Video Remote Interpreting Services in Hospitals: Patient Outcomes, Budget Concerns, and Technological Developments
The need for high quality interpreters in hospitals is now more pressing than ever. Our society is diversifying at an incremental rate and these citizens have an equal right to proper care. Too often, patients that do not speak the local language are forced to rely on “interpreters of convenience” like relatives and hospital staff or worse, they are left without being able to fully communicate with their physician. Language discordance can increase hospital stay and cause poorer patient care. This can have significant financial ramifications. In order to minimize the effect of language discordance, hospitals need to provide specialized interpreters to their patients. The increased budgetary restraints imposed on public health providers coupled with a paradigm of risk management has made this need even greater. Costs can be cut by providing high quality care to all patients and mitigate the risk associated with miscommunication. The development of cost-effective technologies in the language industry has simplified the once complex and expensive interpreting service delivery.
Numerous studies have suggested that language discordance leads to increased costs for the patient and the hospital as well as poorer health outcomes. Specifically, they note that those who do not speak the local language are more likely to: see their physician more often, are less likely to be given follow-up appointments, less likely to return for follow-up appointments, and are less likely to follow aftercare instructions (Bischoff, Loutan:2004; John-Baptiste et al:2004). In the long run this can lead to worse health outcomes and consequently increased strain on an already stressed healthcare system.
Show Me the Money
In monetary terms, one study found that length of stay was increased by an average of 0.5 days for non-English speaking patients in an American hospital. It is important to note that this increase is incremental dependant on the diagnosed condition. With an estimated cost of stay of $680USD per day, the impact of language discordance on hospital and patient budgets can be significant (John-Baptiste et al: 2004).
What We Do Now
From these results, the importance of interpreting in hospitals can be seen but there is a major logistical concern that has to be addressed. In healthcare facilities, immediate service is often required. This need is most often met through on-staff interpreters or non-professionals. On-staff interpreters are a significant budgetary consideration while non-professional interpreters can often compromise proper medical care and expose healthcare providers to liability. The standard for interpreting services currently is over-the-phone. This solution offers scheduling flexibility and on-demand service but it lacks the visual cues that could have a positive impact on diagnoses and, consequently, mortality and length of stay.
What We Should Be Doing
The solution to these concerns is video remote interpreting. Video remote interpreting offers around the clock access to interpreters via a web-based video interface. It works by connecting healthcare professionals and patients with a qualified interpreter through a two-way video interface. This allows visual cues and context to be added to the interpretation thereby increasing the richness of the message conveyed. Additionally, video remote interpreting also offers an efficient way to connect with an American Sign Language interpreter, which of course, requires visual information. Deploying video remote interpreting in hospitals can increase accessibility, quality of care, and patient satisfaction while decreasing the budgetary strain of on-staff interpreters and exposure to risk from non-professional interpretation.
Language interpreting is an integral component of quality care for patients with limited English proficiency. To reduce poor health outcomes, increased length of stay, and consequently, increased budget strain, hospitals should consider using video remote interpreting as a way to compliment their current interpreting service delivery model.
Bischoff, A., Loutan, L. 2004. Interpreting in Swiss Hospitals. Interpreting (6). 181-204
John-Baptiste, A, Naglie, G, Tomlinson, G, Alibhai, S, Etchells, E, Cheung, A, Kapral, M, Gold, W, Abrams, H, Bacchus, M, Krahn, M. 2004. The Effect of English Language Proficiency on Length of Stay and In-hospital Mortality. Journal of General Internal Medicine (19). 221-228