There's no shortage of debate these days on how to improve the lines of communication between doctor and patient. It's even tougher when the two speak different languages.
America's ever-growing cultural melting pot makes it difficult for doctors in hospitals and clinics to be prepared for every patient who walks through the door. Having in-house interpreters can be expensive, whether it's for a small provider or a large system dealing with many languages. And phone-based translation services can be complicated, with both doctor and patient trying to share the same phone while the interpreter is in another location.
The evolving field of virtual interpreters is helping hospitals and clinics make the conversation run a lot smoother – to become more meaningful. And while many vendors serve a wide swath of industries, some are focusing on healthcare including Alta Language Services, CyraCom, InDemand Interpreting, Language Access Network and Stratus Video.
Stratus, for instance, offers remote video translation services on PCs, laptops, even tablets and smartphones. Company president David Fetterolf said the healthcare industry spends about $2 billion a year on interpreting services, with so-called video remote interpreting (VRI) growing rapidly to take over at least half of that demand.
"It's way better than over the phone," he claimed, "and almost as good as in-person … though much less expensive and easier to adopt."
Hospitals can't rely on a spouse, child or family friend to do the translating, he added, because medical terms are complicated and need to be explained precisely by certified medical interpreters. Fetterolf pointed to stories of families forced to wait for hours in an emergency room while the hospital sought a translator or, perhaps worse, lawsuits won by families who received bad care, some even leading to death, due to faulty translations.
Stratus' cloud-based platform enables providers to call in on an iPad and connect with a qualified interpreter in 30 seconds, and currently offers some 175 different languages, with new languages and dialects added often; about a dozen of the most popular languages, which account for roughly 96 percent of the nation's population, are available via video link. The system allows doctor and patient to communicate through the iPad, face-to-face, ensuring that both sides understand what is being said.
Stratus' VRI platform was borne out of a collaboration in 2010 between Apple, which had sent three of its engineers to Florida to help integrate the FaceTime technology into the company's earlier offerings. The collaboration led to the Z Video Relay Service, a sister company of Stratus, with offerings for the deaf and hard-of-hearing, and then was expanded to those with limited English proficiency (LEP), which currently makes up about 10 percent of the population (25.3 million people).
Fetterolf said Stratus is being used in some 16 percent of the nation's health systems now, including Kaiser Permanente, the Mayo Clinic, Steward Health and Texas Health Resources. It's become a key factor in patient engagement efforts included in meaningful use guidelines, and Joint Commission audits often check to make sure the interpreter or translation service is suitably certified. In addition, the Health and Human Services Department's Office of Civil Rights is also cracking down on health systems.
“While most healthcare providers recognize the need to support patients with limited English proficiency, many don’t realize their current LEP systems are inadequate until OCR initiates a compliance review or complaint investigation,” said Sean Belanger, Stratus Video's CEO, in a press release. “At that point, they’re not only challenged with implementing corrective action, but they may also face the added pressures of negative publicity, fines and other noncompliance penalties.”
Among the company's clients is the Sanford Health System in Fargo, N.D. and Sioux Falls, S.D. According to a case study prepared by Stratus, the health system "relied on a slew of overscheduled face-to-face interpreters and an OPI system that often proved to be unreliable or too expensive for the system to use consistently." Sanford Health contracted with Stratus for 20 dedicated iPads for use in the main hospital campus and 10 surrounding clinics. Stratus estimated the health system will save up to $104,000 in the first year with this platform.
The Stratus system "is absolutely essential," Nigeria Stahl, MD, of Sanford Health, said in the case study. "In the ER, things happen very quickly and we need to get information very quickly – but we need to get accurate information and this helps us to do that."
Fetterolf said video interpreting isn't that common in the market now, but will grow into a $1.5 billion industry in the next 3-5 years as the technology improves and health systems see the value. By contrast, he pointed out, health systems are spending three times as much money on in-person interpreters.
"This really is a disruptive technology," he said.