By Eric Andrew Kristof, RN, CAHIMS | Healthcare IT Professional | HIMSS Arkansas Chapter Member
About This Series: The HIMSS Word of the Day is a running blog series drawing from the HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025) — the authoritative reference for healthcare IT professionals and the primary study resource for CAHIMS and CPHIMS certification. Each post paraphrases the term in plain language, grounds it in real-world healthcare IT context, and adds a bedside nursing perspective you won’t find in a textbook.
📖 The Term: Health Literacy
Source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025)
🔍 Plain-Language Definition
Health literacy describes how well people can find, understand, and use health information to make decisions about their care. It covers reading, but also listening, asking questions, understanding numbers, and navigating the health system.
The HIMSS Dictionary defines health literacy as the extent to which people are able to get, make sense of, and understand the basic health information they need to make sound decisions about their health.
Healthy People 2030 broadened the concept by naming two sides of the same responsibility. Personal health literacy is about an individual’s ability to find, understand, and use information and services. Organizational health literacy is about how well organizations make it possible for people to do that. In other words, a confusing form or an unreadable portal is a health literacy problem even when the patient is well educated.
| Dimension | What It Involves | Example of a Barrier |
|---|---|---|
| Reading and Writing | Understanding written materials and completing forms | Consent forms written in dense legal language |
| Numeracy | Working with numbers, doses, and risks | Calculating an insulin dose from a sliding scale |
| Oral Communication | Understanding spoken instructions and asking questions | Rapid discharge teaching with medical jargon |
| Navigation | Finding services and following processes | Scheduling a follow-up through a complex phone tree |
| Digital Skills | Using portals, apps, and telehealth | A portal that requires many steps to read a result |
⚠️ Exam Alert: Health literacy is the ability to obtain and use health information. Literacy alone refers to general reading and writing skills. Numeracy is the ability to use numbers. Digital health literacy applies these skills to electronic tools. Limited English proficiency is a language access issue that calls for qualified interpreters and translated materials, which is related to but different from health literacy.
🌐 Why It Matters: Real-World Healthcare IT Context
Limited health literacy is common, and it affects outcomes. A 2011 systematic review in the Annals of Internal Medicine by Nancy Berkman and colleagues estimated that about 80 million Americans have limited health literacy and found that low health literacy is associated with poorer health outcomes and poorer use of health care services. The National Assessment of Adult Literacy measured health literacy across four performance levels, from Below Basic to Proficient, giving policymakers a way to understand the scope of the problem.
Health IT can help or hurt. Patient portals, after-visit summaries, medication labels, and test result releases put more information directly in patients’ hands than ever before. If that information is written for clinicians rather than patients, it can create confusion, anxiety, and errors.
AHRQ’s Health Literacy Universal Precautions Toolkit recommends treating every patient as someone who may have trouble understanding health information, rather than trying to guess who needs help. Its tools include the teach-back method, plain-language communication, simplified forms, and medication review.
Digital health literacy is becoming just as important. As more communication moves to portals, text messages, and video visits, patients need skills to log in, navigate menus, interpret results, and judge whether online information is trustworthy. Older adults, people with disabilities, and those with limited internet access may face extra barriers, so organizations that offer digital tools also need alternatives, such as phone support, printed materials, and proxy access for caregivers.
Common health literacy barriers in health IT:
- After-visit summaries that list codes, abbreviations, and medical terms
- Portal results released without plain-language context
- Patient education handouts written at a high reading level
- Forms and consents that are long, small-print, and full of jargon
- Medication instructions with ambiguous timing such as “twice daily”
- Apps and portals that assume strong digital skills
Health literacy practices that work:
- Plain-language templates for after-visit summaries and instructions
- Patient education libraries organized by reading level and language
- Teach-back built into discharge and education documentation
- Clear, consistent medication schedules using specific times
- Portal designs tested with real patients, including older adults
- Recording language preference and interpreter needs in structured fields
🏥 The Nurse’s Perspective: Clinical, Bedside, & Workflow
Nurses spend more time teaching patients than almost any other member of the care team, which places them at the center of health literacy in practice.
