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At Avantpage, we partner with health organizations around the country to improve patient care and health outcomes through translation and language access. Our national, state, and community health plans rely on us for data security. Keeping them in compliance and protecting personal health information (PHI) is our priority. That’s why, in 2019, our Systems Team developed a custom data anonymization tool that we call AvantShield. Using AvantShield protects member PHI during translation and allows organizations to safely reap the numerous benefits of translation memory (TM). Using a TM for your translation work means that Avantpage saves every segment of approved translation delivered to your team. Next time you request a project, the file is run through our TM system and any repeated or similar text is instantly identified. Reusing previously-translated segments saves time, increases consistency, and reduces cost. What is Translation Memory?  In accordance with HIPAA regulations, Avantpage does not store PHI in our systems. But the kinds of files that typically contain PHI, such as member letters, are highly repetitive. This makes them great candidates for leveraging a TM. To exclude these files from a translation memory database would be a lost opportunity for process and cost optimization. This is where AvantShield comes in. AvantShield identifies the PHI contained within a file before it goes to our translation teams. Identified text is replaced by a tag that shows linguists the type of data that has been hidden. For example, a medical record number is replaced by @MRN@, the name of the member by @patient_name@, and so on. This greatly aids a translator by ensuring context is not lost during the masking phase. Once the macro has completed its task, the file is sent to translators through AvantFlow. After translated segments are approved by our editors and proofreaders, the text is exported to its original format (Word, Excel, etc.) for delivery to the client. During this final stage, the previously-masked PHI is restored by AvantShield so that the translated document contains the information needed for member communication.  While this is similar to the process above, PHI destruction happens after projects are closed and submitted to the client. This is the point at which translations are saved in the translation memory. Before being saved for reuse, AvantShield is applied to identify PHI, this time for permanent removal. To preserve context for future reference, tags are used in the same way as above. The personal data removed during this stage cannot be restored and the translation memory is considered “clean” and ready for use. If you are working with multiple translation vendors, chances are they each have a translation memory. In order to maximize the use of these tools, it is recommended to consolidate the translation memories at regular intervals. Avantpage provides this monthly service to our national health plans, and data anonymization is an important part of the process. During the consolidation, AvantShield verifies that no PHI remains in any of the vendors’ databases. A clean, secure TM is returned to all vendors for use in the coming month. The primary reason to use AvantShield is to protect PHI. Our linguists are able to perform in-context, culturally-appropriate translations without ever viewing personal data. Before we created AvantShield, some of our clients chose to manually remove PHI from files before sharing with us. This is time-consuming, error-prone, and unnecessary. AvantShield helps you stay HIPAA compliant without losing time on manual tasks. With a clean translation memory, you continue to increase consistency, shorten delivery cycles, and save money, safe in the knowledge that your member data is 100% secure.

Why law firms should consider offering over-the-phone interpreting (OPI) and video remote interpreting (VRI). While English is often the language of choice in business affairs across the globe, it is not always the case for legal proceedings. According to the most recent survey, 25 million U.S residents are considered limited English proficient (LEP) speakers. For these individuals, language access is a civil right in and outside of courts. As Vanita Gupta, Principal Deputy Assistant Attorney General expressed: “Barriers to language access can interfere with the capacity of state courts to accurately evaluate the facts and fairly administer justice. And they can also place unfair and unconstitutional burdens on individuals. Without language services such as over-the-phone interpreting (OPI) and video remote interpreting (VRI), all involved participants can’t fully take part in the proceedings. But before heading to courts, law firms must overcome their own language barriers in order to accurately represent their clients. When do law firms require the assistance of interpreters?
What to look for in a language service provider? You need to use subject matter experts as interpreters. Your legal interpreting needs must be handled by qualified and certified interpreters who have experience in the legal industry.  With over 25 years of providing language services, Avantpage offers round-the-clock, over-the-phone interpreting (OPI) and video remote interpreting (VRI). With fast connection times, and over 250 languages, our interpreters meet the following requirements: We can help you with your next legal interpreting needs. Contact us at 530-750-2040, [email protected], or request a free quote to get started today.

