logo image
  • News
    • People Moves
    • Deal Wins
    • Demand Drivers
    • M&A and Funding
    • Financial Results
    • Technology
    • Academia
    • Industry News
    • Features
    • Machine Translation
    • — Divider —
    • Slator Pro
    • — Divider —
    • Press Releases
    • Sponsored Content
  • Data & Research
    • Research Reports & Pro Guides
    • Language Industry Investor Map
    • Real-Time Charts of Listed LSPs
    • Language Service Provider Index
  • Podcasts & Videos
  • Events
    • SlatorCon Remote May 2021
    • Localizing at Scale for International Growth
    • Design Thinking May 2021
    • — Divider —
    • SlatorCon Coverage
    • Other Events
  • Directory
  • RFP Center
  • Jobs
MENU
  • News
    • People Moves
    • Deal Wins
    • Demand Drivers
    • M&A and Funding
    • Financial Results
    • Technology
    • Academia
    • Industry News
    • Features
    • Machine Translation
    • — Divider —
    • Slator Pro
    • — Divider —
    • Press Releases
    • Sponsored Content
  • Data & Research
    • Research Reports & Pro Guides
    • Language Industry Investor Map
    • Real-Time Charts of Listed LSPs
    • Language Service Provider Index
  • Podcasts & Videos
  • Events
    • SlatorCon Remote May 2021
    • Localizing at Scale for International Growth
    • Design Thinking May 2021
    • — Divider —
    • SlatorCon Coverage
    • Other Events
  • Directory
  • RFP Center
  • Jobs

Register Now for SlatorCon Remote on May 13th!

  • Slator Market Intelligence
  • Slator Advertising Services
  • Slator Advisory
  • Login
Search
Generic filters
Exact matches only
Advertisement
Why Parkland Memorial Hospital Insourced Interpreting and Invested in Dallas County

2 years ago

September 30, 2019

Why Parkland Memorial Hospital Insourced Interpreting and Invested in Dallas County

Features ·

by Seyma Albarino

On September 30, 2019

2 years ago
Features ·

by Seyma Albarino

On September 30, 2019

Why Parkland Memorial Hospital Insourced Interpreting and Invested in Dallas County

They say everything is bigger in Texas. That is certainly true about the volume of healthcare interpreting.

Dallas-based Parkland Memorial Hospital is an 882-bed facility that handles more than one million outpatient visits each year. Its interpretation and translation needs are not just high, but also symbolic of the demographic changes in the US: 41% of Parkland’s patients speak a language other than English; 39% speak Spanish.

Of the approximately 11,000 Parkland employees, only 458 are qualified bilingual staff  — not enough to meet demand, even with 80 onsite interpreters.

Advertisement

As Parkland’s Language Services Director Meredith Stegall explained to the audience at SlatorCon San Francisco 2019, a unique in-house call center model turned this challenge into an opportunity for both the hospital and the local community.

Providing language access for patients has been legislated and regulated at different levels in the US.

Some states have specific requirements for providers, but these do not apply to Parkland because Texas has not expanded Medicaid.

Most meaningful, according to Stegall, are the Joint Commission standards, because the Joint Commission (whose rules have traditionally been the strictest) is the certifying body for hospitals. As such, it has the power to terminate programs.

On top of these are the requirements introduced by ACA 1557, the nondiscrimination provision of the Affordable Care Act (Obamacare), which has had a ripple effect on the healthcare and language industries since its enactment in 2010.

Slator 2020 Language Industry Market Report

Data and Research, Slator reports
55 pages. Total market size, biz dev and sales insights, TMS & MT review, buyer segment analysis, M&A, Covid impact & outlook.
$480 BUY NOW

ACA 1557 requires providers to ensure that individual patients, not just patient populations, have access to language services. This compels hospitals to collect extensive data on individual patient experiences and follow up with clinicians who have decided not to use interpreters in specific instances.

For an institution of Parkland’s size, Stegall said, “the data-collection burden becomes quite onerous.” At the same time, there is also pushback from much smaller, over-extended rural facilities that are struggling to stay open, let alone meet the standards demanded of larger hospitals.

