The  Disconnect Between Medical Interpreting Services and  LEP Patients During the Pandemic


Although it is a law that you have to provide language interpreters to the patients that need it, and some hospitals do have staff interpreters,  it is too far from the norm in many hospitals. Yet, despite being a law not to mamy are aware that is a responsibility and have not implemented and enforced it due to varying state laws , changing demographics and state reimbursement practices. Most importantly however,  most facilities  cite costs and time constraints as a reason.  Rather they rely on  interpretation from  either their hospital personnel that  is not qualified to interpret,   or family members (usually young children) to interpret for them.

Why is this important?

By law, if  you receive federal funds through grants or through Medicare and Medicaid, you are supposed to  provide language access to the patient that needs it but  that  means that you have to file a physical claim  and wait until you are reimbursed  and depending on the state, the state is not obligated to reimburse the provider for such services, therefore incurring the cost. It  is mandatory to be free to the patient but with their contract with the language provider, the language provider bills them then bill via claim.


There is no federal requirement to be certified as an interpreter  but  it is highly requested  and desirable that one is. Many errors can and do occur when someone interprets outside their field of expertise but  because of these requirements and certifications, the availability of a certified and qualified interpreter  is  difficult to attain.  The use of certified interpreters also  command a higher rate  than a freelance  uncerrtified interpreter  and charge per hour even if  it is 10 minute  consult with a patient. For reasons already stated, many forgo the practice of using them.


besides being a law,   Is its very important particularly now that we are going through a global pandemic and patients with limited English proficiency are less likely to get the proper and lifesaving  care they need. Granted that  during this pandemic hospital workers are burned now and have to act  immediately to save lives and having a language barrier only adds to their inability to provide immediate care.


In person interpretation or face-to-face  is more desired by both patients and doctors alike.  it is not always feasable and under  the recent outbreak  it is not desirable or recommended.


Because the coronavirus is so contagious even  with PPE  ( proper protective equipment)  many hospitals are releasing their in house interpreters because  they are keeping ‘essential personnel”  but rather opting for third party services which are less costly so  they resort to over the phone interpreting (OPI) and Video Remote Interpreting (VRI).

Given the new normal, even if you are qualified and certified  hospitals only request to have OPI or VRI interpreting  and not within their  regular place of employment  either In some  hospitals the inhouse staff interpreters are given the option or stay in as a full-time interpreter or take unpaid leave but without the possibility of working from home.  This option puts them in a serious situation it is either your job or your health  because no one other than medical personnel is allowed in the room or emergency room with them, not even when critical.

However, that is not the true reason, they are opting for OPI and VRI for cost. Many hospitals because of the pandemic are losing revenue because all other procedures that normally get billed are not being performed and the revenue stream to supply for these services is low.

OPI and VRI are billed by the minute and paid for as long as they are needed compared to the full hour of service.

So not even the most qualified interpreter can’t be personally there to help and assist linguistically and LEP patients are literally left to die. There is so much need  and urgency at the same time for the  doctors  that they have to be “efficient before effective communication”that patients  are suffering  grave consequences.

Getting in touch with  OPI interpreters takes seconds but that also depends on the language  requested.  Spanish is a relatively easy language to request but  depending on the language, it may take minutes to find and locate an interpreter with that language requested and some say that they have to wait up to 10 minutes for an interpreter. Also, many hospitals do not have the proper video equipment to provide video interpreting and because of privacy laws and patient confidentiality  the use of Zoom and other video conferencing is not a feasible option. That is valuable time waiting when you have others that are  just as severe.

Studies and stats already show the disparity in care for non English speakers and minorities  Mostly  because there is such a rush of patients where all of them are in need  of lifesaving care.


Despite this, there is a very disturbing  reality when it comes to the healthcare system and that is that  healthcare is business and most agencies, facilities and healthcare organizations are looking at the “bottom line “ to provide services.   When the bottom line is profit, and added costs ( as they believe  interpretation services ) are slashed, patients that rely on these services suffer greatly communicating their symptoms to a doctor.


So not only do you have qualified, certified interpreters ready to work and patients desperate to communicate with the doctor but with a huge disconnect between them.


So here you have two great needs one available and able to provide it, and on the other hand doctors desperate to understand and save patients and having this huge disconnect between the two services and the ones suffering are patients themselves.



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