They did this by using five ongoing National Institutes of Health studies of kidney transplant recipients and older adults with chronic comorbidities that had collected detailed sociodemographic, psychosocial, and health literacy information. Serper then shared information about her research, in which she and her collaborators have been able to examine the attitudes and beliefs of older adults during the COVID-19 pandemic and gain some idea about the uptake and acceptability of telehealth in this cohort ( Bailey et al., 2020 Wolf et al., 2020). For example, fewer than half of Black and Hispanic Medicare beneficiaries say they own a computer, while Medicare beneficiaries who live in rural areas or who are 75 years or older are less likely than urban or younger Medicare beneficiaries to own a computer or smartphone ( Koma et al., 2021). Serper noted, however, that not all Medicare beneficiaries possess the technology they need to access telehealth appointments, and the trends also reveal inequities in access. 1 Practices serving Medicare beneficiaries increased their offerings to older adults from 18 percent of visits prior to the pandemic to 64 percent during the pandemic ( Koma et al., 2021). At their peak, telehealth outpatient claims nationwide grew 78-fold from prepandemic levels, and they have since stabilized at 38-fold greater than before the pandemic. While telehealth had been growing gradually over the past decade, video-enabled telehealth exploded during the pandemic when shelter-in-place orders first went into effect in March 2020. Serper began her presentation by reviewing the changes in the telehealth landscape during the COVID-19 pandemic. Serper presented on what her research team has learned about telehealth use among older adults and what the Penn Medicine health system is doing to overcome some health literacy challenges. Shiyanbola introduced the first presenter of the day, Marina Serper, assistant professor at the University of Pennsylvania Perelman School of Medicine. THE PROMISE AND CHALLENGES OF PROVIDING HEALTH LITERATE VIRTUAL HEALTH SERVICES He then introduced the first moderator of the day, Olayinka Shiyanbola, associate professor at the University of Wisconsin-Madison School of Pharmacy. To begin the webinar, Lawrence Smith, executive vice president and physician in chief at Northwell Health and dean of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, welcomed attendees. They should not be construed as reflecting any group consensus. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies. The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop-in Brief was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. The following sections of the Proceedings of a Workshop-in Brief present summaries of each of the workshop’s three presentations and the panel discussion that followed them. The workshop examined the experiences that individuals with low health literacy have with using virtual or telehealth services best practices for ensuring that individuals with low health literacy are able to obtain, process, understand, and act upon health information and services provided virtually or through telehealth and health system and provider strategies for ensuring the delivery of health literate virtual health services that benefit patients and practitioners alike. To explore the challenges that virtual or telehealth services may pose to those with low health literacy, as well as the opportunities for increasing access to care, the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Health Literacy held a virtual public workshop on September 23, 2021. While this change may have important benefits to patients, such as increasing access to care, it may also pose challenges for those with low health literacy. Th COVID-19 pandemic led to a dramatic increase in health services being conducted by telephone or video.

Virtual health services