Today, April 15th we observe the National ASL Day which is a great opportunity to celebrate and learn more about American Sign Language.  On this day in 1817, the American School for the Deaf (ASD) opened in Hartford, Connecticut. There, teachers and students worked together and, by intermingling Native American Signs, French Sign Language, and even Martha’s Vineyard Sign Language, American Sign Language (ASL) was born.  With time, more schools for the deaf were founded and ASL spread not only to those schools but to the world. ASL is used in the majority of Canada, all throughout the American continent, and has even expanded to Central Africa, West Africa, and Southeast Asia. 
Have more ideas? Share them with your network and local organizations with the hashtag #ASLday. 

Sources: 
Day of the Year: ASL Day 
Wikipedia: American Sign Language 
National ASL Day Official Website 

At Avantpage our experienced team can help guide you through the translation process and make it fast and easy. To find out more about our services call us at 530-750-2040 x11, or request a free quote.
From the desk of María Fernanda Aguilera Villegas, Project Manager at Avantpage. 

According to the Centers for Disease Control and Prevention (CDC), 61 million adults in the USA live with a disability. This means that 26% of the society, 1 in 4 people, has some type of disability in areas such as mobility, cognition, independent living, deafness, vision, or self-care. Therefore, assuring that the content is accessible for these communities is not only a good practice, but it helps provide equal opportunities for all. Opportunity and empathy, the core values of Avantpage, drive us to make our contribution to the accessibility area and raise the awareness of the language access-related needs of this large community. Only in the past few years, we’ve led hundreds of projects that served language minorities with disabilities in the areas of healthcare, social & governmental services. By now, over 30% of our translation projects that were compliant with the Americans with Disabilities Act (ADA) were directed to Spanish-speaking communities, 20% to Russian speakers, and 20% to the Vietnamese community. We have also supported our clients with translation and accessibility requests into languages of lesser diffusion, such as Marshallese and Samoan, and it makes us proud to be able to deliver our services to even the smallest communities in the US. At Avantpage, we make a difference by assisting our clients in the accessibility needs of their target audiences. Our team takes part in specialized training and conferences related to accessibility topics in order to keep improving our processes and deepen our expertise in this subject. A big shoutout to our entire Avantpage team, especially to our Project Managers and Coordinators, for their hard work and for their commitment to our values: rigor, empathy, and opportunity, put into practice by assisting those in need. For more information on how accessibility impacts all of us, please refer to the Centers for Disease Control and Prevention website. From the desk of Joanna Olton-Galindo, Quality Process Coordinator at Avantpage. 

