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A few years before Avantpage was founded, our CEO Luis Miguel’s friend had a bit of a health scare.  This friend, a native Spanish speaker with limited English proficiency (LEP), went to the doctor one day to check up on a health concern he’d had. Though he often brought his daughter to doctor’s appointments to interpret for him, he decided not to this time around, in case it was something serious. But when he left the doctor’s office, he wasn’t sure what to make of the experience — he knew he had a growth in his chest, but he had no idea if it was malignant or not. So he asked Luis Miguel to help him out. Luckily, it was just a cyst, and not a tumor, as he had feared. It was this experience, among others, that inspired Luis Miguel to found Avantpage nearly three decades ago. Luis’s friend’s experience was lucky, but not entirely unique — millions of patients across the United States have LEP, making a routine trip to the doctor’s office a fairly complicated excursion. As we celebrate Avantpage’s 27th birthday on Oct. 31, we think it’s worthwhile to understand what it means to be an LEP patient navigating the all-too-complex healthcare system in the United States. In this blog post, we’ll explore the LEP meaning through the experience of LEP patients, while also providing a few key tips for healthcare providers to keep in mind as they attempt to support individuals with LEP.  As defined by the United States government, an individual with LEP “does not speak English as their primary language and has a limited ability to read, speak, write, or understand English.” Nearly 10% of the country’s population fits into this category — as of 2021, there were 25.7 million residents of the US above the age of five years old with LEP. LEP means an individual can have a major obstacle for individuals seeking out healthcare, whether that’s navigating the complex health insurance market or calling an ambulance during an emergency. Individuals with LEP struggle to comprehend complex medical terminology and effectively communicate their healthcare needs with providers. Healthcare is complex enough as it is. Most of the documents and information you’ll encounter in a healthcare setting — things like the instructions on your prescriptions, or informational pamphlets you receive at the doctor’s office — require a 7th- or 8th-grade reading level to fully understand. 88% of adults (English speakers included) in this country have inadequate health literacy levels. So if it’s hard for English speakers, it’s even harder for LEP patients. It’s important for healthcare providers to be thoughtful in their approach to language access, so that patients who don’t speak English are able to understand their health and take an active role in their care. Misunderstandings in healthcare settings can have dire consequences. A misdiagnosis due to language barriers, a failure to follow prescribed treatments, or misunderstanding post-treatment instructions can all lead to compromised health outcomes. It’s important to provide a little extra support to LEP patients to lower the chances of such misunderstandings taking place. The first step toward fully supporting and caring for LEP patients is to devise a language access plan and put it into action. Working with interpreters, translators, and language service providers is a good way to ensure that your patient-facing communications are accessible in languages other than English. It’s also important for healthcare organizations to invest in training their front-line staff so that they’re prepared to work with LEP patients and have adequate cross-cultural communication skills. Here’s a checklist of things front-line staff need to keep in mind when working with LEP patients: A patient’s English skills should never be a barrier to quality healthcare. At Avantpage, we believe it’s absolutely critical to provide an extra layer of support for LEP patients — here’s how you can train your front-line staff to work with individuals with LEP and ease their journey in navigating the healthcare system: At Avantpage, we’re proud to have spent the last 27 years helping LEP patients navigate the healthcare system. If you’re looking to improve the health outcomes of LEP patients in your organization, Avantpage is here to help with translation, interpreting, localization services and more. Contact us today at info@avantpage.com or (530) 750-2040 for more details. 

It should come as no surprise that strong health literacy is associated with more positive health outcomes.  Health literacy — that is, an individual’s ability to understand and utilize information on health and medical care — is an important part of being able to advocate for yourself in a healthcare setting, whether that’s at the emergency room or a routine check-up. In one 2022 study, researchers found that hospital patients with poor health literacy were more likely to revisit the hospital 90 days after discharge than patients with adequate health literacy. But developing a strong sense of health literacy can be difficult — especially since a good deal of medical literature and information is presented in complex, inaccessible language. Even more challenging is developing a strong sense of health literacy when you have visual impairments that make it difficult to read this information in the first place. On its own, then, accessible language isn’t enough — healthcare providers also need to ensure blind and low-vision patients have access to health information in alternative formats like braille, audio recordings, and large print. In providing a breadth of information in various accessible formats, healthcare providers can promote improved health outcomes for all of their patients. The beginning of October marks National Disability Employment Awareness Month, a time to highlight the importance of making healthcare information and services accessible to all individuals, regardless of their abilities. In this blog post, we’ll explore the crucial role of health literacy in achieving positive health outcomes and explore ways to improve health literacy using accessible language and alternative formats. The vast majority of people in the US have limited health literacy — according to Pfizer, just 12% of people in the nation are proficient when it comes to their health literacy. Health literacy isn’t necessarily about being able to understand medical jargon or decipher dense medical texts — after all, regular patients can’t be expected to understand health and medicine at the same level as trained doctors, nurses, or pharmacists. Health literacy, then, is more about being able to parse through the information a doctor or healthcare provider gives you in a way that allows you to make informed decisions about your well-being. Individuals who are health literate are better prepared to navigate the healthcare system and can play a more active role in their medical care. People with limited health literacy often struggle to fully understand their health conditions. They may also struggle with figuring out how to properly apply their medications and maintain good health overall. Consequently, they may experience poorer overall health, higher healthcare costs, and an increased likelihood of rehospitalization and mortality. On the other hand, individuals with better health literacy are more likely to experience improved health outcomes. They can better comprehend basic health information, communicate effectively with healthcare providers, and make informed decisions about their care. As such, it’s in everyone’s best interest to close the gaps in health literacy. With a more health literate population, hospitals can reduce readmission rates, in turn lowering the amount of stress placed on our healthcare system and improving health outcomes for society as a whole. One of the first steps to closing gaps in health literacy is to ensure that patient-facing documents and other materials are provided in accessible language. That means language that’s welcoming and easy to understand. While there’s a time and place for medical jargon, it’s important that complex topics are presented in a way that’s actually meaningful to the patient. If you’re looking to provide patients with information that can boost their health literacy, you may want to look at some of your pre-existing materials — flyers, brochures, webpages, etc. may benefit from a complete rehaul to clean things up. It’s important for every step of the patient journey to be as accessible and understandable as possible — from scheduling appointments online to informational pamphlets about a specific health condition. Read our guide on plain language to learn more about how you can present information to patients in an easily understandable fashion that sheds light on their health condition. Here are just a few of the benefits of using accessible language with your patients: However, we shouldn’t stop at accessible language. Some groups face unique barriers when it comes to health literacy. For example, researchers at the University of Illinois at Urbana-Champaign have noted that individuals with visual impairments may struggle more in honing their health literacy skills due to the fact that they’re less able to access certain visual cues that can aid them in deciphering relevant medical texts. As such, it’s important to refine this approach by making sure that relevant materials are accessible in alternative formats for people with visual impairments. Here are a few examples of alternative formats that can be used to ensure that people of diverse abilities are able to access your content: Once you’ve written your materials in accessible language, it’s time to work with an alternative format service provider to make sure that your content is accessible for every patient. By providing patients with accessible information in various alternative formats, you can help elevate your patients’ health literacy and improve outcomes for all. As we recognize National Disability Employment Awareness Month this year, we encourage healthcare providers to take the following steps to promote health literacy: At Avantpage, we’re committed to supporting healthcare organizations in their journey toward improved accessibility. We offer a comprehensive range of alternative format services, including audio, braille, and large print, to ensure that healthcare information is accessible to all — if you’re looking to boost health literacy among your patients, contact us today at info@avantpage.com or (530) 750-2040.

