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Health Care Consumers Go Global with Medical Tourism

This week, a 66-year-old British woman made international headlines for her role as the oldest mother-to-be on record. When her wish for a bundle of joy went unfulfilled in the United Kingdom due to her age, she turned to health care providers in Ukraine, where the message of her desire for a baby was received loud and clear.

Medical tourism is big business in an array of countries:

  • Thailand. As the top destination for medical tourism, Thailand treated 1.2 million patients who traveled from other countries for health care services in 2006.
  • Brazil. This nation has become a hotspot for medical treatment, especially cosmetic surgeries – its market for plastic surgery is one of the largest in the world.
  • Malaysia. Medical tourists seek a wide variety of medical procedures in Malaysia, including cardiac, dental and plastic surgeries. The Association of Private Hospitals in Malaysia reports US$59 million in revenue from foreigners seeking healthcare services in 2006.
  • India. Looking for lower-cost cardiac and orthopedic procedures, half a million foreign patients visited India in 2005 to obtain health care services. The country is predicted to rake in US$2.2 billion in annual revenue from medical tourism by 2012.
  • Panama. Per the National Center for Policy Analysis, costs of surgeries in Panama are 40 to 70 percent lower than in the United States.
  • Poland. The country is one of the world’s most popular destinations for “dental holidays,” especially for patients from the UK, since the cost of dental work there can be as little as 40 percent of the prices in Britain.

More and more nations are getting in on the medical tourism game, competing largely for British pounds and American dollars– these two nations produce the largest numbers of medical-procedure-seeking globetrotters. But what’s all this got to do with language?

Quite a lot, actually. Medical jargon in one’s native tongue can be confusing enough for the average person. Traveling to another country — one where both the culture and local language are unfamiliar — can present communication challenges for many patients. Here are some of the ways in which the booming medical tourism industry may affect the language services market:

  • Language testing. Patients will want assurance that providers can speak with them in their native languages. Facilities that can prove their staff are highly skilled in other languages — for example, holding a “superior” level rating on a language proficiency test — will have an edge over competitors.
  • Interpreting services. Health care staff that do not share a common language with patients may rely on interpreting services — in person, via video, and over the phone. Companies such as CallUma and Language Line already offer telephone interpreting services specifically for consumers. Meanwhile, video interpreting is becoming more common at health care facilities in places like Thailand.
  • Written translations. Patients and clinicians will need translated copies of medical records, results from diagnostic tests, lab results, discharge instructions, and other documents — both for purposes of preventing complications for the overseas procedures, and for relaying this critical information to primary care providers back home.

The only problem? Most language services providers are geared more toward the needs of corporate buyers than to the needs of individuals, so it’s doubtful that they will be clamoring to launch business-to-consumer marketing campaigns anytime soon.

Instead, we predict that savvy medical facilities across the globe will seek to differentiate themselves by boosting the diversity and quality of language services they make available to their prospective patients. After all, the potential for confusion even between monolingual medical terms — such as aphagia/aphasia, pleuritis/pruritus, and vesical/vesicle — is one that poses risk. An investment in language services may just be a welcome antidote.

The Global Watch Tower

Testing for National Medical Interpreter Certification to Enter Pilot Phase

The National Board of Certification for Medical Interpreters will begin the pilot phase of the performance exam that will be part of the testing for National Medical Interpreter Certification. Over the next few weeks, 300 interpreters will “test the test” designed to verify the ability of interpreters to apply their knowledge and skills in real-life medical interpreting scenarios. This process will provide additional input to the assessment tool’s design, allowing test developers to make final adjustments before its national implementation.

The National Board of Certification for Medical Interpreters program, just founded jointly this year by Language Line® University and the International Medical Interpreters Association (IMIA), will consist of a single “certification process” that will award to individuals the credential of “Certified Medical interpreter” (CMI) in a specific language. To qualify for the CMI credential, a medical interpreter will have to successfully pass the prerequisites, the National Board Written Exam, and the National Board Performance Exam.

“This new National Board is committed to bringing to fruition a national certification that recognizes the professional achievements necessary to provide quality language assistance in healthcare settings,” said Louis Provenzano, President and COO of Language Line Services. “Accurately assessing an interpreter’s knowledge and skills is essential and every measure has been taken to ensure that the National Board’s written and performance exams accomplish that goal.”

A call for subject matter experts and pilot participants was shared with attendees at the Third Annual National Medical Interpreter Certification Forum held on May 1, 2009, in Denver, Colorado, where an invitation was also extended to interpreter organizations to participate in the pilot. Medical interpreters interested in volunteering to take the written and performance exams should email info@certifiedmedicalinterpreters.org.

“I would certainly encourage interpreters to become part of this process,” advised Orlin Marquez, President of the Medical Interpreter Network of Georgia. “Certification has been a long time coming. We are thrilled that this effort is finally making significant progress, and we eagerly await a recognized national certification for the valuable services provided by medical interpreters on a daily basis.”

