While there is more targeted assistance for the twenty-first-century struggles faced by traditional medical facilities like hospitals, general practices and pharmacies, no facet of healthcare interpretation can afford to wait. Urgent care centers and similar facilities face problems comparable to those of traditional facilities. They experience unique issues too. Pharmaceutical development is another field confronting new international challenges. Luckily, devising language interpretation solutions for globalization-related challenges in urgent care centers and pharmaceuticals is not as difficult as it may seem at first. Both areas face surprisingly similar challenges with related solutions.
Challenges in Urgent Care Centers
In the twenty-first century, urgent care centers, walk-in clinics and stand-alone emergency rooms have exploded in popularity. Patients walk in most spontaneously. Apart from hospitals’ emergency rooms, there is no division of medicine that needs to react to patient diversity faster than urgent care centers. This randomness presents challenges for these facilities. They sometimes must spread thin the expertise of physicians and nurses. For conciseness’ sake, walk-in clinics and stand-alone emergency rooms will be referred to as “urgent care centers,” despite their known differences.
There is an old adage to the effect: “with every blessing, there’s a burden.” In the case of urgent care centers, the blessings and benefits are numerous. Patients don’t need an appointment and can be seen out of town. They can go on the weekend or after 5 p.m. For the benefit of the greater healthcare system, non-emergent issues are less likely to clog up emergency rooms. However, a burden or challenge is that these clinics must field hordes of issues that patients present with daily. They must field diverse issues and diverse patients simultaneously, with fewer medical professionals and resources than a hospital’s ER.
Traditional general practitioners keep their patients’ history. The provider can make more informed decisions. Likewise, the advantage of an appointment requirement is that GPs have (in theory) more time to prepare for the ailment. If they can’t treat it, they don’t set an appointment and refer patients elsewhere. While urgent care centers can physically turn away patients with problems beyond their capacity, the issue of patient diversity remains.
Diversity Challenges Patient Trust and Quality
Trust and fast rapport are important for providers to establish for quality of care purposes. However, in urgent care, the visit is so spontaneous that establishing patient trust and rapport is more difficult. Also, the walk-in process and urgent care’s reputation for diffusing medical expertise throughout a busy clinic can increase patient hesitancy or suspicion. When adding in the globalization issue of increasing patient diversity, especially in regard to language, it’s clear that urgent care centers need particular assistance in coping.
Medical issues resulting from language challenges can have horrible effects for everyone involved. Overall, errors stemming from language barriers can jeopardize the health of 8.6% of the US population. This is also an issue for the Deaf and Hard of Hearing. If patients do not properly understand their treatment recommendations upon leaving the urgent care center, they may end up in the hospital. The same is true for medication compliance and interactions. Unnecessary hospital admissions are tallied and can impact quantifications of healthcare systems’ quality of care. Ramifications for poor care vary based on the type of clinic and region. Patients need to have the ability to conduct their healthcare conversations in their first language.
When patients and providers don’t communicate thoroughly, the ramifications can include more than just patient injury or death. It’s not uncommon for malpractice suits to involve communication issues. According to the Harvard medical community’s insurance program, of their cases over the course of four years, 484 had communication-related factors. That is 41% of total cases, with $264 million total incurred. Common allegations included inadequate informed consent for procedures (20%), along with poor rapport and unsympathetic responses (15%). Language barrier complications comprised 10% of allegations. While language barriers weren’t an overwhelmingly large factor, the potential for uncited language barriers is still costly. As diversity climbs, it’s vital to keep reducing language complications altogether.
Luckily, improving patient communication is easier than ever. Each medical facility doesn’t need a fleet of interpreters or bilingual staff. After covering related struggles in the field of pharmaceutical development, solutions will be outlined.
Globalization Challenges in Pharmaceuticals
Many pharmaceuticals travel a long and complex path to reach patients. From discovery and development to FDA review and release to the public, many materials, environments, systems and people are involved in shaping a product. In the twenty-first century, pharmaceutical development is spanning international and regional borders more often. Globalization can bring the world the medicines it needs faster. However, complicated international processes must run proactive and smoothly.
Medicinal remedies made from materials originating in disparate locations have been transported around the world for centuries. Nowadays, multi-regional clinical research must comply with rigorous standardized procedures. For efficiency, cost-effectiveness and wider applicability of results, the procedures should be designed to pass multiple national regulatory guidelines at once. Above all, quality control and error-reduction measures are vital in complicated international processes. Errors in communication between controlling research teams can be insidious and costly.
International Cooperation in Pharmaceutical Development
Expanding further on the areas in the chain of development requiring better cohesion and communication is necessary. But first, the nature of and reasons for pharmaceutical development by international parties should be clear. Multiregional clinical trials (MRCTs) span different countries or regions. By gathering data about the treatment effects from distinct regions and drawing conclusions about appropriateness and usage, these trials become invaluable. Actually, they become invaluable only if the multiregional procedures are executed correctly.
Continuing with the benefits of MRCTs, they can increase the efficiency of drug development. Large sample sizes for different regions boost statistical power (within ethical size constraints). Better yet, the large sample sizes can be more carefully managed by teams of researchers in distinct countries. That’s the case only if team members cooperate and communicate well. This prevents unwieldy, mistake-ridden and long-duration MRCTs. Likewise, more researchers have pooled their expertise and that of their countries’ regulatory boards to craft and execute a better trial.