When we hear the word “accessibility”, especially within the localization industry, we tend to focus on accessible documents and web content. However, the Americans with Disabilities Act (ADA) covers more than websites and written publications. Here is a breakdown of the scope of the ADA regulation: First of all – what is considered a disability? The ADA defines the term “disability” as a physical or mental impairment that substantially limits one or more major life activities for an individual. The condition can be mild or severe, temporary or permanent. Under this definition, some examples of disabilities included in the ADA are deafness, blindness, intellectual disability, mobility impairment, ADHD, HIV, bipolar disorder, cancer, depressive disorder, schizophrenia, among other conditions. The ADA does not cover conditions that result in illegal activity or are considered anti-social, such as pedophilia, kleptomania, or exhibitionism. Gender identity and sexual orientation are no longer considered disorders and are therefore excluded from ADA protection. Now, the ADA covers persons with disabilities against discrimination through its five sections: This section of the law protects individuals with disabilities against discrimination in the workplace. The title guarantees equal employment opportunities and benefits for people with disabilities, under any employer with 15+ employees. This includes private entities, State and local governments, employment agencies, and labor unions. Title I is regulated and enforced by the U.S. Equal Employment Opportunity Commission. The second title prohibits discrimination based on disability by all public entities. This includes all programs and services offered by state and local governments, as well as public transportation and housing.
Title II is enforced by the U.S. Department of Justice, the U.S. Department of Transportation, and the Office of Fair Housing and Equal Opportunity. This section covers against discrimination in places of public accommodation, which include privately owned, leased, or operated facilities like hotels, restaurants, retail shops, doctor’s offices, private schools, movie theaters, and similar services. It also sets standards for accessibility when building commercial or privately owned facilities, and for businesses to communicate effectively with customers with disabilities.
Title III is enforced by the U.S. Department of Justice. The fourth title requires telephone and Internet companies to provide telecommunication systems that allow individuals with hearing or speech disabilities to communicate over the phone. This title led to the installation of public teletypewriter machines (TTY), as well as other Telecommunications Devices for the Deaf (TDD).
Title IV is regulated by the Federal Communication Commission. Finally, Title V contains a variety of provisions that relate to the ADA as a whole, like its relationship to other laws, a list of conditions that are not considered disabilities, among other factors. So now you know a little bit more of how the law can help us create a more accessible environment across all entities. You encounter and use ADA-compliant services, transport, files, websites, and many other resources every day: whether you benefit from accessibility directly or not, remember that it makes our society more democratic and inclusive for all of its members. Sources:
An Overview of the Americans With Disabilities Act | ADA National Network (adata.org) 
Americans with Disabilities Act of 1990, AS AMENDED with ADA Amendments Act of 2008 From the desk of: Mariana Salamanca Vázquez, Project Manager at Avantpage. 

Wearable technology is transforming the healthcare landscape. From fitness trackers to blood sugar monitors, wearables empower individuals to take more control over their health. Yet wearable data is equally valuable for healthcare providers and health insurers. They can use it to provide personalized recommendations and develop resources that target specific demographics—including limited English proficiency (LEP) speakers. Given that many commercial wearables allow users to choose their preferred language, they can be particularly useful for LEP speakers. They provide recommendations that a user may not receive otherwise, and the language data they generate can help improve health outcomes. That’s because wearable data can inform decisions on interpreting, website localization, and other healthcare translation needs. But before we dive into how wearable data can improve LEP patient care specifically, let’s take a look at the benefits for both healthcare providers and health insurers. Wearables offer a window into a patient’s behavior and lifestyle. More reliable than self-reporting for metrics such as daily activity, these devices help doctors develop personalized treatment plans. Yet wearable data not only improves individual patient care. Hospitals that use remote patient monitoring—including wearables—saw improvements across metrics such as hospital admission, readmission, patient satisfaction, operating costs, and more. Rising health insurance premiums pose a major barrier for U.S. residents who need access to healthcare. However, wearables can help reduce premiums by incentivizing members to improve their lifestyle. For example, Humana developed a platform that allows members to connect their wearables with the Go365® app, the company’s wellness and rewards program.  LEP patients typically experience poorer health outcomes due, in part, to a lack of language support. Language preference data can help healthcare organizations determine which languages have the highest demand and how much they need to budget for interpreting and translation services. LEP speakers may need access to a remote interpreter to: In order to access patient portals, member portals, and other online resources, they may need to have the website translated into their preferred language. This is also true for office signage, patient forms, information about treatment options, and other print materials. However, the benefits of collecting language data go beyond assisting individual patients. It can also help organizations develop multilingual patient education. By combining language data with health trends across racial and ethnic groups, organizations can create public health campaigns and other types of outreach in multiple languages. With the purpose of improving outcomes for LEP patients, organizations must take information such as race, ethnicity, health trends, and language preferences into consideration. Using this data to provide multicultural and multilingual patient experiences is an essential part of providing more effective healthcare.  If you need assistance with translation, website localization and/or interpreting, we recommend working with a language service provider (LSP) that specializes in healthcare. At Avantpage, we’ve worked with hospitals and clinics, health insurers, and other health organizations to provide the language support LEP speakers need. By analyzing data, we can make recommendations on language choices, content development, and more.  Ready to discuss your multilingual project? Contact us today to get started.

