HealthManagement, Volume 9, Issue 4 /2007

Telephonic Interpretation Opening Cultural Doors in Healthcare

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Michael Greenbaum

CEO, CyraCom,

Email: [email protected]



The United States has always been a melting pot of diverse cultures, a nation rich in ethnic heritage that stems from an immigrant population dating back to its beginnings. Nearly 11 percent of the U.S. population is foreign-born, and nearly 20 percent speak a language other than English at home.


Providing adequate language services to communicate with growing numbers of limited English proficient (LEP) patients continues to be a challenge in America’s hospitals and healthcare facilities. While many hospitals use on-site interpreters, the number of different languages needed cannot be fulfilled by staff members only. One way that U.S. hospitals supplement the need for language interpretation is through telephonic services.


Telephonic interpretation is used by hospitals to quickly access dozens of languages 24-hours-a-day. The process involves a dual-handset phone that allows caregivers to communicate face-to-face with limited- English proficient patients via interpretation by a trained medical interpreter. CyraCom is the country’s leading healthcare-only provider of language services, including telephonic interpretation, document translation and interpreter testing and training.


The company serves more than 1,000 hospitals and healthcare facilities throughout the United States, and provided its service in 143 languages in 2006. It would be impossible to attempt to fulfill those language requirements with on-site interpreters around the clock.


The dual-handset phone operates using a standard telephone jack. A caregiver can access an interpreter in any language by simply picking up the left handset, pressing the “access” button, and then pressing the personal identification “account/PIN” button when prompted.


The preferred language may be accessed via voice prompt or by entering a code from the language list.


An interpreter in the desired language will come on the line in an average of less than 15 seconds. The caregiver may then choose to either give the right handset to the patient or use the speaker-phone function to begin the face-to-face interpretation session.


The service is a 24/7 rate for any language, at any time. Contracts may vary according to individual hospital needs that can include telephonic interpretation, document translation and/or testing and training of staff. The dual-handset CyraCom phones are owned by the company and the average cost per call is US$20.


The phones are typically used in the emergency room and other patient care units, such as labour and delivery. Some hospitals also use the phones in admissions and billing departments. Telephonic interpretation is also part of patient safety and satisfaction efforts in many U.S. hospitals.


Telephonic interpreters work closely with physicians, nurses and staff to not only help with understanding the language, but also to manage and understand cultural differences. CyraCom telephonic interpreters practice cultural competency skills during training sessions that involve interacting with a variety of cultures. The interpreters learn how to negotiate the resolution of cultural issues that commonly arise while providing healthcare to LEP patients.


Each interpreter completes 120 hours of classroom instruction in medical interpretation to learn how to perform effective, over-the-phone interpretation. The innovative training techniques instruct the interpreters in how to facilitate a complete and accurate flow of communication between LEP patients and caregivers.


Furthermore, research has shown that LEP patients who face linguistic barriers when accessing healthcare services are less likely to seek treatment and preventative services. This can create poor health outcomes and longer hospital stays. Conversely, telephonic interpretation puts patients at ease and allows them to communicate and understand their medical condition while having a face-to-face conversation with a doctor or nurse. Trained telephonic interpreters are also instructed in how to use and explain medical terminology. In addition, the language services company can provide hospital staff training in how to access language services, as well as monitor and report on LEP patient situations.


CyraCom provides up to 25 hospital participants with on-site training in how to develop effective interpretation techniques.


The training includes the application of ethics, standards and protocols of medical interpretation and techniques used to facilitate effective interaction between LEP patients and healthcare professionals. A “train-thetrainer” course is also available to provide healthcare organisations with a flexible, cost-effective approach to operating their own interpreter training programme.


An efficient hospital diversity programme that includes staff preparation, effective communication with staff and patients, and cultural competency training helps hospitals steer clear of ineffective treatment and provide the best patient care possible.


Some U.S. healthcare facilities have instituted cultural competency programmes. Others translate patient forms and informational material. Still others develop partnerships with community-based organisations to better understand their neighbours and to increase their cultural competency.


A critical response to increasing diversity is knowing the patient population and understanding its needs and background. Many U.S. hospitals are working to recruit more diverse employees, and hospital leaders are actively participating to ensure the success of diversity programmes.


The following are five main areas that hospitals should consider before deciding whether to work with a language services company:


1. Need – This may appear obvious, but many hospitals are still reluctant or blind to the accelerated pace of diversity in the country. A hospital must reflect the community it serves, so take steps now, both inside and outside your facility to recognise and communicate with LEP populations.


2. Access – Patients may feel more comfortable speaking their native tongue with someone in person, but how quickly can a trained interpreter who speaks Urdu be found at 3 a.m.? Telephonic interpretation provides the ability to access trained medical interpreters in multiple languages, 24-hours-a-day, seven-days-a-week.


3. Training – A clinician must be sure that LEP patients completely understand what is being communicated. He or she must also be clear about how the patient responds. Only an interpreter trained in medical terminology, ethics and compliance regulations can truly deliver the actual intent of what is being spoken.


4. Reporting and Medical Record Number Integration – Compliance issues increasingly require tracking and reporting of language services. The information is alsohelpful in gauging how and where the services are required. An effective language services company should have the ability to assist in the electronic medical recordkeeping process by integrating the medical record number into a language usage report.


5. Cost – Once the extent of the need for language services is determined, it is best to weigh and compare how related costs should be budgeted. Some U.S. hospitals find a combination of live and telephonic interpretation works best, others find it more cost-effective to use one or the other.


European hospitals and healthcare facilities face increasing diversity—more languages spoken by immigrants who are settling in a larger number of locations. Telephonic interpretation offers a solution for dealing with the rising tide, while offering cost-effective quality care.

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