Breaking the Language Barrier in Remote Healthcare

By: Sabrina Par

Maintaining good clinical communication is crucial in providing healthcare services. However, miscommunication in hospitals remains a big issue, especially with Limited English Proficiency (LEP) patients. These LEP patients are those who have difficulty writing, reading, speaking, and understanding the English language despite living in the U.S. For this reason, many healthcare providers are experiencing communication errors when conversing with them.

There are over 21 million LEP people in the U.S, and about 95 million residents do not have enough literacy to understand medical terms. This hinders them from receiving the effective diagnosis and treatments that they need. For these reasons, it is beneficial for healthcare/professionals to look for ways to overcome the language barrier by implementing policies, systems, and alternatives for multilingual solutions in the medical field.

Understanding the common language-related issues in the healthcare system

According to the U.S. Census Bureau, there are about 350 languages spoken around the United States. This language diversity may create a barrier between English-speaking medical practitioners and LEP bilingual patients. A study from Oman Medical Journal showed that about 66.7% of LEP patients have difficulty accessing proper healthcare due to miscommunication. It is also difficult for them to keep up and arrange their appointments. Furthermore, they are susceptible to misdiagnoses and physical harm, which could cause several consequences to healthcare providers.

In addition, some hospitals may have the inability to translate the essential paperwork to a language that their patients can understand, which could be an issue. Healthcare providers must produce various crucial documents, and two of them are the patient’s consent and intake form. Both parties must also understand all the details included in the papers before they continue with the medical procedures.

However, in some cases, instead of involving the patients in the process, the practitioners don’t have a choice but to make decisions for them due to the lack of qualified medical interpreters and translators. It serves as a significant obstacle and detrimental to an individual’s health management. Adverse events are more likely to happen to patients with LEP, becoming a great challenge in the medical field. Here are some of the medical negligences that most practitioners commit due to miscommunication:

Failure to diagnose – This happens when a medical practitioner fails to make a proper diagnosis due to a language barrier.
Failure to warn – If a patient could not understand the health risks and options for medical treatments, the physician breached his duty.

Furthermore, the 1964 Civil Rights Act requires all healthcare providers receiving federal funds to provide language services such as medical translations and interpretations to LEP patients. However, the University of California’s study found that nearly one-third of the hospitals in the state are still not following this requirement. As a result, over 2,000 recorded deaths are due to clinical communication errors, according to a report from CRICO Strategies National CBS.

Aside from that, the pandemic plays a significant role in clinical miscommunication as it causes the need for remote healthcare. Delivering digital health services is one of the most critical healthcare institutions’ tasks, and communicating via voice call or video call is inconvenient. It makes conveying medical terms with LEP even more difficult. This opens up the importance of having a medical interpreter that healthcare providers can rely on when they need their services.

Hiring bilingual health workers

A language barrier between medical providers and patients could cause a lot of misunderstanding and miscommunication in remote healthcare. Medical practitioners should let the patients know about the possible treatments and medications that they can have. However, if these individuals have low English proficiency, it will be hard to communicate with them. Even if they can speak and understand the English language, there is still a possibility that their skills are insufficient to comprehend medical terminologies. Even if family members with higher English proficiency can help LEP patients, it will compromise the patient-doctor confidentiality under the HIPAA.

Most of the hospital board of trustees and management are making much effort to overcome the language barrier, and hiring some bilingual health workers is one of the best solutions. It is essential to have some receptionists, nurses, and doctors who could speak in other languages that the patients may use. Besides helping them understand all the vital information, having someone who could appreciate your patients well could make them feel better. It could also result in a more effective diagnosis and smoother processes.

Today, healthcare providers consider the ability of medical applicants to speak more than one language. Hiring bilingual nurses, receptionists, occupational therapists, and assistants is a more cost-effective method than looking for medical interpreters that would work as a third party on medical procedures.

Formalizing effective communication methods

All materials and documents that hospitals provide must contain reliable and professional content. However, merely relying on Google Translate can result in misinterpretations and defeats the professionalism of hospitals. The mistranslated statements could cause some medical issues with the patients and distrust from the institution.

