Video Network Links California Patients With Interpreters

Reprinted from NurseWeek

By Scott Mace

When you need a language interpreter, how fast can you get one?

For an increasing number of nurses in California, the answer can be measured in seconds, thanks to the Health Care Interpreter Network (HCIN) (http://www.hcin.org/). HCIN provides access to medically trained interpreters fluent in 15 languages including American Sign Language (ASL) during clinic hours. Interpreters appear on low-cost, high-quality interactive videoconference screens or high-quality handsets or speakerphones accessible or movable throughout hospitals and health clinics.

Before HCIN, we would wait for an hour for an interpreter, and now it’s less than 30 seconds,” says Ken Beckerle, RN, clinic nurse manager at Riverside County Regional Medical Center in Moreno Valley, Calif. “It’s a huge difference, and it really helps our patients.”

Saving time

HCIN links together interpreter resources already in place at member institutions around the country. The system routes requests to the next available interpreter fluent in that particular language. “In days past, our interpreters would have eight pagers, and they’d all be going off at the same time,” Beckerle says. “Now we have our own [communication] unit that we just plug into the wall.” Onsite interpreters save time by remaining in one place rather than constantly having to move from office to office.

If no one recognizes the language the patient is speaking, HCIN can help there, too. “We had a 60-year-old lady come in,” Beckerle says. “No one could figure out what dialect of Spanish she was talking. We got her on HCIN, and I think it was someone from Kern County who understood the dialect from a small area in Nicaragua. We spent 20 minutes, whereas we would have spent all day trying to figure this out with the phone system.”

Requests for languages not available from among HCIN participants, or during shifts when they are not available, are routed to a telephonic commercial language service provider that offers 170 languages 24 hours a day, seven days a week.

HCIN officials say its interpreter services are 75 cents a minute between HCIN members — about half the cost of a typical commercial telephonic language service provider. HCIN provides higher-quality audio and the added benefit of two-way video.

Breaking down barriers

Hospitals are under existing and expanding requirements to provide interpreter services. The Joint Commission requires that interpretation be provided to all patients who have communication barriers. The Centers for Medicare & Medicaid Services requires all recipients of reimbursement to adhere to federal civil rights legislation, which prohibits discrimination on the basis of national origin, which includes speaking a language other than English.

Starting in 2009, Senate Bill 853, signed into law in 2003, will require private health plans in California to provide limited-English-speaking enrollees with language assistance services.

In Los Angeles, the Women’s and Children’s Hospital at Los Angeles County + USC Medical Center deployed HCIN early this year. “We see the face of Los Angeles in our clinics and here at our facility,” says Margaret Woodard, RN, nurse manager of the hospital’s Women’s Health Clinic. “There’s just a crying need for an expansion of good interpretation services, and I feel like we’ve got it. We’re on the cutting edge.”

One day, Woodard discovered that a young woman who required an ASL interpreter had entered the clinic. “We pushed the video unit into the exam room and plugged it in,” she says. “Within less than a minute, we had an American Sign Language interpreter on screen signing and speaking to both the patient and the doctor who was going to see her. The look on the patient’s face just told it all. I’m sure wherever she goes in life, these sign language issues are huge for her, and we were able to help her almost immediately. It’s such a relief to the patient to be speaking to someone whom they can express themselves with and be understood.”

Nurses praise the network’s ease of use. “If you can put a phone jack in the wall — and they even outline the correct jack to use — you can do it,” says Betty Jo Riendel, RN, Healthy Beginnings French Camp/GYN clinic manager at San Joaquin General Hospital in French Camp, Calif. “When you have an individual who’s isolated by a language barrier, and you compound that with an illness, they are just doubly isolated. To be able to provide this to people who are at their most vulnerable, there’s nothing like it.”

HCIN also helps administrators make better use of interpreters already on site, who now can take calls for other network participants at times when the interpreters might otherwise have been idle. “Our productivity has tripled since we became part of the HCIN network,” says Nora Gonzalez, interim language and cultural services supervisor at Riverside County Regional. 

Scott Mace is a freelance writer. To comment, e-mail editorCA@nurseweek.com.