A patient can receive a clearer explanation and still miss the information needed to act. A recent discharge-letter study makes that distinction visible. An AI-generated version improved overall comprehension scores, but did not significantly improve identification of follow-up appointment dates.
For healthcare executives, the question is whether communication helps patients take the next appropriate step. A message marked delivered, a shorter document, or a completed call cannot answer that question alone.
Organizational health literacy provides a useful standard. It asks leaders to make information and services easier to find, understand, and use. Applied to patient access and contact-center operations, that means connecting clear instructions with a check of understanding and a workable route to help.
Organizational health literacy is a system responsibility
The CDC's definition concerns how organizations equitably enable people to find, understand, and use information and services for health-related decisions and actions. It places responsibility on the organization as well as the individual.
AHRQ's health literacy universal precautions translate that principle into practice. Simplify communication and confirm understanding with everyone, make care easier to navigate, and support patients' efforts to manage their health.
This approach avoids making clear communication conditional on a staff member's impression of a patient's ability. The relevant design question is whether the interaction works for the person receiving it.
October offers a timely reason to review that design. In its October 2, 2026 Health Literacy Month guidance, ODPHP emphasizes the role of institutions in removing barriers to understanding. The opportunity is to examine the work behind patient communication, beyond awareness materials.
Recent research separates understanding from the next action
The September 2026 study in the International Journal for Quality in Health Care compared a GPT-4-generated, accessibility-optimized discharge letter with a conventional letter.
Two controlled quasi-experimental studies analyzed 341 adults recruited online and 791 medical and nursing students at the University of Turin. Median structured comprehension scores were 4 versus 2 in the first study and 4 versus 3 in the second, favoring the AI-generated letter. Identification of follow-up appointment dates did not significantly improve.
Those findings have important boundaries. Allocation depended on age parity rather than randomization. The authors called for validation using real clinical letters and diverse patients. The study does not establish improved appointment attendance, safer clinical outcomes, or fewer readmissions.
It nevertheless suggests a useful testing principle. Evaluate the specific information required for action, rather than assuming an overall comprehension score captures every operational need.
Checking understanding belongs inside the interaction
A 2024 JAMA Network Open randomized trial tested a communication bundle among 198 English- and Spanish-speaking caregivers of hospitalized children six years or younger at one US children's hospital.
The bundle combined plain-language pictogram instructions, medication-dosing demonstration, teach-back, and show-back. Among the 151 caregivers who completed the primary assessment, an incorrect liquid medication dose was observed for 24 of 79 caregivers receiving the intervention, or 30.4%, versus 39 of 72 receiving standard counseling, or 54.2%.
This was a pediatric medication study, not a contact-center trial. Its bundled design cannot isolate teach-back's effect, and missing follow-up limits interpretation. It supports checking what people can do with instructions in that setting, without supplying a health-system savings estimate.
AHRQ's teach-back guidance also applies to nonclinical staff explaining appointment requirements. Patients explain the plan in their own words. The purpose is to check the explanation, not test or embarrass the patient. Asking whether someone understands is not an equivalent check.
Easier language still needs an accuracy check
AI-assisted simplification should be evaluated against accuracy and completeness as well as readability.
In a separate 2024 JAMA Network Open evaluation of 50 adult discharge summaries, transformed versions had a lower mean reading grade level, 6.2 versus 11.0. However, 18 of 100 physician reviews identified safety concerns.
Those were review-level findings from a specific historical model and workflow, not a current failure rate for all AI. They were not observed patient harms. The operating lesson is to preserve essential meaning and require appropriate professional review when simplifying clinical information.
Design one patient handoff for usable information
Health-system leaders can start with one recurring interaction, such as explaining an appointment's location and preparation requirements. The following health literacy strategies are proposed operating practices, not an intervention package tested by these studies.
Specify the next action. State what the patient needs to do, when, where, and whom to contact if the plan cannot be followed. Keep clinically approved preparation instructions intact.
Confirm the explanation worked. Use the teach-back method for important instructions within staff roles and training. Clarify misunderstandings before ending the interaction. Route clinical uncertainty to an appropriately qualified professional.
