If you provide eye care to Medicare or Medicaid patients or accept Medicare supplementary plans, you likely must legally provide language services.
The good news: following the law may help grow your practice’s revenue and improve patient safety and satisfaction. Here are our top four considerations for ophthalmologists, optometrists, and opticians treating non-English-speaking patients:
1. QUALIFIED INTERPRETATION IS REQUIRED OF MANY PROVIDERS
Passed in 2010, the Patient Protection and Affordable Care Act fundamentally altered practice of medicine in the US. The Act included Section 1557, a provision which built on the language access requirements previously set by Title VI of the Civil Rights Act.
Section 1557 went largely unnoticed until 2016, when the Department of Health and Human Services reviewed it and issued a ruling. According to HHS, 1557 requires providers to offer “meaningful access to each individual with limited English Proficiency,” if that provider:
- Receives federal funding (including accepting Medicare/Medicaid payments)
- Is administered by HHS (i.e. Medicare Part D), or
- Participates in the ACA’s Health Insurance Marketplaces
Many eye care providers fall into one of these categories, and the American Optometric Association has advised its members that “the vast majority of optometrists need to comply with [the] new regulations.”
In brief, Section 1557:
2. LANGUAGE BARRIERS CAN POSE A RISK TO PATIENT SAFETY
Patients who don’t speak English well may fall victim to medical misunderstandings if their providers fail to take preventative measures. Modern Healthcare sums up the problem, explaining that providers “often ignore…policies on using qualified interpreters, typically because of time pressures, lack of knowledge about the availability of interpreters, or procedural difficulties in arranging for them.”
The Journal for Healthcare Quality studied this phenomenon and concluded that failing to use an interpreter can lead to unnecessary or counterproductive treatment. The Agency for Healthcare Research and Quality (AHRQ) agrees, stating that “Nearly 9% of the U.S. population is at risk for an adverse event because of language barriers.”
Eye care providers with diverse patient populations have realized the importance of communicating in-language.
“Language barriers can present challenges for eye care providers attempting to communicate the details of a surgery,” Justin Schweitzer, O.D. told Glaucoma Today. “It is crucial that we clinicians communicate effectively and thoroughly with our patients, even in the presence of a language barrier.”
“At my center, our first impressions team schedules a translator to be present throughout the examination for non-English-speaking patients,” he continued. “This portion of the visit takes more time than usual, but I find it is worth every minute to communicate effectively.”
The National Center for Biotechnology Information (NCBI) found that patients who speak a different language than their providers report worse interpersonal care and are more likely to rate providers poorly when surveyed.
These patients are:
- 9x more likely than their English-speaking peers to have trouble understanding a medical scenario
- 4x more likely to misunderstand medication labels
- 4x more likely to have an adverse reaction to medications prescribed
However, NCBI also studied providers who made an effort to provide culturally competent in-language care and found that these efforts:
“…may improve overall patient experiences, but may particularly benefit minorities in their interactions… Such effort may not only serve longstanding goals of reducing racial/ethnic disparities… but may also contribute to general quality improvement.”
The real-life experiences of eye care professionals seem to confirm these findings.
“I worried that, as an English-speaking optometrist, my messages were not clear to patients who speak English as a second language, or not at all,” explained Dr. Kirk Smick, O.D. “I knew we needed to make changes to provide quality care.”
Dr. Smick has experienced the benefits of these changes firsthand.
“My staff now playfully refers to Clayton Eye Center as the “United Nations of eyecare practices,” he said. “My practice has patients who speak many different languages. While some of this change has been a result of natural shifts in the population, much has been earned as a result of referrals and word-of-mouth communication.”
Clinics may not have the time and resources to hire and manage their own staff of interpreters. Another option: partnering with a language services provider that can supply interpreters via phone or video chat on-demand.
Phone interpretation is a three-way conference call with the patient and a live, human interpreter who acts as a bridge for communication. See a demonstration here.
Video interpretation is the video chat equivalent of phone interpretation. It provides the advantages of face-to-face interpreting for the most sensitive medical scenarios. Deaf patients, children, and patients with mental or behavioral health issues also benefit from video. See a demonstration here.
Video interpretation works with many smartphones, tablets, and computers with an internet connection. Providers like CyraCom also offer custom equipment designed to optimize the video interpretation experience.
Choosing an interpretation provider is an important decision, since the service's speed, quality, and security will likely determine whether your staff actually uses it.
CyraCom is the leading provider of language interpreting services to healthcare. Contact us at getstarted@cyracom.com to start using language services today.