Medication labeling that warns of “bloating,“ when translated into Vietnamese, can mean “exploding,“ says Richard Fitzpatrick.

Fitzpatrick, CEO of the Language Access Network (T-LAN; Columbus, Ohio), cites this as just one example of what can be lost – or in this case, added – when translation fails to capture the nuances of medical terminology. And what may sound like a comedy of errors can become a serious mistake that could jeopardize a non-English speaking patient's health, he says.

Together with wireless video networking, T-LAN's team of trained interpreters helps healthcare providers bridge the language gap for patients with limited English proficiency by putting a face to words.

Beyond drug labeling – often difficult for even English speakers – Fitzpatrick says there are “a lot of issues related to healthcare and to our bodies that are very culturally different, and a lot of words require more of a context in the culture and the understanding of the individual.“ And that context, he says, often needs more than a voice.

The company has developed a wireless, mobile videoconferencing service that connects hospital personnel in real-time to an on-demand video interpreter for more than 180 languages.

Made of off-the-shelf videoconferencing components, the system features a 19“ flat screen monitor built on the framework of a StyleView Cart from Ergotron (Lincoln, UK). The wheeled cart houses a camera that can instantaneously connect medical personnel to a video operator who will direct the video call to someone speaking the appropriate language. System features include a double pivot mount for screen rotation, an 18-inch footprint for space-constrained environments, a certified, integrated power system and extended run-time on a single charge.

“It's a simple system,“ explains Fitzpatrick. “The nurse or doctor uses the remote control and presses one button that connects to our operator, and the operator says 'May I help you? What language would you like?' And if it's a language [for which] we have a video interpreter immediately available, within a couple seconds the interpreter pops up on the screen.“

“We assure the hospitals that we will cover their top three languages,“ which vary by region, Fitzpatrick says. And as the company grows, he promises “a great number of languages covered in video within six months to a year.“

For languages not immediately available in video, the call is switched to an audio interpreter.

The company recently completed beta testing of the system at the Ohio State University Medical Center (OSU; Columbus), with units now deployed in 14 separate areas of the hospital.

“We wanted to make sure we really had something that worked – that's why we spent over six months simply upgrading in one hospital system,“ Fitzpatrick told Medical Device Daily. “We learned a lot and made a lot of different changes in the product itself to be able to meet a healthcare system's requirements.“

The initial system was called PAL (Personal Assisted Languages) and was designed for the emergency room; since then other models have evolved for different applications in a healthcare facility.

“In the next month or so, we'll come out with a version that is simply an add-on to any existing computer,“ Fitzpatrick says, including software, camera and microphone. The smaller units are ideal for clinics, which are “places where a lot of people who are from other countries tend to rely upon for healthcare,“ he says. “We don't need the big, very substantial system we have in the ER. It doesn't even need to be wireless, you can just set it up.“

Fitzpatrick says the T-LAN system drew positive response from physicians and patients at OSU.

“The give-and-take of two-way video really got a great deal of satisfaction from the patients,“ he says. “So much of communication is more than just the sound of a voice.“ A video interpretor “adds a sense of comfort. The patient is looking at a person who probably looks like them and can build more rapport and trust than simply hearing a voice on a distant phone.“

He compares this to current options for non-English speaking patients when visiting a healthcare provider, which include a telephone interpretation service; a staff interpreter; or translation by a family member.

“Often the person, if it is a family member, is giving the answers they think [they should give], rather than exactly what the patient is saying.“ And, he adds, there is the matter of HIPAA privacy and the push for patient safety by the Joint Commission on Accreditation of Healthcare Organization's (Oakbrook Terrace, Illinois), which surveys hospital records to see if a patient's language was recorded and interpretation was provided.

“We see ourselves as a third choice [to] having a telephone voice – which, when you're trying to explain something as important as what a procedure might be, a distant voice is not really enough – or having a live interpreter, which means huge staffing budgets.“ He estimates that hospitals spend more than $1 million a year to provide onsite interpretation, and $10,000 to $20,000 a month on telephone interpretation.

“Obviously we're vastly cheaper than having 24-hour in-person interpreters,“ Fitzpatrick says, adding that the T-LAN service is comparable in price to the telephone method of interpretation.

“We want to blend in and work out a system where basically we cost [hospitals] as much as a telephone interpretation would, a couple dollars a minute. They're only paying for interpretation when they actually use it,“ he says.

The company is now in the process of launching the T-LAN systems into the market, which are available for sale or for rent, making the case, he says, “that it is so much better than simply having a voice on the telephone, at essentially the same price, so it's not a hard decision for a healthcare organization.“

T-LAN employs 14 professional interpreters – operating out of a Columbus call center – with a vested interest, as stockholders, in the company's success.

The company's interpreters “are all trained medical interpreters, not simply people who know the language but people who have been trained in the particular phraseology and medical terms; they've all been independently tested,“ Fitzpatrick says.

And he emphasizes that T-LAN doesn't want to replace face-to-face interpretation, but rather to supplement it.

“There's just not enough qualified medical interpreters to go around,“ he says. “We're really making the interpreters who are qualified much more efficient – they can spend time doing what they do without having to drive across town or even going across campus [of a medical center]. When you're talking emergency room, those minutes are really critical and care could have been given. We can supplement, and be there.“

T-LAN began as a provider of remote, networked communication for the gaming industry. The company decided to apply its technology to healthcare, and in September 2005 acquired Preciss (Columbus), which operates a video linguistics center.

“By creating video interpretation, we are creating an industry, too,“ says Fitzpatrick, citing as a possible competitor the main player in telephone interpretation, Language Line Services (Monterey, California). “We welcome them and everyone else – it's such a huge need.“

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