The Language Access Gap: Why Contracted Services Go Unused

Imagine this scenario: A patient seeking care in a U.S. emergency room speaks little English. The healthcare worker can’t waste any more time looking for a roller cart. So, to overcome the language barrier instantly, they grab their smartphone and use an off-the-shelf translation app, such as ChatGPT, to communicate with the patient. Or maybe they rely on the patient’s child or friend to interpret. Easy peasy. Problem solved, right? Wrong.

Despite good intentions, these shortcuts don’t meet federal requirements, and they put organizations at real risk of a Section 1557 and/or HIPAA violation. Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act mandate that organizations provide meaningful access to qualified healthcare interpreters and translations.

Examples of Disastrous Clinical Outcomes

How Do Professional Interpretation and Translation Services Affect Patient Outcomes?

The data is clear: When professional interpretation services and translation services are provided, patients experience improved communication and greater satisfaction with care, are more likely to adhere to their care plans, and achieve better health outcomes.

Conversely, statistics compiled by Worldmetrics indicate a higher likelihood of adverse events among individuals with LEP due to language barriers.

How Do Professional Language Services Affect Hospital Risk?

When hospitals fail to comply with language access requirements, they risk reputational and financial damage.

• In the case of the quadriplegic 18-year-old highlighted above, the ensuing lawsuit resulted in a $71 million settlement.
• The family of the deceased Vietnamese girl reportedly settled their malpractice claims against the hospital and the doctor for $200,000. Legal fees totaled $140,000.
• In the case of the chemotherapy overdose, the patient was awarded $105,000. Legal fees totaled $27,000.

These punitive outcomes are not isolated. A study by the University of California, Berkeley, School of Public Health found that medical malpractice resulting from language barriers is costly. The study analyzed medical malpractice cases from a malpractice carrier insuring in four states to identify claims in which language barriers had a direct or indirect effect on health outcomes.

The carrier paid more than $2 million in damages and more than $2 million in legal fees to settle 35 claims. In 32 of the cases, the healthcare providers failed to provide competent interpreters. In 12 of the claims, providers failed to translate important forms, including informed consent documents and discharge information.

Yet despite the risks of withholding language access, the use of a professional healthcare interpreter remains low, even when contracts with language providers are in place.

What Is the Rate for Professional Interpretation?

National estimates underscore how low the use of professional interpretation is for patients with Limited English Proficiency (LEP) in ambulatory settings and reveal a significant gap between mandates and actual compliance. Based on a sample of 273,796 outpatient physicians, Springer Nature reports that fewer than half of the respondents often use professional interpretation services.

What Barriers Discourage the Use of Professional Interpretation?

In most, if not all, cases, hospital systems are aware of language access laws, and contracts with language providers for professional interpretation and translation are often in place. So, what gives?

Several barriers contribute to noncompliance, including difficulty accessing services, a lack of cross-departmental and cross-functional training, and insufficient resources for language access.

• It’s easier to pull out an iPhone or rely on ad hoc interpretation from a bilingual family member than to track down a cart, navigate complex menus, and deal with poor customer service when issues arise.

• Lack of interoperability within the organization (often due to inadequate training) can lead to inconsistent practices across departments.

• Hospital systems often view language access services in healthcare as a compliance requirement rather than as a core safety issue and an essential part of care.

While it is incumbent upon providers to recognize the importance of language access and the potential dire consequences of withholding it, Lionbridge’s solutions help hospital systems overcome other barriers.

How Can Hospitals Close the Gap Between Language Access Availability and Actual Use?

Eliminate burdensome processes

You can now access professional interpretation in more than 380 languages directly from the patient’s Electronic Health Record (EHR) through LionbridgeLink™, our on-demand interpretation solution for Epic interpretation integration.

The solution promotes standardization across the organization by establishing a uniform process. Most importantly, it simplifies access by enabling providers to get these professional services via built-in audio and video on EHR Workstations on Wheels (WOWs), which are common in most exam rooms. No more searching for iPads attached to carts. No more complex menus that discourage use. And no more frustration from broken or malfunctioning hardware.

The LionbridgeLink solution complies with the Health Insurance Portability and Accountability Act (HIPAA) and meets the requirements of the General Data Protection Regulation (GDPR). Worried about encountering a problem? Our industry-leading customer service team is available 24/7 if you need assistance.

Want to see LionbridgeLink in action? Watch the demo on interpretation integration to see why it’s a game changer for securing professional interpretation.

Promote interoperability from patient registration to discharge through comprehensive training and a strategic partnership

Getting employees to consistently use your contracted language provider's services across the board is difficult but not impossible with the right partner.

Lionbridge facilitates interoperability by taking a proactive role in training initiatives across departments and functions, including patient registration staff and care providers, to drive adoption.

Why Lionbridge?

With Lionbridge, you don’t just get a set-and-forget partnership model with an email alias for reactive interactions; you get a dedicated team that engages with senior leadership and meets with you regularly to advance language access, an issue we’re unapologetically passionate about.

Present and proactive, we identify language access gaps within your health system, share insights into industry trends, interpret your reports (including language requests and frequency, call length, and quality monitoring), train your staff, and actively monitor population changes in your geographic areas to ensure you are prepared to address constantly shifting migration patterns and emerging language needs.

Many large language providers specialize in either translation or interpretation. Lionbridge delivers both at scale. Because equitable healthcare depends on language access in every form, spoken and written, we meet the full range of your patient needs: from real-time interpretation in the emergency room to expertly translated documents, such as informed consent forms and discharge information.

• On the interpretation side, you can rest assured you’ll have secure, compliant services with industry-leading connection times, giving you access to specially trained, qualified medical interpreters across 380+ languages.

• On the translation side, you’ll benefit from our mature, compliant technology, delivering fast turnaround and scalability across the languages you need.

That is how an active, strategic partnership functions.