Language Access Key to Equitable Telehealth for Marginalized Communities

Language Access in Telehealth

Since 2010, when Section 1557 of the Affordable Care Act (ACA) first required US healthcare providers to offer free language services to patients, the demand for medical interpreting and translation has only increased, especially as the population of patients with limited English proficiency (LEP) continues to grow and age.

The scale of opportunity associated with these services is well-illustrated by AMN Healthcare’s headline-making USD 475m acquisition of remote interpreting provider Stratus Video in 2020 — a move that continues to pay off for AMN. 

At SlatorCon Remote December 2022, UpHealth’s Tatiana González-Cestari, Director of Language Service Advocacy, and Danielle Meder, Director of Organizational Quality and Partner Support, discussed the challenges of integrating language access within telehealth.

The digital transformation of healthcare, accelerated by the pandemic, has left LEP patients behind — but a more nuanced approach to the technology can bring telehealth to marginalized communities.

González-Cestari and Meder, who both sit on the Board of Directors of the National Council on Interpreting in Healthcare, explained that policy changes, an increase in data, and greater investment of capital have supported this digital transition. But without language support, these advances are of limited use to LEP patients.

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One concrete example is a patient portal, where users can view their information in order to come prepared to appointments. A user who cannot read their provider’s messages or write directly to their provider is unlikely to find the portal helpful.

“I probably have at least three or four telehealth apps, but not one of them has anything to do with language access,” noted Meder. “Communicative autonomy really means everyone gets to say what they want, when they want, how they want. That’s for everybody.”

Meder and González-Cestari said that making language access an integral part of any new healthcare technology, rather than an add-on or after-thought, is key to advancing equitable healthcare. 

From the beginning, they said, make sure all stakeholders are at the table. This group could include patients, providers, interpreters, and frontline workers, among others. Their input will be invaluable when testing a given solution. 

Research and data analysis, when used appropriately, also contribute to better decisions and improved services, said González-Cestari. “Even though we have key players who provide great data, we don’t always utilize it or always ask the right questions,” she pointed out.

And when partnering with a hospital system, service providers, or other vendors, Meder added, agility is a must.  

“We have to really look at what we offer as stakeholders in this space. The end goal is equitable healthcare for all, regardless of language,” she said.

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