The following is a guest blog post by David Fetterolf, President of Stratus Video.
The need for language services in healthcare is widespread. Each day, providers are encountering a larger number of patients with limited English proficiency (LEP). Both the frequency and number of languages requested have increased significantly in recent years. The Agency for Healthcare Research and Quality estimates that “at least 8.6 percent of the U.S. population is at risk for adverse events because of barriers associated with their language ability.”
To better serve a patient population with increasingly diverse language needs, healthcare facilities are implementing video remote interpretation (VRI). VRI enables providers to reach a wide range of qualified interpreters that are readily available and accessible via encrypted, HIPAA compliant video, with just a few presses of a button. The implementation of VRI enables acute care providers to better serve a significant patient population, boost LEP patient engagement and offer a higher level of care for LEP patients.
Serving a Significant Patient Population
Planning for LEP patients is challenging, particularly with walk-in, urgent care and emergency care patients when no background information is available and the patient’s language preference is unknown. Having onsite interpreters available for all foreign language encounters is no longer feasible for most acute care organizations, as the demand for language services greatly outweighs the supply.
The LEP patient population is significant. Survey results from a national survey conducted by Health Research & Educational Trust and the National Health Law Program demonstrate that 80 percent of surveyed hospitals encounter LEP patients frequently, on a monthly or weekly basis, and over 40 percent serve LEP patients on a daily basis. Twenty percent or more of hospitals indicated Spanish, Chinese, Vietnamese, Japanese and Korean as the most frequently requested languages. An overwhelming 90 percent of hospitals reported Spanish as the most commonly encountered language other than English.
In addition to a larger LEP patient population, healthcare facilities are challenged with providing interpretation for less common languages. Qualified language services are more difficult to obtain for languages of lesser diffusion or less common languages, like Mixtec, an indigenous language of Mexico, which has recently become a more frequently encountered language in California hospitals. Refugee relocation zones also experience significant rises in new patient populations with distinct language needs.
With such a rise in requests for language services, healthcare facilities struggle to provide onsite interpreters in every language requested at all hours of operation. This is especially the case when languages of lesser diffusion are requested in remote areas with less diverse language pools.
Video remote interpretation provides access to a larger pool of interpreters that are available immediately to enable effective patient provider communication when a language barrier is present. For many acute care practices, VRI serves as a safety net to ensure coverage when onsite interpreting services are exhausted or unavailable.
In addition to a significant rise in the LEP patient population, federal regulations surrounding language access in healthcare have tightened. Section 1557 of the Affordable Care Act expressly prohibits the use of untrained interpreters, also known as ad-hoc interpreters, barring extreme circumstances. The act requires healthcare facilities to use qualified medical interpreters to ensure meaningful access to healthcare information.
VRI ensures complete compliance with Section 1557 of the Affordable Care Act, Title II of the ADA for Deaf and Hard of Hearing (HoH) patients and Title VI of the Civil Rights Act of 1964, among other federal regulations surrounding language access in healthcare.
With VRI, acute care organizations have more flexibility to ensure coverage. Onsite interpreters can be staffed for top languages or scheduled for appointments, while video or over-the-phone interpreters can be accessed when onsite interpreters are not available or for situations of immediate need. In addition to ensuring compliance with federal regulations, the use of qualified interpreters is associated with improved LEP patient outcome, satisfaction and engagement.
Effective communication in healthcare is associated with better patient outcomes. This is particularly true with LEP patients. Mounting evidence shows that LEP patients, who are unable to effectively communicate with their provider, are at higher risk for medical error in comparison to English speaking patients. This is due to the strong correlation between communication error and medical error. Fortunately, the use of qualified medical interpreters greatly reduces this disparity, raising the level of care and reducing the risk of error for LEP patients.
The visual component of VRI enables interpreters to convey meaning of any nonverbal cues that could be key to diagnosis and treatment as well as clarify any cultural nuance that could be impacting the patient provider conversation.
In addition to fewer communication errors, the use of qualified medical interpreters is associated with shorter hospital stays and reduced likelihood of readmission. A study published in the Journal of General Internal Medicine, analyzing the effectiveness of using a medical interpreter for LEP patients, found that LEP patients without access to language services at admission and discharge stayed in the hospital nearly 1.5 days longer than patients with access to an interpreter.
The use of qualified medical interpreters is also correlated with improved LEP patient satisfaction and adherence to care plans. When patients can have a meaningful conversation with their provider in a way they can understand throughout the course of medical treatment, they are empowered to become an active participant in their healthcare plan. A significant decrease in the number of communication errors combined with a boost in patient engagement and adherence with healthcare plans results in improved outcome for LEP patients.
VRI provides LEP, Deaf and HoH patients with immediate, meaningful access to their healthcare information, an essential tool for modern healthcare. With VRI, acute care providers can ensure all patients, regardless of language or cultural background, are receiving the same level of high quality care.
About David Fetterolf
David Fetterolf is President of Stratus Video, a language services company that is changing the way limited English proficiency patients communicate with their healthcare providers.