Video Interpreting to Meet Patient Needs


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Presentation delivered at NCIHC and IMIA helping hospitals and providers make educated decisions about integrating video interpretation.

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Video Interpreting to Meet Patient Needs

  1. 1. Utilizing All the Tools: Video Interpreting as an Option in Meeting Your Patient’s Communication Needs
  2. 2. Who We Are <ul><li>Erika Shell Castro </li></ul><ul><ul><li>Director of Interpreter Services—Language Access Network </li></ul></ul><ul><ul><li>Previous Manager of Interpreter Services at largest hospital system in Ohio </li></ul></ul><ul><ul><li>Bridging the Gap/Cultural Competency Trainer </li></ul></ul><ul><ul><li>Contact: [email_address] </li></ul></ul><ul><li>Jeff Mercer </li></ul><ul><ul><li>VP of US Midwest Sales—Language Access Network </li></ul></ul><ul><ul><li>3 years in field—both OPI and Video </li></ul></ul><ul><ul><li>7 years healthcare experience </li></ul></ul><ul><ul><li>Contact: [email_address] </li></ul></ul><ul><li>Language Access Network Located in Columbus, OH </li></ul>
  3. 3. Defining Video Interpretation <ul><li>Methods of Delivery </li></ul><ul><li>Relationship with vendor </li></ul><ul><ul><li>Self-initiated and operated video with staff interpreters </li></ul></ul><ul><ul><li>Contracted services with a 3 rd party vendor </li></ul></ul><ul><ul><li>Partnership constructed among hospitals utilizing a shared pool of interpreters from each hospital </li></ul></ul>
  4. 4. Role of Video <ul><li>A tool in your “toolbox” </li></ul><ul><ul><li>On site staff </li></ul></ul><ul><ul><li>Contracted </li></ul></ul><ul><ul><li>Remote/telephonic </li></ul></ul><ul><ul><li>Video </li></ul></ul><ul><li>Not a replacement for on-site interpreters </li></ul>
  5. 5. Meeting the Need Appropriately <ul><li>Where Video Shines: </li></ul><ul><ul><li>Emergent care areas </li></ul></ul><ul><ul><ul><li>Emergency rooms </li></ul></ul></ul><ul><ul><ul><li>Labor and Delivery </li></ul></ul></ul><ul><ul><ul><li>Urgent Care </li></ul></ul></ul><ul><ul><li>Extended stay </li></ul></ul><ul><ul><ul><li>Patient floors </li></ul></ul></ul><ul><ul><ul><li>Other in-patient areas </li></ul></ul></ul><ul><ul><li>Extension of interpreting resources </li></ul></ul><ul><ul><ul><li>Back up interpreter </li></ul></ul></ul><ul><ul><ul><li>Access to variety of languages </li></ul></ul></ul><ul><ul><ul><li>Immediate access </li></ul></ul></ul><ul><ul><ul><li>Management of resources </li></ul></ul></ul><ul><li>Avoid Video for: </li></ul><ul><ul><li>Highly emotional cases such as a trauma or terminal diagnosis </li></ul></ul><ul><ul><li>Psychiatric care </li></ul></ul><ul><ul><li>Patients with low vision </li></ul></ul><ul><ul><li>Encounters where understanding may be compromised </li></ul></ul><ul><ul><ul><li>Sedating medications </li></ul></ul></ul><ul><ul><ul><li>Dementia </li></ul></ul></ul><ul><ul><ul><li>LEP with hearing loss </li></ul></ul></ul>
  6. 6. Needs of LEP vs. Deaf <ul><li>LEP </li></ul><ul><ul><li>70% of communication is non-verbal </li></ul></ul><ul><ul><li>Increased ability of interpreters to pick up on cues </li></ul></ul><ul><ul><ul><li>Facial expressions </li></ul></ul></ul><ul><ul><ul><li>Body language </li></ul></ul></ul><ul><ul><ul><li>Non-specific speech </li></ul></ul></ul><ul><ul><li>Improved back up plan over audio-only </li></ul></ul><ul><li>Deaf/Hard of Hearing </li></ul><ul><ul><li>Line of sight </li></ul></ul><ul><ul><ul><li>Positioning of patient </li></ul></ul></ul><ul><ul><ul><li>Exams, procedures, etc </li></ul></ul></ul><ul><ul><li>Limited vision </li></ul></ul><ul><ul><ul><li>Usher’s Syndrome </li></ul></ul></ul><ul><ul><ul><li>Cataracts, glaucoma, etc </li></ul></ul></ul><ul><ul><li>Linguistic variances </li></ul></ul><ul><ul><ul><li>Regional </li></ul></ul></ul><ul><ul><ul><li>Language Proficiency </li></ul></ul></ul><ul><ul><ul><ul><li>Minimal language skills </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Alternate sign language </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Late-deafened </li></ul></ul></ul></ul>
  7. 7. Goal of Video <ul><li>Assure appropriate access to interpreters for patients and providers </li></ul>
  8. 8. Making a Business Case for Video <ul><li>Due to volume , some patients may wait for an interpreter </li></ul><ul><li>Due to scarcity of interpreters patients may wait or not have access to an on-site interpreter </li></ul><ul><li>Typically institutions pay either a package plan or a per minute charge which eliminates waste and controls cost </li></ul><ul><li>As part of a tool kit, video can be a valuable and cost effective way of meeting ADA and Title VI requirements </li></ul>
