Healthcare institutions have many options when it comes to providing language assistance to their non-English speaking patients.  As with all interactions, but especially in the area of healthcare, good communication between patient and practitioner is essential to high quality care/service and improved patient outcomes.  With various ways of providing language assistance services, institutions are always concerned about having the “right” services available.

There are three modalities of providing interpreter services – face to face interpreting, over-the-phone interpreting, and video remote interpretation.  All three modalities have their benefits and offer options that a facility should consider when deciding on which modality to employ.  Simply stated, face to face offers benefits that may not be available via the other modalities but is also subject to limitations/constraints that must be considered.  The following series of questions review the benefits and limitations of face to face, identify situations when, if possible, face to face should be used, and provide guidelines to be considered when making these decisions in a healthcare environment.

Availability

Perhaps the first question to be addressed regarding face to face interpretation is:

“Is a qualified face to face interpreter available to provide the service?” 
Face to face interpreters are available in many but not all languages.  So the first consideration must review the language needed and the ability to find an interpreter that speaks that language.  Once the question of availability is answered, the next key question is:

“Can the interpreter be available to provide the interpretation in line with the time requirements of the facility?” 
It does no good if an interpreter is “available” but not able to be present during the specific time needed by the facility.  Especially in healthcare situations, waiting for an interpreter to be “available” may cause detrimental effects on patient outcomes.  A third question to consider:

“Is the face to face interpreter “qualified” to perform the service?” 
If the facility is using a staff interpreter or a contract interpreter, they should take steps to ensure that the interpreter has met the hospital’s qualification standards.   A person may be bi-lingual in the language needed but a hospital must have assurance that the interpreter has the requisite skills to act as an interpreter.  A final question in this vein:

“What if the patient wants to provide their own interpreter?” 
While this may seem like a great cost-saving approach, using a patient’s interpreter places the facility in considerable jeopardy.  In cases where a patient insists on using their own interpreter, it is in the best interest of the hospital to have their own interpreter there also to ensure the interpretation provided is consistent with the message being delivered.

Need

“When is it beneficial to employ the services of a face to face interpreter?” 
There are many instances when using a face to face interpreter is preferable to using either over-the-phone or video interpreters.  Among the most significant reasons are the following:

  1. When an interpretation session will be very lengthy in time.
  2. When an interpretation session will be providing complex information that must be discussed and explained in detail – such as complex medical procedures where the risks/benefits must be fully understood by the patient.
  3. When an interpretation session will be providing sensitive information – such as end of life decisions.
  4. When an interpretation session will be provided in a group setting – such as a family conference where several members of the group may be participating.
  5. When an interpretation session involves a mental health patient.
  6. When an interpretation session will be enhanced through the use of visual cues – such as body language.

Cost

As in most interpreter interactions, the cost of providing the service should always be considered in light of the need.  Most clinical encounters are short in duration, and as such, lend themselves for working with either an over-the-phone or video interpreter – to provide cost-efficient, appropriate interpretations.  However, as noted above, there are instances based on such factors as length of time needed or the sensitivity of the interaction where, if possible, a face to face interpreter should be employed even if it is a more costly solution. In a perfect system, a hospital would have all three modalities available for use and employ services in the most cost-efficient and effective manner to achieve optimum patient care.

Confidentiality

An ongoing concern, no matter what modality of interpreter is employed, is protection of the confidentiality of information transmitted during an interpreter session.  While this issue is typically easily addressed for over-the-phone and video interpretations, the issue may come into question in areas where a face to face interpretation is used for a rare language with a small local population that speaks that language.  In these cases, the patient and the interpreter may be known to each other – so the facility must take special precautions when working with a face to face interpreter and may, as a result, opt for using an approach other than face to face.

Conclusion

Working with face to face interpreters offers many benefits for both patients and practitioners.  However, those benefits must always be weighed against the other factors in developing a robust interpreter services program that provides effective and cost-efficient service.  To ensure ongoing and evolving appropriate services, hospitals should continually monitor their service patterns to identify population trends that could benefit from having a face to face interpreter component available and then adjust their programs accordingly.

About the author