™www.InDemandInterpreting.com / 1-877-899-3824

Top 5 Considerations When Selecting a VRI Provider for Your Organization

The limited English pro�cient (LEP) population grew

have di�culty hearing and 1 million of those individuals are Deaf

over the past 30 years to over 25 MILLION

of U.S. hospitals frequently encounter

LEP patients

of U.S. hospitals encounter LEP patients DAILY

of U.S. hospitals encounter LEP

patients WEEKLY

of U.S. hospitals encounter LEP

patients MONTHLY

140% growth

1.1 MILLION AMERICANS

80% 43% 20% 17%

> 20% of this population does not speak English at home

According to the Migration Policy Institute, the U.S. continues to attract more immigrants than any other country in the world, bringing

more than 300 indigenous and immigrant languages with them.

LEARN MORE: Changing Demographics in Healthcare

02 Top 5 Considerations When Selecting a VRI Provider for Your Organization

Why is language access critical to effective patient care? Limited English proficient, Deaf and hard of hearing populations are rapidly growing and they are impacting your organizations.

03 Top 5 Considerations When Selecting a VRI Provider for Your Organization

STAY TUNED FOR OUR NEXT EBOOK: Patient Safety and its Impact on Language Access

Communication & Patient Safety Language access barriers and poor patient-provider communication can result in a myriad of healthcare disparities and challenges, including delays to treatment and consent, increased medication errors, readmissions, adverse events, healthcare associated infections and a longer length of stay.

* When individuals were not provided with a qualified interpreter on admission and discharge.

• Pediatric patients whose families did not use

an interpreter were TWICE as likely to incur

serious medical errors as patients who

utilized an interpreter 1

• The average length of stay for LEP patients is

0.75 TO 1.47 DAYS LONGER than

English-speaking patients* 2

• 30-day READMISSION RATES ARE 9.4% HIGHER for LEP patients* 2

• LEP patients had 29% HIGHER INFECTION RATES after cardiac bypass surgery which

were also associated with longer length

of stay* 3

InDemand Interpreting has helped

us to increase our use of interpreters,

which has reduced our overall risk

and improved patient satisfaction.

Video remote interpreting provides

many benefits and is economical.

Using our own telecommunications

network, we know it is secure. At the

click of an icon, clinicians have access

to an interpreter within seconds.

“

“ — ELIZABETH SWAN

RISK MANAGEMENT,

BANNER HEALTH, AZ

Your organization may also be in danger of legal and regulatory consequences from noncompliance

04 Top 5 Considerations When Selecting a VRI Provider for Your Organization

Section 1557 of the Affordable Care Act (ACA) prohibits discrimination

on the basis of race, color, national origin, sex, disability and age by any

health program/activity that receives federal funding and includes health

insurance marketplaces and all plans offered by issuers that participate

in those marketplaces. This includes regulations that interpreters meet

concrete standards and have documented proof of testing that they are

qualified to interpret in a healthcare setting.

TESTING STANDARDS INCLUDE:

• Adherence to ethical principles, including confidentiality

• Proficiency in both English and another spoken language

• Ability to accurately and impartially deploy specialized medical terminology and phrasing as necessary

Providers must use “qualified” medical interpreters when treating LEP,

Deaf and HOH patients. Using untrained interpreters is a violation of HIPAA laws. Having above-average familiarity with speaking or under-

standing a language other than English does not suffice as qualified. Even

more, LEP patients have the right to sue providers for language access

violations. Section 1557 of the ACA increases the risk and liabilities of

non-compliance, and malpractice insurance does not cover a violation of

language access laws.

Your healthcare organization may be considering video remote interpreting (VRI) to increase language access, improve compliance with regulations, enhance the patient experience, improve clinical effi-ciency and/or facilitate better outcomes. To improve communication

between clinicians and their limited English proficient, Deaf and hard of

hearing patients across the continuum of care, healthcare organizations

are partnering with high performing, technology-enabled, Healthcare

interpreting solutions providers. Selecting the right VRI partner can be

daunting because of the many factors that ultimately impact the quality

and reliability of the interpreting service. This eBook will serve as a guide

for exploring excellence in video remote interpreting and important

considerations when selecting a language services partner.

We consider these five elements the most important when selecting aVRI

solution to complement a language services program:

We use InDemand VRI interpreters

every day. It is absolutely filling a

demand for us and has been nothing

but an asset and a resource to our

health system. For Aurora (IL) 25%

of our patients have a Spanish-lan-

guage need, and we are not able to

fill that with our on-site interpreters

alone so we rely on VRI to support

our patients. The VRI technology is

just impressive. InDemand has such

a great product. We went from a

very poor product to this and we’ve

been with InDemand for 2 years and

the feedback from the staff is just

fantastic.

