Providing Quality Interpretive Services to Limited English Proficiency Patients Under the “Patient First” Model of Care

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By David Fetterolf, Stratus Video President

Any healthcare provider will tell you that no two patients are alike. Some are anxious…others are comfortable. Some are very informed on their prognosis and conditions, and others can barely pronounce the medications they take. With the growing diversity in the United States (over 25 million Americans are considered to have limited English proficiency), some patients cannot even communicate with their healthcare providers in English.

Fortunately, a new philosophy has become popular among providers in recent years. The “patient first” philosophy puts patient need before historic healthcare practice and hospital policy and procedure. Healthcare providers are stretching their care models to meet each patient at their level. Are they anxious? Time to practice good bedside manor. Are they uninformed? Time to educate. Do they speak a language other than English? Time to provide medically qualified interpretation. “Patient first” standards make the protection and safety of patients top priority; regardless of cultural influences or the primary language each patient speaks.



An overview of Limited English Proficiency (LEP) Patients in the United States:

As a nation of immigrants, the United States has always been host to language diversity, but in recent years the LEP population has grown drastically. According to the Migration Policy Institute, the number of LEP individuals in the US has grown by 81% between 1990 and 2011. Federal law states that LEP patients have a right to receive meaningful access to language services within our healthcare system, which is a prudent decision considering that LEP patients who do not receive access to medically qualified interpreters often experience a longer length of stay and an increased risk of readmission.

The Civil Rights Act, Americans with Disabilities Act, and Affordable Care Act all stipulate that LEP patients receive interpretation services at no cost to them. The use of “ad hoc” interpreters (i.e. untrained interpreters, like a patient’s family member, friend, or a bilingual staff member) is highly discouraged baring emergency situations. Interpreters must be trained, tested, and familiarized with medical terminology and procedure.

These stipulations, aimed at improving patient safety and providing equal care to all patients regardless of primary language spoken, really exemplify the “patient first” model of care.

How Healthcare Intuitions Provide Meaningful Access to Language Services:

There are three modalities of interpretation available to healthcare providers today: Over-the-phone interpretation (OPI), video remote interpretation (VRI), and on-site interpretation. There are pros and cons to each solution.

With OPI, access to interpreters is quick, and hundreds of different languages can be accessed through a simple phone call. Unfortunately, the lack of visual cues between patient and interpreter via phone call means that communication is less efficient, and can take longer than it needs to.

With VRI, access is quick and hundreds of languages are available, plus there is the added benefit of visual cues via video call. Unfortunately, not all healthcare institutions have strong enough WiFi to support video calls.

As for onsite interpretation, it is slow to access and expensive to provide, but it does offer the highest quality of interpretation, and is recommended for use in lengthy or high-stress patient encounters, like labor and delivery or end-of-life discussions.

Offering Interpretive Services Under the “Patient First” Model:

Any healthcare institution looking to practice “patient first” care should offer all three of those interpretation modalities. OPI is key for patients calling in for information or to book appointments, VRI can be used for quick or unexpected encounters, and for languages of lesser diffusion, and onsite interpretation can be reserved for lengthy or stressful patient. By providing all three modalities of interpretation, and adhering to clear guidelines on when each modality should be used, healthcare providers are ensuring that their LEP patients never go without the language assistance they need, regardless of where they are within their healthcare journey.

When it comes to “patient first” care, it is important to remember that all patients deserve clear, understandable communication, regardless of the language they speak. Fortunately, through a robust suite of language service products, there are quick, easy, and efficient ways for healthcare institutions to provide meaningful access to interpretation in hundreds of languages.

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