Navigating language barriers in healthcare organizations

Healthcare institutions may find themselves serving patients speaking a variety of languages. These barriers can include patients with Limited English Proficiency (LEP) or those whose primary language is not the dominant language of the healthcare system. 

This language disconnect leads to difficulties in communicating vital healthcare information effectively, understanding patient needs and medical histories, patient safety through accurate medication management, and facilitating patient education. 

HIPAA and patient rights relating to language preference 

When healthcare providers encounter patients who have difficulty communicating in English or are deaf or hard of hearing, HIPAA allows for the use of interpreters without needing the patient's specific authorization. According to the HHS, “...when a covered health care provider uses an interpreter to communicate with an individual, the individual’s authorization is not required when the provider meets the conditions below.” It means healthcare providers can engage interpreters or use their own staff, like bilingual employees or volunteers, to help with communication without violating patient privacy. In cases where patients choose to bring family members, friends, or interpreters of their choice, the providers can communicate without formal authorization.

See also: What are patient rights under HIPAA?

Methods of overcoming the language barriers

Healthcare organizations must implement strategies for overcoming language barriers because ensuring effective communication allows for equitable healthcare provision to all patients.

1. Professional medical interpreters: Employ certified medical interpreters fluent in the patient's language and medical terminology.
2. Telephone interpretation services: Employ telephone interpretation services for immediate access to interpreters in various languages. These services are particularly useful in emergency situations.
3. Using secure communication as an alternative: HIPAA allows patients to select their preferred form of communication, such as HIPAA compliant email or secure messaging, to transmit their protected health information (PHI).
4. Bilingual staff: Encourage healthcare staff who are fluent in multiple languages to undergo medical interpreter training and become certified. They can serve as valuable resources when professional interpreters are not available. If applied consider using language badges for staff members with language skills, indicating their proficiency in respective languages.
5. Translated materials: Offer educational materials, consent forms, and discharge instructions in multiple languages to assist patients in understanding their healthcare plans.
6. Community partnerships: Establish partnerships with local community organizations and cultural groups to access additional language resources and promote cultural competence.

Other legislation that applies to navigating language barriers

Title VI of the Civil Rights Act of 1964

Title VI prohibits discrimination on the basis of race, color, or national origin in any program or activity receiving federal financial assistance. This law is a stepping stone for ensuring language access in healthcare services.

Executive Order 13166

Issued by President Clinton in 2000, this order, also known as "Improving Access to Services for Persons with Limited English Proficiency," reinforces Title VI and directs federal agencies to take reasonable steps to provide meaningful access to LEP individuals in federally conducted and federally assisted programs and activities.

Affordable Care Act (ACA)

ACA extends language access provisions, requiring qualified health plans to provide access to language services for LEP individuals, which includes oral interpretation and written translations.

Limited English Proficiency Plan

While not legislation, LEP Plans are recommended for federal agencies and entities receiving federal funding. These plans outline how they intend to provide language access services to LEP individuals in compliance with Title VI and Executive Order 13166.

Civil Rights Act of 1964, Title II

Title II of the Civil Rights Act of 1964 applies to public accommodations, which may include healthcare facilities, ensuring that LEP individuals have equal access to services.

See also: Staying up to date with regulatory changes in healthcare

FAQs

What is ESL?

ESL stands for English as a Second Language, which is a program or course designed to teach English to individuals whose native language is not English. 

What is an NPP?

An NPP is a Notice of Privacy Practices, a document that healthcare providers must provide to patients.