The Computerworld Honors Program
Honoring those who use Information Technology to benefit society
LOCATION:
Columbus, OH, US

YEAR:
2007

STATUS:
Laureate

CATEGORY:
Healthcare

NOMINATING COMPANY:
Polycom

ORGANIZATION:
Language Access Network

PROJECT NAME:
LAN

Short Summary
Language Access Network (LAN) believes there is a dire need for interpretation services in the medical setting. According to the 2000 Census, nearly 47 million people in the United States, or 18 percent of the U.S. population, speak a language other than English at home. As of the year 2000, there are an estimated 21,320,407 Limited-English Proficient (LEP) individuals in the U.S. with an average 10 year growth of 1.65 percent

LAN was started based on the parallel belief that efficiency could be improved, and costs could be reduced by providing interpretation services through two-way video conferencing from centralized service centers. LAN installed a dedicated network connection from a medical facility to its video linguistic center. Medical personnel use a wireless and powered mobile cart, equipped with state-of-the-art video conferencing equipment, to connect to an interpreter. This system is called “MARTTI" (TM) (My Accessible Real-Time Trusted Interpreter) and it combines the personalization of having an onsite interpreter with the convenience of being able to have immediate access to more than 150 languages with a simple “push of a button.”

The availability of the MARTTI system in hospitals and other healthcare settings is fundamentally changing the way LEP patients access healthcare. They no longer have to endure long waits for an appropriate interpreter to be found and reach the facility where they are seeking treatment. They don’t have to make decisions based on possibly inaccurate or incomplete information or rely on their children to act as interpreters. Overall, video translation through the MARTTI systems is raising the standard of healthcare for the United States’ LEP population.

Introductory Overview
According to data from the 2002 Commonwealth Fund study, there are more than 21 million limited-English speaking people in the United States and 28,000 deaths per year in this country occur because of medical translation errors. Michael Guirlinger, CEO of Language Access Network (LAN) describes the current state of medical interpretation.

“Right now, when a limited-English speaking patient seeks medical treatment in the United States, there are two options – in-person interpretation or a telephone call with an interpreter,” Guirlinger explains. “With an in-person visit you run into the problem of being able to quickly schedule the right interpreter for the right language, it’s tough to get an interpreter into an emergency room at 3:00 a.m. on a Sunday morning. And while a telephone call with an interpreter is quicker, you lose a lot in terms of visual interaction, a patient can’t point to where it hurts.”

It’s LAN’s mission to change the medical interpretation landscape by using the latest in visual communications technology, and in doing so, reduce the toll medical translation errors take on the nation’s limited-English speaking population.

LAN, headquartered in Columbus, Ohio, offers language interpretation services over its two-way dedicated connection for video to hospitals on a 24x7 basis in more than 150 languages.

LAN has established a robust, secure video conferencing network that it uses to connect with hospitals and health clinics where it has deployed its’ MARTTI(TM) wireless, mobile, video conferencing service that connects hospital personnel in real-time to an on-demand video interpreter. The hospital accesses translation services using the MARTTI solution and is billed per minute of use.

By leveraging the medically-approved wireless system deployed in the hospital, each MARTTI unit can be moved freely to any patient's bedside for an immediate interpretation. The push of a button instantaneously connects medical personnel to a video operator who will direct the video call to the appropriate language interpreter. The signals are carried over a secure fiber-optic network, making the solution HIPAA compliant.

It is, of course, crucial that medical interpreters are highly skilled, and LAN puts its translation personnel through an intensive training program that includes testing through a third party.

“The real benefit we offer to hospitals is cost containment, it’s just not feasible for the hospital to have an interpreter in every language available at a moment’s notice,” says Guirlinger.

Guirlinger reports physician feedback referring to the LAN interpretation service as “revolutionary.” And for patients, gone are the days of sitting in the emergency department waiting room thirty minutes or longer while an interpreter is located. That translates directly into an improvement in the quality of healthcare.

Having instant access to hundreds of languages is particularly important for federally-funded hospitals which must comply with regulations to treat all patients equally. The Americans with Disabilities Act, for example, requires equal treatment in medical situations for the deaf and hard of hearing,

LAN adapted Polycom’s VSX 3000 personal video conferencing system to fit its MARTTI wireless cart and optimized its infrastructure with additional Polycom solutions.

Operators at LAN’s office take requests from hospitals for interpretation and then schedule the video calls through Polycom’s MGC bridge. The company relies on the Polycom PathNaviator advanced gatekeeper to remotely monitor the MARTTI systems deployed at the hospitals and make sure all the sites are running optimally.

“We’re also able to offer a desktop video translation solution called MARTTIpcTM based on Polycom’s PVX personal video conferencing software application for PCs,” says Guirlinger. “PVX provides the ultimate in mobility and is ideal for clinics and physician’s offices that have a significant need for interpretation, but a limited IT infrastructure.”

Benefits
Has your project helped those it was designed to help?   Yes

What new advantage or opportunity does your project provide to people?
LEP patients receive better healthcare thanks to the availability of LAN’s video interpretation services. Patients who don’t speak English no longer have to wait hours in the Emergency Department while a translator who speaks the correct language is found and can travel to their location. LEP patients also no longer have to settle for a telephone translation where critical visual cues are absent.

The hospitals and medical clinics that deploy LAN's MARTTI(TM) systems also reap substantial benefits. It’s simply not feasible to have a live interpreter in every language available at a moment’s notice. Hospitals have saved upwards of 20 percent by outsourcing their interpretation services through LAN. And, it’s not always all the interpretation services LAN provides, many facilities leverage the MARTTI systems for overflows or to offer languages they don’t support with their own interpretation staff.

