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At the surface level, language services like translation and interpreting might seem like fairly straightforward processes: You take content (or speech) in one language, and reproduce the meaning and message in another. But in practice, it’s all a lot more complicated than that. Translators and interpreters have to take all sorts of other considerations into account, from the specific context of the source to the audience who will be receiving the message in the target language. After all, the content you might read in an advertisement is worlds away from the language a medical interpreter has to relay back and forth between a patient and their doctor. And certain settings, such as healthcare, emergency services, and legal services, may require providers of language services to take into account the trauma that a person might have experienced before needing those services. As a result, translation and interpretation become inextricably linked with providing trauma-informed care, and it’s important that language service providers working in these sectors be able to pair non-English-speaking individuals who’ve suffered trauma with interpreters who are well-equipped to provide trauma-informed language services. For language service providers working in these domains, translation and interpreting are far from just matching and pairing languages — it’s also about making sure individuals with limited English proficiency (LEP) get the care they need and are able to advocate for themselves in light of traumatic experiences. Interpreters in particular are likely to work with clients and patients who need trauma-informed services. When working with individuals who have dealt with traumatic experiences — whether it’s violence or serious injury — interpreters need to be knowledgeable about how to effectively provide trauma-informed care. Here, we’ll discuss what trauma-informed care looks like and what interpreters and language service providers in general can do to ensure that they’re providing effective and sensitive trauma informed language services. Trauma-informed care is a way to provide effective care and services to individuals who may have experienced some form of trauma. It’s a matter of being sensitive to an individual’s traumas and making sure that they’re able to receive adequate care in response to these traumatic events. Revisiting and discussing traumatic events can actively harm somebody’s mental well-being — as a result, it’s important to be sensitive when providing care to people who have faced such trauma. In recent years, providers of both legal and medical services have championed ways to provide trauma-informed services, from reframing the way they talk about traumatic events to avoiding triggering topics altogether. Providing trauma-informed care can be even trickier when there’s a language and/or cultural barrier. As a result, using interpreters who are specialized in the art of providing trauma-informed language services can help build bridges for limited English proficient individuals to receive adequate care. Before delving into trauma-informed language services specifically, it’s worthwhile to go over some general considerations that apply to most interpreting settings. These include: The key consideration to keep in mind when providing trauma-informed services is the emotional and physical well-being of the client or patient.   Trauma-informed language services acknowledges the potential vulnerability, distress, or triggers that individuals may experience in sensitive or traumatic situations. By implementing trauma-informed practices and considerations, language service providers can create a safe and supportive environment for effective communication and healing. Here are some additional considerations language service providers should take into account when working with patients who have experienced some form of trauma.  It’s also important to note that these considerations go beyond trauma-informed services as well — even if a client hasn’t experienced severe trauma that you know of. While especially so in particular settings, being sensitive to a client or patient’s needs and triggers is critical to providing effective language services. A trauma-informed approach to language access services is absolutely crucial, especially when it comes to interpreting for patients and clients in need of mental health, medical, or legal services. By considering an individual’s needs, experiences, and preferences, language service providers can deliver more effective and supportive services. Here are just a few things you should keep in mind when providing interpreting services in a sensitive or trauma-informed setting: If you’re looking for a language service provider that’s up to date on providing trauma-informed care, look no further. At Avantpage, we’re proud to provide trauma-informed interpreting to all sorts of clients, from legal offices to healthcare providers and beyond. Contact us today at [email protected] or (530) 750-2040 to learn more.