“

“ — ROSALINDA JUSTINIANO

PATIENT ADVOCATE,

LANGUAGE SERVICES COORDINATOR

RUSH-COPLEY MEDICAL CENTER

What is High Performing VRI for Healthcare?

100% HEALTHCARE FOCUS

① Certified Medical interpreters

② Reliable & Appropriate Software & Equipment

③ Service Availability and Ease-of-use

④ Features designed to Support Clinical Workflows

⑤ Client and Technical Support

05 Top 5 Considerations When Selecting a VRI Provider for Your Organization

“

① Certified / Medically Qualified Interpreters

One of the most important considerations when selecting a provider is the quality of the interpreters who support the clinician/patient encounter. Interpreters are the bedrock of a VRI program; all quality

language access programs start with a foundation of excellent

interpreters. To ensure your VRI interpreters are providing the highest

quality service, it’s important to consider several aspects including

their testing, training, compliance with federal and state regulations

regarding qualifications, certifications, professional development and

continuing education opportunities.

Credentialed and/or medically qualified interpreters are central to delivering effective communication.

LEARN MORE: Interpreter Quality Standards & Compliance Measures

06 ETop 5 Considerations When Selecting a VRI Provider for Your Organization

100% HEALTHCARE FOCUSED. It is important that the

interpreters who will be serving your organization are

exclusively healthcare-focused.

EXPERIENCED EMPLOYEES (NOT CONTRACTORS). InDemand interpreters are all employees, not contrac-

tors, who serve patients and providers every day and

have on average 15 years of experience and facilitate

hundreds of medical encounters each month.

CULTURAL AND ETHICS TRAINING. All interpreters

receive training on the cultural nuances and sensitives

for interpreting with many unique cultures in a medical

environment.

CERTIFIED. Interpreters should possess the requisite

medical interpreting qualifications, experience and

training to facilitate the most effective communication

between clinicians and their patients. This means inter-

preters are nationally certified for spoken languages by

either the Certification Commission for Healthcare Inter-

preters (CCHI) or the National Board of Certification for

Medical Interpreters (NBCMI) or on a path to pursuing

certification. American Sign Language (ASL) interpreters

and Certified Deaf Interpreters (CDIs) should be creden-

tialed by the Registry of Interpreters for the Deaf (RID)

and have substantial experience as medical interpreters.

“

① Certified / Medically Qualified Interpreters, continued.

07 Top 5 Considerations When Selecting a VRI Provider for Your Organization

COMPLIANT AND QUALIFIED. InDemand interpreters

meet and exceed HIPPA and federal regulations in

Section 1557 of the Affordable Care Act for “medically

qualified interpreters.” If healthcare organizations

receive Medicare, Medicaid or reimbursement from

federal health programs, they are legally obligated to

provide language access services to LEP, Deaf and hard

of hearing (HOH) patients.

Under the regulations, a “qualified” interpreter is defined as an individual who:

• Adheres to interpreter ethics and client confidenti-ality requirements

• Has demonstrated language proficiency

• Can interpret effectively, accurately and impartially including specialized medical terminology.

THIRD PARTY EVALUATION. Achieving certification

is important, but it’s also critical to conduct internal

testing to evaluate interpreter effectiveness. All

InDemand interpreters take and pass a medically-

focused interpreting assessment in both their target

language as well as English at a suitable level. InDemand

uses ALTA calibrated tests to ensure interpreters are

able to pass the Interagency Language Roundtable (ILR),

a government established language and interpreting

proficiency scale, which are calibrated to the American

Council on the Teaching of Foreign Languages (ACTFL)

proficiency scale.

PERFORMANCE MONITORING. Measuring the quality

of interpreter performance on the job is key to a high

performing VRI program. InDemand has a robust silent

monitoring program to measure performance against a

standardized set of criteria to effectively evaluate inter-

preters. Silent monitoring trainers are qualified, trained,

calibrated and evaluated for their ability to objectively

evaluate interpreter performance. The results are used

to provide feedback for training, interpreter coaching

and professional development goals and a well-docu-

mented action plan for performance improvement if

interpreters do not meet expectations.

PROFESSIONAL DEVELOPMENT. Professional

interpreters seek out opportunities to improve their

skills and maintain certifications. InDemand offers

opportunities to improve knowledge and skillset(s) on

a regular basis that responds to clinician needs and

identified areas of growth from silent monitoring.

