Medical Jargon, Acronyms that Most Confuse Patients. By F. Randy Vogenberg, PhD, RPh, May 5, 2018, published in Managed Healthcare Executive
Today’s health plans must ensure clear language is used across all audiences and all types of communications, from verbal exchanges with colleagues to written outreach to plan members. The use of easy-to-understand language is especially important as it pertains to the pharmaceutical industry. Why? With an ever-increasing alphabet soup of acronyms and jargon, the “lingo” of the pharmaceutical industry can confuse not only clinicians but also colleagues within an organization, as well as plan members.
Consider the patient who receives the instruction to take a medication “hs.”—or at bedtime. While the physician and even retail pharmacist may have explained what that means, patients forget or get confused. Another example is the term BID—or twice a day. Without an understanding of Latin, it’s hard to determine what those initials mean. And if a patient calls the health plan with a question, and the member services representative isn’t sure, that can present problems and frustrations for all. Clearly taking just a few seconds to provide clear definitions can avoid misunderstanding without impacting efficiency.
To be sure, acronyms and abbreviations have their place as a shorthand to help quickly share information. Unfortunately, if we’re not all on the same page in terms of what words mean, it can also lead to confusion and misunderstanding.
And that’s a shame because health plans have considerable information to communicate: From pharmacists’ guidance about how call centers should communicate with members, to ensuring that those responding to Requests for Proposals (RFPs) use the right terminology, to educating marketing and sales personnel on how to best communicate with current and prospective customers’ decision-makers.
A recent article in the Journal of the American Medical Association highlights the need for precision in how we communicate to avoid the misunderstanding of words in the context that they are being used. The takeaway for all in the healthcare industry is that in thinking about things we say, it’s not always what we think has been said when talking about health. It’s about what our colleagues, as well as patients, understand.
The issue of better communication is especially important for health plans in their communications with members, many of whom may have varying understanding of not just clinical terminology, but also their pharmacy benefit and coverage.
It’s estimated that nine in 10 adults lack the skills needed to “manage their health and prevent disease.” For most people this is not due to a lack of intellect, but rather a lack of familiarity with common terminology. This means that those who interface with members—from physicians to customer service representatives—must use the clearest form of language over acronyms and jargon whenever possible.
Take the term Explanation of Benefit (EOB) for example. As a patient, I think this document title means I’m getting an explanation of what my benefits are—not what happened to my claim or how much I need to pay. This misunderstanding could lead to frustrated members who take their concerns to their benefits department. The result: an unhappy member and an unhappy benefits department, which ultimately impacts the MCO.
The Glossary of Common Drug Related Terms and Acronyms provides additional examples of acronyms that can lead to confusion:
- Average Manufacturer Price (AMP)
Average dollar amount that a wholesaler pays a manufacturer for a medication minus prompt-pay discounts. AMP is a benchmark created by the U.S. Congress in 1990 to calculate rebates owed to Medicaid by drug manufacturers.
- Drug Use Evaluation (DUE)
Founded on the belief that improved systems and processes will reduce the number of undesirable outcomes, DUE is the examination of the process of prescribing, dispensing, administering and monitoring drugs, and in some cases, assessing treatment outcomes for the purpose of improving patient outcomes.
- Drug Utilization Management (DUM)
Efforts to ensure a prescribed drug therapy is cost-effective and appropriate for a patient. DUM tools include prior authorization for select drugs and placing limits on the type and amount of drugs that will be covered by a health care plan
- Medication Possession Ratio (MPR)
Mathematical formula used to measure a patient’s compliance with drug therapy instructions. The number of drug doses a patient obtains is compared to the number of doses the patient should have obtained. A value of one means all refills were obtained while a value less than one indicates less than perfect compliance. MPR does not measure how many medications a patient has actually taken but it has been validated as a substitute measure for medication compliance.
- Patient Assistance Program (PAP)
Program administered by a pharmaceutical company or its agent that offers free or reduced-price drugs to persons who meet the program’s qualification criteria, for example, low-income individuals.
- Per Utilizer Per Month (PUPM)
Unit of measure which depicts the drug cost for a specific patient cohort afflicted with the disease.
- Wholesale Acquisition Cost (WAC)
Dollar value that wholesalers report they pay to a manufacturer for a drug product. WAC does not represent the actual price paid by wholesalers because wholesalers may obtain discounts through special purchases or discount deals.
Reaching a common understanding
The goal of today’s health plans must be to ensure that all members are communicated with in a manner that ensures not only that their benefit is understood, but also that the prevention, health and wellness instructions from providers are readily grasped and followed.
Toward that end, there are a number of steps that can be taken. Care management may be employed to assure that the quality of shared information across care providers is understood by the member and to answer questions not asked when interacting with clinicians.
Additionally, clinicians working with non-providers need to make sure they better define acronyms and avoid jargon. For example, there should not be any confusion about the use of PT for patient and PT for Physical Therapy or cyst/o for urinary bladder cyst, and, cyt/o, which refers to cells.
The utilization of acronyms, jargon and common medical terms will continue within the healthcare industry. And like it or not, new terms will be introduced. The key for the entire industry is to encourage the use of clear language when communicating with non-clinician colleagues as well as with members. Saving a few seconds using an abbreviation is not worth confusion and possible damage to the health and wellness of a plan member. The guiding principle must not be what’s easiest and most familiar to and for us, but what is the clearest and easiest for all colleagues and plan members to understand.