What happens when patients and caregivers don’t speak the same language? For one thing, when non-English speaking patients aren't provided interpreting services, patient engagement rates drastically decline.

That's not good for hospitals' population health management projects, since studies show that patients who are engaged with their care are more likely to follow healthcare plans, attend more appointments and fulfill more prescriptions – and less likely to be readmitted to the hospital within 30 days of discharge.

Southcoast Health, a New Bedford, Massachusetts-based community health system, has found itself experiencing a steady increase in patients with limited English proficiency in recent years. And it found the task of providing ample translation services challenging, especially for less common languages.

In response, the health system implemented a video remote interpretation service – an app that connects providers to qualified medical interpreters over video.

Southcoast staff members have been trained to use the video remote interpretation service, from Stratus Video, as a first choice for patient communication.

Fully understanding what a limited English proficiency patient has to say is critical to that patient’s care and outcomes, and hospitals and health systems have an array of interpreting services to choose from that offer real-time video service. These vendors include CyraCom, InDemand Interpreting, LAN, LanguageLine, Martti, TransPerfect and WorldWide Interpreters.

The top languages used at Southcoast Health are Spanish and Portuguese. (The southeast region of Massachusetts has one of the largest populations of Portuguese speakers in the U.S.)

In the first quarter of 2017 alone, Southcoast Health accessed more than 14,000 minutes of Spanish video remote interpretation and more than 3,000 minutes of Portuguese video remote interpretation. The addition of visual communication has led to shorter, more efficient interactions between limited English proficiency patients and providers, officials from the health system said.

Prior to implementing the video remote service, Southcoast Health relied heavily on over-the-phone interpretation, and requests for interpretation were overwhelming, said Robert Caldas, MD, chief medical officer at Southcoast Health.

“In FY 2015, there were 42,195 interpretation requests,” Caldas said. “Over-the-phone is a common choice, but it lacks the benefits of the visual connection offered by video remote interpretation. Over-the-phone did not offer the ease of use that video remote interpretation offers, as video remote interpretation offers a more personal experience.”

To access an interpreter, Southcoast providers simply grab one of more than 45 available iPads, open the app, and press the button for the appropriate language. With just two taps and a 60-second wait, there is a live and medically qualified interpreter on the screen.

That "allows for real-time video interactions and allows others, who may be important in obtaining a history, to participate in the process,” Caldas said. 

By having supportive caregivers or loved ones hear the information as well, they can help remind the patient what their course of treatment is, he added.

"Last year we compared over-the-phone calls from Q1 of 2016 to video remote interpretation service calls from Q1 of 2017," said Caldas. "In Q1 of 2016, Southcoast over-the-phone calls averaged a length of 17.5 minutes. In Q1 of 2017, Southcoast video remote interpretation service calls averaged a length of 8.5 minutes. That is a 51% decrease in call length.”

The added benefit of visual cues means that communication happens smoothly and efficiently, drastically reducing patient interaction times, he explained. Past studies have shown that limited English proficiency patients have a longer length of stay than their English-speaking counterparts. 

"Interpreters help guide a patient through the medical process, allay their fears, and help them understand treatment plans," said Caldas.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com