The United States generally, and California in particular, is becoming increasingly a multilingual place. According to the 2010 Census, 44% of Golden State households speak a language other than English. According to the office of the state’s Attorney General,19% of Californians report speaking English “less than very well.”
Why Medical Interpretation and Translation Services are More Important than Ever
The problem of Limited English Proficiency becomes especially acute in this global health crisis. In the current pandemic, with physical presence deterred by an infectious disease, the impact of this deficiency is multiplied. Essential information is not reaching those who need it most. One of the easiest solutions is to use telehealth healthcare options in order to get remote, live interpretations during the medical consultation. Despite large foreign-speaking populations in California, many documents are not translated. While some press conferences have signers for the hearing impaired, there is rarely interpretation in multiple languages.
Federal law requires that healthcare providers deliver services in a language that patients can understand. Title VI of the 1964 Civil Rights Act prohibits discrimination on various grounds, and the US Supreme Court has ruled that language access is a protected right. Federal purse strings and state law have given this law “teeth.” More than 200 languages are now supported throughout the country.
This right to access healthcare in an understandable language is difficult to implement. Larger hospitals can afford to hire translators and interpreters only in the most frequently spoken languages in their areas. But what about smaller hospitals and clinics? What about uncommon languages? And what to do when lockdowns keep service providers at home?
Distinctions between Translation and Interpretation Services for Healthcare
Before addressing these questions, and seeking out solutions, we need to address the terminology. While translation and interpretation are sometimes used interchangeably, there is a clear distinction between the two terms.
Translation refers to the adaptations of text from one language to another. It can apply to documents, webpages, articles, or software. It can either be literal – with an attempt to render the translation as close to the original text as possible. Or it can be loose, with an effort to capture the intent and spirit of the original text, even if the translation is expressed somewhat differently.
Interpretation, by contrast, refers to the spoken word. An interpreter renders what has been said from one language to another. In some cases, the interpretation is simultaneous, given at the same time as the original speech, usually via headphones. In other cases, the interpretation is sequential, often alternating with the speech in the original language.
Translation does not require physical presence. A translator does not need to be present in a health care facility. However, the interpretation is different. It is event-driven, whether the event is a press conference or a conversation between healthcare providers and patients.
An interpreter must render the service at the same time as the communication is made.
Innovations in Medical Interpretation and Machine Translation Services
For decades, the rudimentary solution for remote medical interpretation was to deliver these services over the phone. When a healthcare provider needed to confer with a patient and their family about an urgent medical matter, a call would go out to a provider of Over the Phone Interpretation (OPI) services. The doctor would speak to the interpreter and the interpreter would speak to the patient and family.
There were many problems with this approach. First, it was awkward and risked misunderstandings, potentially health and life-threatening. Diagnoses, prognoses, and prescriptions would be mangled, lost in translation as in a game of “telephone”. Sometimes there was a need for the patient to repeat back what was said through the interpreter so the provider could confirm the accuracy of the interpretation. There is also the problem that some patient populations — especially children, the elderly, and the disabled – do not understand easily over the phone. They are not comfortable or receptive to audio-only communications.
In recent decades, as video communications became technically feasible and economically affordable, a new delivery system for medical interpretation has now largely displaced OPI as the preferred method of delivery. Video Remote Interpretation has become the delivery channel for telemedicine, or telehealth, now used by billions. The health care provider sits in one place, the patient in another, family members in others, and the interpreter in yet another. Today, multi-person, multi-lingual video conferences have become common.
Virtually everyone has a smartphone. Flat screens are everywhere. Costs of transmission are minimal. The main technical challenge is connecting to interpreters, on-demand, and in real-time, in diverse languages. The solution to this problem is that providers of the telemedicine systems, which host the video conferences, have partnered with translation companies which, in turn, make available their global networks of trained interpreters. Large translation companies often support hundreds of language pairs. A sufficient supply of interpreters ensures that someone will be available for each medical healthcare meeting.
A further problem arises in one-to-many multilingual video conferences. Here it is not enough to provide a single interpreter, because the audience has several to many languages that need to be a supporter. Few organizations have the resources to provide a bank of simultaneous human translators, as the United Nations or European Parliament do. The solution here is found in the realm of Artificial Intelligence. In AI-driven interpretation, machine translation replaces the human interpreter, with pleasant-voiced bots delivering the interpretation of a speech in the preferred language to all attendees. The quality of translation and interpretation has improved dramatically in recent years. This technology has been packaged as a feature in Microsoft Translator and other apps, available to all.
How Can You Contribute to Health Care Interpretation and Translation?
If you are bilingual and can translate and interpret from one language to another, you can contribute your linguistic skills during this healthcare crisis. Many marketplaces and talent pools exist online which enable you to post your profile and contact information along with rates, ratings, and reviews. The average hourly rate for medical interpreters is upwards of $22/hour and more experienced interpreters can command more.
Check out general freelance marketplaces like Freelancer.com or Upwork. There are also talent pools and marketplaces for interpreters only. Just Google “interpreter marketplace” or “translator marketplace” and you can find many. By so doing, you not only supplement your income, but also improve your skills, and contribute to easing the current crisis. You help ensure that nothing – or at least not so much – gets lost in translation.
Ofer Tirosh is the founder and CEO of Tomedes, a professional language service provider specializing in translation, interpretation, and localization.