America’s Healthcare System: Not the Greatest in the World…But It Could Be.

June 16, 2016

Written By: James "Jamey" Edwards

The link below is to a brilliant clip from the HBO series Newsroom.  If you haven’t seen it, watch it.  If you have seen it, watch it again:

The United States of America is often referred to as the greatest country in the world. And while this may hold true in some facets of our society, there is overwhelming evidence to suggest that healthcare isn’t one of them. We’re ranked #34 in the world for life expectancy, #40 in the world for infant mortality, and our #1 cause of bankruptcy is medical expenses. While those statistics aren’t quite as bad as those quoted by Jeff Daniels in his Newsroom rant above, they’re not the vital signs of a healthy medical system: they’re the dashboard of a system in crisis. But, the patient isn’t dead yet, and there is still hope to revive the system that millions of Americans rely on everyday. Here are our top 5 ways we can fix healthcare in America:

  1. Re-engage the patient as the owner of their care. People who are treated like children can be expected to act like children, and this is particularly true of the way in which patients are managed in US hospitals. Guided from one department to the next with little information on their condition and minimal access to their records, patients are forced to place all responsibility for their care in the hands of doctors. Open access to information, namely their patient health record, combined with new healthcare technologies such as wearable devices, can put this responsibility back on the patient and make them an owner of their healthcare team. With the support of their coaches (also known as their primary care provider, nutritionists, doctors, nurses and specialists) and team mates (such as friends, family members and work colleagues) the goal of better health can be achieved.
  2. Have the difficult conversation around end of life healthcare. As our population grows older we face a moral dilemma – how long should we prolong life for the sake of living? Beside the cost to insurers such as Medicare (which can be as high as $50 billion per year) there is also the question about how we want to spend our final days – will it be in ICU with beeping machines and tubes, or in relative comfort at home surrounded by loved ones. Fact: 30% of all Medicare expenditures are attributed to the 5% of beneficiaries that die each year, with 1/3 of that cost occurring in the last month of life. How do we measure quality of life when the patient often can’t communicate? Sometimes the family’s desires differ from what the patient would have wanted for a broad variety of reasons.  Advanced directives can certainly help, but more needs to be done. It’s time to have a conversation about when it’s o.k. to let nature take its course and allow death with dignity.
  3. Change patient behavior through economic incentives. There’s no question that drinking or smoking to excess has negative health impacts. The question now is how do we incentivize a change in behavior to reduce the burden of preventable conditions caused by these activities and their effect on our healthcare system? One method is to tie insurance premiums to these behaviors in the same way as a pre-existing condition would influence our payments. This is also a critical part of re-engaging people in their own care: creating a tangible link between lifestyle and health. Step away from the bad behaviors and stop treating health care like a endless buffet.
  4. Eliminate healthcare as the #1 cause of bankruptcy in America. A 2009 study found that medical debt was the leading cause of personal bankruptcy in the US. Of those filing for bankruptcy, approximately 60% held insurance but had incurred substantial costs due to gaps in coverage. People have lauded the ACA as being responsible for helping insure more people, but the fact is large portions of those who have signed up are now underinsured and are surprised by their high deductibles and what they still owe after a doctor’s office visit or a trip to the ER. Many potential patients go unseen by medical professionals as they avoid visiting hospitals in fear of accruing more debt. This is a phenomena unique amongst developed countries, where the majority of nations offer a universal public healthcare system that creates a safety net. It’s time to reexamine how insurers structure their policies and create an environment that encourages preventive healthcare and wellness to the benefit of both patients and providers.
  5. Increase transparency and reduce complexity in healthcare products and pricing. A lack of transparent pricing, meaningful education and the ever growing complexity of our health insurance products have conspired to make it impossible for the average American to be a good consumer of healthcare. How much should an MRI cost? What is left on my deductible? Which doctor has the best track record on the procedure I need? What the heck is a DofR (Division of Financial Responsibility)? All good questions with no easy answers in today’s environment. For patients to be able to take control, they will need simple, easy to understand tools, reports and mechanisms to make informed decisions about their care, where it is given and the quality performance of who is giving it.

