Video Addresses 'Growing Concerns About Racial, Ethnic and Language Disparities in Health Care'

By Susan Jones | November 17, 2009 | 11:49 AM EST

( - The nation's physicians must concern themselves not only with their patients' health, but also with their patients' "language access."
Qualified interpreters must be provided for patients who are deaf/hard of hearing and for those who do not speak English. That's the point of a new YouTube video produced by the Health and Human Services Department and The Joint Commission, an independent group that sets health care standards.
The HHS Office for Civil Rights and The Joint Commission say the video highlights "what is required...with respect to patients who are deaf/hard of hearing or limited English proficient."
The news release mentions "growing concerns about racial, ethnic and language disparities in health care." It notes there are an estimated 28 million people in this country with deafness/hearing loss and an estimated 47 million who do not speak English.
The Joint Commission and HHS stress that effective communication is a critical aspect of safe, quality patient care: "Many patients of varying circumstances require alternative communication methods, and this new video will help health care organizations determine the best methods of care for meeting these communication needs," the Web site says. "Language access remains a matter of national importance. The video identifies tools that health care organizations can use to build effective language access programs."
The video invokes federal civil rights standards as well as accreditation standards.
For example, Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, or national origin in programs that receive federal funds. Therefore, failure to provide language access services for Limited English Proficient persons may be a form of discrimination on the basis of national origin, the Web site says.
Similarly, Section 504 of the Rehabilitation Act of 1973, which protects the rights of individuals with disabilities, requires health care organizations that receive federal funds to provide effective communication (such as sign language interpreters) for patients who are deaf or hard of hearing. The Americans with Disabilities Act requires health care organizations to meet the same standards, regardless of whether the health care group receives federal funds.
HHS and The Joint Commission say they do not endorse one mode of interpreting over another. But they do note that interpreters must be accessible and effective in meeting the needs of patients and their families -- and they say the obligation to determine whether an interpreter is effective falls on health care providers.
“Ineffective communication between patients and providers can result in misdiagnosis, inappropriate treatment or medication errors,” said Amy Wilson-Stronks, a project director and investigator at The Joint Commission. “When a provider cannot communicate effectively about a disease or treatment, or when a patient cannot describe their illness, they lack the basic connection needed to result in appropriate care. Appropriate communication is necessary for ensuring quality and safety in health care.”
Georgina Verdugo, director of HHS Office for Civil Rights, said the video highlights "the rights of patients in getting access to crucial medical services."
In the video, Verdugo emphasizes doctors and other health care providers cannot necessarily depend on bilingual staffers -- or on the patient's family or friends to interpret for someone who need assistance.
"Providers should be careful. You have the obligation under law to ensure effective's your obligation -- so, if someone elects to use a family member or a friend to provide interpretation, we often advise that health care providers take reasonable steps to determine whether the person providing the interpretation, as a family member or a friend, is competent or qualified to provide this service accurately and impartially. This includes determining whether there could be a conflict of interest, confidentiality or emotional involvement or other concerns that frankly make the use of a family member or friend inappropriate."
Bottom line, said Verdugo, "If a family member or friend simply isn't competent, the health care provider, under the law, must provide someone who is."
The Joint Commission, an independent, not-for-profit organization, accredits and certifies more than 17,000 health care organizations and programs in the United States. It says its mission is to "continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value."