Health literacy is about more than a person’s ability to read and write. The growing need to obtain, process and understand basic health information affects Americans of all education levels, and new tools are emerging in order to improve the readability of complicated medical documents.

“There is a medical culture that has its own language, and they tend to communicate with their patients from within that culture, and often patients don’t understand the language that they’re speaking,” said Wendy Fluckiger-Brown, RN, director of consumer health information in the health services department of San Diego-based American Specialty Health (ASH).

In 2008, ASH decided to make a change toward improving the readability level of their communications material content, which includes print documents, Web documents, text messages and emails. The company is one of about 1,000 users of the Health Literacy Advisor (HLA), a literacy tool produced by Md.-based Health Literacy Innovations.

HLA, an add-on to Microsoft Word, assesses documents for readability, highlights complicated words and suggests replacements in order to make the content easier for consumers to understand and act upon in an educated manner. HLA aims to bring material to a 6th grade reading level, keeping in mind that the average reading level of health communication materials is 10th grade, while 30 million Americans have a reading level of 5th grade or below.

White space, graphics, layout and typography are all taken into consideration, said Aileen Kantor, director of innovation for Healthcare Literacy Innovations, who added that the program also functions as an editorial tool, picking up on clunky sentences that are too long and words with too many syllables.

“When people don’t understand what information means, mistakes happen,” said Kantor. “And when mistakes happen, healthcare costs go up; outcomes go down.”

According to research from Health Literacy Innovations, the average annual consumer healthcare cost of a person with low health literacy is $13,000 – compared to $3,000 for those with higher literacy levels.

Jo Poorman is the senior director of print and digital media at Chicago, Ill.-based Health Care Service Corporation (HCSC), a customer-owned health benefits company that has been using HLA since 2009. Poorman said it is important to “provide communication to people in a way that they want to receive it.”

“You’ve got to have something that’s attractive and interesting and engaging,” she said. “The health literacy software helps build that foundation by making sure that we have the best words possible and the simplest words possible, and then build on to that with all of the other elements.”

But the literacy advisor does not replace the writing and editing skills required to create and edit the original documents.

Doug Metz, DC, chief health services officer and executive vice president of ASH, said the tool has been a great addition to the development and editorial process that goes into producing thousands of pages of communication materials, speeding up the process and making it more efficient. But, he added, the literacy advisor “isn’t the total answer.”

“That’s always a challenge with automated tools,” said Metz. “Sometimes they’ll be missing something and you have to be careful. That’s why you need a human eye to look at it.”

Metz said lowering healthcare costs comes down to getting consumers to change how they use the system and how they care for their health. Creating literate resources is a huge step toward achieving this end.

People “take a more reasoned response to something because they understand it more clearly,” he said. “People do something different; they do something better.”