In times of emergency, effective communication becomes paramount. Being able to understand and be understood can be a matter of life or death in emergencies. Rush translations — i.e., translations that are produced within a tight deadline, usually within 24 hours of the original request and some regulations requiring translation turnaround in as low as 4 hours — play a critical role in breaking language barriers when communication is especially urgent. These services can ensure that vital information reaches those who need it most. It’s especially common for public health organizations, emergency departments, and public information offices to request rush translations to facilitate urgent communication. For example, local health departments might request rush translations of a document warning members of the community about a disease outbreak, while a hospital emergency room might need to rush translate a patient’s old medical documents from a foreign language to give them adequate care. The urgency of rush translations means that there’s even less room for error when it comes to their production. While some agencies might be tempted to use quick and widely accessible tools like Google Translate to prepare an emergency translation, this is not a responsible approach, as it can create an unreliable translation. Instead, it’s important for agencies involved in providing emergency services to work closely with a trusted language service provider (LSP) that’s able to provide quick translation services on the fly. Emergency organizations can form partnerships with LSPs to contract rush translation services before an emergency strikes, allowing for the delivery of quick translations when they’re needed. In this blog post, we’ll explain why rush translations play such an important role in providing adequate emergency services. Read on to learn about the ins and outs of translation services for emergencies — or jump down to the Summary section for a quick recap.
It can be challenging enough to create and distribute effective communications in one language when you’re handling an emergency. But it’s vital to emergency management that agencies provide equally accessible communications materials to individuals with limited English proficiency (LEP). LSPs can help you tremendously with this, but there are also things that you can do on your end to streamline the process and ensure that your organization’s most urgent and time-sensitive communications are translated effectively. Here are four important factors to consider when preparing multilingual communications in response to an emergency: One common challenge associated with rush translations is the potential risk of reduced quality due to the need for speedy delivery. Emergency communications have to occur rapidly, as they typically deal with time-sensitive content. But just because rush translations are produced according to a faster timeline than your usual translation, doesn’t mean that you can cut any corners. Here are some ways that your organization can ensure high-quality rush translations: They wouldn’t be called “rush” translations if there weren’t a need for speed. Emergency communications and documents are typically quite time-sensitive, so it’s important to request rush translations as soon as possible.  Whether you’re facing federally imposed time constraints or simply have urgent communication needs, try employing the following strategies to help expedite the translation process: The need for fast turnaround and additional requirements can often lead to higher costs for rush translations. And it makes sense — when a rush translation request comes in, LSPs and their translators may have to put other projects on the back burner, or expand the number of linguists on a project, to ensure the timely delivery of your translation. Plus, emergency services may also require additional considerations and add-ons, such as a trauma-informed care qualifications or HIPAA compliance. However, strategic planning can help optimize the use of language services while minimizing expenses: Maintaining confidentiality is crucial for many organizations, and the level of required confidentiality may vary. Each organization and document will have different requirements — an emergency management agency producing public-facing communications will of course have fewer confidentiality restrictions (if any) than a hospital requesting a rush translation of a patient’s medical documents. To ensure that your LSP understands and meets your confidentiality needs, consider doing the following:
In emergencies, effective communication is vital, and rush translations help bridge language barriers, ensuring critical information is conveyed promptly. Here are some important factors that agencies must consider when commissioning rush translation services from LSPs. Managing emergencies is stressful — but the right LSP can ease the burden of producing multilingual communications. AvantPage is proud to provide rush translations to all kinds of emergency management organizations and agencies. Reach out to us today at info@avantpage.com or (530) 750-2040 to learn more about how we can help you manage your multilingual emergency communications effectively.

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 info@avantpage.com 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 info@avantpage.com 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 info@avantpage.com or (530) 750-2040.