Medical interpreters stand out to be critical players as they promote the delivery of appropriate medical care to patients diagnosed with Limited English Proficiency (LEP) patients; however as much as they play this critical role healthcare services fail to fully utilize them. This not only results in the inability to deliver ideal quality care to patients but also raises grave questions in relation to providing equal opportunity to access healthcare resources and the safety of these patients.
The Evidence of the Underutilization of Interpreters is Broader Than Comprehend
Numerous literature has confirmed that patients who are LEP have always been deemed to have, for the lack of better word, been a challenge for the healthcare services, however the issue relates to the effective deployment and utilization of interpreters. Many of the patients' appointments have not witnessed the presence of interpreters, however they are still recorded as having an interpreter during the appointment. Moreover, there is ample evidence to suggest that providers are known to use the interpreters only on a handful of occasions.
As highlighted by the 2023 Canadian study highlighted, it was found that out of a total sample of 37000 visits from patients who are deemed to be LEP, only 0.31% utilized language interpretation services. These findings are not confined to Canada only as they have been recorded in other nations such as US and UK where a majority of LEP patients have not been able to effectively communicate.
Such figures become more worrisome when we focus on particular health care sectors. A 2021 publication in Pediatrics which studied the use of interpreters recalls a 2021 view of an inner city children's hospital:
- 91.8% of healthcare personnel admitted that at one point they would provide care to limited English proficient (LEP) families without an interpreter being present
- Only 0.7% of providers said that they used interpreters in all clinical situations
- Interpreters were used 'infrequently' for regular checks in almost 79% of the cases
Getting to The Bottom of the Issues
Workflow Time Consideration
Even when providers are aware of interpretation services, they face significant time pressures. The time needed to achieve the required interpretation services seems to be a deterrent to normal usage particularly when carried out in everyday clinics.
Accessibility and Availability
The study showed that there is a problem with interpreter gap especially during specific time periods and for some languages. In the words of one provider, "It is difficult to get interpreters for languages other than Spanish outside of daytime hours." As a result, some LEP patients receive an unequal opportunity of access to the language services than others.
Technical Infrastructure
Technology, which is meant to provide more access to interpretation services, becomes a hindrance in the first place. The study reveals that "Both the interpreting computers as well as interpreting phones we currently use almost never work." Such unreliability may cause providers to look for hazardous options such as interpreters during the daytime who happen to be family members or even children which alters the intended objective of the service provisioning.
Providers' Awareness
A fundamental barrier to interpreter use is awareness. According to the Canadian study, 80% of providers who never used the interpretation services simply did not know there was such a service despite seeing LEP patients. This is the ideal space where improvements can be made through more efficient provider training and onboarding.
Cultural and Organizational Barriers
Of lamentation is the increasing trend of LEP patients to be provided with inadequate medical care. The research also revealed concerning practices such as rounding where LEP families are not included. One healthcare aide commented as follows "Physicians will round outside of the room and not include the family sometimes." Such systematic exclusion suggests that there are other organizational cultural problems that need to be solved.
The Cost of Underutilization
Efforts made to properly leverage the interpretation services are guaranteed to yield positive outcomes, but the same cannot be said for their absence. The consequences of such issues are manifold:
- Greater Rate of Admission and Readmission To The Hospitals
- Overcrowding and Raised Pressure in Emergency Departments
- An Increasing Likelihood of Ever Surviving an Adverse Medication Reaction
- Recommended Diagnostic Tests Are Not At All Provided in Certain Situations
- The Chances of Being Discharged Without Any Follow Up Are Higher
- Overall lower patient experience or dissatisfaction
Can we get to 100% Utilization?
Today's interpretation solutions face several barriers, which actually many times encourage providers to "get by" and find other ad-hoc solutions on the frontline (family member, bilingual peer, hand gestures). The current landscape of interpretation services, while well-intentioned, often pushes healthcare providers toward risky workarounds.
New technological advancements, like No Barrier, will become more and more spread in 2025 to facilitate immediate, real-time communication between providers and LEP patients - by facing the current solutions challenges - of workflow burden, need for speed and high and accurate medical communication. These emerging solutions promise to:
- Eliminate wait times through instant access
- Integrate seamlessly into existing clinical workflows
- Provide consistent, high-quality medical interpretation
- Support a broader range of languages 24/7
- Make every provider linguistically autonomous
While achieving 100% utilization requires both technological innovation and cultural change, new solutions that remove barriers rather than create them could finally make universal language access a reality in healthcare settings. The key is ensuring these solutions enhance rather than complicate the provider-patient relationship, making interpretation the easiest choice rather than a burdensome requirement.
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