Remote Video Interpreting (RVI) Services
Using two-way video instead of on-site staff to provide interpreting services for a busy health system, Sutter Health has been able to serve more patients more efficiently, while maintaining the quality of care. Without the need to commute from clinic to clinic across four of Sutter Health’s campuses in San Francisco, medical interpreters have been able to double the size of their caseloads, and now serve 8 to 12 patients a day. The size of the interpreting team has grown from 19 to 39 interpreters and because the two-way video system has the capacity to be installed in every patient room as part of the electronic healthcare record system, patients can now have their language needs met at any time, even if the patient has a drop-in appointment, the schedule changes unexpectedly, or their physician is running late. The RVI model has also proven to be significantly less expensive than vendor-provided interpreting services, and more cost-effective per hour than in-person interpreting, as more time is spent working directly with patients. The current study on Sutter Health’s RVI intervention is focused on reducing health disparities among limited English proficient (LEP) patients with Type 2 Diabetes or Hypertension. Once the pilot phase has been completed, Sutter Health will consider rolling the RVI model out to their entire system.
Sutter Health is a large not-for-profit health system in Northern California, serving over 18 million patients in over 100 communities spread across 22 counties. Sutter Health supports more than two dozen locally run acute care hospitals as well as physician organizations, medical research facilities, regional home health, hospice and occupational health networks, and long-term care centers.
Maria R. Moreno MPH
Health Services Researcher | Sutter Health
633 Folsom St. 7th Floor San Francisco, CA 94107
One in three patients who receive services at Sutter Health doesn’t speak the same language as his/her doctor. In San Francisco County alone the percentage rises to 42%, and the native languages spoken by patients range from Russian to Spanish, Cantonese to Tagalog, Vietnamese to Arabic. Sutter Health had a medical interpreter program in place, but with such high demand and such far-flung locations, interpreters spent half of their hours commuting from campus to campus instead of meeting with patients. The implementation of a comprehensive electronic medical records system at Sutter created the opportunity to access medical interpretation in a new way as well. By installing two-way video equipment in all patient rooms in the pilot study, interpreters were able to congregate in a call center, and communicate with patients and physicians via video screen when they were needed. From the beginning of the pilot, interpreters were able to double their daily caseload. Now, the interpreting staff has grown from 19 to 39, and by utilizing this team as well as outside vendors, Sutter Health has been able to significantly improve access to care for non-English speakers in their community.
Interpreters at Sutter Health are not only fluent in a variety of languages, they are trained specifically as medical interpreters and as cultural interpreters as well. Whenever possible, interpreters are native-born speakers of their languages and familiar with the customs, traditions, dietary habits and requirements of the ethnic minority groups with whom they interact.
Because of this connection, many interpreters have formed relationships with their patients when they served them in person in the hospital setting, and were concerned they would lose the intimacy of those relationships when working via video. However in practice, interpreters have found that by serving the same patients at every visit, they have been able to maintain and create lasting relationships with both patients and medical staff. That aspect of the RVI initiative, combined with much easier and less time-consuming access to their patients, has made the intervention very successful for the interpreters involved. Patients have adapted easily to the video option and the participating physicians have responded positively as well – better communication with their patients leads to better adherence and healthier patients.
Promising Practices on Disparities
Research has demonstrated that the likely result of using untrained interpreters is more medical errors, poorer patient-provider communication, and poorer follow-up and adherence to discharge instructions.Learn more