The San Antonio Health Literacy Initiative: Enhancing Communication Between Patients and Their Providers

By: Kaparaboyna Ashok Kumar, MD, FRCS, FAAFP
Thursday, October 2, 2014

As physicians, we must recognize how important health literacy is when we interact with patients. Health literacy directly affects each patient’s health because he or she must understand the information we give verbally during encounters and in writing in the form of patient education brochures and other resources. In short, we must consider and tailor our instructions to each patient’s health literacy.

The Institute of Medicine (IOM) defines health literacy as “the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions.”1 The IOM also estimates that “nearly half of all American adults, 90 million people, have difficulty understanding and acting upon health information.”

We and other health providers must know each patient’s level of health literacy so we can communicate our advice at the level that person can understand. Since we have limited time with each patient, it makes sense to involve other members of the healthcare team (e.g., physician assistants, nurses and receptionists) to help us with patient education and health literacy efforts.

Assessing a patient’s health literacy requires us to verify that they understood our instructions. Since even well-educated patients may be reluctant to tell us they don’t understand our instructions, take 30 seconds to ask the patient to repeat what you just said. Then, clarify or correct any of the patient’s misconceptions.

Giving information at each patient’s level of health literacy benefits us. Besides seeing patients improve, we also benefit from fewer phone calls from healthcare personnel such as pharmacists when a patient did not truly understand what we said. Since we and our hospitals are evaluated on our effectiveness using re-admission rates, providing information at the proper level can improve our patient outcomes (e.g., in congestive heart failure [CHF]). Studies show that in patients with CHF, those with improved health literacy skills had lower re-admission rates.2

As physicians, we must identify and develop tools for our staffs to use in educating patients. One of these tools is the San Antonio Health Literacy Initiative, a program of The Health Collaborative. Founded in 1997, The Health Collaborative is a powerful network of citizens, community organizations and businesses that addresses the health needs of San Antonio and Bexar County. Members include the major healthcare systems in San Antonio, Bexar County and Metro Health, among others.

A major project of San Antonio Health Literacy Initiative is the 10th Annual Texas Health Literacy Conference being held Oct. 10 at the La Quinta Inn & Suites in the Medical Center area. All area physicians and hospitals can take advantage of the excellent information the conference provides by enrolling their staff. Nationally recognized experts on health literacy will give specific examples of ways to address health literacy issues in physician practices. The conference will also have small group sessions in which tools and strategies for improving health literacy in clinics and organizations will be shared. For more information on the conference, visit

In a city as culturally diverse as San Antonio, we need to consider each patient’s unique culture, beliefs, educational level and health literacy level. Health literacy is the key to overcoming any obstacle that impairs a patient’s understanding of what we say. Improving the health literacy of our patients can help us improve the health of our entire community.

Kaparaboyna Ashok Kumar

Dr. Kumar is 2014 President of the Bexar County Medical Society and Honorary Chairman, 10th Annual Texas Health Literacy Conference.