Gastroenterologists Understand Health Literacy and Counsel Patients but Document Inconsistently: 2515

Introduction: Health literacy is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate decisions. Health literacy has been correlated with patient outcomes and measurement and documentation of patients' health literacy has been advocated. This study evaluated knowledge of and attitudes about health literacy among gastroenterologists at an urban academic medical center and the prevalence of documentation of health literacy in gastroenterology office notes. Methods: Gastroenterology faculty and fellows completed an anonymous survey regarding health literacy, the degree of health literacy in the urban area in which they practice, and their methods and habits for assessing and documenting health literacy and counseling. Using the electronic health records, a retrospective review was performed on 300 consecutive visits occurring in a one month period in the gastroenterology division of the same academic medical center. Patient demographics, the reason for the visit, documentation of counseling, and documentation of health literacy assessment were recorded. There were no exclusion criteria. This project was approved by the IRB. Results: Twelve (75%) gastroenterology faculty and fellow physicians responded. Ten (83%) accurately defined health literacy, and all 12 described acceptable ways to informally assess their patient's understanding of the encounter. Eight (67%) were able to correctly identify the literacy rate in the city in which they practice. Nine (75%) reported they assessed their patient's level of health literacy less than half of the time, and 11 (92%) stated they did not document their assessments and counseling. Of 300 patient encounters, 144 (44%) had documentation of a health literacy assessment, and 261 (87%) documented a discussion or counseling provided to the patient. Physicians provided counseling more frequently than they reported (p Conclusion: While most GI practitioners have a good understanding of health literacy, formal health literacy documentation is suboptimal. On the other hand, gastroenterologist underestimated the rate at which they documented patient counseling and education. Counseling and coordination of care are a common undertaking in a subspecialty medical practice. Increased efforts to assess and document patients' health literacy might enable physicians to tailor their patient education efforts and improve outcomes.