Another benefit is the results will be more widely applicable. With subject samples selected from populations that are diverse genetically and in terms of lifestyle and types of exposure, researchers can conclude more about the drug faster.
Additional advantages of MRCTs come in the domains of regulation and marketing. Concurrently seeking approval and marketing authorization in the trial’s different regions makes the study more efficient. However, cooperation and thorough communication are key components. Otherwise, researchers who haven’t synthesized their trials and submissions forfeit the possible efficiency.
Communication and Cooperation in MRCTs
Communication between international and multiregional parties needs to begin while planning an MRCT. When coordinating in multiple languages, quick dialogue and clarification are needed. Of course, much communication is conducted in writing. However, resolving uncertainties and explaining researchers’ arguments for choices is often best done orally. Resolving issues aloud is usually faster too.
Without quick multi-lingual agreements and resolutions, researchers can waste funding, time, medicinal materials and laboratory resources. If the pool of subjects has been gathered, speed is also important to maintaining their participation and current health or medicinal status. It’s important for researchers to communicate early and often in order to comply with all involved countries’ regulatory requirements. Areas about which they should communicate and agree include:
- Patient subject pool requirements
- Wording of patient recruitment materials in each language
- Facilitation of recruiting and excluding
- Compliance of procedures to all regulatory requirements
- The best marketing verbiage in each language
- Patient diary issue resolution
Multicultural Communication in Action
Without early communication that is linguistically and culturally sensitive, the risk of wasting time, money and resources is high in MRCTs. Consider the possible ramifications resulting from a lack of communication about a subject pool. The ever-pertinent illness malaria threatens half the world’s population. Imagine a malaria trial in which it makes sense to exclude a certain faction of the potential subject pool based on their previous exposure, probability of getting more critically ill or just a certain likelihood of contraction.
Malaria is transmitted by mosquito bites. Different segments of the population may spend more time outside than others. Therefore, sometimes the risk of contraction varies based on socioeconomic status, work or lifestyle. Complicating factors more, local residents can acquire immunity from exposure as they age.
In order for researchers from distinct regions, countries or cultures to respectfully and tactfully decide on the parameters for inclusion in their subject pool, they must navigate these potential subjects’ sensitive life factors. Researchers from an urban area in a developed country wouldn’t want to use language that offends their research team members (or subjects) in a lesser developed country when they talk about field work or more basic outdoor jobs. Likewise, if upon further investigation a subject should be disqualified because of a previously unknown health factor or life condition, removing them from the pool needs to be done respectfully.
Subject selection is a stage of a trial when live language interpretation can facilitate cooperation, interpersonal respect and good science. The safest, best-case scenario for such an interpretation would be a Video Remote Interpretation (VRI) carried out by interpreter(s) who are native to, or deeply familiar with, the involved languages and cultures. With VRI, facial expressions and gestures are conveyed to achieve maximum sensitivity.
Precise Communication in Urgent Care & Pharmaceutical Trials
When quality of care and provider reputations are on the line in urgent care centers, it’s important to take a proactive approach to treating diverse patients. In pharmaceutical development, patients can reap the benefits of medications developed by international research teams sooner if cross-linguistic and cross-cultural communication happens early and often. Telelanguage has decades of experience in medical interpreting. We have high standards for our interpreters’ ability to navigate complicated medical situations. Telelanguage also helps set standards in the medical industry and drives them further.
4 Means of Conducting Medical or Pharmaceutical Interpretations
In-Person – On the designated day of an in-person interpretation, the interpreter comes to the site. They interpret between the Limited-English-Proficient (LEP) patient and the provider. Or they interpret between pharmaceutical researchers from different countries. Billing processes are usually taken care of after the interpretation and may include the interpreter’s mileage.
Video Remote Interpretation – Video Remote Interpretation (VRI) uses devices such as web cameras, tablets or smartphones to provide spoken language or sign language interpretation via camera. The interpreter remains offsite. These can take place when one or more parties are located internationally. Medical video remote interpreting affords patients, providers and researchers the benefits of visual cues like gestures and facial expressions.
Telephonic Interpretation – Medical interpreters can also be reached by phone, which has several advantages. As long as it is not an obscure language, clients often connect to interpreters quickly. At larger language service companies, a pool of interpreters awaits client calls. Fast access can prevent the need to schedule an interpreter. Providers and researchers often have busy, erratic schedules. Telephonic interpretation can avoid rescheduling, or the need to schedule at all! This is a great option for those trying to communicate across time zones.
Zoom or Remote Meeting Interpretation – This classification of interpretation is similar to VRI, however, an interpreter can join the healthcare entity’s existing meeting. When parties in a medical or research situation are located at multiple sites, the interpreter can join their virtual meeting.
Director of Interpreter Service
Kaz has been in the language industry since 2005. An interpreter himself, he oversees all operations of the Virtual Interpretation Division (OPI/VRI) for Telelanguage Inc. His responsibilities include Recruitment, Staffing and Coverage Coordination, Quality Assurance, and supervision of over 6,000 contracted/employed interpreters. Additionally, he leads our interpreter certification program. Kaz matches the interpreters’ unique skill-sets to specific organizations and customers. He develops and implements recruitment strategies as well as talent retention plans to ensure access to the most qualified interpreters in over 350 languages.