Development of a Visual Literacy Standard to Promote Health Literacy using the Omaha System

Health literacy enables healthcare professionals and consumers to express, receive, and process important health information. Vulnerable populations such as older adults, immigrants, minorities, and low socio-economic status groups are at risk for low health literacy levels that may contribute to poor health outcomes. The National Association of Adult Literacy estimates 36% of adults in the United States have limited health literacy. The digital divide further marginalizes these vulnerable populations because language, literacy, and access to technology may be barriers to electronic communication in web sites, electronic health records (EHRs), and personal health records (PHRs). Methods are needed to address health literacy disparities. Visual literacy can support health literacy because seeing simple, clear images can improve understanding of health information. There is potential to incorporate standardized images in digital and print communication tools to support health literacy. A standardized interface terminology, the Omaha System, is a publicly available instrument that can be used to convey health information at the human-computer interface in EHRs and PHRs. However, methods for depicting the Omaha System using images have not been developed. The purpose of this study was to develop icons for Omaha System concepts to support visual literacy as a way of enhancing health communication for all users at the EHR interface. Our objective is to achieve a complete set of 42 icons that meet three objectives: simple and intuitive; convey perceptible information; and are user friendly. User studies and universal design methods were used to determine appropriate imagery for the icons. A team of undergraduate researchers developed peer-informed prototypes for further refinement through crowdsourcing and expert opinion that will be presented in an interactive session. Feedback from the conference will be used in consideration of the final set of icons. Individual comment sheets/ballots will be available for written feedback during the presentation.