In the July edition of the CEH Blog we interview Jolyon Burford, CEH Professional Development Trainer, eLearning Designer & Plain Language Consultant. Jolyon is a Cultural Competence and Health Literacy trainer who also develops engaging eLearning in both of these topics.

We asked Jolyon why health services are hard for consumers to use. We also discussed how health services can make it easier for consumers to find, understand and use the services they provide.

Photo: Jolyon doing trainer hand gestures at a plain language training for Frankston Council this year.

Jolyon and I discussed why consumers find it so hard to use health services. He sent me these comments.

As I’ve gotten older I’ve started to get sick sometimes and had to use a range of health services. Despite a high level of literacy, being born in a country with health services like Australia, having a mum who was a surgical nurse and being very much able to advocate for myself I find the medical system hard to understand and use. I’ve spent the past 6 years researching health literacy to understand why this is. I’ve used this research to help organisations make changes to improve the consumer experience. I have many thoughts on this matter. VERY MANY. I had to limit what I said here, but I hope it still offers you some insight in directions we can take to improve services.

Photo: This is me with my serious training face on.

Health Services and MOST SERVICES are hard to use!

I think that people working in the health system know on some level that information and systems are too complex. But they are inside these systems, it’s hard to see what needs to change.

So what is the problem?

ASSUMPTION is the biggest problem!

Health information and services are most often designed with the assumption that consumers:

  • understand the logic of the health system, know what services are available, how their processes work and what their specialised language and concepts mean
  • will remember what you say
  • have the confidence and motivation to guess or look up what they don’t understand
  • can synthesise this complex information into decisions
  • can advocate for themselves with a variety of workers to meet their goal

What happens when consumers have to use information and services created with these assumptions?

In short, they struggle. Many people who need the help most don’t find out help is available or simply give up. This can look many ways, but here are some examples:

Consumers have difficulty even accessing services – the information about service is promoted in the wrong places for some community members or in the wrong language for them.

Consumers fill forms out incorrectly making additional work for staff and creating more chance of the person dropping out of the system

Consumers don’t understand internal and external processes so they can’t plan and advocate for themselves or their family

Consumers don’t know how and when to ask questions about their case, who to talk to if they think something is wrong

Let’s go a bit more in depth by looking at one of the most common medical interactions – getting a script filled. When we look at this a little closer [SEE LINKED RESOURCE], it’s not as easy as it intuitively seems. What seems like one step- ‘fill script’- is actually a whole series of tasks with knowledge and skills required for each. 



So, enough of making me depressed, how can we improve this situation and make services more consumer-focused?

Map the consumer journey! 

Consider the timeline of a journey for common services you offer. Decide what information and decisions are made at each point where a consumer interacts with your service. Review this timeline with consumers and find out how to improve that journey. Use this map to decide how and when to give information to consumers.

Make the treatment journey clear. And make this overview available to consumers in a digital or physical format.

GP appointment → specialist appointment→ specialist communicates to GP→ GP appointment to review→ next steps.

Provide manageable information in chunks and at the right time for your consumer. Give consumers access to information as they need it, not all at once at the start of a process. For example, an executive summary at a first appointment with the option to learn more with a click or scan of a QR code they can use later. Make sure it is easy to understand!

Image: How to make information easy to understand.

Use a range of automated processes to help with this. SMS reminders with information about their upcoming appointment, links to information about it and a number to call if they have questions. SMS automated follow ups when people don’t attend encouraging them to make contact. There are many ways to do this, they all enable the same fantastic outcome – automated personalised care.


Make it easy for people to understand by using plain language, an easy to understand format in the language they speak. If you can ask consumers to give guidance on what information they want and compare that with what you are currently giving them. If you don’t have the budget for this make sure your team is trained to use plain language – here’s a course we made on the topic. It’s online and takes 2 hours. Medical writers tell us it changes the way they write immediately and for the better.



You might look at this proposal and think it’s impossible, but it’s not. It just requires a different set of skills to the ones most health professionals are trained in. Reach out to marketing people and user design people, they know how to design a user experience and automate it. That’s right it’s like marketing we’re doing, except this marketing reduces consumer stress, gives consumers information that they can use when they need it, enables better decision making and catches people that fall through the gaps.

Reduce stress, allow people to make better health decisions and you will see better outcomes.