With the COVID-19 vaccine rollout underway, the end of the pandemic may soon be in sight. Yet healthcare professionals still face the daunting task of vaccinating millions of residents in the coming months. Vaccine distribution, misinformation, and a lack of language support for limited English proficient (LEP) populations all pose major challenges to their success.   Fortunately, with the proper planning, healthcare organizations can better serve LEP members using a combination of multilingual outreach and language services. In this article, we’ll offer guidance on the ways in which you can improve vaccination rates and member care in these communities.   Given the diversity within the LEP population, a one-size-fits-all approach is probably not your best bet. Views on vaccines, healthcare, and the medical establishment vary among cultures. For example, a Langer Research study found that only 34% of Latinos trust that the vaccine is safe—despite being a high-risk group.  Before you launch a campaign that targets a specific community, you need to develop messaging that will resonate with them. That may mean addressing fears about safety, misinformation about side effects, and other misconceptions about healthcare in general.   Next, you need to decide which materials need to be translated. We recommend translating digital outreach such as:   We also recommend translating any direct mail or member information you plan to send. Mailers not only give recipients something tangible, but they’re also more accessible. Not everyone uses social media or has internet access.   Outreach in multiple languages is a great first step, but LEP speakers also need language support before, during, and sometimes after a vaccine appointment. Yet a study conducted at Seattle Children’s Hospital found that only 45.4% of families who preferred a non-English language used an interpreter during a visit. And interpretation services were even less common during busier times of the day. This underutilization often leaves members struggling to communicate with providers and unable to understand procedures, recommendations, and treatment options.   Due to the risks of COVID-19, bringing a medical interpreter onsite may not be a viable option. However, over-the-phone interpreting (OPI) and video remote interpreting (VRI) make it easy to connect with one remotely. The method you choose will depend on the circumstances.   OPI works well when members:   VRI works well during:   Translated member information leaflets from the pharmaceutical company, fact sheets, and other member-facing materials are also useful. These help members understand what to expect and provide guidance on which side effects may require follow up care.     As you can see, removing language barriers requires a combination of culturally-appropriate translation and interpreting services. That’s why you need a language services company that knows how to serve LEP communities. At Avantpage, we work with healthcare providers, government organizations, life sciences companies, and health insurance carriers to provide LEP speakers with the language support they need.    Ready to start your next translation project? Contact us today to find out how we can help!

From researching doctors and hospitals to booking appointments, more people than ever are starting their healthcare journey online. The need for digital resources doesn’t stop there, either. Existing patients benefit from provider websites with patient portals, which offer access to health records, test results, and more. Yet language barriers make it difficult for patients with limited English proficiency (LEP) to access these resources. However, healthcare organizations can ensure multilingual patients receive the support they need through a combination of website localization, translation, remote and interpreting. Given their diverse backgrounds, LEP speakers have differing views about healthcare. Simply translating web content into another language may fail to take this into account. That’s why we recommend a process known as website localization, which involves adapting cultural elements in addition to translation. Localization may include: A linguistically and culturally-relevant website not only gives LEP speakers access to online resources, but can also help build trust between patients and their providers. While translation is an essential part of website localization, other patient materials—both online and off—may need to be translated as well. Office signs, patient forms, and treatment instructions are just a few materials you may want to provide in multiple languages. This makes it easier for LEP patients to navigate the healthcare system and participate in their own care. Although the accuracy of machine translation has improved in recent years, human translators are still better at providing accurate, culturally-relevant translations that meet regulations. A language service provider (LSP) that specializes in healthcare can ensure that all of your translations meet those requirements. LEP patients often experience poorer health outcomes due, in part, to poor patient-provider communication. Language barriers make it difficult for patients to express their needs and understand treatment recommendations. While bilingual staff and onsite medical interpreters typically bridge this gap, they may not always be available. Fortunately, remote interpreting options make it possible to connect with a medical interpreter at any time. There are two types of remote interpreting: video remote interpreting (VRI) and over-the-phone interpreting (OPI). Each has its benefits. VRI works well for: OPI works well for: Most LSPs offer remote interpreting services and can even advise you on which method will best meet your needs. As you can see, website localization, translation, and interpreting work together to provide LEP patients with the resources and support they need. While this process may sound complex, an LSP that specializes in healthcare can help you develop experiences that let patients move seamlessly through the healthcare journey. By partnering with Avantpage, you’ll benefit from our expertise in healthcare—as well as our localization, translation, and interpreting services. We specialize in working with organizations that serve LEP communities, and know how to help you address their unique needs. Ready to discuss your multilingual project? Contact us today. Want to learn more about how localization, translation, and remote interpreting can improve multicultural patient care? Download our white paper Digital-First Multicultural Healthcare: Improving Language Access Through Localization, Translation, and Interpreting.

