The potential for HIPAA violations in language services

When interpreters or healthcare providers rely on unsecured communication methods, like non-compliant apps or systems, they inadvertently put patient data at risk. Adding to this vulnerability, using untrained or unofficial interpreters can further escalate the threat.

The nature of language services

Language services in healthcare settings are often referred to as "interpreter services" or "language assistance services." These services ensure that patients who speak different languages or have hearing impairments can communicate effectively with healthcare providers. An Author Manuscript study provides, “How nurses and other healthcare providers respond to the communication needs of patients with LEP also has a significant impact on patient satisfaction, with effective use of interpreter services or bilingual healthcare professionals contributing to higher patient satisfaction ratings.”

Healthcare organizations provide for language barriers by offering various types of language support. They employ interpreters, provide documents in multiple languages, and use translation technology. Staff training also includes how to work with interpreters and understand cultural differences. The goal is to ensure that all patients receive accurate and understandable health information, no matter what language they speak.

In smaller or rural healthcare organizations, providing language services can be more challenging due to limited resources. These organizations might not have full time interpreters. Instead, they often rely on telehealth technologies that offer remote interpretation services. Some might partner with larger networks or use community volunteers who are fluent in local languages. 

See also: Navigating language barriers in healthcare organizations

The potential for violations 

The potential for HIPAA violations in the context of language services and care for Limited English Proficiency (LEP) patients mainly arises when healthcare providers use untrained interpreters or unsecured technological solutions. Often, in an effort to bridge gaps quickly, healthcare staff might rely on family members or untrained staff for interpretation. The practice risks exposing protected health information (PHI) because these individuals might not be aware of the strict confidentiality required under HIPAA.

The increasing use of remote interpretation services can introduce risks if these services are not properly secured. Insecure connections can be vulnerable to breaches. Challenges also arise in documentation. Accurately documenting the details of interpreted medical consultations requires precision and confidentiality. Any lapse in these processes can lead to PHI exposure, especially if interpretation or translation inaccuracies occur and are documented as such. 

Using email to mitigate the risks 

• Use HIPAA compliant email providers that the email service provider signs a business associate agreement (BAA) and adheres to HIPAA requirements. 

• Implement systems where access to remote interpretation services is controlled and monitored. Use secure logins and track usage to ensure that only authorized personnel are using these services.

• Regularly audit and review interpreter interactions to ensure compliance with confidentiality agreements and HIPAA standards. This includes checking for any unauthorized disclosures during interpretations.
• Encourage the use of VPNs by remote interpreters to secure their internet connections, especially when interpreting sensitive information via telehealth platforms.

• Provide targeted training that covers specific scenarios they might face.

• Ensure that all interpreted conversations are securely documented within the patient's EHR. Use interfaces that automatically encrypt these entries and restrict access based on user roles.

• When sending documents that have been translated, ensure that both the original and translated versions are transmitted securely and stored correctly. Always verify that any attachments are encrypted before sending.

• After each interpreted session, conduct a brief review to ensure no PHI was improperly disclosed. This can involve a quick check of the communication logs and a confirmation with the interpreter.
  
  

FAQs

Can an interpreter have access to patient PHI? 

Yes.

Is patient consent necessary before an interpreter is used? 

Patient consent is generally required before using an interpreter.

What are common ESL challenges in healthcare?

Misunderstandings due to limited vocabulary, difficulties with medical jargon, and cultural differences that may affect communication.