You probably don’t need us to remind you that in 2020, the United States declared the COVID-19 pandemic to be a public health emergency (PHE) — but now it’s looking like we’re finally in the clear, after three years of masking, social distancing, and working from home.  That’s not to say the pandemic’s over or that we no longer need to worry about COVID-19 — just that the state of emergency is over. Last month, the United States officially ended the PHE that was put in place more than three years ago. Among other aspects of daily life, the PHE had a profound impact on healthcare and how we access it — as such, the PHE ending is also likely to have an equally profound impact on telehealth. “[The Department of Health and Human Services] and the leadership across the Department remain focused on protecting the health and well-being of all Americans, particularly those at highest at risk, including seniors and immunocompromised people, making sure we don’t leave the uninsured behind, and monitoring the latest subvariants so we’re prepared and ready to manage the risks of the virus moving forward,” secretary of health and human services Xavier Becerra said in a statement on May 11, when the PHE officially ended. In response to the PHE, doctors and other healthcare providers adopted several telehealth measures and practices to allow patients and healthcare workers to stay safe in the face of COVID-19. The US Department of Health and Human Services first declared a PHE in response to COVID-19 in late January 2020. But it wasn’t until about a month and a half later that things began to hit the fan. In mid-March of that year the number of people diagnosed with COVID started rising fast — in response, businesses began to close their doors, students attended class on their laptops, and the video communications platform known as Zoom became a household name. During the PHE, virtual doctor’s appointments and other forms of telehealth became more prominent — this was possible because the PHE relaxed certain HIPAA requirements and allowed patients to file insurance claims for more telehealth services. And in the language services domain, remote interpreting became an even more important method of delivering services than before. The shift to telehealth meant healthcare providers had to rely on remote interpreting technology more than ever before.  It certainly stands to reason that this change should have had a positive impact on patients with limited English proficiency (LEP). Instead, it seems that telehealth was often less accessible to patients with LEP than those without. From problems with digital literacy to inaccessible user journeys, many patients with LEP struggled to receive the care they needed during the PHE. As we transition into this post-PHE era, here’s what healthcare providers — telehealth or otherwise — should know about accessing language services and providing equitable care to patients with LEP.
Throughout the COVID-19 pandemic, language barriers have posed challenges to effective healthcare delivery for individuals with LEP. Even before the pandemic, healthcare providers have had to take measures to break language barriers for patients with LEP.  But the pandemic and the shift to telehealth under the PHE made things even tougher. Insufficient digital literacy, lack of access to digital requirements like broadband internet among certain populations with LEP, and occasionally erroneous or misleading translations of important public health information made it harder for patients with LEP to access telehealth. And as a result, research suggests that populations with LEP were more likely to suffer adverse consequences from COVID-19 than other groups. These disparities shed some much-needed light on the importance of language access in healthcare. Ultimately, the PHE created a motive for healthcare providers to develop programs and innovative solutions to address language access barriers and ensure equitable healthcare for all. 
With the end of the PHE last month, many healthcare providers will be less likely to rely upon certain telehealth practices. And some things that were allowed under the PHE — for example, a relaxation of HIPAA that let providers who were covered by Medicare to use WhatsApp and FaceTime — will no longer be allowed. Likewise, the end of the PHE also means that doctors are no longer able to prescribe controlled substances to patients via telehealth alone. Patients will be required to come in for an in-person visit with the doctor before any such prescriptions can be written or filled. While video doctors’ appointments will certainly stick around, they’ll likely become less common than they were during the pandemic — especially since fewer telehealth visits will be covered by insurance, requiring many patients to default to onsite visits to the doctor. This means patients with LEP could potentially have to travel longer distances to meet with a doctor who speaks their language. Healthcare providers will still be able to use remote interpreting technology to get connected with an interpreter, in the event that a patient needs an interpreter. Demand for in-person interpreting may increase, however, as doctors begin to shift away from telehealth appointments and technologies.  Additionally, healthcare providers may need to reevaluate their language access practices to ensure that they meet the needs of patients who are coming into the office or hospital. In-person appointments introduce additional layers — for example, interacting with the receptionist at the front desk — that could cause friction if language access isn’t adequately considered.
About a month into this new chapter, it’s critical that healthcare providers consider ways in which the end of the PHE might impact the accessibility of telehealth services. Here are some things for healthcare providers to keep in mind during this critical junction: As we transition into this new phase of the pandemic, Avantpage is proud to provide consulting, translation, and interpreting services to healthcare providers all across the country. If you need to work on revising your language access plan for the post-PHE era, don’t hesitate to contact us at [email protected] or (530) 750-2040 for more information about our services.