  9. 9. Challenges <ul><li>Initial cost of equipment & connectivity </li></ul><ul><ul><li>Purchasing </li></ul></ul><ul><ul><li>Leasing </li></ul></ul><ul><ul><li>Use of internet or T1 </li></ul></ul><ul><li>Connectivity </li></ul><ul><ul><li>Wireless capability & coverage of institution </li></ul></ul><ul><ul><li>Specific hard wired areas (hot jacks) </li></ul></ul><ul><ul><li>Broadband speed allocated to facility </li></ul></ul><ul><li>On-site interpreters who feel threatened </li></ul><ul><li>Buy in from providers </li></ul><ul><ul><li>Concerns of efficiency </li></ul></ul><ul><ul><li>Change management </li></ul></ul><ul><li>Engaging the LEP and Deaf/ Hard of Hearing communities to embrace the tool </li></ul><ul><ul><li>New technology </li></ul></ul><ul><ul><li>Quality controls </li></ul></ul><ul><ul><li>Staffing concerns </li></ul></ul><ul><ul><li>Appropriate use/access </li></ul></ul>
  10. 10. Recommendations <ul><li>Walk through of hospital, clinic, etc to determine where video can be used most effectively </li></ul><ul><ul><li>Include on-site technical team </li></ul></ul><ul><ul><li>Evaluate type of equipment needed </li></ul></ul><ul><li>Widespread training throughout the departments where video will be used </li></ul><ul><ul><li>Super User/Project Lead trainings for each department where video will be used </li></ul></ul><ul><ul><ul><li>Tips for working effectively with video interpreters </li></ul></ul></ul><ul><ul><ul><li>Equipment troubleshooting and problem solving </li></ul></ul></ul><ul><ul><li>On-site departmental trainings </li></ul></ul><ul><ul><ul><li>Front line staff </li></ul></ul></ul><ul><li>Senior management team support initiative </li></ul><ul><ul><li>Track usage </li></ul></ul><ul><ul><li>Implement policy changes and expectations </li></ul></ul>
  11. 11. Recommendations (Cont’d) <ul><li>Will you contract with a service provider who uses the internet or a dedicated T1 line? </li></ul><ul><ul><li>Costs/Benefits </li></ul></ul><ul><ul><li>Industry compliance </li></ul></ul><ul><li>Include Language Service team in implementation as champions </li></ul><ul><li>Conduct focus groups </li></ul><ul><ul><li>Staff </li></ul></ul><ul><ul><li>Patient </li></ul></ul><ul><ul><li>Community members </li></ul></ul><ul><ul><ul><li>Deaf/Hard of Hearing </li></ul></ul></ul><ul><ul><ul><li>LEP-immigrant and refugee communities </li></ul></ul></ul><ul><li>Community education-health fairs, video training on how to work effectively with an interpreter including the introduction of video as a resource </li></ul>
  12. 12. My Organization is Interested in Video Interpreting… I Should Ask? What are the questions
  13. 13. Considerations (Part 1) <ul><li>What are the technical supports needed? </li></ul><ul><ul><li>Can my organizations IT department take this on? </li></ul></ul><ul><ul><li>Do they have the skills to drive this project? </li></ul></ul><ul><ul><li>Do they have the time? </li></ul></ul><ul><li>What areas could this most be utilized? </li></ul><ul><li>Who in my organization will champion this? </li></ul><ul><li>What is the cost? </li></ul><ul><ul><li>Set up </li></ul></ul><ul><ul><ul><li>Dedication of IT resources to research, set up and support program </li></ul></ul></ul><ul><ul><li>Training </li></ul></ul><ul><ul><ul><li>Time set aside for staff training </li></ul></ul></ul><ul><ul><ul><li>Will provider include training as part of contract? </li></ul></ul></ul><ul><ul><li>Monthly cost </li></ul></ul><ul><ul><li>Length of contract </li></ul></ul><ul><ul><li>Equipment- purchase or lease </li></ul></ul><ul><ul><li>Maintenance agreement </li></ul></ul>
  14. 14. Considerations (Part 2) <ul><li>How will I make the business case? </li></ul><ul><li>What languages are offered? </li></ul><ul><ul><li>In house/staffed languages </li></ul></ul><ul><ul><li>Peripheral language demand </li></ul></ul><ul><li>Do I want a company with a call center or remote interpreters? </li></ul><ul><li>What are the training and qualifications of the interpreters? </li></ul><ul><ul><li>In house qualifications </li></ul></ul><ul><ul><li>State requirements </li></ul></ul><ul><li>What is the customer service provided? </li></ul><ul><ul><li>24/7? </li></ul></ul><ul><ul><li>Service/Maintenance Agreement </li></ul></ul><ul><ul><li>What is included? </li></ul></ul><ul><li>What kind of data is collected and what access will I have to this data? </li></ul><ul><li>How do I connect to the service? </li></ul><ul><ul><li>Wait time </li></ul></ul><ul><ul><li>Efficiency </li></ul></ul>
  15. 15. Who’s Out There <ul><li>Deaf-Talk </li></ul><ul><li>Language Access Network </li></ul><ul><li>Language Line </li></ul><ul><li>LifeLinks </li></ul><ul><li>Paras and Associates </li></ul><ul><li>Local agencies—some do offer video solutions—typically over the internet </li></ul>
  16. 16. Resources <ul><li>NCIHC Open Call May 25, 2007 On-site and Remote Interpreting: When is Each Appropriate </li></ul><ul><li>RID Video Interpreting Papers </li></ul>
  17. 17. Questions? <ul><li>Contact info </li></ul><ul><ul><li>Erika Shell Castro [email_address] </li></ul></ul><ul><ul><li>Jeff Mercer </li></ul></ul><ul><ul><li>Company info—See our booth or </li></ul></ul>