Utilizing All the Tools: Video Interpreting as an Option in

Meeting Your Patient’s Communication Needs

Who We Are

Erika Shell Castro– Director of Interpreter Services—Language Access Network– Previous Manager of Interpreter Services at largest hospital

system in Ohio– Bridging the Gap/Cultural Competency Trainer– Contact: ecastro@languageaccessnetwork.com

Jeff Mercer– VP of US Midwest Sales—Language Access Network– 3 years in field—both OPI and Video– 7 years healthcare experience– Contact: jmercer@languageaccessnetwork.com

Language Access Network Located in Columbus, OH www.languageaccessnetwork.com

Defining Video Interpretation

• Methods of Delivery

• Relationship with vendor– Self-initiated and operated video with staff

interpreters– Contracted services with a 3rd party vendor– Partnership constructed among hospitals

utilizing a shared pool of interpreters from each hospital

Role of Video

• A tool in your “toolbox”– On site staff– Contracted– Remote/telephonic– Video

• Not a replacement for on-site interpreters

Meeting the Need Appropriately

• Where Video Shines:– Emergent care areas

• Emergency rooms• Labor and Delivery• Urgent Care

– Extended stay• Patient floors• Other in-patient areas

– Extension of interpreting resources

• Back up interpreter• Access to variety of

languages• Immediate access• Management of resources

• Avoid Video for:– Highly emotional cases such

as a trauma or terminal diagnosis

– Psychiatric care– Patients with low vision– Encounters where

understanding may be compromised

• Sedating medications• Dementia• LEP with hearing loss

Needs of LEP vs. Deaf

• LEP– 70% of

communication is non-verbal

– Increased ability of interpreters to pick up on cues

• Facial expressions• Body language• Non-specific

speech– Improved back up

plan over audio-only

• Deaf/Hard of Hearing– Line of sight

• Positioning of patient• Exams, procedures, etc

– Limited vision• Usher’s Syndrome• Cataracts, glaucoma, etc

– Linguistic variances• Regional• Language Proficiency

– Minimal language skills– Alternate sign language– Late-deafened

Goal of Video

Assure appropriate access to interpreters for patients and providers

Making a Business Case for Video

• Due to volume, some patients may wait for an interpreter

• Due to scarcity of interpreters patients may wait or not have access to an on-site interpreter

• Typically institutions pay either a package plan or a per minute charge which eliminates waste and controls cost

• As part of a tool kit, video can be a valuable and cost effective way of meeting ADA and Title VI requirements

Challenges

• Initial cost of equipment & connectivity– Purchasing– Leasing– Use of internet or T1

• Connectivity– Wireless capability &

coverage of institution– Specific hard wired areas

(hot jacks)– Broadband speed allocated

to facility• On-site interpreters who

feel threatened

• Buy in from providers– Concerns of efficiency– Change management

• Engaging the LEP and Deaf/ Hard of Hearing communities to embrace the tool– New technology– Quality controls– Staffing concerns– Appropriate use/access

Recommendations• Walk through of hospital, clinic, etc to

determine where video can be used most effectively– Include on-site technical team– Evaluate type of equipment needed

• Widespread training throughout the departments where video will be used– Super User/Project Lead trainings for each

department where video will be used• Tips for working effectively with video interpreters• Equipment troubleshooting and problem solving

– On-site departmental trainings• Front line staff

• Senior management team support initiative– Track usage– Implement policy changes and expectations

Recommendations (Cont’d)• Will you contract with a service provider who uses the internet or a

dedicated T1 line?– Costs/Benefits– Industry compliance

• Include Language Service team in implementation as champions• Conduct focus groups

– Staff– Patient– Community members

• Deaf/Hard of Hearing• LEP-immigrant and refugee communities

• Community education-health fairs, video training on how to work effectively with an interpreter including the introduction of video as a resource

My Organization is Interested in Video Interpreting…

I Should Ask?

What are the questions

Considerations (Part 1)

• What are the technical supports needed?– Can my organizations IT

department take this on?– Do they have the skills to

drive this project?– Do they have the time?

• What areas could this most be utilized?

• Who in my organization will champion this?

• What is the cost?– Set up

• Dedication of IT resources to research, set up and support program

– Training• Time set aside for staff

training• Will provider include

training as part of contract?

– Monthly cost– Length of contract– Equipment- purchase or

lease– Maintenance agreement

Considerations (Part 2)• How will I make the business case?• What languages are offered?

– In house/staffed languages– Peripheral language demand

• Do I want a company with a call center or remote interpreters?• What are the training and qualifications of the interpreters?

– In house qualifications– State requirements

• What is the customer service provided?– 24/7?– Service/Maintenance Agreement– What is included?

• What kind of data is collected and what access will I have to this data?• How do I connect to the service?

– Wait time– Efficiency

Who’s Out There

• Deaf-Talk

• Language Access Network

• Language Line

• LifeLinks

• Paras and Associates

• Local agencies—some do offer video solutions—typically over the internet

Resources

• NCIHC Open Call May 25, 2007 On-site and Remote Interpreting: When is Each Appropriate

• RID Video Interpreting Papers

Questions?• Contact info

– Erika Shell Castro ecastro@languageaccessnetwork.com

– Jeff Mercer jmercer@languageaccessnetwork.com

– Company info—See our booth or www.languageaccessnetwork.com