Interpretation for patients with limited English proficiency: What are the options?

Hospitals, and other medical care providers, are compelled by regulation and quality, ethical and safety considerations to provide language services for their patients who have limited English proficiency (LEP). The need for these services is considerable, as about 20% of the United States population speak a language other than English at home, and nearly 9% speak English less than “very well,” amounting to 24,069,536 people. Spanish speakers account for about 60% of all non-English speakers. Since there are an estimated 311 distinct languages spoken nationwide, this means that there are many lesser diffuse languages. The volume and diversity of languages create challenges for providing sufficient and appropriate language services twenty-four hours a day; the near absence of reimbursement further complicates this scenario. Because there is no single solution for providing interpretation services for all languages and in all settings, health care facilities are employing and experimenting with a variety of strategies for providing medical interpretation services, including in-house and remote interpretation approaches. Given the importance of interpretation services and the anticipation of an even larger need for them in the future, it is important to be aware of the various options and understand their relative strengths and weaknesses. As part of a report for the Connecticut Department of Public Health, we examined the advantages and disadvantages of 14 models for providing interpretation services to patients with LEP, and also assessed their utility based on levels of availability, professionalism and comfort to patient, and quality.