Medical Interpreters are Vital to Quality Care in the ED


The Annals of Emergency Medicine just released an analysis on access to interpreters for the Emergency Department: “Use of Interpreter Services in the Emergency Department.” The Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine.

The recent analysis considered the fact that one in five Americans now speak a language other than English as their native language at home, according to the U.S. Census Bureau, and it found that not having access to appropriate language services in an emergency department can potentially compromise care. According to the report, there are many reasons for a lack of access to language services, but one of the main challenges is a lack of hospital resources and the interpreters have varying degrees of training.

Oftentimes, and particularly in the emergency department, clinicians use any available person to interpret, despite the fact that studies have been shown that using trained, medically qualified interpreters increases patient and provider satisfaction, improves informed consent and decreases readmission rates. In addition, using ad hoc, unqualified interpreters doubles interpretation errors compared with discussions, including misdiagnosis and unnecessary testing and procedures, than when medically qualified interpreters are used.


There were also federal regulation changes made to section 1557 of the Patient Protection and Affordable Care Act in 2016 establishing the standards required of interpreter services. The new regulations clarified that ad hoc interpreters are generally not considered acceptable, and healthcare facilities must hire interpreters who are not only competent, but also “qualified,” meaning they must adhere to interpreter ethics principles, have demonstrated proficiency in speaking and an ability to interpret effectively both English and the additional language.

In the analysis, Jay M. Brenner, MD, Medical Director, SUNY-Upstate Medical University Hospital-Community Campus, determined that providing access to quality medical interpreters has been shown to lower re admissions and limit the possibility of patient misunderstanding, physician misdiagnosis or mistreatment in emergency departments.

To improve language services in the emergency department, the authors suggest improved training and education for physicians on the sensitivity of interpreter services and the modalities available in each facility. It’s also important to educate the community and encourage residents to know their rights and request the appropriate language services when they receive care in addition to partnering with local services to identify and support specific local needs (i.e. ensuring all of the most requested languages are immediately available) and developing more comprehensive policies that support both education and funding for interpreting services.

Video remote interpreting is gaining popularity in emergency departments because it provides patients and clinicians with immediate access to a medically qualified interpreter and improve communications right at the point of care.   InDemand Interpreting provides high performing, technology-enabled, Healthcare interpreting solutions that improve communication between clinicians and their limited English proficient, Deaf and hard of hearing patients.


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