Videoconferencing services offer language translators

Translation services are pitching -- and some hospitals are buying -- videoconferencing technology as a way to improve communication with patients who don't speak English.

But even vendors say that until they make the service more cost-effective, office-based physicians probably won't be interested.

Companies offer videoconferencing as a middle ground between phone translation services and on-site interpreters. Phone-based systems translate for physicians and patients but don't allow interpreters to detect important visual cues. In-the-flesh translators can get a full view of what a patient is trying to communicate, but they can be expensive, often requiring a two-hour minimum even if they're only needed for a five-minute visit.

Large hospitals and clinics are investing in the technology, paying a flat fee of $11,000 to $12,500 for each videoconferencing unit and around $3 per minute for translation.

Interpreters are on call or waiting at a videoconferencing center; they appear on a portable flat-screen monitor that physicians and staff can wheel from room to room. The companies offer interpreters for 150 languages -- many more than even large hospital systems generally have available -- and promise they'll be ready within five minutes of a request.

Emergency physician Michael Sayre, MD, who regularly uses a videoconferencing interpretation system at the Ohio State University Medical Center, said having the visual component makes "a huge difference." Because the system can be moved, translating can happen just about anywhere a patient might be.

"You can see [the translators], but more important, they can see the patient and get the nonverbal cues," Dr. Sayre said.

Sorabh Khandelwal, MD, an emergency physician colleague of Dr. Sayre, said he uses the system at least two times per shift. "It's nice to have no in-between interface," Dr. Khandelwal said. "I can stand back, ask questions and listen to answers without having to fiddle with the phone. I don't have to be the intermediate."

Videoconferencing is primarily hospital- and clinic-based, said Ron Emerson, health care director for Polycom, a provider of videoconferencing services.

Because private practices don't see as many foreign-language patients, "it would be hard for them to justify the cost based on the volume," Emerson said. "It hasn't filtered down to that level."

Some companies are trying to find ways to cut the price of video translation services so they can be sold to office-based physicians. For example, the Language Access Network, which created the system used by Ohio State, developed a smaller desktop unit that costs between $1,000 and $2,000, said CEO Michael Guirlinger.

Analysts say the best hope for adoption of video interpreting by physicians is to bring the services to the Internet, which could significantly lower the cost, because physicians would not be required to pay for videoconferencing equipment.

Vendors are already trying to make other telehealth services, such as data transmission and remote patient monitoring, available online, said Pamela Whitten, PhD, a professor and assistant dean of the College of Communication Arts & Sciences at Michigan State University. Her research focuses on health care technology.

"They're hoping [physician] demand will drive the application," Whitten said.

However, the low quality of Internet video presents a problem, said Melinda Paras, CEO of Paras & Associates, a communications firm that develops video networking systems for hospitals.

Watching an interpreter via public Internet wouldn't produce the same results as would a videoconferencing system's dedicated private network, Paras said.

"It would be a stuttery picture, like on a Web camera," Paras said. "The video image is not going to be the television-quality image people are used to."