Virginia Telehealth Network

Improving Access to Telehealth for Patients with Limited English Proficiency

Edward Jenner

Telehealth can be challenging for those who aren’t familiar or comfortable with technology, but patients whose first language is not English face another set of barriers. Patients with limited English language proficiency (LEP) are historically less likely to visit the doctor and less likely to get preventative care services, regardless of health status, access to health insurance, regular source of care, and other economic factors. And the rapid move to telehealth made it especially difficult for these patients to procure care. To support multi-lingual patients and ensure they have access to high-quality care, here are some tips and resources to help enhance equity at your practice:

Consider Federal Regulations

To address this need, all recipients of federal funding must provide meaningful access for LEP patients through language services such as oral interpretation and written translation. Before you move forward with creating a plan for interpreter support, make sure you are complying with federal regulations, as well as any regulations for your state and locality.

No One Size Fits All

Keep in mind that one approach to addressing language barriers around telehealth may work for one provider, but not another. For example, as a provider to one of the nation’s most diverse communities, the team at Arlington Free Clinic knew they faced a unique set of challenges. To utilize telehealth without compromising the quality of care, they created a new position to help facilitate the technical side of the appointment.

Create a Plan

It’s important to have a plan in place for how to best address patients with limited English proficiency. This will make serving and onboarding new patients a seamless process. Here are a few things to consider when building a plan for your practice.

  • First and foremost, identify the languages your patients speak and how frequently you expect to use language services so you can determine which languages are most relevant for your practice.
  • Review your patient communications to decide what should be translated into other languages. To comply with federal regulations, you must translate all documents considered “vital.” Keep in mind that telehealth is more than just video or audio calls. Providers can utilize SMS text check-ins, asynchronous questionnaires, electronic intake forms, etc. that are available in multiple languages.
  • Communicate with patients using accessible materials in multiple languages. Use resources like “I speak” cards to determine a patient’s preferred language before their virtual appointment. Have other resources available that assist LEP patients with the logistics of participating in telehealth such as instructional videos on how to download zoom in multiple languages.
  • Use third-party services to provide real time interpretation in telehealth visits. These solutions can be used with audio-only visits which may be better for low-broadband regions. In addition, third-party medical interpretation services are considered business associates and are required to protect patient data.
  • Don’t rely on Google Translate for providing medical instructions. While Google Translate and similar tools are very useful in some settings, using it in a medical setting can give patients who speak less common languages misleading information, which can be dangerous.
  • Have a qualified expert available after the visit to help translate or interpret for the patient in case of additional questions via phone or email.

As telehealth services expand, incorporating interpretation is extremely important in addressing the challenges LEP individuals face when seeking care. Telemedicine can make sure health care meets the needs of these patients by utilizing technological approaches to improve communication while cutting costs and preventing emergency room visits down the road.

For more resources on enhancing equity at your practice for patients with limited English proficiency, Visit VTN’s Equity & Telehealth Initiative.