Intended for healthcare professionals

Letters E-patients and healthcare

Skills and characteristics of the e-health literate patient

BMJ 2018; 361 doi: (Published 16 April 2018) Cite this as: BMJ 2018;361:k1656
  1. Richard Osborne, professor of public health1,
  2. Lars Kayser, associate professor2
  1. 1Health Systems Improvement Unit, WHO Collaboration Centre for Health Literacy, Centre for Population Health Research, Faculty of Health, Deakin University, Victoria, Australia
  2. 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  1. richard.osborne{at}

Riggare considers what healthcare professionals could learn from e-patients.1 People and communities will inevitably embrace digital technologies, including search engines that gather both up-to-date and fallacious information. Healthcare systems and their public and private funders need to respond in an informed and structured manner. Not every current or future patient will be an e-patient, but it will soon be the norm. In the meantime, one of our biggest challenges is to not generate a digital divide.

Health literacy—the ability to understand, access, retrieve, and use health information and health services—provides insights into how to go forward.23 To characterise the e-health literate patient, we undertook a global consultation to derive seven domains of digital health literacy: ability to process information; engagement in own health; ability to actively engage with digital services; feel safe and in control; motivated to engage with digital services; access to digital services that work; digital services that suit individual needs.4

Current and future e-patients are going to have diverse patterns of these skills and abilities—as are our health professionals. To advance healthcare quality and access, while avoiding a digital divide, we need to understand users’ knowledge, skills, and experiences of current and emerging systems. A new measure of e-health literacy has been developed for this purpose.5 We need to revise and plan health professional training not just to respond to changing technology but to co-design both the development and implementation with patients and technology developers. This will ensure that digital health systems are fit for purpose, enable systematic inclusion of those who are not yet e-patients, and assist organisations to redesign care pathways that suit both the emerging e-patient and the evolving e-health professional. This process should mitigate the large scale implementation failures the UK experienced a decade ago6 and, importantly, ensure no one is left behind.



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