Lost in Translation: New Technologies are Closing the Language Gap in Healthcare

Published: Wednesday, Feb 13, 2008
Mahamu Kanneh, a Liberian immigrant living in Gaithersburg, MD, was arrested in August 2004 on charges that he repeatedly raped and molested a seven-year-old girl over the course of a year. Kanneh’s case has failed to go to trial in the three years subsequent to his arrest and has now been dismissed by a Montgomery County, MD judge because the court could not find an interpreter fluent in Vai, Kanneh’s native language.

While this particular case remains in the appeals process, it doesn’t require a great leap of the imagination to conceive of other situations in which communication failures caused by lack of access to translation services can create immense difficulties. When the venue shifts from the courtroom to the exam room, insufficient access to interpreters can mean it’s private physicians or hospital systems that stand to face jail time or stiff financial penalties for noncompliance with federal regulations requiring the use of interpreters for individuals with limited English proficiency (LEP). Although this may seem harsh, one need only peruse the data and statistics databases of the Office of Minority Health or the Agency for Healthcare Research and Quality to understand how seriously an individual’s health can be

affected by a lack of understanding of the English language.

Supply and Demand

The issue at heart, however, is not one of English-speaking ability, but that of giving LEP patients information about their medical needs that they can understand in their native language. Typically, this is done through a medical interpreter, one who possesses command of a number of languages—from the vernacular to advanced medical jargon—who can facilitate communication accurately between patient and physician to ensure that proper care is given.

“In an ideal world, we’d get to the point that our healthcare workforce matches the linguistic makeup of our patient population, we’d have as thorough a distribution of bilingual healthcare providers as we have bilingual patients, and they’d all be located in the same place so no assistance anywhere would be needed,” says Don Schinske, Executive Director of the California Healthcare Interpreting Association, in conversation with MDNG. “But that’s not the case.”

A look at the numbers quickly reveals why that is so. There are far more patients than interpreters; according to the Bureau of Labor and Statistics (BLS), of the 31,000 interpreters and translators employed in the US in 2004, only 4,100 worked in the healthcare sector (usually in the hospital setting). There is little financial incentive to become a medical interpreter; salaried interpreters and translators had median hourly earnings of $16.28 in May 2004.

Statistically, LEP patients are not going to have ready access to medical interpreter services in either a hospital or private practice setting, but technological advances are beginning to change that reality. Physicians can expect to utilize a number of technologies, both on the horizon and currently available, to overcome language barriers and effectively treat their patients.

Two-Way Street

Machine translation has a history dating back to the early 1930s, but did not begin to really accelerate until the onset of the Cold War, when researchers involved in the Georgetown-IBM experiment utilized the IBM 701 computer to accurately translate Russian into English. Spurred by the experiment, the federal government began heavily investing in machine translation technology, hoping it would result in the production of fully automatic high-quality translation. Fast forward to 2007, and the federal government is again investing heavily in translation technology to aid its combat and intelligence efforts in the Middle East.

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