Interpretation isn't about word substitution between languages. It relies upon individuals who not only know multiple languages, but also know multiple cultures, sub-cultures and contexts. Healthcare interpreters face the difficult challenge of not only transferring information between staff and patient, but also mastering the jargon of healthcare—something even native speakers struggle with.
Because of this specialization and the growing number of people with limited English proficiency, medical staff across the country often sees waiting for or finding a qualified interpreter as a delay that may compromise medical care. Alternately, they may not have language services to turn to. Instead, conveying information may be left to untrained bilingual staff or the family and the friends of the patient.
Telephonic translation does an admirable job of meeting patient needs, adhering to federal and state requirements, and moderating the prohibitive costs related to maintaining a full language services staff.
The Growing Need and the Government
The need for interpreters in healthcare will continue to grow. A paper published in Telemedicine Journal and e-Health acknowledges "the percentage of people with LEP [limited English proficiency] grew from 4.8% in 1980 to 8.1% in 2000. The number of LEP persons is projected to grow by 67 million to an estimated 19% of Americans by 2050."
As time has moved forward, the right to language services has been increasingly codified by the government. In August 2000, US President Clinton issued an executive order that requires all federally funded programs to be equally accessible to those with limited English proficiency. More recently, The Joint Commission has compelled all hospitals to provide professional interpretation services to every single patient who needs it.
Despite federal and state requirements for healthcare interpreters and the growing number of patients needing them, language services are not being successfully implemented. This reality has led to, and continues to lead to the endangerment of patients, as well as rising costs for patients and tax-payers, who subsidize treatments that are related to a lack of preventative care.
Problems identified by those studying the situation and those experiencing it include lack of awareness, lack of respect for an interpreters skill set, lack of funds, and lack of certification.
Regarding awareness and skill sets, many members of hospital staffs are unaware that language services are available or unsure of how to access them. Because of this—coupled with a dearth of information regarding the competency, knowledge, skill and ability needed by an interpreter to be effective—staff will often settle for any bilingual person available.
Even if the staff understands the value of a professional interpreter, the facility may not have proficient interpreters or be able to afford the specific type of interpreter needed on staff. Experts argue standardization of training and certification for medical interpreters would reduce clinical errors related to language services.
According to an article in Modern Healthcare, "the Office of Management and Budget in 2002 estimated that U.S. hospitals' annual costs for providing interpreter services was $78 million for inpatient visits, $12 million for outpatient visits and $8.6 million for emergency department visits." These exorbitant prices cause hospitals with lower budgets to work around language service requirements.
Remote Interpreting Services
Accessing interpreters remotely online, or via the telephone and through a reputable agency is a workable solution that both addresses needs and challenges facing healthcare language services.
Retaining qualified, professional telephone interpreters assures healthcare providers they are fulfilling their requirement to provide language services to their patients without having to rely on untrained individuals. Additionally, telephone interpreting bridges the language gap when in-person interpreters cannot, either because of cost or ability. Plus, language companies such as Ablio, allow swift access to proficient—often certified—healthcare interpreters in literally hundreds of languages. And, the costs are considerably less than retaining the services of language services on-site staff.