How The Section 1557 Ruling Affects Language Access In Healthcare

Kathryn Jackson, vice president of Language Operations, Stratus Video

As a professional within the interpretation industry for more than 25 years, I’ve seen how communication is the cornerstone of good healthcare. I can confidently say high interpretation standards are essential to any successful language access plan in any hospital or healthcare service department. Imagine trying to get through a medical appointment and not being able to understand your physician. This situation is all too common for millions of limited English proficiency (LEP) patients in our healthcare system today. It has been shown more positive health outcomes can be achieved with improved patient communications, but due to lack of high quality interpretation services implemented in the healthcare system, many of these patients do not receive clear communication.

This past year, new standards under Section 1557 of the Affordable Care Act went into effect. This new regulation prohibits discrimination in certain health programs and activities on the basis of race, color, national origin, sex, age or disability and reinforces the assertion healthcare institutions are required to provide meaningful access to individuals needing communication assistance.

In order to be compliant with the new standards, federally funded healthcare institutions are required to provide “language assistance services” for LEP patients. There is great value in the use of qualified interpreters who possess the necessary medical terminology. Healthcare providers must ensure their interpreters are medically qualified and their patients are made aware of the language access services available to them. New standards surrounding language services include the following:

• Healthcare professionals must use qualified interpreters who adhere to interpreter ethics and client confidentiality and possess all of the necessary medical terminology.
• The use of family members, friends, and unqualified bilingual staff for medical interpretation is now expressly prohibited barring extreme circumstances.
• Patients must not be encouraged to turn down language access services or provide their own interpreters.
• Patients must be made aware of their language access rights.
• Notice must be posted in the top 15 languages of each state.
• Written translation must be provided.

In many situations, healthcare institutions do not have the appropriate interpretation services available and have to resort to using an ad hoc interpreter. An ad hoc interpreter is anyone nearby who happens to be bilingual. I’ve heard stories from my team in the field of patients receiving sensitive medical information through underage children, cafeteria workers, and Google translate. Institutions may be tempted to turn to anyone who can speak the needed language with the intention of getting the message across without realizing the likelihood of error, language barriers, and even emotional trauma that can result from asking someone to relay a bad diagnosis to a patient.

Not only do proper interpreters need to be medically trained, they also must follow the interpreter code of ethics. The code of ethics is vital to interpretation delivery in healthcare as it covers the importance of confidentiality and HIPAA requirements. The interpreter being trained in medical terminology is absolutely crucial as any miscommunication can result in both patients and hospitals landing in a compromising position. Without proper training and abidance by the code of ethics, the risk of error increases and can result in misdiagnosis or mistreatment. The use of qualified interpreters greatly reduces the risk of inaccuracy, all while increasing patient outcome and satisfaction.

While the final Section 1557 ruling may be new to the healthcare industry, the need for medically qualified interpreters is long standing. I currently serve as Vice President of Language Operations at Stratus Video, a technology company that provides telehealth solutions and language services, and I have consistently held my team to these standards from the start. Language access is not something that crosses the mind of the average English speaking American, which is why I often urge people to put themselves in the shoes of an LEP patient and imagine what it would be like to not fully understand what is happening when your health and well-being are at stake. The way our hospitals treat the LEP patient population is about to change, and I hope to see an increased use of professional language services across the country.

About The Author
Kathryn Jackson is the vice president of Language Operations at Stratus Video.