Is Machine Translation Compliant in Healthcare? What Section 1557 Allows—and What Creates Risk
Healthcare organizations need to be quick and efficient in communicating with their patients—after all, patients don’t have a lot of time to wait for critical messages like discharge instructions or dosing guidance.
When dealing with patients who have limited English proficiency (LEP), it may be tempting to use automated Machine Translation (MT) tools to speed up the communications process, but MT alone can be a risky approach. Regulations like Section 1557 of the Affordable Care Act emphasize the importance of review and editing by human medical translators.
Machine translation may be fast and cost-effective, but compliance with regulations like Section 1557 is non-negotiable. In this blog post, we’ll take a closer look at how hospitals and healthcare organizations can strike a balance, using machine translation post-editing (MTPE) services.
Table of Contents
Section 1557 and Language Access
Machine Translation in Healthcare
When Machine Translation is Compliant
When MT Needs Human Review (MTPE)
Best Practices for Healthcare Organizations
Frequently Asked Questions About Machine Translation Compliance in Healthcare
Building Safer, Compliant Translation Workflows in Healthcare
Section 1557 and Language Access
Section 1557 of the Affordable Care Act requires individuals with LEP to have meaningful access to information about their healthcare. While it acknowledges that machine translation can be a useful tool for streamlining communications to patients with LEP, it also warns against using it as the sole means of translation for critical documents—things like discharge papers, insurance coverage information, and consent forms, just to name a few examples.
“If a covered entity uses machine translation for critical documents, those translations must be reviewed by a qualified human translator to ensure accuracy, when accuracy is essential, “when the source documents or materials contain complex, nonliteral or technical language, or when the underlying text is critical to the rights, benefits, or meaningful access of individuals with LEP,” reads a 2024 memo on language access and Section 1557 from the Department of Health and Human Services (HHS).
This is because machine translation isn’t always reliable on its own—there are numerous instances where machine translation tools produce inaccurate or unclear translations of important information. Having qualified human translators review machine translations ensures that these errors don’t slip through the cracks.
HHS does allow for unreviewed healthcare machine translations in emergency situations where a qualified translator is not available and action needs to be taken swiftly: “If an emergency medical technician must provide urgent medical care to an individual with LEP, and no other language assistance services are available, it may be reasonable to use machine translation technology to communicate with that person,” while waiting to find a professional translator or medical interpreter. However, these translations must be reviewed later to ensure accuracy, and any errors should be corrected as needed.
If you’re looking to stay compliant with Section 1557 while ensuring accurate, patient-centered communication, get in touch with Avantpage to learn how our qualified human translators can support your language access needs.
Machine Translation in Healthcare
Machine translation is any sort of software that automatically translates speech or text from one language to another—think of tools like Google Translate or DeepL. Increasingly, generative AI tools like ChatGPT are being used for machine translation as well. However, it’s important to keep in mind that machine translation tools may struggle to accurately translate medical jargon and clinical terminology.
Healthcare organizations can usually get by using unreviewed machine translation for non-critical messages like appointment reminders, patient education handouts, and general clinic info. On the other hand, critical documents like consent forms, discharge instructions, medication guidance need to have a human in the loop.
Whether that means working with human translators to translate them from scratch or having human reviewers edit machine translation output after the fact, there should always be a human professional involved in translating these documents. In the following sections, we’ll go over some examples of when machine translation can be used on its own, and when a human needs to be involved.
When Machine Translation is Compliant
While you should always strive for 100% accuracy in your communications to patients, there are some non-critical documents where machine translation is unlikely to produce significant errors. In these cases, machine translation alone can be compliant. Below are some guidances for specific examples where unreviewed machine translation meets healthcare compliance standards:
| Example | Guidance |
|---|---|
| Appointment reminder email or text | MT alone is generally acceptable for simple reminders as these are non-critical and generally present low risk for errors. |
| Patient education handout (general wellness tips) | As long as the content is not technical and does not impact care, MT is acceptable on its own. |
| Clinic or hospital website FAQ (general info) | MT is suitable for general information, but sensitive or legal info requires review. |
| Urgent notifications in emergencies (e.g., clinic closure due to weather) | Exigent circumstances allow MT use if immediate communication is necessary; MTPE should follow when possible. |
| Internal staff communications | Non-patient-facing communications are considered low risk and MT alone may be used. |
| Patient surveys or feedback forms | Non-critical; MT alone can be used as long as the language is simple and straightforward. |
When MT Needs Human Review (MTPE)
As the American Translators Association notes, translations must be reviewed by a human when accuracy is essential to access. That means that when documents have an impact on a patient’s care or feature significant amounts of technical jargon, accuracy is key—here are a few examples of instances where machine translation post-editing is necessary in healthcare settings:
| Example | Guidance |
|---|---|
| Discharge instructions | Critical to patient safety; requires human review (MTPE) for accuracy and clarity. |
| Consent forms (treatment, research, procedures) | Features critical legal information about patients’ rights; MT alone is insufficient. MTPE is a must. |
| Medication instructions or dosage guides | High-risk content that can have a negative impact on patient care if errors are present; must be reviewed by qualified human translators. |
| Insurance coverage or benefits explanation | Impacts patient rights; MTPE ensures meaningful access to information under Section 1557. |
| Legal notices, HIPAA updates, or policy changes | Directly affects compliance and rights; MTPE is required. |
Compliance Risks
Using machine translation improperly can introduce serious risks for healthcare organizations. Accuracy limitations are the most immediate concern: Even small translation errors in discharge instructions, medication dosing, or follow-up care can lead to clinical mistakes, adverse events, or hospital readmissions. Just as concerning are privacy risks—many free machine translation tools are not HIPAA-compliant, meaning protected health information could be stored, reused, or exposed without safeguards.