ACA 1557 has also left healthcare providers vulnerable by creating another reason for patients to sue. Prior to ACA 1557, Stegall explained, language access violations could prompt a lawsuit through tort or through Office for Civil Rights violations and related fines. With ACA 1557, patients could also sue under the Act itself, putting institutions with high populations of limited English proficiency (LEP) patients at risk from expensive litigation.

Going Big AND Going Home

Back in Dallas, Parkland’s in-house interpreters were simply unable to keep up with the growing demand for their services. In response, Parkland outsourced 70% of its interpretation to third-party vendors for USD 9m in 2017, using technology integrated into patient rooms to deliver VRI at the click of a button.

Slator 2019 US Healthcare Interpreting Report

Data and Research
25-page report. US healthcare market overview. Role of the language services industry. Market size. Competitive landscape. Biz Dev and Sales.
$170 BUY NOW

While troubleshooting technical difficulties, Stegall realized that taxpayer-funded outsourcing was costly and often relied on interpreters working outside the US who, unlike in-house staff, had not been trained internally.

Stegall approached Parkland’s board with an idea: “I can do this better, smarter, faster, cheaper,” she promised. Her solution? “Insourcing,” to create Parkland’s own call center.

By June 2018, Parkland was hiring and training interpreters for its call center, which began operating in November 2018. The center now employs over 80 interpreters, and Parkland, as well as Dallas County, are spending less. Interpreting through the Parkland call center costs USD 0.55 per minute compared to third-party vendors at USD 0.74 per minute. This adds up to USD 1.5m in annual savings.

“You absolutely have to have intensity to drive the capital expenses that come with insourcing. I’ve seen smaller hospitals try to do it. I wouldn’t suggest it.”

Interpreters employed in the call center receive not only benefits, but also educational and professional opportunities. Parkland provides 8 to 12 weeks of training for new interpreters, depending on the individual’s skill level. The call center’s goal is to put itself out of business, Stegall emphasized, adding that 25% of current call center interpreters are in nursing school. Onboarding those interpreters-turned-nurses in the future will allow the hospital to match the clinician to a patient’s needs while bringing down staffing costs.

Stegall doubts that the model is appropriate for facilities operating on a smaller scale. She said you “absolutely have to have intensity to drive the capital expenses that come with insourcing. I’ve seen smaller hospitals try to do it. I wouldn’t suggest it.”

Slator 2019 Life Sciences Translation Report

Data and Research
25 pages. Clinical life sciences market size, competitive landscape, industry service model, buyer insights, and more...
$170 BUY NOW

Parkland has also benefited from already having a fully operational call center as part of the hospital’s existing telehealth services. “Part of scale [is] having that available to you,” Stegall said.

Unfazed by Changes to ACA 1557

The call center has already become a “Parkland profit center” by selling its capacity to pre-hospital and hospital clients, and anticipates future savings thanks to the built-in career paths for interpreters.

Proposed changes to ACA 1557 are already making waves in the language industry, but Stegall pointed out several ways in which a rollback could benefit Parkland, and, ultimately, patients.

Lifting the requirement for providers to send pages of “tagline” translation notices in at least 15 languages to inform patients of the availability of interpreting services could save millions, according to a May 2019 statement from the Department of Health and Human Services (HHS).

Placing certain limits on ACA 1557 may also open up avenues for experimenting with new tools like speech-to-text technology, which clashes with the legal definition of adequate translation or interpreting as being produced by a human. Stegall also cited chatbots as an option for enhancing the patient experience in lower-stakes administrative and financial interactions.

SlatorSweep - Daily Market Intelligence

SlatorSweep

Data and Research, Market Intelligence
Curated news from thousands of sources, SlatorSweep’s daily news service gives you a competitive edge on time sensitive market intelligence.
BUY NOW

Other opportunities might include helping to improve electronic medical records (EMR) used across the US, which were originally built around homogeneous populations.