Telehealth and its 4 subsets might not have been on your radar until the COVID-19 pandemic brought it into the spotlight back in the spring of 2020. But even as the pandemic’s eased up, telehealth doesn’t appear to be going anywhere any time soon.  It’s become a particularly important tool in providing healthcare to individuals who would otherwise face significant barriers to healthcare services, such as people who live in highly rural locations or those with limited English proficiency (LEP). Simply put, telehealth is a way for healthcare providers to digitally work with patients and interact with the public — though it’s often viewed as synonymous with live video appointments, this is just one aspect of telehealth. There are four subsets of telehealth, ranging from more intimate one-on-one video sessions with a patient and a doctor, to more wide-reaching public health campaigns. The four subsets of telehealth are as follows: For individuals with LEP, telehealth can break language barriers in several different ways. Live video appointments can connect patients with doctors who speak their language but are located far away, while mobile health campaigns can be translated into different languages to ensure LEP individuals are informed about public health issues and other important medical information. Despite all of this, the COVID-19 pandemic highlighted significant disparities in the health outcomes of patients with LEP. Throughout the early days of the pandemic, populations with significant proportions of individuals with LEP often faced the toughest outcomes when compared to their English-speaking counterparts. From insufficiently accessible (and in turn, discouraging) user journeys on telehealth portals to problems with digital literacy, the rise of telehealth made healthcare less accessible for individuals with LEP.  As telehealth became more prominent, so too did awareness of the disparities between patients with LEP and those without. Here, we’ll examine the four subsets of telehealth and how they can impact the care that patients with LEP receive. From remote patient monitoring to store and forward, we’ll discuss ways in which providers can be thoughtful and purposeful in the way they interact with and treat their patients who do not speak English proficiently.
There are a handful of different types of technology that healthcare providers can use when offering telehealth — each one is unique, serving different outcomes and leading to different outcomes.
This is the form of telehealth that you’re probably most familiar with — live video telehealth utilizes video conferencing tools like Zoom to connect patients with their healthcare providers. This allows patients to receive care from the comfort of their homes, and healthcare providers can assess a patient’s health status in real-time. With live video, a doctor’s geographical proximity becomes less important — this allows patients with LEP to more easily connect with doctors and interpreters who speak their language without having to travel long distances. However, video visits may also require interpreting services to ensure effective communication between the patient and the provider. Telehealth providers should always be prepared to offer virtual remote interpreting services for video visits in case a patient is and provide instructions and training materials in the patient’s preferred language.
Mobile telehealth includes any sort of public health messaging or medical education delivered to patients via mobile devices like smartphones or tablets. This might include a series of mass text messages sent out to alert a community about a disease outbreak in their area or more general campaigns that simply aim to promote healthy behavior. Although these types of campaigns may not be as palpable as a one-on-one appointment with a doctor, they do play an important role in engaging individuals with LEP. By working with language service providers to translate these messages into a linguistically and culturally appropriate format, telehealth providers can ensure that these messages are as accessible and meaningful as possible. When mobile health campaigns aren’t linguistically appropriate, prospective patients might feel alienated or discouraged from pursuing healthcare services — or worse, left in the dark about important public health information like local disease outbreaks.
Remote patient monitoring involves the use of electronic devices to monitor a patient’s health status from the comfort of their own home. These devices monitor things like a patient’s blood pressure, heart rate, weight, and other vital signs — this data can then be sent to healthcare providers to monitor and assess a patient’s health status. Healthcare providers typically use these devices after discharging a patient, in an effort to lower the likelihood of hospital readmission. For patients with LEP, language access is critical in ensuring that they understand how to use remote patient monitoring devices properly and that healthcare providers can understand and interpret the data correctly. Providers should offer instructions and training materials in the patient’s preferred language, and offer interpreter services when necessary. Store and forward is a form of asynchronous telehealth that allows doctors to assess a patient’s status without ever having to schedule a real-time appointment (over video or otherwise). With store and forward, patients and healthcare providers can send photos, videos, and other health records to other specialists for analysis — for example, a patient might send photos of a skin lesion to their primary care physician, who then passes the photo off to a dermatologist for further analysis. To ensure that LEP individuals benefit from store and forward, healthcare providers can work with language service providers to translate and interpret information about store and forward practices, so that they understand the benefit of this type of telehealth.  Telehealth can be an undoubtedly powerful tool for improving health equity among patients with LEP. Within the realm of telehealth, there are four subsets that must be applied in different situations. For each type of telehealth service, providers must keep in mind unique considerations for patients with LEP. To recap, here are the four subsets of telehealth and how they work: At Avantpage, we’re proud to help telehealth providers improve their approach to language access and unlock telehealth’s potential to break language barriers for patients with LEP. If you’re looking to make your telehealth services more accessible to individuals with LEP, contact us at [email protected] or (530) 750-2040.