It is not industry standard that spoken language interpreters hold a certification from CCHI or NBCMI, however InDemand believes that certification demonstrates training, testing, coaching, support and a commitment to linguistics in both the target language and English as well as professional ethics and standards. An interpreter can be qualified according to the ACA without a certification, however, InDemand takes the extra step to work with interpreters to obtain the fullest certification available in their language. That is one of the many reasons we trust InDemand as our language services partner.

“

“ — MICHELLE ROSSDIRECTOR, PATIENT ACCESS SERVICES

ST LUKE’S HEALTH SYSTEM, IDAHO

② Reliable & Appropriate Software & Equipment

The equipment used to access a VRI service can be critical to the overall delivery of effective communi-cation with LEP, Deaf and HOH patients, as it directly impacts everything from overall communication quality to the patient/provider experience.

VARIETY OF EQUIPMENT OPTIONS. Screen size

and positioning can directly impact the efficacy

of communication when using a video remote

interpreter. InDemand VRI devices are medical-grade

and are specifically designed and assembled to function

in every clinical setting with audio options designed

to cut through noisy surroundings to ensure the best

communication for patients and providers. This includes

a wide variety of equipment options and VRI apps to

support most Windows and iOS devices including:

• Large screens to provide effective visuals for

American Sign Language (ASL) interpreters

• Rolling carts for convenient VRI in tight spaces

• Small handheld devices to support VRI on the go

Reliable and appropriate software and equipment specifically designed to meet the needs of Healthcare

InDemand VRI devices are medical grade and specifically designed to support clinical workflows across the continuum of care.

Be aware that no charge equipment and/or

low cost per minute plans should be carefully

evaluated against more tailored and integrated

options to meet the ultimate goals of a quality

language access program to increase compli-

ance, improve clinical efficiencies and favorably

impact outcomes while controlling cost.

WARNING

07 Top 5 Considerations When Selecting a VRI Provider for Your Organization

② Reliable & Appropriate Software & Equipment, continued.

SEAMLESS INTEROPERABILITY AND CLINICIAN WORKFLOW. In Demand’s agile VRI application seam-

lessly interoperates/integrates with other applications

that involve patient communication, providing reliable,

easy to use custom software application that runs on

most any device (Telehealth, bedside media, iPads). If

VRI is integrated within the existing clinician workflow,

such as video conferencing applications that are already

in use, adoption is a much easier and a more convenient

experience.

HIPPA COMPLIANT. VRI applications and devices are

secure, encrypted and HIPAA compliant and do not

require additional infrastructure.

CONVENIENT FEATURES. Privacy screens and gender

specific interpreters are available with the click of an icon.

RELIABLE AND AVAILABLE. InDemand VRI has an

average uptime of 99.9 over a 24-hour time period.

CONSTANT INNOVATION. InDemand is constantly inno-

vating to improve reliability, efficiency and optimization

of language access programs.

ROBUST ANALYTICS DASHBOARDS AND REPORTING. InDemand provides in-depth,

granular knowledge of how VRI is being used on a

day-to-day basis and insights into larger trends of

usage across an organization, facilities and depart-

ments. Built-in analytics offer insights into program

value, performance, usage and quality language

services data to support informed decisions.

09 Top 5 Considerations When Selecting a VRI Provider for Your Organization

Gender Selection Privacy Screen Chat Feature

③ Service Availability & Ease-of-use

In addition to effective technology to support your organization across the care continuum, it should be easy to access interpreters. This supports early adoption and ongoing use of the language access program. With a “one touch” application, there is an increasing likelihood that clinical staff will readily utilize the VRI service.

• One-touch interface

• Connect to an interpreter in 30 seconds or less

• 94% of customers rate InDemand VRI easy to use, according to the 2018 Net Promoter Survey (NPS)

• On demand anytime, anywhere access (24/7/365) to certified medical interpreters

• InDemand supports 29 VRI languages, including ASL & CDI, and

over 200+ languages over-the-phone

Service reliability and easy access to high quality, certified interpreters are essential to supporting successful communication

Providing our patients with imme-diate access to medically qualified interpreters through VRI and OPI, enables nurses and clinicians to bridge communication gaps, better evaluate a patient’s condition and ultimately, deliver better care.

“ — DAWN ALEXANDER

CHIEF NURSING OFFICER,

NASHVILLE GENERAL HOSPITAL WATCH THE VIDEO: St. Luke’s Mobile Clinic- Breaking Down Communication Barriers

10 Top 5 Considerations When Selecting a VRI Provider for Your Organization

I have been using VRI at our clinic for more than two years now, and I’m really pleased with the accessibility of the solution and that we do not need an appointment to connect with an interpreter. I’m a huge fan of InDemand VRI. I find it very convenient and easy to use.