Additionally, if machine translation errors prevent patients with LEP from fully understanding their care, benefits, or legal rights, organizations may fail to provide the “meaningful access” required under Section 1557. In real-world scenarios, incorrectly translated discharge instructions have led to patients misunderstanding treatment plans or medication schedules—outcomes that are both dangerous for patients and legally risky for providers.
If you’re not sure when machine translation alone is sufficient, a language service provider can help. Contact Avantpage today to devise a language access plan that uses machine translation effectively and safely.
Best Practices for Healthcare Organizations
At Avantpage, we work with hundreds of healthcare organizations to safely implement machine translation into their workflow, speeding up the translation process without compromising accuracy. Over the years, we’ve developed the following best practices for healthcare machine translation:
- Implement MTPE workflows consistently.
- Audit and document language access processes.
- Choose qualified MTPE providers with healthcare experience, like Avantpage.
- Develop internal policies on when MT can be used versus when MTPE is required, and train your staff on these policies.
Ultimately, integrating MTPE into your translation workflow is a matter of reducing risk—for both you and your patients—while maintaining efficiency and accessibility.
Don’t Risk Errors in Critical Healthcare Translations
When accuracy impacts patient safety and compliance, machine translation alone isn’t enough. Partner with Avantpage to implement secure, human-reviewed MTPE workflows you can trust.
Frequently Asked Questions About Machine Translation Compliance in Healthcare
How do we implement a safe MTPE workflow in our healthcare organization?
A compliant MTPE workflow typically involves generating a machine translation draft followed by a review from a qualified human linguist experienced in healthcare terminology. This ensures accuracy, cultural appropriateness, and legal compliance. Avantpage provides end-to-end MTPE solutions, including workflow design, documentation, and auditing support to keep your organization both efficient and compliant.
Are there privacy or HIPAA concerns with using off-the-shelf machine translation tools?
Yes. Consumer-grade tools often do not meet HIPAA standards, which can expose patient data to privacy risks. Avantpage uses our secure, HIPAA-compliant translation platform and proven processes to protect sensitive patient information while maintaining high-quality translations.
How do we know when MT is sufficient versus when human review is required?
The deciding factor is impact on patient care, rights, or compliance obligations. Avantpage provides expert consultation to classify your documents, recommend MT vs. MTPE use, and implement robust processes so you can confidently balance efficiency with legal and patient safety requirements.
How does Section 1557 define “meaningful access,” and how does it affect machine translation use?
Section 1557 requires that patients with LEP can understand information affecting their care, rights, or benefits. Raw MT alone often cannot meet this standard for critical content due to accuracy limitations and a lack of cultural nuance. Avantpage’s MTPE solutions ensure that translations are both linguistically precise and compliant with meaningful access requirements.
How should healthcare organizations document their MT and MTPE processes for auditing purposes?
Organizations should maintain records of which materials were machine translated, which underwent post-editing, and who reviewed them. Documenting workflows, vendor qualifications, and review steps demonstrates due diligence in audits. Avantpage provides guidance and templates for proper documentation to satisfy Section 1557 and internal compliance requirements.
Are there specific standards or guidelines for MTPE in healthcare?
While MTPE isn’t mandated explicitly in regulations, industry guidance from HHS and the American Translators Association emphasizes that critical patient content must be reviewed by qualified humans. Avantpage applies these industry standards to ensure that every translation meets both legal and clinical expectations.
How can we balance efficiency with compliance when using MT for patient communications?
The key is a tiered approach: use MT alone for low-risk communications (appointment reminders, general info) and MTPE for critical content affecting patient care or legal rights. Avantpage assists healthcare organizations in designing these workflows, training staff, and selecting secure, compliant MT tools—so efficiency doesn’t compromise patient safety or legal obligations.
Building Safer, Compliant Translation Workflows in Healthcare
Machine translation can be a powerful tool for improving efficiency and expanding language access—but it rarely stands alone. For communications that affect patient safety, rights, or clinical outcomes, qualified human review is essential to meet Section 1557 requirements and ensure meaningful access for patients with LEP.
Healthcare organizations that proactively evaluate their translation workflows—or partner with experienced healthcare-focused language service providers like Avantpage—can move faster without compromising compliance or patient care. Contact us today at (530) 750-2040 or [email protected] to learn more about how we can help you strike the right balance for all your healthcare machine translation needs.