Video Remote Interpreting (VRI) solutions have been with us in the last 10 years - the rolling cart that are often seen in healthcare institutions, to get medical interpreters for encounters with Limited English Proficiency patients. This visual experience is considered as the evolution of the Over-The-Phone (OPI) interpreters which are audio-based communication - but both methods co-exists in the healthcare industry.

However - ever noticed that on an average hospital floor (like the ER), there are usually only 1-2 interpreter iPad carts? There are many medical providers, patient rooms, and encounters happening - but very few mobile video interpretation stations available.

Healthcare providers have shared with us that during medical encounters with limited English proficient (LEP) patients, they often find themselves "chasing carts" and struggling to locate one of the scarce video remote interpreting (VRI) stations.

We looked into the reasons behind this shortage of VRI carts, and identified key factors:

1. Upfront Hardware Costs - Each VRI station can be quite expensive, potentially up to several thousands dollars for the iPad, high-definition video, camera, microphone, speakers, mounting cart and installation costs.
   
   
2. Higher Video Interpreting Rates - The per-minute rates for video interpretation are higher than phone interpreting. For example, LanguageLine charges 25% more on video interpreters ($4.95 per minute for video versus around $3.95 per minute for phone). Those cost differentials add up quickly.
   
   
3. Ongoing Maintenance and Support - Like any hardware deployment, there are costs for ongoing technical support, repairs, sanitization and lifecycle management of the VRI carts.
   
   
4. Languages availability - in some companies the variety of languages available for video interpreters is much smaller than what is available for phone interpreters.  For example - in LanguageLine there are 40 languages on VRI and 240 on phone interpreting. The same ratio between video and audio languages is seen also in another large vendor - AMN Healthcare.
   
   

In our discussions with providers, there were mixed opinions on VRI carts. Some strongly preferred video remote interpreting for improved communication and visual cues. Others found mobile VRI less stable due to connectivity issues, and instead opted for the more readily available phone interpreters to avoid wasting time locating an iPad cart on their floor.

To summarize, while video interpretation is valuable, the significant upfront and ongoing costs of VRI hardware and services limit how many mobile carts hospitals can deploy. This leads to an unfortunate shortage that frustrates providers during encounters with LEP patients. Striking the right balance between video and phone interpreting modes remains an operational challenge for most facilities.

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