Videoconferencing helps medics overcome language barriers

Cisco Systems is touting teleconferencing as a way of making US hospital visits faster, safer and less stressful for non-English speaking patients and the doctors who care for them.

The Health Care Interpreter Network (HCIN) uses video and audio conferencing to link doctors and patients in three California hospitals with a network of interpreters covering Spanish, Cambodian, Hindi, Tongan and Hmong.

HCIN began pilot testing in August 2005 and uses videoconferencing equipment from Cisco to link the doctors and patients using a network of portable videophones, Cisco Polycom wireless phones or traditional landlines.

Dr Susan Ehrlich, medical director of the Ron Robinson Senior Care Center, explained that after selecting the language she can be video-linked to a live operator within seconds or transferred to an outside translation agency.

"Before HCIN I would have desperately tried to find an interpreter in that language, and I may or may not have been successful," Dr Ehrlich told vnunet.com.

"If I was successful, the person would have to leave their job and come down here. During that time the patient is anxious, the whole clinic is thrown off and the interpreter is not able to do their job.

"And if there wasn't an interpreter available, I would have to stumble along in English."

David Hook, director of marketing and communications at the San Mateo Medical Center, added: "At best, we were not giving top quality health care, and at worst we could have some serious medical errors."

Dr Ehrlich said that the system also allows for better follow-up care by explaining more clearly the reasons and directions for medications.

"It makes a difference for me to be able to say what the medications are and why the patient is taking them, and for the patient to tell me their experiences in taking the medication," she said.

"If I don't understand that they're having side effects from the medication, I won't get why it is that they're not taking it and won't be able to think of other options for the patient."

Fernando Ibanez, the only full-time Spanish interpreter at the medical centre, explained that the job involves more than just translating word-for-word, and that often the video conferencing is necessary to determine literal meaning from local dialect.

"In some Spanish cultures, they call the 'hand' the whole arm, so if you're not seeing the patient and he says that his 'hand hurts' you're going to tell the doctor that the patient has a problem with his hand, but what he means is all the way up to his arms," said Ibanez.

Every one of the interpreters must undergo 40 hours of training, which Ibanez said includes medical terminology, ways to encourage the doctor and patient to speak directly to each other, and how to handle emotionally difficult situations.

"Sometimes you have to tell them that there's nothing you can do for them, and it's hard, but you have to detach from that," said Ibanez.

Even the bad news, however, can be softened by delivering the message in the patient's native tongue.

"I had a patient who had a large mass on her kidney, and I had to make sure that she really understood and had an opportunity to ask questions, and she was amazed," said Ehrlich.

"She was so grateful, and it actually made the news a lot easier to tell. It was really remarkable. It almost brought me to tears."

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