Make help accessible. AHRQ's telephone guidance recommends clear scripts and an option to speak with a person. Its language-access guidance recommends recording spoken and written language preferences and using qualified language services. Simpler English does not replace those services.
Assign unresolved work. A patient question should have an owner and a defined response path. Record enough context to prevent the next team from restarting the explanation, within organizational privacy and documentation policies.
Evaluate the redesigned handoff locally. Review whether patients can identify the required action, whether unresolved questions reach an owner, and whether the need is resolved. Track repeat clarification contacts alongside staff effort and patient feedback. These are proposed local measures, not universal benchmarks or proof of avoided cost.
PEC360's perspective connects knowledge with execution
PEC360 approaches patient experience as an operating discipline. Organizational health literacy adds a specific question to that approach. Can the patient use the answer the organization provides?
The implication is to connect approved information, the employee's workflow, and the patient-facing explanation. A consistent answer that leaves the next step unclear still requires improvement. An easy explanation that changes clinical meaning requires correction. Leaders need both content responsibility and operational responsibility.
That distinction fits PEC360's healthcare operations and AI-orchestrated patient-experience platform. PEC Central provides live agents with contextual knowledge and workflow guidance. Sherlock EKOL supplies governed enterprise knowledge across the connected platform. Those capabilities can support a more consistent information foundation. They are not evidence that PEC360 has validated a health-literacy intervention or automates clinical discharge counseling.
For organizations exploring this approach, the first discussion should identify which explanations create uncertainty, who approves their content, how agents handle unanswered questions, and how the organization will assess understanding. Human judgment remains essential for clinical interpretation, empathy, complex circumstances, and escalation.
PEC360's operating perspective also favors reviewing the explanation and the handoff together. Teams should ask whether the approved answer was usable in the interaction and whether an unresolved need reached the right person. This is a proposed improvement practice, not a validated product result.
Technology should support that operating design. It should not turn message volume, call completion, or readability into a substitute for knowing whether the patient can proceed.
Start with one instruction patients need to use
Choose a handoff where the next action matters. Review the wording, test whether patients can explain the step, and check what happens when they need help. Organizational health literacy becomes practical when an organization takes responsibility for that complete interaction.
Authoritative sources
- CDC. What Is Health Literacy? October 16, 2024. https://www.cdc.gov/health-literacy/php/about/index.html
- ODPHP. Build Health Literacy at Your Organization During Health Literacy Month. October 2, 2026. https://odphp.health.gov/news/202609/build-health-literacy-your-organization-during-health-literacy-month
- Bert and colleagues. Comprehension of an AI-generated discharge letter versus a traditional discharge letter: two controlled quasi-experimental parallel-group studies. International Journal for Quality in Health Care. September 12, 2026. Accepted manuscript, DOI 10.1093/intqhc/mzag133. Publisher abstract verified; full manuscript PDF not independently reviewed. https://academic.oup.com/intqhc/advance-article/doi/10.1093/intqhc/mzag133/8792929
- Carroll and colleagues. Health Literacy–Informed Communication to Reduce Discharge Medication Errors in Hospitalized Children: A Randomized Clinical Trial. JAMA Network Open. January 16, 2024. DOI 10.1001/jamanetworkopen.2023.50969. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813929
- Zaretsky and colleagues. Generative Artificial Intelligence to Transform Inpatient Discharge Summaries to Patient-Friendly Language and Format. JAMA Network Open. March 11, 2024. DOI 10.1001/jamanetworkopen.2024.0357. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815868
- AHRQ. Health Literacy Universal Precautions Toolkit, third edition, 2024. Overview reviewed January 2025. https://www.ahrq.gov/health-literacy/improve/precautions/index.html
- AHRQ. Use the Teach-Back Method, Tool 5. Reviewed April 2024. https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html
- AHRQ. Be Easy To Reach, Tool 7. Reviewed March 2024. https://www.ahrq.gov/health-literacy/improve/precautions/tool7.html
- AHRQ. Address Language Differences, Tool 9. Reviewed September 2024. https://www.ahrq.gov/health-literacy/improve/precautions/tool9.html