Remote Video Interpreting Services
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Sutter Health
California
Diabetes and Cardiovascular Disease Risk Factors
Outpatient clinics
Patients with Limited English Proficiency
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PROJECT
Patients with limited English proficiency receive interpretation services via a two-way remote video link.
Language interpretation services are offered via remote video technology that uses existing laptops and clinic intranet to connect providers and patients with an interpreting center. Instead of using in-person or external telephone-based interpreter services, patients see and are seen by interpreters via a two-way audio and video link.
Staff and providers receive cultural competency training and learn how to use the new video interpretation system. Physicians submit a request for interpretation services via an online form, and an interpreter connects to the clinic through a webcam on a computer in the exam room. The remote video link utilizes existing clinic computer hardware, and does not require costly or dedicated-use videoconferencing equipment.
Three California Pacific Medical Center primary care practices in partnership with Sutter Health will participate.
RATIONALE
Inadequate interpretation services have been shown to decrease the likelihood that patients will be able to follow doctors’ orders, which creates an indirect hidden cost in health services. Additionally, the use of traditional telephone interpretation methods has limitations, including the inability for the interpreter to see the patient when giving instructions or to get a full assessment of the patient’s body language. Using a video-based system reduces the chance that interpretation services will be perceived as removed and cold by both the patients and providers. The transition to remote video interpreting has the potential to improve patient flow, reduce interpreter wait time, improve the documentation and tracking of interpreter services, and improve interpreter protocols. As interpretation services are improved, both patient-provider communication and satisfaction may be improved, potentially leading to greater adherence to treatment, and better health outcomes.
EVALUATION PLAN
Funded by Finding Answers in 2010.
Researchers are conducting a pre-post intervention assessment of both process measures and clinical outcomes in patients with limited English proficiency and diagnosed with type 2 diabetes or hypertension. Researchers are assessing patients’ improvement in HbA1c control and LDL cholesterol level, blood pressure and adherence to medication or treatment regimen. Researchers are also collecting data about patient, physician and interpreter satisfaction with interpretation services. In addition to quantitative measures, the researchers are also using key informant interviews and focus groups to assess barriers and facilitators to remote video interpretation. Qualitative data collection topics include staff and provider readiness, impact upon relevant standards of care, processes to provide remote video interpretation, clinic culture and contextual factors. Researchers are also analyzing interpretation service costs before and after the intervention,
to determine if remote video services represent a cost-effective alternative to in-person or telephone interpretation services.
Principal Investigators:
- Maria R. Moreno, MPH (Health Services Researcher, Sutter Health)
- Regina Otero-Sabogal, PhD (Adjunct Professor, University of California-San Francisco)
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