With 26 million people who are considered to have limited English proficiency in the United States, providing equitable care to non-English speaking patients is essential. Yet, many healthcare institutions struggle to offer seamless language support throughout a patient's journey. 

Let's explore the multiple touchpoints where language barriers can occur and the current solutions' limitations.

When a non-English speaking patient enters a healthcare facility, he encounters numerous touchpoints, for example, here are some possible touchpoints:

• Reception / Front desk
• Triage nurse
• Medical assistant
• Nurse
• Doctor / physician
• Specialist (if required)
• Diagnostic technicians (e.g. for X-rays)
• Billing / insurance staff
• Pharmacy

At each of these interactions, there's a need for effective and accurate communication.

Current solutions

Healthcare institutions that provide language accessibility, typically rely on two main professional interpretation methods: on-site interpreters and remote interpretation services. Both have their strengths, but also present challenges in providing consistent, timely support throughout the patient journey.

The On-Site Interpreter Approach

Having an on-site interpreter follow a patient through their entire visit seems ideal. In that approach - the interpreter can be present in every step of the way. Research shows that this is the most desired solution by patients. One research⁽¹⁾ calculated the average encounter duration with an interpreter (47.4 min) and the average total interpreter time that includes before and after the encounter (91.1 min) - demonstrating the “time investment” in real life that on-site interpreters might do in specific settings.

However, waiting time for interpreters, off-hours availability and other challenges around scale can get to nonoptimal workflow. For example - one study⁽²⁾ suggests that the average wait time for an on-site interpreter is about 19 minutes. This delay can disrupt schedules, extend visit durations, add unnecessary costs, and potentially impact patient outcomes.

The Remote Interpreter Approach

Many institutions use remote interpreting services, such as Language Line and Proprio. While this can provide more immediate access to interpreters and diverse language availability, it comes with its own set of challenges:

1. Multiple Waiting Periods: Each touchpoint may require a new call, involving routing, wait times, and repetitive interpreter disclaimers. This time accumulates at each point, leading to delays in care that affect both providers and patients.
   
   
2. Lack of Continuity: Different interpreters may be involved at each stage, leading to a loss of context and potentially requiring the patient to repeat information.
   
   
3. Inconsistent Use: Due to time constraints or perceived inconvenience, some providers might attempt to "get by" without proper interpretation, risking miscommunication.

The Need for a Better Solution

The current state of medical interpretation often fails to align with the natural workflow of healthcare institutions, and the patient journey.
This misalignment can lead to:

• Extended patient visit times
• Increased stress for both patients and providers
• Potential for medical errors due to miscommunication
• Inconsistent quality of care for non-English speaking patients
• Increased costs that get passed onto patients

As healthcare continues to evolve, there's a pressing need for more integrated, efficient, and patient-centric interpretation solutions. These solutions should seamlessly fit into the healthcare workflow, providing consistent language support across all touchpoints without causing significant delays or disruptions. 

Innovative approaches, such as AI-assisted interpretation could help bridge this gap. By addressing the language barrier more effectively, healthcare institutions can improve patient outcomes, increase satisfaction, and provide truly equitable care to all patients, regardless of their language proficiency.

‍
Resources
(1) 2017 - Assessment of the efficiency of language interpreter services in a busy surgical and procedural practice
(2) 2024 - Patient Time Spent With Professional Medical Interpreters and the Care Experiences of Patients With Limited English Proficiency