Therefore, having an effective communication method for the healthcare facility could save its integrity. With the internal communication method, forming a smoother process of setting up appointments, assigning tests, and sharing information would be more efficient. It will also help assess medical interpreters’ skills and update the record of bilingual individuals in the hospital.

An effective way of improving internal communication is to develop an environment that promotes better hospital staff collaboration. It is essential to create diversity in groups and include bilingual staff to communicate convenient communication with LEP patients. It is also ideal to develop an integrated communication system where authorities will instantly convey critical information about the patient. It will give enough time to find bilingual staff or medical interpreters to attend to the patient’s needs and avoid misunderstandings.

Here is a sample procedure that healthcare providers could follow when creating an LEP communication policy:

Identify LEP patients and their language.
Find a qualified interpreter.
Provide written document translations.
Provide translated notices to LEP patients.
Assess language needs and implementation.

Involving medical interpretation agencies

It is impossible to have every medical practitioner speak and understand all possible languages that the patients may use. If hiring bilingual staff is limited or impossible, getting professional medical interpreters could also be your option. They can help your doctors and patients speak more comfortably to one another. Moreover, using remote medical interpretations is one of the medical industry trends due to the global pandemic.

There are two options for remote interpretation: telephonic interpretation and video interpretation. The first one is more convenient in bridging the language gap between practitioners and patients as most interpretation agencies prefer calls. Meanwhile, video interpretation is also gaining hospitals’ interest and is one of the fastest-growing foreign language services in the industry.

Remote medical interpreters offer various benefits to the patient and healthcare system as they improve clinical care quality and patient satisfaction. Rather than having an interpreter physically go back and forth to a hospital and paying more for their services, it would be more efficient to have someone attend to the practitioners’ needs at one call. If you want to know more about how medical interpreting works, check this article.

Questions that trustees must ask when hiring medical interpreters

Having medical interpreters is essential to build better relationships between healthcare providers and patients with LEP. With the increasing demand for remote healthcare due to the pandemic, the need for professional medical interpretations increases. However, hiring the right medical interpreter requires much effort and various considerations.

Here are some of the questions that the trustees must ask when hiring medical interpreters:

1. Do the interpreters have enough experience in the medical interpretation field?

When hiring a medical interpreter, ensure that they have enough skills and more than three years of experience in the medical field. Ask about their past experiences and the outcome of their previous jobs. Check if they have healthcare-related certification or qualifications to know if they are fit for the job description.

2. How many languages can they support?

According to the 2018 Migration Policy Institute report, about 22 percent of the U.S. population does not have enough English proficiency at their home. Moreover, over 350 languages are spoken across America, heightening the importance of knowing the number of languages that the medical interpreters could provide for the medical institution. When outsourcing for interpretation agencies, choose one that could support the most number of languages.

3. What is their availability?

There will be patients that need some medical attention at any time of the day. To attend to their needs, medical interpreters should always be ready to deliver their services 24/7. Before hiring an interpreter, make sure that they can listen to the healthcare providers’ and patients’ needs at all times.

4. Is it easy to connect with them when needed?

One of the most significant challenges for remote medical interpreters is ensuring that the healthcare providers can contact them instantly. Ensure a seamless experience for the patients by knowing if connecting with the interpreter is almost instant or with a reasonable wait time. If there are available reviews for the agency or company, spend some time reading them.

4. Do they comply with the HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) protects patient information privacy, and all healthcare providers must comply with it. It is essential to ask the medical interpreters if they are HIPAA compliant since they will have the privilege to know the patient’s health information while interpreting.

5. Are they knowledgeable about ASL interpretation?

There could be some patients with hearing issues, and it is essential to ensure their healthcare accessibility within the facility. Ask the interpreters if they could support American Sign Language (ASL) in the medical field. Look for their certifications and adequate experiences in working for healthcare providers.

Sabrina Par is a Legal Management graduate who grew up in a family of medical practitioners. She is passionate about writing medical articles that are particularly related to legal systems and languages.

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