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What technologies can assist in meeting the language needs of patients and providers?

Posted: 14 Nov, 2016   Recommendations: 4   Replies: 9

What are the benefits and risks of these technologies?

Replies

 

Thomas Bauer Replied at 11:29 AM, 14 Nov 2016

I do not believe their is one technology that best meets the needs of all patients and health care settings. 1:1 (In person) interpretation has many benefits including relational and the ability to evaluate body language of all members of the conversation. Phone interpretation provides near immediate access to a very wide array of languages but lacks the visual aspect of communication.. Video remote interpreting is emerging as a blend of the benefits of both forms of interpretation. As we look to explore these options I am looking forward to learning more about our communities experiences in all forms of interpretation.

How are we meeting the written just in time needs of our patients?

How are you providing medical information for those with visual impairments?

Danilo Formolo Panelist Replied at 1:09 PM, 14 Nov 2016

There are a vast number of technologies to be used in medical interpreting. I agree that remote interpreting tools may not be appropriate for every encounter. Examples where an onsite interpreter may be appropriate include: end of life scenarios, multi-disciplinary plan of care meetings, new diagnosis, etc. With the rise in use of healthcare technology, specifically telemedicine, it is necessary to leverage tools that enhance the patient experience. With rising healthcare costs, it is necessary to deliver care in the most cost-effective manner. Video Remote Interpreting (VRI) is a great hybrid of high-tech and high touch. Providers may obtain an interpreter in a very short timeframe at the touch of a button. In an emergent situation, this creates better patient satisfaction and improved throughput versus waiting for an onsite interpreter. Costs are kept to a minimum since healthcare systems only pay for minutes used. Finally, with over-the-phone interpreting (OPI), quick access to over 200 languages as well as lowered costs are the benefits to this technology.

I'd like to share a slide from a colleague in the field. Mateo Rutherford heads up the Language Services program at UCSF (officially giving him full credit for this work). He has created a simple illustration which is a mere guideline for using technology in medical interpreting settings. This is only a guideline; one is permitted to "cross over" as appropriate:

Attached resource:

Danilo Formolo Panelist Replied at 10:43 AM, 15 Nov 2016

Good morning participants and panelists! Today I want to briefly highlight potential risks associated with the use of technology in an interpreting session. The first one that comes to mind is risk of acceptance. Many patients and providers are hardwired to leveraging an onsite interpreter. This can lead to negative views of its use and dissatisfaction of both parties. However, proper introduction and education of these technologies are key stakeholders in its success. The other risk that comes to mind is use of the technology itself! How many times do we have an error with our computer, tablet, or smart phone that is unexplainable? The use of video interpreting relies heavily on technology, in particular wireless networks and internet traffic. While it may have a reliability of 95%+ in many areas, there are those rare occasions where a call may drop. Can anyone think of other risks associated with remote interpreting?

David Fetterolf Panelist Replied at 1:09 PM, 15 Nov 2016

Hey Danilo!

Question for you - have you (or one of the healthcare providers at your facility) ever had a patient refuse to use remote interpreting? How do you guys handle that?

Danilo Formolo Panelist Replied at 1:56 PM, 15 Nov 2016

For our healthcare system this generally isn't an issue. It is important to explain that this (VRI, OPI, etc.) is the technology we will use to aid in communication. On rare occasion, a patient might "refuse" remote interpreting simply because he/she is resistant to innovation. If resistance is encountered, we ask the patient to at least try it out, and also ask if there is any type of issue that would prevent them from understanding their medical care as a result of using remote interpreting. The other technique is in an emergency situation (especially if we need to call an outside agency) where we let a patient know that we are happy to call an onsite interpreter, but this would delay care by an hour. Most of the time the patient chooses the remote interpreting option. To me, reasons such as "I don't like it!" simply do not fly. We must be resourceful and overcome objections in the most sensitive matter. Ultimately, however, we do respect the desires of our patients and will respect their request for an onsite interpreter if requested.

A/Prof. Terry HANNAN Replied at 2:53 PM, 15 Nov 2016

It would seem the National Acadamies Press is following us as they have just published this free (PDF) download.

Relevance of Health Literacy to Precision Medicine:
Proceedings of a Workshop (2016)
https://www.nap.edu/catalog/23592/relevance-of-health-literacy-to-precision-m...

Abdullahi Sheikh Panelist Replied at 4:10 PM, 15 Nov 2016

Great point Danilo,

Technology is the emerging “fast” and “quick” solution for many industries. Normally, employees will most importantly be required to have technological skills in order to be able to operate new devices that will be adapted for use in a company. Comparing OPI and VRI, OPI requires less training and tools. With VRI, employees are required to know how to operate the online platforms that will be the everyday means of interacting with interpreters and patients. The employees must therefore have the technological knowhow in order to be relevant in the future workplace (Cole, Waite, Nichols 2004). The skill sets that will be most sought after by employers are therefore IT related (Alchian, Demsetz 1972). They will be expected to make meaning of the readings and analysis that will be yielded by the computer software and programs. General skills like customer service will not be very relevant because there will be minimal face to face interaction with the patients. However, the employees will require some general skills such as problem solving skills, creativity, emotional intelligence and critical thinking.


References:

Alchian, A. A., & Demsetz, H. (1972). Production, information costs, and economic organization. The American economic review, 62(5), 777-795.
Cole, K. D., Waite, M. S., & Nichols, L. O. (2004). Organizational structure, team process, and future directions of interprofessional health care teams. Gerontology & geriatrics education, 24(2), 35-49.

Thomas Bauer Replied at 2:47 PM, 16 Nov 2016

There is an app for that..... The medical encounter is incredibly complex and the use and meaning of one word can change the outcome of any conversation. I often think about watching a show from Australia or England as an American. Even though we share the same language words often are used different or have different means. Consequently, cultural translation is an essential component of the symphony that is medical interpretation. While it is intriguing to think an app that interprets or translates could increase access the concerns for accuracy and safety must first be addressed as clear communication is the foundation of quality health care

Kathleen Addison Panelist Replied at 10:44 AM, 18 Nov 2016

I'd like to point out that while remote interpreting technologies have the spotlight at the moment, the written translation and localization industry is also experiencing technological advances, which are equally growing in sophistication:

- TM (Translation Memory) is a linguistic database that captures, stores and re-uses repeated translated content for future use. Content is accumulated in source and target language pairings so that the same sentence never needs to be translated twice. This means, the more you build up your TM lexicon, the more quickly you can expedite turnaround and the more you reduce cost

- Macrosimplification is the simplification of English text into 'plain English.' This technology streamlines, re-organizes and reduces written content, by recognizing plain English as a distinct language which can be translated. This ensures that it actually connects with audiences of all backgrounds and education, before being translated into another language. It makes for easier adaptations for hearing and visually impaired - like audio tapes, large type, and Braille formats. And because it reduces page count by 20-30%, it offers significant ROI to to its end-users!

The advances just keep on coming!

This Expert Panel is Archived.

This Expert Panel is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.