Those are our top 5 ways to fix healthcare in America. By no means an exhaustive list, but a good start in our eyes. Help us keep the dialogue going. Share your thoughts in the comments or join the conversation by using the hashtag #HumanizeHealthcare on Twitter.

Quality Interpretation Matters, Here’s Why

April 26, 2016

Written By: James "Jamey" Edwards

Most healthcare professionals know that the best way to improve patient outcomes is through good, open & trusted communication. Achieving those outcomes goes beyond understanding simply what ails a person, and extends to the bond formed between patient and care provider. Little Known Fact: In a recent study with IBM Watson, people were more open in describing their situation to an AI (Artificial Intelligence)  than they were to the person in the room. There is an intrinsic fear of judgement that exists in human contact. Have you ever left information out that could have been relevant to your doctor, but you may have been too embarrassed to bring it up?

It can also be a method of risk management, with good communication adding to the bottom line of a hospital through reputational benefits and lower litigation rates.

Despite all these advantages, effective communication in a hospital setting is anything but simple. Stressed patients mix with time-stressed healthcare professionals to create a perfect storm where important information is misunderstood or poorly communicated. Add to this situation a growing number of patients with limited English proficiency and it’s no surprise that the emphasis can shift from providing high quality healthcare to simply reaching the most accurate diagnosis possible.

Effective interpretation plays an important role in moving the focus back to patient satisfaction and positive patient outcomes. By empowering both doctors and patients to openly communicate, the information needed for a proper diagnosis, the anxiety reduced in the encounter and the trust and understanding developed upon discharge all contribute to humanizing healthcare by bringing the needs of the individual to the fore. Patients who struggle to communicate often feel like a burden on doctors, while the doctors themselves are anxious that they may not be able to give an accurate diagnosis. In the absence of easy verbal communication, patients rely on non-verbal cues from doctors. As the video below comically demonstrates, this isn’t generally the preferred method of communicating potentially life saving information:

That look on the provider’s face, which may reflect their anxiety about providing effective care to their patient, can often be misinterpreted as annoyance by already stressed patients. Despite best intentions, I’ve seen patients faced with this situation decide that the provider’s annoyance is caused by the patient wasting their time, and downplay the severity of their problem or leave the hospital – exactly the opposite of building an environment of open and trusted communication.

Many hospitals have now realized that they require access to multiple solutions so they may provide timely access to interpreters in the highest quality way possible.

Video Remote Interpreting (VRI) services such as Martti™ have helped over 500 hospitals nationwide streamline access to interpreters over 60,000 times per month and greatly simplify communication between doctor and patient. At the touch of a finger patients can access culturally competent certified medical interpreters, dedicated to ensuring that patient and provider understand each other during the times it most matters.

More than simply identifying and diagnosing the patient’s condition, a fast and effective interpretation system reintroduces understanding to the patient/doctor interaction – the key to compassionate care. While hospital administrators may look at these situations from a risk standpoint – the potential for malpractice is very real – those on the frontlines see the benefits in smoother patient flows, clearer diagnoses, and ultimately more satisfied patients and providers.

Request a demo to see how VRI can break down communication barriers

How to Improve Patient Flow

March 15, 2016

Written By: James "Jamey" Edwards

As every aspect of our lives gets busier, our expectations have changed with them. It doesn’t matter whether it’s our local coffee shop or the hospital ER, we no longer expect to wait for service. But while businesses such as restaurants have been quick to accept these changes and act accordingly, many healthcare services still struggle to find the balance between efficiency and providing a positive experience for patients. Well designed patient flow is key to ensuring that your hospital remains profitable while achieving what it set out to do in the first place – help people in need.

It’s no coincidence that healthcare services have a harder time achieving efficient patient flow than many other industries; few sectors are as heavily regulated as healthcare. But despite this, healthcare remains one of the most important areas for finding the balance between patient satisfaction and efficiency.

