Brazilian Social Enterprise Addresses Health Illiteracy

Originally posted May 11th 2016 on Medium

Approximately 743 million people worldwide are illiterate, and even more are health illiterate — meaning they do not understand instructions about taking medication properly or caring for themselves to prevent and treat disease.[1]

When patients can’t read, or they can’t understand information from doctors and pharmacists, their health suffers. They are less likely to be well, more likely to require additional hospital stays, and can suffer potentially fatal complications. This cycle not only affects patients, it also wastes hospital resources and decreases the efficiency of doctors, who find that even spending longer times with patients often doesn’t improve adherence to instructions.

Letras de Médico is using an innovative software program to address the problem of health illiteracy.

Founded in 2015, Letras de Médico empowers patients by making prescriptions and medical information easy to understand. Its software program translates prescription and patient care information into easily understood instructions with informational designs and pictures.

Letras de Médico aims to promote empathy, understanding, and efficiency in the doctor-patient relationship, increasing both hospital revenue and quality of patient care.

Turning First-Hand Experience into a Social Enterprise

While in medical school, Rogerio Malveira noticed a general lack of understanding of how to effectively communicate with illiterate patients. When he was elected a National Officer on Human Rights and Peace for the International Federation of Medical Students Association (IFMSA) in Brazil, he began studying medical literacy and discovered that pictograms and informational designs could be an effective way to communicate with illiterate patients.

One study found that 80% of patients felt that their understanding of prescriptions improved significantly when pictograms were used.[2] Rogerio believed that presenting prescription and other medical information pictorially could increase patient understanding and improve health outcomes while reducing medical consultation time.

When Rogerio came up with the idea for software that could convert medical information into pictograms, he partnered with his childhood friend, Carla Tenecy, to create Letras de Médico. With the Letras de Médico software, doctors would retain control over the information being passed to the patients, and patients could review care instructions when needed.

A Letras de Medico prescription

In 2015, Letras de Médico was one of 50 enterprises selected to participate in the Social Good Brazil (SGB) Lab, where Rogerio and Carla partnered with a programmer to create a prototype of the online Letras de Médico platform. Letras de Médico won 2nd place in the SGB Lab competition, which provided seed funding to launch a pilot program at a local teaching hospital.

Doctors at the teaching hospital had positive feedback for Letras de Médico, and the pilot generated a lot of interest from private physicians and hospitals.

The success of the Letras de Médico pilot program validated Rogerio and Carla’s idea and prototype, but before scaling the social enterprise they embarked on the SGB GSBI® Boost program, adapted from Global Social Benefit Institute (GSBI) curriculum developed at Miller Center for Social Entrepreneurship and made possible through the support of eBay Foundation.

The SGB GSBI Boost program provided the structure needed to fine-tune the Letras de Médico business and growth plan. Working with mentors who took the time to gain an in-depth understanding of their business, Rogerio and Carla advanced through the curriculum modules and identified key business drivers for Letras de Médico. Using the financial template to do “what-if” analyses, Rogerio and Carla projected that they would need about 50,000–80,000 BRL (12,000–20,000 USD) to update the Letras de Médico software and begin to scale.

Because hospitals are already interested, Rogerio and Carla’s next step is to get Letras de Médico investment-ready. They are implementing the financial plan they created during the SGB GSBI Boost program; securing investments; updating the Letras de Médico software; and hiring a full-time programmer to help maintain the online platform. Longer term, they are planning a clinical trial to quantify the impact of Letras de Médico, and they are extending their impact by developing a mobile app that will allow patients to access information on their phones once at home.



[1] Terry C. Davis, Michael S. Wolf, Pat F. Bass Jason A. Thompson, Hugh H. Tilson, Marolee Neuberger and Ruth M. Parker. Literacy and Misunderstanding Prescription Drug Labels. Annals of Internal Medicine, 2006.

[2] Arun Mohan, Brian Riley, Diane Boyington and Sunil Kripalani. Picture RX: Illustrated Medication Instructions for Patients with Limited Health Literacy. J AM Pharm Association, 2003.