Stegall asserted that Parkland’s commitment to language access will stay strong regardless of any changes to ACA 1557.

“We truly feel this will have a minimal impact on our patients,” she said, noting that Parkland will continue to meet the Joint Commission’s higher standards, and that hospitals have trained physicians and nursing staff about the expectation to use interpreters.

According to Stegall, “the likelihood that this will change, in my opinion, is next to nothing.”

SlatorCon San Francisco 2019 Speaker Presentations

SCSF19 Presentation Meredith (Parkland Hospital)

555 KB

DOWNLOAD

TAGS

ACAACA 1557Affordable Care ActDallashealthcarehealthcare interpretingin-houseinterpretationinterpretingmedical interpretingMeredith StegallOPIProvision 1557SlatorConSlatorCon San Francisco 2019TexasUS healthcarevideo remote interpretingVRI
SHARE
Seyma Albarino

By Seyma Albarino

Staff Writer at Slator. Linguist, music blogger and reader of all things dystopian. Based in Chicago after adventures on three continents.

Advertisement

SUBSCRIBE TO THE SLATOR WEEKLY

Language Industry Intelligence
In Your Inbox. Every Friday

SUBSCRIBE

SlatorSweepSlatorPro
ResearchRFP CENTER

PUBLISH

PRESS RELEASEDIRECTORY LISTING
JOB ADEVENT LISTING

Bespoke advisory including speaking, briefings and M&A

SLATOR ADVISORY
Advertisement

Featured Reports

See all
Pro Guide: Translation Pricing and Procurement

Pro Guide: Translation Pricing and Procurement

by Slator

Slator 2020 Language Industry M&A and Funding Report

Slator 2020 Language Industry M&A and Funding Report

by Slator

Slator 2021 Data-for-AI Market Report

Slator 2021 Data-for-AI Market Report

by Slator

Slator 2020 Medtech Translation and Localization Report

Slator 2020 Medtech Translation and Localization Report

by Slator

Press Releases

See all
MasterWord Services Inc. Names Jeanette Stewert as Vice President of Operations

MasterWord Services Inc. Names Jeanette Stewert as Vice President of Operations

by MasterWord

XTRF Welcomes Roberto Ganzerli to Its Advisory Board

XTRF Welcomes Roberto Ganzerli to Its Advisory Board

by XTRF

Venga Reshapes Language Review with InQA Cloud Application

Venga Reshapes Language Review with InQA Cloud Application

by Venga Global

Upcoming Events

See All
  1. SlatorCon Remote May 2021

    by Slator

    · May 13 @ 3:00 pm - 8:00 pm

    A rich online conference which brings together our research and network of industry leaders.

    More info $110

Featured Companies

See all
Sunyu Transphere

Sunyu Transphere

Text United

Text United

Memsource

Memsource

Wordbank

Wordbank

Protranslating

Protranslating

SeproTec

SeproTec

Versacom

Versacom

Smartling

Smartling

XTM International

XTM International

Translators without Borders

Translators without Borders

STAR Group

STAR Group

memoQ Translation Technologies

memoQ Translation Technologies

Advertisement

Popular articles

Google Translate Not Ready for Use in Medical Emergencies But Improving Fast — Study

Google Translate Not Ready for Use in Medical Emergencies But Improving Fast — Study

by Seyma Albarino

The Slator 2021 Language Service Provider Index

The Slator 2021 Language Service Provider Index

by Slator

Why Netflix Shut Down Its Translation Portal Hermes

Why Netflix Shut Down Its Translation Portal Hermes

by Esther Bond

SlatorPod: The Weekly Language Industry Podcast

connect with us

footer logo

Slator makes business sense of the language services and technology market.

Our Company

  • Support
  • About us
  • Terms & Conditions
  • Privacy Policy

Subscribe to the Slator Weekly

Language Industry Intelligence
In Your Inbox. Every Friday

© 2021 Slator. All rights reserved.

Sign up to the Slator Weekly

Join over 13,800 subscribers and get the latest language industry intelligence every Friday

Your information will never be shared with third parties. No Spam.