“ — GLENDA BROWN

SOCIAL WORKER,

NORTHWEST KIDNEY CENTERS, WA

④ Features Designed to Support Clinical Workflows

Considering features of a VRI application that are right for your organization is important to gain adoption/acceptance among your clinical staff. Selecting a VRI solution that offers features and functions that satisfy the needs of your providers and their patients is imperative to ensuring a successful language services implementation. The InDemand solution is app-based, offering broad interoperability across most Windows, IOS and Android devices while also seamlessly integrating into almost any telehealth system. InDemand purpose- built peripherals ensure safety, speed, accuracy and patient privacy.

• Fast and accurate encounter documentation

• ID scan

• Dual handset/headset

• Hands-free setting controls

• Speaker switch

• Chat

• Document upload option

• Advanced reporting and analytics

• 5-star rating system

What VRI features are the most pivotal to support a successful VRI program?

At Banner, we believe in making

healthcare easier so life is better,

which is why we have invested in

the standardization of our language

access program using video remote

interpreting. The InDemand VRI

system creates continuity of care,

increases efficiency, improves patient

and provider communication and

ultimately, outcomes.

“

“ — PAULA HARSIN

CORPORATE LANGUAGE AND CULTURAL

SERVICES SENIOR MANAGER,

BANNER HEALTH

11 Top 5 Considerations When Selecting a VRI Provider for Your Organization

⑤ Client and Technical Support

A complete support structure, including a dedicated client services manager, network assessment engineers and 24/7 technical and help desk support are vital elements of any quality VRI solution. These resources are

proven to directly impact the success of a VRI language

services program. Together this team should partner with

you to design a customized solution and implement a

plan to support adoption, train staff and provide 24-hour

support seven days/week every single day of the year.

Technology-enabled language access solutions require

strategic/implementation support, expertise and

on-demand technical support to ensure service

availability.

Customized solutions are designed to meet your language access needs all throughout your journey:

• Evaluate your current challenge, where language access can provide support

• Develop a customized language access plan for your organization

• Provide support for adoption effectiveness/staff training

• Provide, support, guidance and strategic direction along

the way

Experienced in launching language service solu-

tions across 2,000 care settings nationwide

24/7/365 Help Desk support

Diverse team including clinicians, Language Service Managers & certified interpreters

Client Retention

Average Customer Star Rating for

Services Support

Real-time reporting & analytics to optimize

language access program

How do the client and technical services team support your organization throughout the process?

Our IT Service Desk team is always available to answer your questions 24 hours a day, 7 days a week, 365 days a year.

12 Top 5 Considerations When Selecting a VRI Provider for Your Organization

Understanding our patients and

being able to communicate with

them allows caregivers to provide

the highest quality of care and our

patients the comfort and conve-

nience that help make a medical

experience more positive. VRI allows

us to bridge communication gaps,

better evaluate a patient’s condition,

and ultimately, deliver more compas-

sionate care. We see patients every

day who benefit from our ability to

communicate effectively with them.

VRI allows us to better serve the

needs of a growing, diverse

population.

“

“ — SUNITA MISHRA, MD

MEDICAL DIRECTOR OF INNOVATION,

PROVIDENCE HEALTH + SERVICES, WA

LEARN MORE: InDemand Interpreting Brochure

How We Can Help

InDemand Interpreting provides high performing, technology-enabled Healthcare interpreting solutions that improve communication between clinicians and their limited English proficient, Deaf and hard of hearing patients across the continuum of care.

13 Top 5 Considerations When Selecting a VRI Provider for Your Organization

Since 2007, InDemand has been driven by a mission to ensure

every patient, in any medical setting, should receive the highest

quality healthcare regardless of language, cultural background or

disability. We deliver a comprehensive suite of language access

capabilities and services including a suite of devices and hardware,

experienced medically certified interpreters and consultative

program optimization services. Our services are currently being used in over 2,000 care settings and in 42 states across the country to eliminate communication barriers between clinicians and their LEP, Deaf and HOH patients.

InDemand welcomes the opportunity to share more about how we can support your language access needs. Get in touch today and we’d love to share more.

Please contact us at info@indemandinterpreting.com or call 1-877-899-3824.

™www.InDemandInterpreting.com / 1-877-899-3824

1 “Are language barriers associated with serious medical events in hospitalized pediatric patients?” (Cohen AL, Rivara F, Marcuse EK, McPhillips H, Davis R) https://www.ncbi.nlm.nih.gov/pubmed/16140695

2 “Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates” (Lindholm M, Hargraves JL, Ferguson WJ, Reed G) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445680/ 3 “The relationship between language proficiency and surgical length of stay following cardiac bypass surgery” (Tang WE, Go J, Kwok, A) https://journals.sagepub.com/doi/abs/10.1177/1474515115596645