Medical Interpretation: A Key Component of Health Equity for LEP Patients
By David Fetterolf, Stratus Video President
The Institute of Medicine (IOM) defines health equity as “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, & socioeconomic status.”
To ensure health equity for all patients, hospitals must provide the same services to all individuals, regardless of language ability or cultural background. In order for LEP, Deaf and Hard of Hearing (HoH) patients to receive the same level of care as English-speaking patients, they must be provided with adequate language services.
Consider receiving hospital discharge instructions. What if vital information, like medication management, was written in a language you could not understand? The risk for error resulting in adverse effect would greatly increase.
When compared to English-speaking patients, Limited English Proficient (LEP) patients are more likely to:
- Have a longer length of stay in the hospital
- Experience an adverse effect due to a communication error
- Be readmitted to the hospital within 30 days
and are less likely to:
- Adhere to care plans
- Fill prescriptions
- Attend follow-up visits
All of the above improves when a qualified interpreter is used to facilitate communication, a key component of health equity for LEP patients.
In an effort to help reduce health disparities and better achieve health equity, the U.S. Department of Health & Human Services established National CLAS Standards for hospitals. CLAS stands for Culturally and Linguistically Appropriate Services. The following four steps apply specifically to communication and language assistance:
- Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
- Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
- Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
- Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.
Joint Commission requirements have also been established to help achieve health equity for LEP, Deaf and Hard of Hearing patients. As a part of its commitment to help ensure the quality of care, the Joint Commission published A Roadmap for Hospitals: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care. The roadmap includes a list of patient centered communication standards, self-assessment guidelines for hospitals and tips to best comply.
Requirement RI.01.01.03 applies specifically to the provision of language services and reads as follows:
"The hospital respects the patient’s right to receive information in a manner he or she understands. EP 2 The hospital provides language interpreting and translation services. Note: Language interpreting options may include hospital-employed language interpreters, contract interpreting services, or trained bilingual staff. These options may be provided in person or via telephone or video. The hospital determines which translated documents and languages are needed based on its patient population."
VRI Helps Achieve Health Equity
In order for your facility to achieve health equity, the same medical services must be offered to all patients regardless of primary language spoken. By ensuring language services are available to limited English proficiency, Deaf and HoH patients at all points of care, you are ensuring equal access to healthcare information and programs. This includes providing access to telehealth programs for LEP patients.
The need for qualified language services in healthcare is well documented. Patients with access to a medical interpreter at check-in and discharge have been found to have a significantly lower rate of readmittance within 30 days and experience a higher level of care than those without. Video remote interpretation is an ideal solution, as it provides direct access to qualified interpreters who are readily available in a wide variety of languages. VRI is interoperable with many telehealth solutions and can be leveraged to add medical interpreters to sessions with LEP, Deaf and HoH patients. With this interoperability, providers can ensure patients in need of language services can participate in telehealth programs. Learn more about how VRI interoperability with telehealth helps achieve health equity for LEP patients.