Patient education improves health outcomes
Patient education is more than simply giving patients information. When it is structured and connected to the patient’s care, it can function as a clinical intervention.
A major analysis covering more than 776 studies and approximately 75,000 patients found that patient education improved physical, physiological, psychological and functional outcomes. Benefits were identified across diabetes, cardiovascular disease, respiratory disease, cancer, musculoskeletal conditions and mental health conditions. Patient education was also associated with reductions in pain, medication use, and visits to healthcare facilities. reference 1
Personalized care planning helps patients manage their health
A Cochrane review of 19 randomized trials involving 10,856 patients found that personalized care planning produced small but measurable improvements in patients’ health and their ability and confidence to manage it. reference 2
The review found improvements in blood sugar, systolic blood pressure, depressive symptoms, self-efficacy and self-care. One asthma study also reported improved asthma control. Benefits were greater when care planning was comprehensive, involved the patient’s usual clinician, and was integrated into routine care. reference 2
This supports making the written care plan a standard part of the healthcare visit, not an optional handout added afterward.
Education can improve medication adherence
A systematic review of 18 randomized trials found low- to moderate-quality evidence that educational interventions improved medication adherence, with the clearest benefit among patients with type 2 diabetes. reference 3
The American Heart Association also identifies patient education and counseling among the strategies that can support medication adherence, especially when education is individualized, repeated, and provided when a condition or medication is first introduced. reference 4
A written care plan gives patients something they can review after the conversation ends, when questions about medications, instructions and next steps often arise.
Written and verbal instructions work together
A single-center pre-post study evaluated a communication process that combined a written summary, physician-led verbal instruction, and teach-back to confirm understanding. Among 120 hospitalized adults, patient understanding improved in every major area. reference 5
21.5%
Diagnosis
35.1%
Treatment
45.8%
Medication changes
38.1%
Follow-up instructions
Improvement in patient understanding among 120 hospitalized adults, in the study cited above.
Most areas showed larger gains among patients with less formal education; understanding of medication changes was the exception. reference 5
Although the study measured immediate patient understanding rather than long-term outcomes, its communication process closely reflects the PENCIL Health™ model: provide a clear written care plan, review it with the patient, answer questions, and confirm understanding before the encounter ends.
Teach-back confirms that communication worked
Teach-back asks patients to explain the care plan in their own words. It is not a test of the patient. It is a way for the healthcare team to confirm that the information was explained clearly.
A systematic review reported beneficial effects in 19 of 20 teach-back studies across different healthcare settings and patient populations. Reported benefits included improvements in understanding, knowledge, recall, self-management and quality of life, and, in some studies, hospital readmissions. reference 6
The Pencil Check supports this same goal by prompting patients to review each step, identify questions, and confirm what they will do next. When clinicians also ask patients to explain the plan in their own words, the process becomes formal teach-back.
Written summaries support communication and continuity
A scoping review of 73 studies found that reported benefits of after-visit and discharge summaries included better patient understanding, engagement, adherence, communication, care transitions and continuity of care. reference 7
Patients valued written summaries most when they were:
- Clear and concise
- Personalized to their care
- Written in understandable language
- Focused on actionable next steps
- Easy to access and share with caregivers
Technical language, excessive information, inconsistent formatting and poor integration into the clinical workflow reduced their usefulness. reference 7
A true written care plan should do more than repeat information from the medical record. It should clearly tell the patient what the condition means, what to do next, what to monitor, and when to seek help.
A portal alone is not enough
A 2026 cross-sectional study at a large urban academic health system examined more than 6.2 million ambulatory visits. Although digital engagement with after-visit summaries increased over time, only 37.6% were viewed in 2023. reference 8
Physicians spent a median of 1.38 minutes preparing patient instructions, yet the digital summary was not viewed after 62.4% of encounters. Patients were more likely to engage when the physician included personalized instructions. reference 8
Although these results came from a single healthcare system, they reinforce an important point: providing information through a patient portal does not guarantee that it will be opened, understood or followed. This supports providing and reviewing the care plan during the visit, rather than placing information in a portal and assuming the patient will find and use it later.
What the evidence means
Taken together, the evidence supports a clear end-of-visit standard: explain the plan, put the plan in writing, and confirm that the patient understands the plan.
Verbal instruction provides context and allows questions. A written care plan gives the patient something clear to follow after the visit. Teach-back confirms that the plan was understood correctly.
PENCIL Health™ translates established evidence on patient education, personalized care planning, written instructions, plain-language communication, consistent organization and teach-back into one repeatable clinical workflow. Together, these practices can improve patient understanding, self-management, medication adherence, care continuity, patient satisfaction and selected clinical outcomes.