The National Board Written and Performance Exams were developed under the guidance of PSI Services, LLC, an industry-leading provider of professional testing services. Interpreter focus groups, a national job analysis survey, and input from subject matter experts helped define the test content outline in this highly complex statistical and scientific process. Test scoring guidelines were also established. A report on the test development and validation process will be provided following the analysis of the pilot results on the official National Board website at www.certifiedmedicalinterpreters.org.

“This pilot phase is a critical part of the test certification process as it is a key component in ensuring the reliability and validity of the test instruments,” said John Weiner, Chief Science Officer with PSI Services.

The test design team included active medical interpreters who hold medical degrees, professionals with medical interpreter test design experience, specialists with medical interpreter training development background and those with experience in establishing national interpreter standards, medical interpreting trainers, and testers with experience administering medical interpreter testing.

About the National Board of Certification for Medical Interpreters

The National Board of Certification for Medical Interpreters will be a non-profit organization, formed from an independent group of industry professionals that represent all key stakeholder groups including professional medical interpreters, trainers, employers, and regulators. The Board will serve as the certifying entity and will be given independent authority over all essential certification decisions. It will not be responsible for accreditation of educational or training programs or courses of study leading to the certification. The formation and structure of the National Board of Certification will adhere to the standards and requirements for certification program governance mandated by the National Organization for Competency Assurance.

Earth Times

Video Interpreters Save Lives

Dr. Bruce Hensel reported on a potentially lifesaving video interpretation service for patients in hospitals throughout the country.

“I can tell you from experience, when patients don’t speak the same language as the doctor, life threatening problems can occur, even if you have a phone or staff interpreter around. I’ll show you why; this video service is personal, comforting, reduces liability and can be life saving for some patients,” Dr. Hensel said.

It is called “MARTI.” It is not a person..a computer or a video screen. MARTI is, in a sense, hundreds of people; And one of them is about to make a major difference in Maria Bocanegra’s life.

Maria is among millions of Americans who do not speak the same language as their doctors or nurses. In the past, Dr. Michael Chin would have tried to solve that problem with local staff who are not trained interpreters, or a telephone interpreter; But those methods have two potentially dangerous limitations, according to Dr. Michael Chin of Corona Medical Center: “We cannot know if the medical terminology has been translated correctly and we do not know if the patient really understands your translation so they can trust your care.”

MARTI, which stands for “my accessible real time trusted interpreter” uses two way video to solve both problems while adding the human touch.

Ken Rivers, the CEO of Corona Medical Center, says using a professional medical interpreter in this way makes an impact: “It’s a face with a voice, and when you bring that to the patients and the family members and they can see someone talk to them then they can feel that someone is communicating directly.”

Jeff Paugh from the Language Access Network says that 70% of all human communication is non-verbal, “So it is very important that when you talk to a patient you see the frowns, the sadness, the tears, the smiles, the grins, everything else…the arm movements, the hand movements. So, you can interpret what the patient is actually going through and feeling.”

The system’s interpreters are trained in translation and medical terminology and on call 24 hours a day 365 days a year

“We can do up to 150 different languages including American sign language,” Paugh said.

“Using the MARTI is very simple; push one button and MARTI will connect to Columbus, Ohio where the interpretation center is housed,” Dr. Hensel said.

Maria, who has diabetes, came in for hyperbaric treatment of a wound that wouldn’t heal; the blood tests, exam and therapy are complex.

MARTI helped Maria communicate her feelings and understand everything, according to her Brother-in-Law Fred Diaz, “Its just like talking to a person like someone in person. She feel a lot comfortable talking and she knows that that way she can understand what the doctors or nurses are asking her. Patients are starting to feel that way all around the country. Numerous hospitals have portable MARTI’s now: Community medical centers like Corona Regional, and high end tertiary care facilities like Sloan Kettering and universities like Ohio State.

There are MARTI’s in intensive care units, children’s centers, labor and delivery, and in emergency rooms. In places like that; the video interpretation saves more than just time.

“It can be life saving; if we don’t understand what the patient is saying we can’t treat them,” Ohio State nurse Lisa Kozer said.

“MARTI’s creator came up with the idea when he and his brother were in Mexico. His brother got hurt but nearly died because he couldn’t speak Spanish. He was lucky and survived. His creation is now saving countless others. It’s already in numerous hospitals around the country and will soon be in more,” Dr. Hensel said.

NBC Los Angeles

Doctoring in a Foreign Language

Most hospitals offer language interpreters to help doctors communicate with patients. But research shows many doctors don’t use them, an issue explored in the latest Doctor and Patient column by Dr. Pauline Chen. Dr. Chen writes:

Dr. Alicia Fernandez and colleagues at the University of California, San Francisco, and at Yale University examined language barriers between patients and doctors at two teaching hospitals with excellent interpreter services. The investigators interviewed 20 residents, young doctors recently graduated from medical school who make up the clinical frontline at these two urban medical centers.

Continue reading Doctoring in a Foreign Language

May 2012
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