Industry Voices—Video remote interpretation cuts costs, improves patient and provider satisfaction

Woman showing a patient in bed a tablet computer
At Main Line Health, the majority of interpretation encounters are done through video. (Getty/monkeybusinessimages)

More than 60 million Americans speak a language other than English at home, and more than 25 million are considered to have limited English proficiency (LEP). Most people have experienced the frustration of not being able to communicate with someone who does not speak their language, but imagine the frustration and the danger of not being able to communicate in a healthcare situation.

At Main Line Health, we take language barriers very seriously and have set up an array of language access solutions that ensure that our LEP patients can and do communicate with their healthcare providers. All of our hospitals—Bryn Mawr Hospital, Bryn Mawr Rehab Hospital, Lankenau Medical Center, Paoli Hospital and Riddle Hospital—provide onsite interpretation, over-the-phone interpretation, and most recently, video remote interpretation (VRI).

The type of interpretation used is dependent on the type of encounter. For example, a family member should never be informed of a loved one’s death through an over-the-phone encounter. At the same time, it is unnecessary to call in an onsite interpreter for a quick, 15-minute checkup.

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The majority of the interpretation encounters that take place at Main Line Health are handled with VRI. It is quick, on-demand, and still affords the benefits of visual communication.

Why we chose VRI

We chose to implement VRI as a way to provide easier access to language services and to save our institution time and money. With VRI, our nurses and physicians simply open the interpretation app on a tablet and select the language they need. This everyday technology is incredibly easy to use, and connection takes place in under a minute.

Prior to VRI, providers would either have to wait for onsite interpreters to arrive from outside our facility or go without a visual connection and resort to over-the-phone interpreting. VRI is an excellent option as it speeds everything up and is less costly than onsite interpretation.

Patient satisfaction with VRI

As always, when implementing a new patient-facing process, there are concerns over patient satisfaction. Fortunately, all of our LEP patients have been very receptive to using VRI for communication. With VRI, there is rarely a wait, and the high-resolution video makes it easy for patients to see and connect with their interpreters.

With the implementation of VRI, we have revised our interpreter nondiscrimination and accessibility policy and posted Main Line Health’s nondiscrimination and availability-of-services notices in patient and family areas throughout our hospitals. Patients are more informed of their rights than ever before, which has manifested in reduced anxiety and ease of communication.

Provider satisfaction with VRI

Our healthcare providers are extremely satisfied with VRI as well. On more than one occasion, our nursing department and providers have given the feedback that VRI enhances patient safety, patient care, and patient experience. Since it is such an easy system to use, we hypothesize that the services are being used more often than the old services we had in place, which means that LEP patients are receiving higher-touch care than they had before.

The measurable impact of VRI implementation

Prior to the implementation of VRI, we relied on onsite interpreters for deaf/hard-of-hearing patients. The average patient encounter cost $66.55. These are costs that are not passed on to insurance or the patient, meaning that every time a deaf/hard-of-hearing patient was treated, Main Line Health was paying a $60 bill.

Following the VRI implementation, many deaf/hard-of-hearing patient encounters were transitioned to video. The average cost associated with a VRI encounter is an astoundingly low $25.35. By simply moving some interpretation to video, our facility is saving more than 60% of our prior interpretation budget.

In addition to the dramatic cost saving we are seeing with deaf/hard-of-hearing patients, our overall interpretation costs are down. In 2013, we spent more than $250,000 for just one of our language access vendors. By 2017, we were spending less than that for all four of our language access vendors combined, without sacrificing patient satisfaction.

We have been extremely satisfied with VRI. It has become our go-to method for interpretation when it comes to communicating with LEP patients. It is rare to see something so new be adopted at the rate VRI has. The rolling iPads in our facility are a favorite among staff and patients alike. Having the ability to call a professional, medically qualified interpreter with just the push of a button has made treating LEP patients easier than ever before.

Regardless of primary language spoken, everyone has the right to effective communication with his or her healthcare provider. With VRI, effective communication happens across various languages every day at Main Line Health.