Readability Level of Health Insurance Portability and Accountability Act Notices of Privacy Practices Utilized by Academic Medical Centers

Recently enacted Health Insurance Portability and Accountability Act legislation requires health care professionals to provide patients with a “Notice of Privacy Practices” (NPP) document as part of their informed consent process to participate in assessment and treatment. We were interested in the readability of these forms. We attempted to find a NPP from an academic medical center in each state plus the District of Columbia where documents were placed on the institution's Web site. Documents were obtained from 40 jurisdictions and were then analyzed utilizing two measures of readability. The majority (65%) of these documents were written beyond the 12thgrade reading level, and almost the entire sample (90%) fell in the difficult range of reading ease. Academic medical centers have an ethical obligation to improve the readability of these documents and should do so to improve clinical practice and reduce liability.