Due to immigration, the population of the United States increasingly grows diverse. Based on census data, the Center for Immigration Studies released a report in 2016. The following were the highlights:

• About 64.7 million residents in the U.S., native-born and foreign-born, spoke another language at home
• Highest percentage increases in speakers of other languages from 2010 to 2015 were in Persian, Gujarati, French Creole, Chinese, Urdu, Hindi and Arabic.
• In terms of numerical increases during the same period, the largest were among Urdu, French Creole, Filipino (Tagalog), Hindi, Arabic, Chinese and Spanish.
• Languages with over one million speakers were Korean, Arabic, French, Vietnamese, Filipino, Chinese and Spanish.
• Surprisingly, most of the non-English speakers at home were already born in the U.S. instead of immigrants.

What do these facts indicate?

This means that both translation services and interpreting services will have an increase in demand, especially in the healthcare industry. Recently, the Section 1557 of the Affordable Care Act was finalized, which requires all healthcare related services providers to provide interpreters when treating patients with limited English proficiency.

The need for language services is not concentrated in the healthcare industry. Businesses have to effectively communicate with their employees and clients who do not speak English or those with limited proficiency in the English language. In many instances, oral communication is needed.

Interpreting

Several types of interpreting are available, including over-the-phone interpreting and onsite interpreting. The healthcare industry is one of the many industries that commonly use these two interpreting methods. Other industries that conduct businesses with foreign markets often use them as well.

1. Over-the-phone interpreting

Over-the-phone interpreting (OPI) normally requires a three-way call between the interpreter and two other parties, each one speaking a different language. The role of the interpreter is to facilitate their conversation.

Typically, this is an on-demand service that operates the entire day, every day of the week. The service supports several languages. The service does not often involve prior scheduling. The call center for an OPI service has a unique access code to prevent unauthorized charges. The caller chooses the languages that are to be used during the conversation, and speaks to the interpreter in his or her preferred language while the interpreter lets that other party know what is being said in his or her own language. The call is timed for proper billing.

2. Onsite interpreting

When an onsite interpreting is conducted, the interpreter is in the same place as the two people who must properly communicate. This type of interpreting is more mobile and can be utilized for special events such as foreign tour groups or business delegations, lectures and conferences. The interpretation could be for a longer period, and require more than one interpreter and the use of more sophisticated listening and transmitting devices.

Onsite interpreting is very useful in legal and healthcare settings.

Advantages and disadvantages

While each type of interpreting is useful, each one has advantages and disadvantages as well.

1. Over-the-phone interpreting

OPI is very useful if you are talking about efficiency and time, since it is often available any time of the day. With the special access code, people requiring the service can have an interpreter quickly. The caller and the other party need not be in the same location while the interpreter could also be in another place.

Phones are very accessible and the clients could be served immediately. In some businesses, the service is automated. Using a special access number, the client can receive the instructions in their preferred language on how to use the system or immediately be connected to a multilingual person who can help them.

The disadvantage of OPI or over-the-phone interpreting is the lack of direct human contact. The interpreter cannot read the body language and cues of the speakers. The interpreter cannot pick up the signs if the speakers are trying to convey a specific feeling which they have difficulty in verbalizing.

2. Onsite interpreting

Many clients appreciate the presence of an onsite interpreter. During a conversation the interpreter is able to see the speaker and the other party and can read the body language of the two people. The interpreter is able to see if the client shows signs of confusion or difficulty in comprehending the instructions and needs further clarification. Reading body language is very important for effective communication, especially in cases where they are feeling shy or intimidated due to their lack of proficiency in the language, for example English.

One of the big disadvantages of onsite interpretation is the lack of time and resources. There are instances when an interpreter is not available. This is the advantage of OPI over onsite interpreting services. Onsite interpreters normally have higher hourly rates. In some cases, the cost of their lodging and travel is charged to the client.

OPI and onsite interpreting in healthcare

Clients often ask language services providers how over-the-phone interpreting differs from onsite interpreting. They want to know which one is more efficient or more effective. Typically the efficiency and effectivity of one type of interpretation service is dependent on the factors or circumstances that would be greatly affected by the service in the particular setting.

Each particular healthcare setting could benefit greatly with one type of interpreting service or the other or the combination of the two. Various situations require a different type of interpreting service, as shown below.

Situations where onsite or in-person interpreting is preferable:

• The client has speaking and/or hearing difficulty. In a situation where the client finds it difficult to hear or speak, using a phone will prove difficult.
• When the patient requires mental counseling. In clinics and other medical facilities that provide mental health care, it is better to provide in-person interpreting. It would be difficult for the patient and the interpreter to conduct conversation over the phone, because the client could be easily agitated or confused.
• Several persons are in the location. It would be very difficult for the interpreter to effectively understand the conversation and convey the specific message if there are many people in the clinic or doctor’s office.
• In situations where a visual element is used. An in-person interpreter is essential when a medical practitioner must do a physical checkup or must discuss body parts that sustain injury or are causing pain to the patient. In this type of situations, the medical practitioner must have precise and direct communication with the patient, thus a live interpreter must be present. In-person interpreting is also essential in sessions for physical therapy. The patient must fully understand the instructions of the therapist and the feedback given by the patient must be understood by the therapist.
• When communication with children and the elderly is involved. Children’s limited vocabularies make it nearly impossible for over-the-phone interpreters to communicate with them effectively. For clearer communication, a live interpreter is advisable. It is more beneficial to elderly patients with hearing and cognitive difficulties to have a live interpreter.
• When a patient is traumatized. Mental or physical abuse patients usually find it difficult to communicate their problems. It may take time to coax the victim to talk, which is why a person who speaks their language is essential to effectively communicate with them.

Other situations where a live interpreter is beneficial include group discussions that may include the doctor, patient and members of the family. Background noise and speakers talking simultaneously would make it difficult for an OPI to fully comprehend what is being said. An onsite interpreter is also better during end-of-life or sensitive discussions. Longer discussions and procedures also benefit greatly from the presence of an onsite interpreter.

Settings where over-the-phone interpreting works effectively:

Even in simple tasks, people with limited English (or any language) proficiency (LEP) need help. Thus an OPI service is effective for billing and collection, reminders, registration and scheduling of appointments. Other instances include follow up phone calls, during emergencies and short contact with LEP patients who are in the hospital overnight and need medication.

An over-the-phone interpreter is a good alterative when a live interpreter is not present, especially when there are unanticipated calls in other languages that need to be interpreted and there are unanticipated calls from patients who do not speak English very well.

It is not advisable for family members and other unqualified persons to act as patients’ interpreters under Section 1557 of the Affordable Care Act. The U.S. Centers for Medicare and Medicaid Services (CMS) created the Language Access Plan to impose the implementation of Section 1557. Healthcare-related institutions and facilities in each state are required to provide translations of written information in the 15 most-spoken languages in the state. The same is also applicable to interpreting services.

This means that healthcare facilities must contract with professional language services providers for interpreting and translation services. They have the resources and qualified staff members who are subject matter experts, to provide the most accurate foreign language support.

Business owners should review the options available to them before they decide on what type of interpreting services would be better for the services they offer. Both types could offer accurate interpreting services in many languages.

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