This article discusses the factors affecting the provision of interpreter services in health care services. The authors discuss factors affecting the provision of interpreter services, including Patient clinical conditions and preferences, the costs of providing interpreter services, and the impact of COVID-19 on the provision of interpreter services. They conclude that interpreter services should be offered as a ‘right’ for all patients. Read on to learn more.
Patients’ clinical conditions
Although patients’ preferences vary, a recent systematic review found no differences between bilingual and non-bilingual healthcare interpreters. A higher proportion of patients in emergency departments opted for healthcare interpreters, despite being less satisfied with the services provided by bilingual clinicians. Although the results of this study are preliminary, they provide valuable insight into patients’ preferences. For example, patients with cancer preferring to use interpreters of a ‘personal nature’ preferred those of a healthcare interpreter.
In fact, patients with LEP are less likely to understand medical implications and to be satisfied with their treatment if interpreters are not present. This finding is in line with other studies that have found that patients with LEP do not always understand medical implications. By providing facilitated communication, patients can receive higher quality medical care. However, health care providers may face challenges in meeting their goals, particularly when they receive limited reimbursement for interpreter services.
Patients’ personal preferences
It’s essential that you know your patient’s personal preferences when using interpreter services in health-care settings. Some patients prefer their family member or friend to interpret for them, so you should thank them for being a second set of ears. However, you should leave the interpretation role to a professional interpreter, who is likely to be more familiar with the medical terminology. If the patient insists on using a family member to interpret, be sure to document your request in writing.
In addition to using an interpreter service, patients should explain their medical information to the interpreter. This is known as teach-back. In some cultures, physicians are still considered authority figures and may not encourage patients or family members to ask questions. Consequently, patients and family members may nod in agreement to please the physician, but failing to explain back to the interpreter will be perceived as a lack of understanding.
Cost of providing interpreter services
Medical interpreter services are not currently reimbursed separately from other costs. Federally-funded medical insurance programs such as Medicaid and the Children’s Health Insurance Program pay for interpreters. Providers may also receive a bonus if they document their use of interpreters in documentation of services. The Centers for Medicare and Medicaid Services have made it possible to reimburse the cost of medical interpreter services by including them in overall provider payment rates.
In rural areas, limited-English-proficient populations tend to increase the fastest. According to Dr. Elizabeth Jacobs, associate vice chair of health services research at the University of Wisconsin-Madison, hospitals should provide interpreter services to the public as easily as possible. Video technology can also help make interpreters more accessible and pick up on nonverbal cues. Although in-person interpretation is preferred, there are also off-site interpreter services that are able to interpret via video.
Impact of COVID-19 on provision of interpreter services
The recent passage of COVID-19 has eased language access regulations, but it has also created a new set of challenges. Undocumented immigrants often face language barriers and fear deportation, which can make it difficult to obtain medical care. As a result, medical workforce preparation is essential for connecting with LEP patients. To date, language access regulations have been a source of frustration for providers, hospitals, and patients.
Several payers have responded to the new guidelines by developing new capabilities to understand patients’ social contexts. These efforts have included geographical maps that map social determinants and direct services to individuals and communities. In California, for example, the Blue Shield organization has created a Neighborhood Health Dashboard, which has been used to calculate California’s Vulnerability Index. This approach has been highly successful, resulting in a significant reduction of emergency room visits and hospitalizations.
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