Medical Translation Apps: First Do No Harm?

Used wisely, technology can be a helpful tool for communicating across language barriers. However, there are some situations where an app just won’t cut it.

Is healthcare one of those situations? New applications promise to help doctors and nurses communicate with patients who don’t speak English, a tempting prospect for cash-strapped hospitals in the US and the UK alike. For example, a recent story on profiled two medical translation apps developed by Transcendent Endeavors. One app relies on a tablet touchscreen to help patients relay basic needs to the nurses who care for them, while another helps health care providers communicate basic medical instructions to patients.

The key word here is “basic,” and critics say that’s the problem. The  level of communication provided by translation apps is simply too basic to be helpful in a medical setting, and may even cause harm.

Dr. Glenn Flores, the director of the general pediatrics division at the University of Texas Southwestern and Children’s Medical Center in Dallas, explained his concerns to

“The medical encounter is incredibly complex and nuanced. If you just have a simple tablet that asks, do you have pain or not, that’s going to give people a false sense of security. You’re going to end up putting people at risk.”

Nextgov points out that medical translation involves more than just language; trained medical interpreters can often help physicians understand important cultural factors that might affect the patient’s symptoms or care, like traditional remedies that could be harmful.

In the future, medical translation apps may improve to the point where they can play a valuable role in healthcare, according to Dr. Flores:

“What I think is exciting, but it’s probably a number of years away, is we may at some point have a smartphone that’s able actually to provide state-of-the-art, spoken-language translation,” Flores says—a tool that accurately translates spoken language in real time. Google Translate’s speech-enabled smartphone apps, an early attempt at this, aren’t always grammatically accurate, he says, and shouldn’t be used in a health-care setting.

At least for now, a trained medical interpreter is the safest, most reliable option for ensuring every patient gets the care they need.


New Study Underscores Importance of Emergency Room Interpreters

Clear communication between patients and doctors is one of the most important components of quality medical care.  A medical emergency is neither an ideal time nor an ideal place to “practice” speaking in a language that you haven’t yet learned to fluently communicate in.

A new study from the United States illustrates just how true that is, and what a difference having access to a professional interpreter can make.

The study looked at two different pediatric ERs, and looked at how miscommunications between parents, patients and hospital staff could have had a “clinical impact” on the young patients. According to Reuters, when a professional interpreter was used, 12 percent of so-called “translation slips” had the potential to cause a harmful medical error.

Many people think that using a friend or a family member to interpret for a patient is a good (and free) alternative to a professional. However, in the study, when a non-professional was used or there was no interpreter at all, the percentage of clinically significant translation errors spiked to between 20 and 22 percent.  Again, these are errors that could compromise the health of the patient. For example, in one case mentioned in the article, a family friend told the physician that the patient had no drug allergies without first confirming with the parent.  As Dr. Glenn Flores, one of the authors of the study, told Reuters:

“The findings document that interpreter errors of potential clinical consequence are significantly more likely to occur when there is an ‘ad hoc’ or no interpreter, compared with a professional interpreter.”

Medical interpreters are not just fluent in both the requisite languages, they have also received some training about  interpreting medical terminology and on how to make sure all important information is being conveyed correctly between the doctor and the patient. For example, a trained interpreter would have understood the importance of asking about drug allergies rather than making an assumption.

In addition, the study found that the more training interpreters had, the fewer clinically significant mistakes they made- down to less than 2 percent for interpreters with over 100 hours of training.

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Medical Interpreting Services Help Bridge Language Gaps In Some US Hospitals

Hospitals naturally encounter patients who speak a cornucopia of different languages-far too many for them to have an interpreter on staff for each one. However, language barriers make it extremely difficult to treat patients, preventing doctors from accurately understanding the patient’s symptoms and preventing the patient from fully understanding their condition and treatments.

So, some US hospitals have turned to medical interpreter hotlines to help medical personnel communicate with patients who don’t speak English. Medical interpreter lines and video interpreting services not only make the staff’s job easier,  patient outcomes improve as a result.

For example, the Houston Chronicle describes the story of one elderly Korean man with an aggressive form of cancer who had a reputation for being a “bad,” uncooperative patient. When the team at Holy Name Hospital in Teaneck, New Jersey used a medical interpreting service to talk to him, they soon figured out that he wasn’t cooperative because he had no idea what was wrong with him. Once his condition was explained, the staff easily persuaded him to agree to treatment.

Unfortunately, cost constraints keep many hospitals from offering similar services. The Chronicle notes that Parkland Memorial Hospital in Houston spends $160,000 per month on medical interpreting services. While hospitals receiving federal funding must provide access to interpreters for patients who don’t speak English, only 13 states offer funding to reimburse the cost of translation services for patients.

Unfortunately, medical mistakes caused by language barriers can be expensive, too-costing the hospital money due to litigation, costing patients and insurance companies for additional treatment and even more important, costing patient lives.

For example, the Houston Chronicle notes that in 1980, a Spanish-speaking ER patient  became paralyzed for life  when one of his relatives stated he had been “intoxicado” before he collapsed. Since “intoxicado” is a cognate for the English “intoxicated”, the ER team assumed that mean he had overdosed on drugs, but in Spanish it can simply mean “nauseous.” He actually had a brain injury. The resulting lawsuit cost the hospital $70 million.

Medical Interpreting: Helping Women Out of Poverty

A charity in Boston, Massachusetts is helping local women get out of poverty by training them in medical interpreting. Called Found in Translation, the organisation trains bilingual women, usually immigrants or children of immigrants, to use their existing language skills to become medical interpreters.

Why Medical Interpreting?

Why does medical interpreting make such an excellent career choice for poor immigrants? Three reasons:

  • There’s a high demand for medical interpreters. Demand is expected to grow 46% in the next 10 years.
  • The job pays well. The median wage is $45,430.
  • It saves lives. Also, it allows these women to give back to their communities while bettering themselves.

Medical interpreters provide an essential service in doctor’s offices and hospitals. They help doctors accurately understand patients’ symptoms and histories. They help patients understand what’s happening with their care and treatment. Often, no interpreter is available and the job falls to the family member with the best English skills. Usually, that’s a child. And that’s a huge responsibility for tiny shoulders.

According to Mashable, Found in Translation founder Maria Vertkin was inspired by her own experience as a six year old “medical interpreter.”

The problem is that family members, especially children, don’t have the skills to be good translators in a health care setting.  They may be fluent in both languages, but that’s not enough. As Matilde Roman, senior director of medical interpreting firm New York City Health and Hospitals Corporation, told Mashable:

“Medical interpreting is a very finite skill set. Not only do you need to have competency or language proficiency in a target language and in English, but you also have to have a level of competency in medical terminology and ethics.”

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