At the Bedside
Teach-back is one of the most effective tools nurses have. Instead of asking “Do you have any questions?”, the nurse asks the patient to explain, in their own words, how to take a new medication or what symptoms should prompt a call. If the explanation is incomplete, the nurse teaches again in a different way and checks again. The goal is to confirm the teaching was clear, not to test the patient.
Numbers deserve special attention. Doses in milliliters, insulin scales, and instructions to take a medication every six to eight hours as needed can confuse patients who read well. Showing the measuring device, writing exact times, and asking the patient to demonstrate the dose help close the gap.
Nurses also recognize warning signs. A patient who says they forgot their glasses, asks to take materials home to read later, or cannot name their medications may be struggling with health literacy, regardless of education or background.
In Clinical Workflow
Discharge is where health literacy has the highest stakes. A patient leaving with several medication changes, follow-up appointments, and warning signs to watch for needs instructions that are short, specific, and organized. Nurses often rewrite or highlight key points in the after-visit summary so the most important actions are clear.
Language access is part of the same workflow. Using a qualified interpreter for teaching, rather than a family member, and providing materials in the patient’s preferred language support understanding and safety.
In EHR Implementation (Go-Live Perspective)
During an Epic Go-Live, after-visit summary templates, patient education libraries, and portal settings are configured and often redesigned. Nurses can advocate for plain-language templates, clearly ordered medication lists, and education documentation that captures teach-back results rather than just “education given.”
At-the-elbow support analysts often help nurses find and attach patient education materials, choose the right language, and print or send after-visit summaries. Those small tasks directly affect what patients understand when they leave.
🎓 CAHIMS / CPHIMS & HIMSS Perspective
CAHIMS Exam Domain Mapping
Health literacy appears in patient engagement and equity questions:
| CAHIMS Domain | How Health Literacy Appears |
|---|---|
| Healthcare & Technology Environments | Healthy People 2030; health equity; patient engagement trends |
| Clinical Informatics | Patient education workflows; teach-back documentation; after-visit summaries |
| Healthcare Information & Systems Management | Portal design, education content libraries, language and reading-level settings |
| Management & Leadership | Organizational health literacy policies, usability testing with patients, quality measurement |
Key Terms to Know Alongside Health Literacy
- Personal Health Literacy — an individual’s ability to find, understand, and use health information and services
- Organizational Health Literacy — how well organizations enable people to find, understand, and use health information and services
- Teach-Back — a method in which patients explain instructions in their own words to confirm understanding
- Numeracy — the ability to understand and use numbers in daily life, including doses and risks
- Digital Health Literacy — the ability to find, evaluate, and use health information from electronic sources
- Plain Language — communication that the intended audience can understand the first time they read or hear it
HIMSS Organizational Position
HIMSS connects health literacy to patient engagement, digital health equity, and usability. Its Global Health Equity Community addresses barriers such as digital skills and access that affect how patients use health technology. Members can find related education and research through the HIMSS Resource Center.
🔗 Explore Further: External References
- Healthy People 2030 — Health Literacy in Healthy People 2030 https://odphp.health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030
- AHRQ — Health Literacy Universal Precautions Toolkit https://www.ahrq.gov/health-literacy/improve/precautions/index.html
- AHRQ — Use the Teach-Back Method (Tool 5) https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html
- Berkman et al. (2011), Annals of Internal Medicine — Low Health Literacy and Health Outcomes: An Updated Systematic Review https://pubmed.ncbi.nlm.nih.gov/21768583/
- National Center for Education Statistics — National Assessment of Adult Literacy: Health Literacy https://nces.ed.gov/naal/health.asp
- HIMSS — Global Health Equity Community https://www.himss.org/networking/communities/global-health-equity-network/
Term source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025). All definitions in this series are paraphrased for editorial purposes. Readers are encouraged to consult the primary source for exact language.
Eric Andrew Kristof, RN, CAHIMS is a Healthcare IT professional and HIMSS Arkansas Chapter member based in Hot Springs Village, AR, with hands-on Epic Go-Live experience and a diverse healthcare and IT background. He writes at kristof.org at the intersection of clinical care and healthcare technology.
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