5 Questions to Ask When Creating Custom Health Education

Krissy Kuhlmann, Healthwise Implementation Consultant

Your healthcare organization will probably create its own customized patient education at some point. Authors of this type of content typically vary from physicians and nurses to education and training managers, all of whom are trying to ensure patients get the right information they need at the right time.


Education can be delivered to patients within several workflows and usually come from some combination of three sources:

  • A health education vendor, which writes, edits, and maintains an entire library of patient education for you to use
  • Publicly available material from sources like the CDC, WHO, and AHA
  • Custom content written by someone within the healthcare organization

That last type—in-house content—is sometimes needed to address highly specialized treatment plans, a process unique to a particular location or physician, brand-new procedures, or gaps in vendor content. When properly maintained and vetted, these topics can be excellent additions to your system’s library.

On the other hand, here’s what many companies end up with:

  • Clinicians writing about whatever content they feel is important, regardless of redundancy or potential excessive length
  • Academic language written at the college level that many patients can’t or won’t read
  • Ad hoc distribution, usually by the author (remember that college professor who always assigned his own textbook?)
  • Outdated, poorly maintained, or disorganized material

One example of old content that fell through the cracks comes from Parkview Health. When they created a governance process to inventory their patient education, they found a handout that hadn’t been updated since 1978!

Generating your own custom topics is a great way to augment your library of health education from other sources. But to make sure every piece of content is user friendly, accurate, necessary, and consistent with the rest of your messaging, ask some questions and put processes in place before approving and creating it.


Question 1: Who decides whether we should create custom health education?

If you don’t already have an advisory/governance committee to oversee all your content, it’s time to put one together.

It’s a cross-functioning team of clinicians, informaticists, patient experience specialists, education, training specialists, and other professionals. The goal is to have representation from across the organization and service lines to advocate for the right health education for patients.

This group runs point on all content decisions and is responsible for answering the rest of the questions below. Whenever your organization wants to add new health education, the request should go through the advisory committee.

Question 2: Does our health education vendor already have this content?

Before spending time and money on a new piece of material, the advisory committee will most likely look to your health education vendor first. Have they already created a similar resource? If the answer is yes, the committee can share that with the requesting party/department.

If not, would it be more efficient to submit a content request to the vendor, and let them do the heavy lifting? Most health education companies—including Healthwise—have a process by which the governance committee can request additional topics when they determine a need.


Question 3: Who will maintain the health content?

Your advisory committee should have a policy specifying how often content is reviewed and updated. At Healthwise, we recommend every 2 years. This process provides opportunities to evaluate your content with an eye to the following:

  • Is there still a need for this content? (e.g., discontinued medicines, procedures no longer performed by your organization)
  • Is this information still accurate? (e.g., changes to health recommendations)
  • Is the writing inclusive? (e.g., multicultural graphics, gender-neutral terminology)

The actual updating of the content should be done by the original author or someone in the same department to ensure consistency, but the update request will come from the advisory committee.

Question 4: Who will write and edit the health education?

One of the biggest challenges of custom content is ensuring the content is inclusive and at a literacy level that patients can understand. Without a literacy review, patients may receive content that is written at a 13th or 14th grade reading level—which is only natural, since most health professionals have college degrees and are comfortable with healthcare terminology and concepts. But many patients struggle to understand health content unless it’s written in plain language and at an appropriate reading level. And even the ones who could read it will probably glaze over, forget what they’ve read, or simply ignore the education you give them if they have to work overly hard to get through the material.

The advisory committee’s review process should include literacy and inclusivity validation. The two go hand in hand because health literacy must be viewed in the context of a patient’s language and culture.1

When creating a health literacy policy, here are just a few of the guidelines to consider when setting up this policy:

  • Maximum reading level
  • Inclusivity guidelines for graphics
  • Examples of inclusive terminology to be used, and exclusive terminology to be avoided
  • Additional languages/translations needed, based on your organization’s community demographics
  • Plain-language best practices

Most organizations have literacy review software or an individual who specializes in health literacy. This is an expert who has trained in plain language guidelines through organizations such as the Center for Plain Language which teaches writers and editors how to communicate complex topics in simple ways and recognizes some of the best health content in the industry through its annual ClearMark Awards. Healthcare organizations that have a health literacy specialist who can edit any content submissions to fit the health literacy policy are more likely to successfully incorporate custom content into their existing patient education.


Question 5: How will clinicians access and find the content?

Location, location, location! Where will the content live? On a shared internal drive? Intranet? Is someone custom building for EHR access?

Ideally, clinicians can access the content inside of the standard EMR workflows so they don’t have to spend additional time tracking down health education. We hear stories of content being copies of copies of copies from a different decade that have been stored in file cabinets at the office—that’s never good. The goal is to have all custom content within the workflows where other patient education displays. This ensures it’s documented on the patient’s profile and available to review at a later time.

Also, when the content is in the EMR, you have data to show whether clinicians are using it. Organizations can use this data to determine whether to retire content that isn’t being used a lot, or to dig deeper and find out why it’s not being used so a solution can be found. For example, perhaps doctors are hesitant to use the content because it’s outdated, or it conflicts with their treatment plan… or they simply didn’t even know it existed.

For clinicians to find patient education within an EMR, all custom content needs to be tagged with the correct metadata. Metadata enables the retrieval of patient education in very precise ways—such as through keywords, medical and diagnostic codes, or demographic filters—to return a relevant list of material specific to that patient. Tagging custom content in this way will improve efficiency for the clinicians and ensure patients are receiving the appropriate education for their diagnosis.

Augment Content as a Service With Your Own Custom Content

Creating and maintaining health education is a resource-intensive process. Using your advisory or governance committee as the gatekeepers of your content library will save your organization a lot of time, effort, and money.

But creating new in-house material should be done only on a limited basis—using it as your go-to method of getting content would bury your staff and make your governance committee’s job a thousand times harder than it needs to be. A health education vendor can do most of the back-end work for you and provide a continuous library of accurate, plain-language patient education that’s regularly reviewed and updated.

In addition to video and topic libraries, Healthwise now specializes in Content as a Service (CaaS), which provides “plug and play” content for you to customize and use across your system. Download our free eBrief, “The Healthcare Marketer’s Guide to Structured Content,” to learn more. Also check out this story of how one hospital used Content as a Service to respond quickly to a public health emergency.

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091931/