VRI Provides Culturally Affirming, Non-Biased Care to Limited English Proficient Patients


Community health centers nationwide are grappling with how to meet the needs of a growing and diverse patient population while also striving to improve clinical effectiveness and operate patient-centered safety models. Howard Brown Health, one of the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) organizations, located throughout the Chicago metro area was also facing this challenge. Nearly 10 percent of the organization’s patient population require access to language services, and they were trying to determine how to provide language access in a way that made patients feel comfortable. This included Deaf patients who communicate using American Sign Language (ASL) and limited English proficient (LEP) patients whose native language may not be English.

“This was truly a struggle for me as a provider,” said Kristin Keglovitz Baker, COO and Certified Physician Assistant at Howard Brown Health. “When I learned many of our interpreters were expressing bias or not communicating with patients in a way that was affirming, I knew we needed to make a change right away. Our primary mission is to eliminate disparities in healthcare experienced by lesbian, gay, bisexual and transgender people and to ensure all patients feel their healthcare is affirming and providers (and interpreters) provide care in a way that is non-biased and sensitive to their healthcare needs.”  See the case study for further details.

Video Remote Interpreting Adopted to Provide Affirmative, Non-Biased Care

Howard Brown Health was seeking an additional modality to meet their language access needs while also ensuring communication was being relayed in an affirmative and non-biased way. The organization began looking into video remote interpreting (VRI) options. They decided to partner with InDemand Interpreting because they appreciated that the interpreters were focused solely on the medical industry and bound by HIPAA as well as compliant with federal and state language access guidelines.

“We wanted to find an additional tool that was visual, but not an on-site interpreter whom the patient may know from within the local community. We wanted our patients to have the option to choose in person, phone or virtual,” said Keglovitz Baker. “There were occasions when we would be using on-site interpreters and I would have to ask the interpreter to step out when I began the physical exam and that meant I could no longer communicate with a patient. Now (using InDemand VRI) I have the option to implement a privacy curtain on the screen and I can continue reassuring the patient about what I’m doing throughout the exam.”

InDemand VRI Leads to Increased Patient Satisfaction, Decreasing Costs

The decision to switch to InDemand VRI led to a complete transformation in patient care when an interpreter is used at Howard Brown Health. Immediate access to interpreters has saved time and increased efficiencies, which has led to a cost savings in situations where patients select VRI over an on-site interpreter. This is due to the ability to avoid cancellation fees for no show appointments and paying for interpreter usage by the minute rather than a flat fee from an on-site interpreter vendor.

“There is much more laughter, smiling and our patients are more engaged in their care now that we working with interpreters who are really committed,” said Keglovitz Baker. “We know that our patients are receiving affirming care that is sensitive to sexual minorities. InDemand has been really open to our unique patient needs and has worked together with us to implement training (for interpreters) on how to communicate in an affirming way with transgender patients and to regularly evaluate, evolve and learn about the best ways to meet the meet the needs of our diverse patient population.”


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