Communication is the cornerstone of good healthcare. Imagine trying to get through a medical appointment without being able to understand your physician. This is the situation for millions of Americans with a limited English proficiency (LEP).
Studies have shown that improved patient communication leads to more positive health outcomes – but unfortunately without high quality interpretation services readily available, many LEP Americans do not benefit from clear communication.
I have been working within the interpretation profession for more than 25 years. I will be the first to concur that high interpretation standards are essential to any successful language access plan. Quality language access services are especially important when it comes to healthcare situations. As a member of the Registry for the Deaf and the International Medical Interpreters Association, I place great value on the use of qualified interpreters who possess the necessary medical terminology.
Earlier this year Section 1557 of the Affordable Care Act went into effect, which reflects these assertions that high quality language access services are paramount within our nation’s hospitals. Section 1557 reinforces the assertion that healthcare institutions are required to provide meaningful access to individuals in need of communication assistance. New standards surrounding language access include the following:
Healthcare professionals must use qualified interpreters who adhere to interpreter ethics and client confidentiality and possess all of the necessary medical terminology.
The use of family members, friends and unqualified bilingual staff for medical interpretation is now expressly prohibited barring extreme circumstances.
Patients must not be encouraged to turn down language access services or provide their own interpreters.
Patients must be made aware of their language access rights.
Notice must be posted in the top 15 languages of each state.
Written translation must be provided.
The new standards were set to be enforced on October 16, 2016. In order to be in compliance with the new standards, healthcare providers must ensure that their interpreters are medically qualified and that their patients are made aware of the language access services available to them.
For comparison’s sake, let’s consider a situation that my team has encountered far too many times throughout my career – the use of the ad hoc interpreter. An “ad hoc interpreter” is anyone nearby who happens to be bilingual. I’ve heard from my team out in the field of patients receiving sensitive, medical information through underage children, cafeteria workers, and Google translate. It may be tempting to turn to whoever is nearby with the intention of getting your message across. But consider the likelihood of error and emotional trauma that can result from asking a child to tell their mother about a bad diagnosis, even if the child is an adult and the mother is in a skilled nursing facility.
The interpreter code of ethics is vital to interpretation delivery in healthcare, as it covers the importance of confidentiality and HIPAA requirements. Medical terminology is crucial, as any miscommunication can put both patients and hospitals in jeopardy. When miscommunication is fueled by language barriers, the risk of error increases and can result in under treatment or over treatment, depending on the circumstance. The use of qualified interpreters greatly reduces the risk of error, all while increasing patient outcome and satisfaction.
While the final Section 1557 ruling is new to the industry, the need for medically qualified interpreters is long standing. I currently serve as VP of Language Operations at Stratus, a medical interpretation provider, and I have held my team to these standards since the beginning. Language access is not something that crosses the mind of the average English speaking American, which is why I often urge people to put themselves in the shoes of an LEP American and imagine what it would be like to not fully understand what is happening when your health and well-being is at stake. The way our hospitals treat LEP Americans is about to change. I hope to see an increased use of professional language access services.