An example of provider disconnect was when a former ICU nurse rejected a proposed project due to personal bias, claiming the project was not needed for patients. The bias comes in several layers in this scenario, because most ICU patients will not be discharged directly from the ICU but will be sent to a step-down unit and so forth before discharge education and resources are provided to patients and their families or caregivers. An added bias layer could also come from a high income level influencing their disconnect from the average patient population’s needs, given the current economic hardships many households face. The clinician also claimed that patients should have access to smart devices and know how to use them, yet data from the electronic medical records department did not reflect this claim. This caused a hard pause in the project for over two years before it was able to restart with new staff supporters (“champions”) to push it forward. The new project supporters come from outpatient and treatment support programs that understand the need for the product to support patients’ comorbid conditions or complex cases. This product will address their appointments, health information, health education, resources, programs, and more—in turn supporting health literacy and advocacy for patients.

What Is Your Favorite Tool or Resource to Improve Health Literacy?

My favorite tools to support health literacy are infographics and the use of supportive images, diagrams, tables, or charts that make tough topics or lengthy information easier to digest and comprehend. It would be useful to have templates made in collaboration with patient education and marketing to meet health literacy workflows and organizational brand kit guidelines. This would also improve productivity long-term, with templates ready to edit for quicker production and approval when departments have juggling priorities.

Where Would You Most Like to See Health Literacy Make an Impact?

Policies at all levels of the Socioecological Model should be addressed, but at the least the healthcare sector that serves diverse populations, rural communities, and the school system. It is well known that policies at the federal, state, local, and organizational levels have had broad impact on community members and patient health outcomes, but a large foundation of health literacy is missed due to a stressed education system that has been cutting health education over the past decades. Not only did general literacy rates fall during the pandemic, but they have continued to struggle post-pandemic. Some contributions toward reduced literacy rates within the academic system may be health education not being a core subject and decreased funding for health education, aside from staffing limitations.

A mindful and strategic effort to reintegrate health education should be made at every academic level in conjunction with general literacy skill development. Including health education in the general sciences for preschoolers through adolescence, high school, and required college courses would in turn increase health literacy and understanding of controllable lifestyle behaviors, and hopefully instill healthy preventive practices in individuals throughout their lifetime. Although there are certain environmental factors, current social norms, and family influences that may not change effectively, the strategic design will hopefully be ingrained at the intrapersonal level, forming a stronger frontal lobe and hippocampus for controlled executive function.

How Do You Handle Setbacks or Resistance in Health Literacy Initiatives?

Getting supporters, or “champions,” in key roles such as administrators, managers, physicians, and clinicians on board with your initiative can bring respect and authority to the project. This does require a foundation of interpersonal rapport, organizational networking, and strategic planning of the project. When faced with rejection, take a step back to assess the presentation of the project scope and communications about the project, and revise it to re-propose at a later time. After trial and error, it has been helpful to take time to build the reasoning, framework, and milestones, accounting for workload and cost during budget limitations such as now. This thoughtful consideration will be more appealing to the key parties you are recruiting, as organizations and healthcare systems are pressured to continue performing under tight budget constraints.

Despite administrative changes, funding limitations, and high workloads, for young professionals and seasoned professionals alike, keeping your eyes on the prize and focusing on your purpose or “why” can aid you in your relentless efforts. There is also a component of self-grace when you cannot push the needle by yourself, and you may need to acknowledge small wins for your patients and community. Creative low-cost solutions using community partnerships, interdepartmental collaboration, and flexibility are necessary to overcome the ebbs and flows of economic and uncontrollable pressures. Finding a supportive community, peers, or mentors can ease the day-to-day stressors in the field while managing emotions in other areas of life. If you are deeply passionate about your initiative and cannot implement it at your site, look into proposing your plan to outside organizations such as nonprofit groups, community centers, and private businesses, so long as you are mindful to avoid conflicts of interest or employee contract restrictions.

How Do You Define Success in Health Literacy?

I have seen success in health literacy when patients take advantage of the health programs provided and use the knowledge and skills they developed in those programs to manage their health and treatment. I especially enjoy seeing the product being used in the clinical setting, where user feedback has been more than positive, eliciting feelings of encouragement, hope, and confidence to make informed health decisions.

What Innovation Holds the Most Promise for Improving Health Literacy?

Innovation in technology is fast-moving and can be of great use in expediting workflow, translations, and game-based education. Policies should include a human-centered design where human personnel are required in the workflow, specialists are required at various stages of product development to ensure content accuracy and human touch, and key roles are safeguarded for human personnel, with technology used as a tool to aid work. Technology education should become basic coursework in healthcare-related majors to keep up with the progress of AI on the world platform.

If You Could Shape the Future of Health Literacy, What One Transformative Change Would You Make?

To achieve deep, transformative change in the future of health literacy, we need both initiatives and policy implementation that establish health literacy as a standard through academic and organizational systems. This involves:

Foundational training in general literacy.
Reintegrating health sciences and physical education into core curricula from preschool through postgraduate programs.
Implementing standardized, annual continuing education on key principles, basic health knowledge, and common medical terminology within organizational structures—especially in healthcare industries.

These efforts could elevate entire generations and empower staff with the confidence to apply health literacy in how they speak, teach, treat, respond, and function in their roles while working with patients.

About the Author

Tiffany Vo, MPH, CHES, is patient education coordinator at UCI Health – Orange/Medical Center and a consultant with Lettuce Gather LLC. Her professional start in special education set her foundation for health literacy through close work with children, adults and families with varied learning needs.

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