Fall 2017 Recap 2 – American Healthcare System

“Healthcare quality is emotion and experience-driven rather than fact-driven” 

Emily Friedman

The iron triangle of the healthcare includes Quality, Access, and Cost. These are also the main goals of healthcare, but only two of them exist together at the same time.


American Healthcare System is complicated and hard to navigate to English proficient Americans. We can only imagine how hard it would be for ones with Limited English Proficiency (LEP). In America, more than 20% of Americans speak languages other than English at home.


And about half of Texas has more than 35% county speaks a language other than English at home (see picture below).FA2017_semester.025.jpeg

This means about half of Texans are at the risk of adverse effects of the language barrier in different medical situations.

Adverse effects of language barrier

  • Makes harder to access care
  • Lowers patient satisfaction
  • Worsens conditions by not getting appropriate care at the right time
  • Decreases health literacy
  • Lowers utilization of care both preventive care and regular care
  • Raises non-compliance
  • Heightens risk of being misunderstood by their physicians
  • Increases medical errors and drug complications

Medical Interpretation in the U.S.

    • Title VI of the U.S. Civil Rights
    • The law requires physicians to offer ‘qualified’ interpreters and translators to patients with limited English proficiency (LEP) when doing so is necessary


    • Even telephone interpretation services about
      $2-3 per minute without a contract


  • Patient speaks different languages. More than 100 different languages are spoken in the U.S.
  • Language services are not reimbursed
  • Lack of professional medical interpreter services

Medical interpreter or language line services are current solutions to language barrier in the medical situation but with the emergence of technology such as AI, virtual health and telehealth, government, insurance companies and other healthcare enterprises need to spend more effort, time and resources to improve and develop solutions to this serious and prevalent issue.

Possible solutions

  • Better utilization of interpreters
    • Arrange contracted hours per week for most prominent language
    • Community-based providers and a shared interpreter bank
  • Training and utilization of medical staffs
    • Bilingual PA/RN special interpretation training
    • Training physicians to work effectively with interpreters- by speaking in short, clear sentences and avoiding medical jargon, also improves communication and increases time available for patients to ask questions or make statement
  • Technology
    • Translation apps: Canopy Speak, Canopy Quest and Canopy Learn
    • Meducation : allow access to a database of translated written prescriptions to be deployed in pharmacy applications
    • Telehealth/ Virtual visits

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