Machine translation offers a fast, affordable way to translate web content. In fact, Google Translate provides instantaneous translations in over 100 languages—for free. Yet before you copy and paste your medical content, we recommend weighing the pros and cons of forgoing the services of a professional translator. In this article, we’ll explore the differences between the two methods, and help you decide which is right for your project. Machine translation, not to be confused with Computer-assisted translation (CAT), is a method of automated translation. Artificial intelligence software that has been trained to understand natural languages can translate one language into another. It’s faster, more affordable, and easier to scale than human translation. Yet it still has a lower rate of accuracy and lacks one essential skill: the ability to determine context. Machine Translation works best for projects that: Human medical translators, on the other hand, have an in-depth knowledge of the nuances and cultural differences between the languages they translate. However, human translation is costlier and takes longer. Although translators use CAT tools to help them work faster, they can’t compete with machines in that arena. Given that they require a higher degree of accuracy, human translation is typically best. While machine translation can produce grammatically correct content, it can’t take into account how a reader will interpret it. Here’s an example. A Google generated Spanish translation of the Virginia Department of Health’s website told visitors that the Coronavirus vaccine “no es necesario”, or is not necessary. The health department wanted to make it clear that the vaccine isn’t mandatory. Yet visitors could misinterpret it to mean that Latinos don’t need the vaccine, despite being part of a high-risk group. Whether you have a need for scalability or lack the budget, machine translation combined with human post-editing can serve as an alternative to human translation. Some languages services companies provide post-editing services that will ensure your translation is linguistically accurate and culturally appropriate. Internal bilingual staff can also perform the task. Here’s how:

Working with uncommon languages can present various challenges. Here are our tips for success in your rare language translation project:  Some languages have dialect variations among regions or communities, there can be different names for the same language, and there can be different languages with the same name. Some languages also use various writing systems or have no official standards for their written version.  Therefore, confirm that you have selected the accurate language. The Avantpage team can help you if you are unsure. Remember, the target community for rare languages tends to be small, and confusion could lead to choosing an incorrect language.   For example:   Once you have the accurate language, find out everything you can about it.   Make sure you know what the language looks like (using Google or Omniglot), if it runs right-to-left, if the characters require a particular font, and any other relevant characteristics of the target community. With this information, you can categorize your language:   Before we proceed with the project, our project manager (PM) will work on confirming linguists’ availability and giving you the best possible turn-around-time (TAT) Note that resources for rare languages are sometimes limited, and linguists might not work with our usual computer assisted translation (CAT) tools. This might mean that some additional time may be required for the translation to be ready. If no resources are available, our PM will unfortunately have to decline the project. Projects with rare languages will likely need more supervision from our PM. Here is a sneak peek at what’s going on from the Avantpage side: 

