Translation and Health Literacy in Telemedicine



Are we speaking the same language? How telehealth can help

By David Thompson, MD


“Fever” may sound different in other languages, but it means the same thing. Whether a patient says fever, fiebre, or fièvre, it’s the telehealth provider’s job to deliver the correct diagnosis and treatment. Language differences can add complexity to an already confusing situation for patients. Fortunately, healthcare professionals can help bridge this gap using digital health tools to capture symptoms in the patients’ own language.

Language Translation: So, how can healthcare systems reach the broadest patient base possible and ensure telehealth options benefit everyone? One answer is offering an e-visit intake process (rapid medical history) to patients in multiple languages.

Language-specific documentation checklists support healthcare providers by capturing a detailed history of the patient’s symptoms at the beginning of the medical encounter. Language localization also makes it easier for non-English speaking consumers to use e-health tools and applications to ensure greater accuracy when they use virtual care.

The most recent National Assessment of Adult Literacy (NAAL 2003) found that 89 million Americans have limited health literacy. It’s fair to say a significant percentage of those have English as a second language or speak no English at all. This highlights the need for global health literacy guidelines and healthcare options for all languages. Consider the following reasons to offer multilingual telehealth options.

Improve patient engagement: By using a multilingual telehealth platform, clinicians can help patients of all language backgrounds—even if they, themselves, don’t speak the same language. In addition, more tech-savvy patients can choose their language preference when using e-health applications. The simple ability to communicate health information in their preferred language can improve patient engagement and satisfaction by:

  • Providing easy-to-understand information;
  • Making patients feel they’ve received customized, personal attention;
  • Offering flexibility for individual situations; and
  • Giving patients control over their healthcare, regardless of language.

The bonus is that health systems using flexible telehealth platforms can also see improved retention due to patient engagement and satisfaction.

Support communication along the care continuum: Not only can telehealth technology offer engagement solutions, but it also has the benefit of connecting providers and patients along the care continuum. Patients can see health information in their preferred language, while the telehealth platform provides data coding and translates it into medical terminology. This data can then be shared among medical call center nurses, telemedicine providers, hospitals, and primary care providers. There’s never a need for patients to feel they have less access to quality care because of language barriers.

With advancements in translation technology and digital health platforms, the future of healthcare will be measured by how well organizations and providers appeal to a broad patient audience; capture health information; share data with other providers; and leverage that data to improve medical care, speed up care delivery, and reduce costs.

Consider the case of John Gomez, a twenty-two-year-old, whose primary language is Spanish. John has had knee pain for two days and contacts a telemedicine provider.

Step 1: The initial call: John calls a service representative who works with his doctor. This service representative does not speak Spanish. Using a symptom-checking engine that offers symptom options for “knee pain” in Spanish, she collects information about the patient’s condition. The representative then obtains John’s demographic information, transcribes his chief complaint and helps him complete an online “rapid medical history” for knee pain. The telehealth platform lists recommended care options based on John’s symptoms, his availability, and doctor preferences. The service representative then arranges a telemedicine encounter.

Step 2: The telemedicine encounter: John can speak with a Spanish-speaking doctor or an English-speaking doctor because his information has been transcribed and coded as data in medical terminology. The doctor reviews the medical history, validates the information during the telemedicine encounter and provides treatment recommendations.

Step 3: Follow-up: A nurse in a centralized call center contacts John in two days to make sure he is following treatment recommendations, getting better, and has no further questions.

Serving a broad population: Healthcare is confusing, but fortunately, patients are increasingly becoming more involved in their care. As healthcare and technology continue to evolve, healthcare systems and providers must adapt to serve a broad patient base with consumer-friendly tools and information.

David Thompson, MD, FACEP is CEO and chief medical officer at Health Navigator. A part-time faculty attending in the Northwestern Memorial Hospital Emergency Department, Dr. Thompson also works as an author and partner with Self Care Decisions, LLC and Schmitt-Thompson Clinical Content, LLC. He is board-certified in both internal medicine and emergency medicine, having completed a dual residency at Northwestern Memorial Hospital at Northwestern University. Dr. Thompson is a Fellow in the American College of Emergency Physicians. He can be reached at david.thompson@healthnavigator.com.