What language is that? Using technology to communicate with non-English speaking patients

Imagine walking into an emergency department. You are sick or wounded, gravely enough to warrant a trip to the nearest hospital. You are scared, and likely not thinking as clearly as you would be in a non-emergent situation. Now imagine that no one in the ED speaks your language. You are seeking help, and yet you find yourself unable to even describe your condition. What would you do? Who could you turn to?

Unfortunately, that situation plays out every day in American hospitals. According to the U.S. Census Bureau, more than 60 million Americans speak a language other than English at home. More than 22 million reported speaking English less than “very well”. (1) Considering that communication is the cornerstone of good medical care, it is alarming to think that such a significant portion of our population may not be able to communicate in a healthcare situation. Equally alarming is the strain limited English proficiency (LEP) patients put on the American healthcare system.  Without the use of professional interpreters, the LEP population systematically sees higher readmission rates (2), a longer length of stay in hospitals (3), and uncoordinated, even unnecessary care. Professional interpreters can and do mitigate these adverse effects, but then the challenge becomes finding and connecting with professional interpreters – a problem hospitals across the nation are struggling to resolve efficiently.

There are many ways hospitals can provide interpretive services. Some hospitals in areas with a significant LEP population keep medical interpreters on staff. Others maintain contracts with interpretation agencies, and schedule interpreters as needed. Nearly every facility at least partially relies on over-the-phone (OPI) interpreting, and in recent years many hospitals have begun to implement video remote interpreting (VRI) systems.

Video remote interpreting is rapidly becoming the industry standard for on demand language services. Now, when an LEP patient arrives onsite, medical professionals can reach qualified interpreters over a videophone call. VRI marries the benefits of onsite and over-the-phone interpreters. The patients can still benefit from an interpreter’s visual cues, and the healthcare provider can reach interpreters on-demand, 24 hours a day. Imagine being in that ED again, seeking help from doctors and nurses that don’t speak your language. Now imagine a nurse wheels over a video screen and places a call to an interpreter. Within minutes of arriving at the hospital you are looking at a person who understands you. Imagine the relief that would flood over you as you realize you are understood.

Technology is a fact of life in today’s world – so it makes sense that remote video technology is working its way into our examination rooms. As everyone who has ever spoken to a loved one over Skype understands, a visual connection is incredibly important. This becomes even more crucial in a healthcare setting, where incongruent communication is common. Incongruent communication refers to the moments when body language and verbal instructions don’t match. Picture a man who has stubbed his toe. He may insist vocally that he is fine, but his face is twisted into a grimace and he is clutching his foot. An infamous communication study on conflicting messages found that people are more likely to believe body language to be true when someone’s words don’t match their disposition. (6) So using our previous example, a person who insists they are fine through a grimace will not be perceived as fine. With over-the-phone interpreting, all of that physicality is lost. A smiling face, even over video is far superior to a distant voice on the phone, and immediate assistance is better than waiting for an onsite interpreter to arrive.

This innovative use of video call technology is a complete game-changer for LEP patients and healthcare providers alike. VRI is incredibly popular among healthcare administration, as it has been shown to be the most cost effective solution on the market. Some facilities have seen more than a 70 percent cost reduction following the transition from onsite agency interpreters to VRI (4). Other facilities have saved time, seeing as VRI calls can be up to 25 percent shorter than OPI calls (5), and patient satisfaction has skyrocketed.

The LEP population is growing. Between 1990 and 2010 it grew by more than 11 million (7), and has likely grown even further since. It is important to hospitals to put effective, reliable language access services together now.  Supporting this influx of non-English speaking residents has never been as easy as it is today with the use of video remote interpretation technology. By implementing video call technology now, hospitals are ensuring that they will be able to speak to any and every patient that walks through their doors.