By ANABELLE GARAY and LINDA STEWART BALL Associated Press Writers © 2010 The Associated Press
DALLAS — Dr. Barton Giessel presses on spots down Maria del Rosario Gomez's back while talking into the speaker of a cordless telephone to ask where it hurts.A man's voice spills out from the phone, posing the question to Gomez in Spanish and then relaying her response in English.
"The pain goes to the left breast," the interpreter on the phone says, as if he were the patient. After her consultation ends, Gomez calls the entire exam a blessing.
The telephone interpreter is part of Parkland Memorial Hospital's growing effort to connect with patients in their own language throughout the facility, from the intake windows, to triage to patient rooms. On-the-spot interpreters are accessible through about 1,000 cordless, headset and dual-handset devices at the Dallas hospital.
It is a trend getting more attention at many other U.S. hospitals, several of which are turning to telephonic or video interpretation services to help supplement their in-house interpreters and bridge the language barriers that might otherwise keep growing numbers of non-English-speaking patients from getting an accurate diagnosis or proper medical attention.
Nationwide, the Census Bureau estimates some 24 million people over the age of 5 speak no or limited English, making it likely many will need language services when they get sick.
Parkland's phones are a response to a 40 percent increase in demand for interpretation services at Parkland over the past two years. There are at least 77 languages, including Spanish, Vietnamese, Korean and Arabic.
The hospital has used tele-interpreting phones on a limited basis for more than a decade and expanded their use last fall, placing the devices in every patient's room.
"It makes a huge difference from a patient perspective," said Jonathan Hirsch, Director of Guest Services and Patient Advocate for Holy Name Hospital in Teaneck, New Jersey. "They understand what care they're getting; they're empowered within the walls of the hospital."
Besides telephone interpreters, Hirsch said Holy Name also uses video interpreters who, by seeing a patient's facial cues and body language, can capture nuances that improve translation of the spoken word.
Hirsch recalled a Korean man referred to Holy Name's oncology group with a reputation for being difficult to treat and resistant to his doctors' orders. Using a video interpreter to assist in their first meeting with their new patient, staffers quickly realized he had no clue what was wrong with him or why his previous doctors wanted to do certain procedures.
By the end of that meeting, Hirsch said the man was on board with the treatment plan his doctors recommended to fight his aggressive cancer.
While no data is available on the number of medical mistakes that happen each year in the U.S. due to language obstacles, health care advocates point to the 1980 misdiagnosis of an 18-year-old South Florida man as a tragic example of what can go wrong.
The young man at first complained of a headache and lost consciousness at his home before being rushed to a Miami-area hospital. It was there that one of his relatives used the word "intoxicado" to describe his condition.
For some Spanish speakers, that word means nauseous. But hospital staff misinterpreted it to mean intoxicated, leading doctors to believe he had overdosed on drugs.
It wasn't until later that doctors discovered he had suffered a brain injury. The mistake left the man quadriplegic and cost those who misdiagnosed him $70 million to settle a resulting lawsuit.
Similar problems have been reported in emergency rooms across the country.
Cindy Choy, 47, of San Francisco, believes language problems she encountered two years ago at a Bay area hospital following a severe asthma attack could have proved deadly.
As she gasped for air in the emergency room, hospital staff tried in vain to explain to Choy, who speaks only Cantonese, that she needed to sign a medical release and other papers before they could treat her. Fortunately, she said, her bilingual ex-husband arrived at the hospital in time to interpret.
"It was a very, very scary situation," she told The Associated Press through an interpreter.
The technological advances that have made trained medical interpreters available to patients by telephone and video have helped narrow the language gap at hospitals like Parkland and Holy Name, but such problems persist at many hospitals and clinics, experts say.
"It's very serious," said Dr. Glenn Flores, a pediatrics professor and expert on language barriers in health care. "Essentially there's been very little progress over the last decade in improving access to language services for people who need them."
One reason is cost, Flores said.
Medical interpreters are specially trained and must be fluent in languages, but also in health care terminology.
On average, Parkland spends at least $160,000 a month for the telephonic interpretation service it receives from Language Line Services, a Monterey, Calif.-based interpretation and translation company, according to Deborah Moore, the hospital's manager of patient relations.
Most hospitals get no public money to reimburse the costs of interpretation services. But those receiving federal funds are required to make sure patients with limited English skills are able to access their services and programs.
Flores said only about 13 states reimburse hospitals for those federally mandated services.
"In states where you have that reimbursement structure, you're much more likely to provide professional interpreters for your patients," Flores said.
Texas, California and New York, which have some of the nation's largest immigrant populations, are among the states that offer no reimbursement to health care providers, he said.
"That's really concerning given that we know it can compromise patient safety and outcomes and, when used, can reduce costs," Flores said.
Source: http://www.chron.com/disp/story.mpl/ap/tx/6901554.html