As we keep on working from home and searching for new sources of inspiration, we at Avantpage have continued our Book Club initiative. Our second pick was Don’t Sleep, There Are Snakes: Life and Language in the Amazonian Jungle, by linguist and former missionary Daniel Everett. In the book, Everett recounts his astonishing experiences with the Pirahã people, an indigenous Amazonian tribe in Brazil whom he lived with in the 70s. Everett arrived on the banks of the Maici River in 1977, accompanied by his wife and their three small children. This American, Christian family ended up living among the Pirahãs intermittently for seven years, over a period of three decades. Their mission was funded by the Summer Institute of Linguistics, a Christian nonprofit whose evangelizing method is to translate the Bible into the target community’s language. In order to translate the Bible, Everett had the near-impossible quest to learn Pirahã in order to understand their grammar. During this mission, Everett ended up questioning his own culture, customs, values, and faith, besides discovering some fascinating characteristics of this rare and puzzling language. Everett grasps the readers’ attention from the start with some nerve-wracking anecdotes that include a life-or-death encounter with an anaconda, malaria that almost killed his wife and daughter, and several risky misunderstandings with the Pirahãs themselves. He also notes that, as a linguist, his initial discoveries baffled him: Pirahã language seemed to have no words for colors, no numbers, quantifiers or counting in any form, no past tenses, no comparatives, no recursion... Besides, Pirahã has one of the smallest sets of speech sounds or phonemes in the world: three vowels and just eight consonants for men (seven for women). (If you’re interested in listening to how this language sounds, check out this intriguing recording). After much research, Everett comes to question Noam Chomsky’s broadly accepted theories about grammar through bold claims in the field of linguistics, all based in the Pirahã tongue. Apart from their language, the Pirahãs also have ways of thinking, planning, and acting that seem far from Everett’s strict Christian, Western ways. As the author reflects, “language is the product of synergism between values of a society, communication theory, biology, physiology, physics (of the inherent limitations of our brains as well as our phonetics), and human thought”. This view of language is shown in the book through the links that Everett finds between Pirahã language and culture. This linguist dedicated several years of his life to understanding the Pirahã people, and his accounts make a fascinating read. During our book club meetings, we agreed that perhaps Everett’s writing isn’t the best, but his stories are so captivating that they make the book highly enjoyable. It’s also worth mentioning that this book has produced some controversy, especially among academics, due to its linguistic claims. Still, Everett’s unique anecdotes and theories make his claims worth exploring further. And even if you’re not a linguist, why not travel to the Amazon and find out how the Pirahãs experience the world?

The fact that translation accompanies us in each aspect of our everyday life is undeniable. Very often, we do not even pay attention to its existence. However, there is a specific field of interpreting which has flourished with the technological expansion over the years: Audiovisual Translation (AVT). It is all about making the cinematic experience accessible and entertaining. It is said that the cinema was born with the first movie of the Lumière brothers at the end of the 19th century. At the time, it was impossible to record sound, therefore, the creators were using boards to provide the background for the onscreen action. In a sense, those were the first subtitles available to the movie connoisseurs. In the 1930s, when the cinematic expansion sailed overseas, Paramount Pictures decided to take movie translation to the next level. They opened a studio near Paris and recreated the stage designs of American blockbusters. The screenplays were translated into numerous European languages, and the actors from each country were hired to shoot the movies. Unfortunately, as the idea was too expensive and the European audience was not interested in the American format, Paramount focused on producing movies back in the United States. Thankfully, over the years, many types of communication channels were developed which gave us the opportunity to enjoy audiovisual masterpieces from all over the world. The most popular forms of AVT are subtitles, dubbing, and voiceover (extremely popular in Eastern Europe). However, we need to look beyond meaning. It is important to understand that Audiovisual Translation allowed people with disabilities to receive a movie without any content loss with the advance of audio-description and subtitles for Deaf and Hard of Hearing communities. In the process of Audiovisual Translation, interpreters face numerous difficulties. There is the issue of cultural background which strongly influences translation. Localization is one of the hardest challenges, but if we look at it from another perspective, it gives the linguist the opportunity to let imagination run wild and be creative. AVT does not need to be precise. If the main idea and the mood of the conversation are captured, translation may be considered as a successful one. But after all, it is always up to the audience to determine that, isn't it?