Liability is always a concern for a hospital, and incorrect medical translation is an invitation for litigation. For example, patients are routinely required to sign ‘informed consent’ documents prior to surgery, but it’s likely that patients with limited English proficiency have trouble understanding what they’re signing. This opens surgery facilities up to potential legal issues.

Has your project fundamentally changed how tasks are performed?   Yes

How do you see your project's innovation benefiting other applications, organizations, or global communities?
Organizations that have purchased LAN’s MARTTI(TM) solution are able to leverage the video conferencing deployment to access continuing medical education remotely for staff training, certification and development. And in the understaffed hospital environment, getting patients assessed and treated in a timely manner is crucial, instantaneous access to 150 languages helps facilitate that process.

The MARTTI solution is also helping LEP patients access accurate and complete drug information in pharmacies. LAN recently launched MARTTI units in two Walgreens pharmacies in central Ohio, and has recently expanded to include CVS and Kroger pharmacies, to provide patient consultations to customers who don’t speak proficient English. The company sees significant growth potential in that market based on the positive reaction to the MARTTI units in use in the pharmacies thus far.

LAN is also looking to expand its video translation services into the judicial system, law enforcement sector, first responders, and Homeland Security as well as the international hospitality and convention industry.

In addition, Federal law requires that all health care providers that receive federal funding provide meaningful access to healthcare services for people with LEP. LAN’s MARTTI systems are helping meet this requirement for healthcare organizations all over the country.

The Importance of Technology
How did the technology you used contribute to this project and why was it important?
Video conferencing technology is core to the LAN MARTTI(TM) offering, both in terms of catching important visual cues from the patient and from a logistics perspective. A patient can’t point to where it hurts over the phone, a woman in labor is going to have a difficult time holding a receiver, as would a physician who is trying to take notes. And for the estimated 360,000 to 517,000 people who communicate using American Sign Language (2000 U.S. census), telephone translation is simply not an option.

Originality
What are the exceptional aspects of your project?
Current practices in healthcare interpretation services are markedly deficient. Typically, hospitals have someone in patient services designated to coordinate a network of interpreters who are on-staff, independent contractors, or a combination. Another common practice is having a member of a patient’s family or a bilingual acquaintance assist in interpretation. However, these methods raise substantial privacy and quality of service issues. Other options include the use of “language lines,” which provide access to interpreters over the telephone, and written materials that translate standard medical forms. However, these methods omit body language, a crucial component in human interaction and communication.

LAN’s services provide advanced technology to help people communicate across linguistic and cultural barriers better than any of the existing alternatives. The solution is our two-way video interpretation. We are assembling a specially-trained, proprietary base of interpreters to perform language services to facilitate the delivery of services between our customers and LEP speakers throughout the world. Most importantly, we provide services at a cost comparable to that charged by the existing telephone-only services. The fees charged provide substantial savings over having on-staff interpreters and contractors who customarily charge a minimum of fee plus travel time.


How is it original?
LAN interpretation is high quality, regulatory compliant and available to the patient much quicker. Our services are high quality because of the rigorous qualifying, testing, training, and continuing education and monitoring of our interpreters as they provide our services. We are regulatory compliant because we deliver all of our services over an MPLS via AT&T; this is a private network for data transmission so we are HIPAA compliant. Services to the patient are much quicker because activating the system requires a one touch method similar to a TV clicker and within 30-120 seconds a live interpreter is greeting the patient/customer, inquiring as to what language is required and then transferring to a live interpreter. In medical institutions that do not utilize our services, the patient may wait as long as 3 hours for an interpreter to be called in, or found on the client’s premises for an interpretation.

Is it the first, the only, the best or the most effective application of its kind?   Most effective

Success
Has your project achieved or exceeded its goals?   Achieved

Is it fully operational?   Yes

How many people benefit from it?   100,000+

If possible, include an example of how the project has benefited a specific individual, enterprise or organization. Please include personal quotes from individuals who have directly benefited from your work.
The true test of any technology implemented in a healthcare setting is provider and patient acceptance, and so far in surveys doctors and patients have reported close to 100-percent satisfaction with the LAN video interpretation service.

Using the MARTTI(TM) systems, LEP patients have been overwhelmed by the fact that they are being treated exactly the same as English-speaking patients. And, after using the MARTTI unit in the emergency room, one deaf patient was so excited she asked where she could buy one.

How quickly has your targeted audience of users embraced your innovation? Or, how rapidly do you predict they will?
Patient and provider acceptance of the MARTTI(TM) systems has been extremely rapid. The fact that it allows physicians to do their jobs more effectively and efficiently and that it simply provides a higher standard of care for LEP populations superseded any doubt or technology phobia encountered. Andrew Panos, president of LAN illustrates this point with a recent example:

“On one occasion, the entire wireless system at Ohio State University Medical Center went down. When we let the nurse, who had contacted us regarding the issue, know that the MARTTI unit would only come back on with site reconnection, she replied that she didn’t care what other communications systems were down, the MARTTI unit was vital to her job. To us, that spoke volumes,” recounts Panos.


Difficulty
What were the most important obstacles that had to be overcome in order for your work to be successful? Technical problems? Resources? Expertise? Organizational problems?
The most important obstacles that had to be overcome in order for LAN’s work to be successful include: (a) qualifying, hiring, and continually educating the team of interpreters, (b) ensuring instantaneous connectivity which we have achieved by partnering with AT&T for a private MPLS network which allows the data transmission to be HIPAA compliant, (c) hiring experts to manage certain areas of our business including a Director of Interpreter Services and a CIO with significant video conferencing experience, and, (d) helping our clients understand how easy it is to use our Martti(TM) system to bring efficiency and effectiveness to a LEP encounter.

Often the most innovative projects encounter the greatest resistance when they are originally proposed. If you had to fight for approval or funding, please provide a summary of the objections you faced and how you overcame them.
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