From your perspective, what does health literacy really mean today, and how has that concept expanded beyond simply providing patients with informational materials?

Health literacy can feel like a boil-the-ocean concept, so the healthcare system as a whole has to approach it pragmatically. It’s not about turning every patient into a medical expert. It’s about helping people understand how the healthcare system works, what different providers do, how to prepare for appointments, when to seek care, and how to evaluate the reliability of the information they encounter. Health literacy also includes understanding the value of prevention and how daily decisions shape long-term health. Most importantly, health literacy should help members understand treatment options and make high-stakes decisions such as whether to undergo a surgical procedure and what their more conservative care options are. 

Health literacy is influenced by education, socioeconomic factors, and life experience, so it must be broken down into practical components that patients can realistically address. Ultimately, health literacy is about giving people the tools to navigate their health over time, not just handing them more materials.

Why is it especially difficult for patients to navigate understanding when facing complex, high-cost medical procedures?

When unexpected medical events happen, it’s not fair to expect a patient or their caregivers to suddenly become experts in navigating the healthcare system. In those moments, people are overwhelmed, emotional, and trying to absorb an enormous amount of complex information. The healthcare system should surround them with compassion, patience, and structured guidance, and too often, it does not.

In other cases, the complexity comes at the end of a long, chronic journey where patients have had time to understand the progression of their illness and what may lie ahead. But because health literacy is generally low and the healthcare system does little to support long-term planning, even events that should have been anticipated are often managed like unexpected crises. Many patients don’t fully understand how a chronic diagnosis will affect them over time, leaving them to reach major decision points feeling just as unprepared as someone confronting a sudden diagnosis.

There is also a middle ground that’s often overlooked: preference-sensitive decisions that follow a specific diagnosis but are not necessarily urgent, like certain elective or non-emergent surgeries. In these cases, patients may have time to gather information and weigh their options. However, knowing where to start and what questions to ask can be daunting. Without structured support, many patients default to the recommended course of treatment without fully understanding the risks, alternatives, and expected outcomes.

How can the healthcare system move beyond traditional, one-way information sharing to truly help patients feel empowered to take part in their care decisions? Is technology helping or hindering patients’ understanding – meaning are some patients tuning out because of an overload of complicated technology?

Technology will ultimately improve an individual’s ability to manage their health, but we’re currently at an in-between stage. Patients are exposed to a mix of old and new — photocopied discharge instructions on one hand and AI-generated answers on the other — without strong integration between the legacy and emerging tools. 

Shared decision-making tools, which enable a collaborative approach to care where patients and healthcare providers make decisions together, exist today and are extremely valuable to patients in improving health literacy. While these tools continue to evolve alongside AI and other beneficial technologies, the foundation is already in place.

Looking ahead, I envision an AI-enabled partner that understands a patient’s health history, literacy level, preferences, and support system, and can translate complex medical information into something personalized and actionable for each patient. That kind of tool could reinforce instructions, help patients prepare questions before meeting with their doctor, and facilitate communication with providers and family members. 

Health plans also play a valuable role here and could amplify this impact by implementing similar capabilities into the member experience, proactively supporting members as they navigate care decisions. The technology and infrastructure to leverage AI in this way aren’t far off, but plans can start now by offering members supportive tools that enable shared decision-making with their provider. When used thoughtfully, technology can connect the dots instead of adding to the noise throughout the care journey.

What are the broader benefits of shared decision-making, not just for patients, but also for providers and the healthcare system overall?

Shared decision-making shouldn’t be exclusively physician-driven or patient-driven — it must be collaborative. Historically, some healthcare models leaned heavily on the physician’s recommendation without addressing the power imbalance created by differences in health literacy between provider and patient. That often led to confusion, overutilization, and outcomes that didn’t align with what patients actually wanted. In our My Surgery shared decision support program at Paradigm, we teach patients how to engage in those conversations and clearly articulate their goals around surgery. When patients understand potential outcomes and risks, they’re more satisfied because they’ve agreed to the care plan and know what to expect. For providers and the system, that alignment reduces unnecessary procedures, makes interventions safer, and lowers overall costs. It also builds trust, which is foundational to better long-term health outcomes. For health plans, shared decision-making decreases utilization, strengthens the member experience, and helps ensure resources are directed toward interventions that truly improve outcomes.

How can better patient understanding shape outcomes, ease the care experience, and potentially reduce unnecessary costs over time? What would this look like?

When patients clearly understand their condition, the realistic outcomes of treatment or intervention, and the associated risks, they often make more conservative and thoughtful decisions. Take spine fusion or knee replacement as examples — many patients assume surgery will completely eliminate pain or restore full function, when that isn’t always the case. Through a structured shared decision support process, patients can express what they truly want to achieve and ask whether a proposed intervention will realistically meet that goal. Sometimes that leads to trying less invasive approaches first or simply allowing more time to evaluate alternatives and make a more informed choice. That sense of agency changes the psychology of the experience; patients feel proactive rather than rushed. The result is often fewer unnecessary procedures, lower costs for both the patient and the health plan, and better alignment between expectations and outcomes. And when surgery is deemed necessary, patients enter it with clearer expectations, better preparation, and greater confidence in their recovery process.

Looking ahead, what shifts are most important for building a healthcare culture where patients feel prepared to make confident, informed choices?

The healthcare system needs to build on the evidence already available about what drives better outcomes and improves the patient experience. That means expanding use cases for shared decision support and health plans thoughtfully adopting technologies that help patients understand their risk factors and long-term health trajectory. Providers also need to view patient education and goal alignment as essential clinical steps, not optional add-ons. When patients understand the risks and tradeoffs of their medical decisions, they’re less likely to view providers as scapegoats if outcomes aren’t perfect, and that builds trust on both sides. Continuity with a trusted provider reduces redundancy and unnecessary costs. 

We also need to move away from the idea of “disrupting” healthcare and instead focus on using technology to strengthen relationships and make interactions safer. When implemented thoughtfully, technology should enhance communication and give clinicians more time to connect with patients, not replace the human element of care. Empowerment and trust have to be central to the culture we’re trying to build as a healthcare ecosystem.