Margaret Loveland said that the commissioned paper makes clear the enormous task involved in instilling concepts and practices of health literacy into providers and payors. It is encouraging to hear from the panelists that progress is being made and that some organizations and individuals are beginning to act on health literacy. Another important point that emerged from the paper and the discussion is the idea that health literacy is closely related to patient safety, which may motivate providers to incorporate health literacy into their practices. Finally, although none of the panelists represented the pharmaceutical industry, that sector has been involved in health literacy activities for quite some time because of its recognition that health literacy and medication safety are closely related. Partnerships with that industry may be one way to advance the implementation of health literate practices, she said.

Benard Dreyer expressed great admiration for the commissioned paper and the presentations. He suggested that the 18 attributes described should be reorganized and prioritized in a way that connects them more directly to accountable care organizations or patient-centered medical homes or patient safety. It might also be useful to place them in a Venn diagram with health disparities, he said. Second, something that is specific to children needs to be added. Third, the discussion about the diversity of cultures and language, which is included in the paper, should be elevated to a more prominent discussion. Finally, there is the issue of how to move the discussion into action. One of the points made is that there must be defined measures for assessing whether an organization is health literate. There are a number of current measures, including the new HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), that can be used as a start. Identification and discussion of measures may be a worthy topic for the roundtable to follow up on.

Will Ross said that the paper and presentations effectively married health literacy to dimensions of quality. As a consequence, this has elevated health literacy as a recognized part of the pathway to quality care. The roundtable should begin discussions about and an examination of the relationship between health literacy and quality.

Ruth Parker quoted Oliver Wendell Holmes, Jr., who said, “I would not give a fig for the simplicity on this side of complexity, but I would give my life for the simplicity on the other side of complexity.”1 The paper and the discussion have shown that health literacy is complicated. The next step is to discover how to make the concepts and discussion understandable, clear, actionable, and useful.

Sharon Barrett said that the paper and discussion has helped move the focus from emphasis on the patient’s responsibility to be health literate to

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1 Many attribute this quote to Oliver Holmes, Sr.



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