Problem: Psychiatric and primary care nurse practitioners (NPs) at an outpatient telehealth clinic receive high volumes of electronic communication from patients concerning medication side effects. Low patient health literacy was identified as the root cause. Purpose: The purpose of this quality improvement project was to implement the BRIEF health literacy screening tool and refer patients with marginal or limited health literacy for further medication education, reducing the number of medication-related electronic messages. Methods: The BRIEF tool is a valid, reliable, and evidence-based screening tool selected to identify patients with low health literacy. The quality improvement project lead (QI-PL) interviewed and collected data on patient workflow. Project stakeholders collaborated on planned workflow changes. The screening tool was built into the electronic health system to facilitate screening all new patients and a referral process was created. The QI-PL trained and supported the clinic NPs on the new practice workflow. NPs sent weekly email counts to the QI-PL. Results: Clinic NPs screened an average of 92.8% of new intake patients using the BRIEF tool. The NPs referred 88.2% of patients screened as either “marginal” or “limited” health literate. An average of 27.5% of patient messages contained questions about medication side effects, a decrease from the baseline of 40%, consistent with literature findings that medication education provided by a pharmacist improves health literacy. Conclusions: High adherence to screening and referring patients shows the practice change feasibility. Practice NPs appreciated that the BRIEF tool and workflow change added minimal work and created a standardized process for patient health education. Electronic messages did not decrease consistently but were overall lower than baseline.