In an environment where resources and tempers are often stretched, effective patient flow can make the difference to patients and providers alike. The benefits are tangible: shorter waiting room queues, less strain on doctors, more accurate diagnoses and better patient outcomes.

One of the major considerations for patient flow is language. One in five people over the age of five in the US speak a language other than English at home, according to 2014 U.S. Census Bureau data. That means that the odds of a limited English proficiency (LEP) patient walking through the doors of your hospital are higher than at any other point in history. In the absence of properly trained medical interpreters, language difficulties and cultural misalignment combine to create an opportunity for miscommunication, resulting in not only delays and bottlenecks but potentially serious consequences for patient outcomes. Statistics have shown that these patients simply do not receive the same standard of care as their English speaking counterparts and are more likely to experience harm due to language and cultural barriers.

With some hospitals now dealing with hundreds of languages in their local area (Columbus, OH, for example sees over 126 languages in their waiting rooms), it is no longer possible for multi-lingual hospital staff to provide interpretation. Video Remote Interpreting (VRI) services such as Martti provide healthcare professionals with instantaneous access to medically trained interpreters with just the touch of a finger. Beyond the time saved by not having to wait for an interpreter, these services contribute to improved patient flow by de-bottlenecking the consultation process and reducing the stress on doctors as they attempt to effectively diagnose patients.

Another factor for improving patient flow is designing waiting rooms and patient pathways with the movement of patients and practitioners in mind. Simple operational changes such as allocating space for patients filling out forms can reduce congestion at check-in counters and smooth patients’ movements through the consultation process. Seemingly obvious improvements such as clear signage are often overlooked in healthcare environments, and need to cater for non-English speaking patients as well.

Other tactics for optimizing patient flow within your practice include making workstations readily available for doctors to write up their notes on the go, rather than returning to their offices.

Keep in mind that healthcare can learn from other industries. One of things holding our system back from radical improvement is our belief that healthcare is different. This belief has made us risk averse and fearful of innovation. It’s time to put those fears aside and open our perspectives up to solutions from outside our own sometimes myopic industry focus. In fact, many of the improvements applicable to patient flow come from the retail and manufacturing sectors, which have dedicated years of research to this problem.

So the next time you’re picking up your morning coffee, stop for a moment and observe how people move and communicate – you might find the key to improving patient flow.

Request a demo to see how VRI can improve patient flow in your hospital

Further reading:

Melina’s Story

February 17, 2016

Written By: James "Jamey" Edwards

As our country becomes more diverse, our goal is to embrace that diversity and not let language or culture drive us apart, but rather bring us together to connect.

Communication is fundamental to each patient and provider encounter. Without it, patients AND providers suffer.

Imagine being in a foreign country where you don’t know the language.

You have been injured.

You show up to the ER and people are racing around you yelling things you don’t understand.

Tests are being run and things are happening to you with no explanation.

Sound scary?

It is and it happens at hospitals across our nation each and every day.

Restoring communication does more than get the point across. It allows a provider to order the proper tests. It reduces their anxiety and the patients during their stay. It restores dignity and drives satisfaction. It saves time and money.

As our country becomes more diverse, our goal is to embrace that diversity and not let language or culture drive us apart, but rather bring us together to connect. It is those connections that matter. That create meaning in our work and life. What follows is an example of how our commitment to breaking down barriers is improving healthcare in our country. Thank you for letting us share them with you and feel free to reach out at anytime if we can be of any service.

On a late Friday evening last July, Melina walked into a hospital with intense pain in her chest. A seasonal worker from Bolivia, Melina had just finished her shift when she started having trouble breathing. Speaking only a dialect of Quechua, Melina couldn’t tell the nurse what was happening, or how she could help. With the pain intensifying, Melina was beginning to panic. The doctors initially thought it was trauma to her lungs, but they couldn’t figure out exactly what she was trying to communicate.

“I was very short of breath and the doctors couldn’t understand what I was trying to tell them,” said Melina. “I couldn’t lie down to sleep; it put too much pressure on my chest.”

