Beyond Health Literacy

Patient-provider communication is crucial to the quality of patient care. To avoid communication breakdowns, existing studies often aim to improve patients' health literacy or providers' interpersonal communication skills. Little has been done to look at the interaction between the two parties or the situated health practices where the communication occurs. To understand the barriers and the underlying factors leading to challenges in the patient-provider communication, we conducted an ethnographic study with patients and providers in an emergency care setting. We report three different communication difficulties between patients and providers: 1) conflicting perceptions of how the ED functions, 2) different understandings of the alternative information sources available in the ED, and 3) different perceptions of what information is critical to ED care. Highlighting the importance of ED practice literacy and balanced information sources, we discuss design opportunities for systems to support effective patient-provider communication during emergency care.