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Dome - A Virtual Improvement

Dome March 2013

A Virtual Improvement

Date: March 1, 2013

Steve Bowditch, right, explains to a patient how the “conversation” with an online sign language interpreter works.
Steve Bowditch, right, explains to a patient how the “conversation” with an online sign language interpreter works.

New online service expedites interpretation for sign language and languages other than English.

Early one morning last January, a family arrived promptly at The Johns Hopkins Hospital at 7 a.m., brimming with hope. Their daughter was about to undergo a cochlear implant—she’d be the only member of her family to ultimately enjoy the benefit of hearing. But first, her parents needed to provide consent. Trouble was, the American Sign Language interpreter was stuck in traffic, and the operation couldn’t proceed without an explanation of the procedure.

A quick phone call to Patient Relations led to a solution: NexTalk, a video remote interpreting service for languages other than English and ASL. The program provides 24/7 live access to an interpreter via the Internet. Within seconds of the call, audiologist Steve Bowditch rushed to the OR, wheeling a cart with a laptop. Minutes later, a NexTalk HIPAA-compliant interpreter introduced himself to the child’s parents and described in ASL what to expect (the consent form was faxed to NexTalk). The surgery proceeded on time and proved successful.

NexTalk is being piloted in the pediatric and adult emergency departments, in the Otology Clinic, and in cases like these, when a human interpreter is running late, or if a deaf or foreign patient arrives unexpectedly and has trouble being understood. “Nothing’s more frustrating than not being able to communicate,” says Bowditch. “And we don’t want to take the risk of being misunderstood.”

Managed jointly by Patient Relations and Johns Hopkins Medicine International, the virtual program is an extension of a trend across major hospital centers to incorporate more technology for patient care. (Johns Hopkins Bayview Medical Center and Howard County General Hospital already have similar virtual interpretation programs in place.)

The goal is to improve the delivery of care to patients—and response time, says Johns Hopkins Hospital’s Senior Director of Service Excellence Becky Zuccarelli, who spearheaded the effort. In-person encounters are often delayed, she explains, because a previous patient requires more time. But remote interpretation is almost instantaneous. “It’s easy to use, and patients like the immediacy,” says Zuccarelli.

There’s no ignoring the financial advantage either, notes Zuccarelli. If the system were used for inpatients and ED patients alone, she says, “We could save at least $100,000 to $200,000 per year in fees for deaf interpretation.”

Still, if patients prefer an in-person translator, says Jeff Nguyen, the perioperative services administrator who helped launch the project, that service will remain available. Indeed, there are times when caregivers insist on in-person translation, especially, says Pediatric ED Nurse Manager Jane Virden, when child abuse is suspected, or if a physician needs to deliver bad news. “We try to be sensitive to each situation,” she says.

In most instances, however, says Nguyen, remote interpretation provides quick access and peace of mind that patients will have seamless communication—and enough comfort with the interpreter to express concerns. So far, he adds, every patient interaction with the remote service has been positive.

—Judy F. Minkove