A requirement in the delivery of equitable access to healthcare services is the need to address and consider language diversity. It is important to ensure the same standard of care to Limited English Proficiency (LEP) speaking patients as to those who are English speaking. With the use of interpretation services in healthcare systems these language barriers are obstacles overcome.
A growing number of administrators are responding to the healthcare needs of diverse populations. In turn, restructure and use of language services become integral in these organizations.
Healthcare providers and patients who speak different languages obtain understanding through interpretation. This becomes necessary for appropriate treatment and accurate diagnosis. In addition, information pertinent for illness management should be understood by the patient. It is their right to negotiate their priorities and expectations of care. In some instances where information is not communicated in the patients language and an interpreter is not utilized, a patients inability to manage their illness as a result can be found to be non-compliant. Therefore, if a health provider and patient relationship fails in lieu of an ineffective communication of illness management or consent, the patient could incur further health implications, which in turn may cause the healthcare system or insurer to sustain added costs.
Not everyone is able to act as an interpreter in a healthcare environment. Omissions, summarizations, additions, and lack of knowledge in technical healthcare terminology, among other variables, have been committed by untrained interpreters including family members and healthcare staff when communicating between the patient and healthcare provider. Confidentiality issues concerning the patients medical history and ethical concerns arise when a family member or non-healthcare experienced interpreter is utilized. The burden and expectation that the patient and family will provide their own interpretation adds to the economic difficulty of the non-English speaking families.
Legal consequences of inadequate interpretation, which are associated with incompetent care, must be of interest to healthcare administrations and insurers. It is each organizations duty to have by policy in each patients medical records an informed (meaning fully understood) consent. If the language barriers are not breached with successful communication the hospital or insurer could be liable for an invalid consent to treatment.
In California the state Department of Managed Health Care is drafting regulations for Senate Bill 853, sponsored by Senator Martha Escutia, D-Montebello. The bill passed in 2003 and will require health insurers to provide interpreters by next year. Therefore the proposed rules state that health plans must have language assistance in effect by July 1, 2007 and written communication must be provided in Spanish and other languages by October 1, 2007.
With the assistance of trained medical interpreters, patients who speak a different language than their healthcare providers are able to ensure quality correspondence. The legal liability and ethical concerns surrounding patients in clinical situations or illness management require accurate language services. Whether it is Sign Language, Turkish, Italian, or any other language, organization and implementation of language services is needed to facilitate language diversity in healthcare systems.
