Leveraging technology to better treat limited English proficiency patients

Doctor-patient communication is the cornerstone of quality healthcare. Studies have shown that effective communication can lead to improved patient outcomes, and thus should be considered a priority for healthcare providers.

Effective communication can be difficult to achieve with limited English proficiency (LEP) patients – and with more than 25.9 million Americans reporting that they speak English less than “very well” (which amounts to 9% of the overall U.S. population ages 5 and over), our nation’s healthcare facilities are facing a significant challenge when it comes to communicating with this particular population segment.

Currently there are three main interpreting modalities healthcare facilities can rely on for language assistance: onsite interpreters, over-the-phone interpreters and video remote interpreters. Onsite interpreters are considered the industry ideal, as physical co-presence eliminates technology concerns and allows for nonverbal communication and empathetic connection, but providing onsite interpretation can be wrought with its own challenges. Some facilities choose to utilize agency interpreters, who are often expensive, charge for travel time and generally require lengthy minimum engagements. Other facilities, like Lehigh Valley Health Network, choose to keep interpreters in the most common languages on staff - but even this model of interpretation delivery is difficult, as an assessment of interpreter engagement last year proved that Lehigh interpreters on average spent only 17% of their time engaging in interpretation. A better solution was needed, as the organization had a significant LEP patient population, the interpretive resources, but no way to connect the dots.

Lehigh ultimately selected a geolocation-based application that connects healthcare providers to local onsite interpreters directly in order to address high agency costs and staff inefficiencies. Lehigh has been using the application for over a year to contact both their staffed interpreters, and locally contracted interpreters with outstanding results.

Similar to the applications everyone uses to order cars nowadays, interpretation requests made through the application route directly to the smartphones of local interpreters. At Lehigh, workflows are customized to route requests to staff interpreters first, maintaining everyone’s patient visit calendar with one application. If staff interpreters are at capacity, or if interpretation is needed in a language of lesser diffusion, the organization can route requests to locally contracted interpreters, who have been thoroughly vetted, ensuring that everyone who walks through the door at Lehigh is a trained, medically qualified professional.

Let’s look at an example. Say there is a Spanish-speaking patient arriving at Lehigh for a post-surgical follow-up appointment. A Lehigh dispatcher logs in to the requester portal of the application, selects the date and time, length of the appointment, and location at which it will take place. Once that is set, the dispatcher can select from different pools of interpreters. Spanish is one of the languages that Lehigh staffs for, so the provider may route this particular request to employed interpreters first. Once the request goes out, the available interpreters receive notification on their smartphones. The first to accept the appointment is locked into the schedule, and the appointment information is automatically added to their digital calendars. The application reminds the interpreters of the upcoming engagement as it approaches. Once the interpretation session begins, the interpreter “checks in” to the application, thus accurately tracking their time spent in session.

With the LEP population in Lehigh rising, tools like this are quickly proving to be indispensable. In just the past year, Lehigh has seen its interpreter engagement rise from the aforementioned 17% to an astounding 93% with the use of the tool. The organization attributes this unprecedented increase in staff engagement to reduced travel times between interpreter engagements, transparent scheduling, and a reduction in audio interpretation reliance, as staff interpreters are now easy to reach. At only 17% utilization, the interpreting team at Lehigh was a difficult expense to justify. In contrast, at 93% utilization, the organization was just approved to hire an even larger team of full time, staff interpreters. The need was always there, the application just helped organize and allocate resources in a way that made the interpreter team much more effective.

The application has fundamentally changed the way Lehigh engages with onsite interpreters, and the result has been increased provider, and patient satisfaction. When one of Lehigh’s schedulers was asked about the application recently, he admitted that they “used to struggle to schedule onsite interpreters, and half the time [they] turned to audio interpretation.” With this new tool, Lehigh has complete visibility into how the staff is working within the facility, and the ability to fill in the spaces interpreters miss with contractors. LEP patients are being seen at higher rate, and providers no longer have to stress about whether an interpreter will show up or not. Thanks to innovative technology, Lehigh is delivering higher quality care than ever to its LEP patients.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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