How Providence Health & Services overcame patient-physician language barriers

21 percent of U.S residents speak a language other than English at home

Providence Health & Services was having difficulty finding interpreters for deaf patients and those with limited English skills, so it turned to a virtual option that's been a hit with doctors and patients, Erza Mehlman writes in Hospitals & Health Networks.

About 20 percent of U.S. residents age five or older speak a language other than English at home, according to the Census Bureau. That can create a language barrier between patients and physicians with real consequences, according to research from the International Medical Interpreters Association. Patients with limited English proficiency are twice as likely to suffer adverse medical events than English-speaking patients, their average length of stay is up to 1.47 days longer, and they are more likely to be readmitted within 30 days of discharge.

In the past, Washington-based Providence used on-site interpreters and telephone interpreters to communicate with deaf patients and those with limited English speaking skills. But both doctors and patients were becoming frustrated with the services, according to Cyndy Daniel, assistant emergency department manager for Providence Milwaukie Hospital.

Telephone interpretation was "hit or miss," she said, because of lost connections, soft-speaking patients, and other "issues that anyone can have with phone communication." And third-party interpreters often took too long to get to the hospital, forcing physicians to resort to writing notes to communicate with their deaf patients.

Turning to tele-interpretation

To ensure physicians could communicate with patients, Providence partnered with InDemand Interpreting, a third-party service that facilitates interpreters through live video feeds. Physicians can contact a trained medical interpreter within seconds using a tablet or device hooked up to a wheeled cart.

Providence has more than 300 such devices available throughout the system and is planning to add more, as well as expand remote interpretation services for its home health care patients. Since August 2015, Providence has used InDemand for about 15,000 interpreting encounters in 60 languages.

Providence Medford Medical Center Emergency Department Medical Director Corey Bergey praised the video interpretation system. He said, "Particularly for the emergency department, we can't anticipate when we might need an interpreter or a third-party on-site interpreter," adding, "The new video remote interpreting modality is so much faster than over-the-phone interpreters, as we receive immediate support" (Mehlman, Hospitals & Health Networks, 7/21).

Teach your staff to provide culturally sensitive care

 Teach your staff to provide culturally-sensitive care

As the United States becomes a "minority-majority" population, hospitals must go beyond diversity training to improve education, set goals, and establish central resources to help staff deliver care.

To help its staff better provide care, one health care system created individual "Facts at a Glance" sheets for each culture represented by their patients. These cultural cheat sheets provide staff with vital information about diverse patients, such as religious and dietary practices, plus cultural norms such as gender roles.

Get the cheat sheet


Next in the Daily Briefing

ACO roundup: What the November elections mean for value-based care

Read now