The providers used Martti™ and at the touch of a button were connected to a Certified Medical Interpreter within 30 seconds. With trusted communication restored, the doctors were able to ascertain that her lymphatic system was leaking exceeding large amounts of fluid into her chest and abdomen. With the help of the interpreter, she survived and fully recovered.

At Language Access Network, we provide life-saving communication and are partnered with over 500 hospitals and high-end tertiary facilities, such as Mayo Clinic, Memorial Sloan Kettering and The Ohio State University Medical Center.

We provide state of the art communication technologies and real-time access to certified medical interpreters skilled in over 250 different languages. We ensure that language doesn’t become a barrier to a healthcare professional’s ability to provide the right treatment for every patient’s needs.

We utilize video based technology, Martti™ (My Accessible Real-Time Trusted Interpreter), which ensures that Limited English Proficient (LEP), Deaf and Hard-of-Hearing patients have equal access to clear, concise communication with those who care for them. 24 hours a day, 7 days a week, in more than 250 languages, we’re proud to help drive patient and provider satisfaction, increase diagnoses speed, and improve outcomes for patients just like Melina.

To keep up to date on how you can reduce risk, diagnose accurately and save lives with Martti™.


Humanizing Healthcare: Ron’s First Delivery

January 19, 2016

Written By: James "Jamey" Edwards

“We are a mission driven company.”

How many times have you heard that before? It’s easy enough for companies to say it, or pay lip service to their mission, but living your mission every day with every customer is an entirely different thing.

Our mission to, “Improve healthcare by eliminating language and cultural barriers,” is one we take to heart, because with each and every patient – provider encounter, we are there, helping a scared patient understand what is happening to them, empowering them and their healthcare provider to take control of their care, build a trusted relationship and improve their outcome.

Our stories from the field are everyday stories of breaking down barriers, overcoming obstacles and well, triumph. Triumph over the overwhelming adversity that patients and providers face when they can’t do one of things most fundamental to being human: talking to each other. We are happy to share these stories to bring awareness to the great work that our interpreters do each and everyday on the front lines of medicine.

Thank you for allowing us to share what inspires us to continue to do more, improve and deliver our mission with the same commitment to excellence that our clients have grown to expect from Language Access Network. We hope it inspires you to do the same.

Ron, a Nationally Certified Medical Spanish language interpreter for LAN, was connected in to assist doctors with the delivery of a baby. He worked closely with the mother and with Dr. Adam Kansagor from Aultman University. The woman did not speak any English. Ron played a critical role in the delivery of the baby due to the quality training he received. This is due in large part to the training that qualified him as a medically trained interpreter for Language Access Network.

These days, it is critical to know that you are working with a Nationally Certified Medical interpreter. Communication can be seriously impaired if a health care provider is unaware of, or insensitive to the role of culture norms. Miscommunication can increase the risk of medical errors, inappropriate treatments, and emergency room visits.

A study by the American College of Emergency Physicians in 2012 analyzed interpreter errors that had clinical consequences. They found an error rate of 12 percent as opposed to 22 percent. For professionals who have more than 100 hours of training, these errors dropped to 2 percent.

We’re proud of the fact that our spoken language and American Sign Language interpreters complete Bridging the Gap, a nationally recognized 40 hour Medical Interpreter training program. Additionally, they are required to take a minimum of 10 hours of continuing education and specialty training each year.  This doesn’t include the countless hours of training that go training these interpreters to be prepared for video as well as the specialty trainings our interpreters undergo on a regular basis for things like pastoral care, mental health, pediatrics, and others.

For us, the proof is in seeing interpreters like Ron work with Martti™ alongside medical practitioners to assist with earning their patients’ trust. Thanks to Martti™, our interpreters are able to ensure that the doctors can better understand their patient’s symptoms, medical history, make a more accurate diagnosis, and provide safer, more precise, more complete care. To keep up to date on how you can reduce risk, diagnose accurately and save lives with Martti.