Archive for Karen Donovan

Its National Diabetes Month – Knowledge Can Be So Powerful

As I write this week’s post, its’ tempting to jump into the passionate discussion (or shall I more aptly say fray?) about the healthcare marketplace website(s) functionality, or lack thereof, consuming the country. As the accusations fly and everyone scurries to put fixes in place, I hope we can all keep the ultimate end goal in mind and focus on the intent of reform – improving population health!

With that in mind, I am going to take time this week to remind everyone about an epidemic condition – diabetes – that we can positively affect though education, lifestyle changes and proper medical care. Combating diabetes is a serious public health issue. The statistics are alarming and astound me no matter how many times I see them:

– More than 340 million people worldwide have diabetes
– Nearly 26 million children and adults in the United States have diabetes
– Its’ the seventh leading cause of death in this country
– Another 79 million adults are estimated to have prediabetes
– Diabetes is a major cause of heart disease and stroke
– Diabetes is the leading cause of kidney failure, lower-limb amputations not     caused by injury, and new cases of blindness among adults in the US
– The total estimated cost of diagnosed diabetes in the United States is $245 billion

Whether or not we are healthcare professionals, we can all do our part to part to raise awareness this month. And as healthcare professionals, we can take that a step further by ensuring the limited English proficiency patients we serve have access to educational materials in the native languages that are most meaningful to them.

Click here to learn how one local hospital supported their LEP communities by developing a multilingual diabetes education program.


Announcing VIA’s 2013 Translation Grant Program Winners

This is one of my favorite times each year. Not only because of the spectacular fall weather, but because I get the honor of announcing this year’s grant winners. Our Annual Translation Grant Program awards $1,500 of in-kind translation services to two separate organizations that share our philosophy of improving healthcare access for limited English proficiency communities.

We received a record number of applications this year from organizations across the country – all doing incredible work in their communities.  It was extremely difficult to narrow the selection down to the following two winners:

Lutheran HealthCare, Brooklyn, New York
Lutheran HealthCare serves a diverse, largely non-English speaking, immigrant community in Southwest Brooklyn. As a result of the growth in immigrant seniors in the community, they are working on a new website that includes a wide variety of information for seniors which they will translate into several different languages.

North East Medical Services, San Francisco, California
North East Medical Services is one of the largest community Health Centers in the United States servicing the medically underserved Asian population. They are currently working on translating materials for Affordable Care Act outreach and a new program for pediatric patients.

VIA is proud to support initiatives that further education, understanding, and access to healthcare coverage and services for seniors, children and previously uninsured populations. Congratulations to this year’s winners!


What are you doing to curb rising healthcare costs?

Albeit at a slower rate, Healthcare spending continues to rise. NPR covered a Kaiser Health News article this week titled Health Care Costs Are Projected To Outpace Economic Growth.

Some staggering statistics include:

  • The nation will spend $2.9 trillion this year on health services
  • Health spending will rise by 6.1% in 2014 to $3.1 trillion
  • By 2022, health spending will total $5 trillion amounting to a fifth of the gross domestic product

While much of the increase is attributed to the rising number of baby boomers moving into Medicare, and 11 million previously uninsured people gaining coverage through new Marketplaces and Medicaid expansion resulting from the ACA, this trend is clearly unsustainable.

Furthermore, it is still unknown if any of this additional coverage and access to care will actually improve outcomes. Are there just more patients entering the healthcare system, or are we truly on our way to accountable care and effectively improving population health? Will new collaborative approaches and reimbursement models help us concentrate on cost efficiencies?

In addition, we understand you might be a little overwhelmed when considering how you are going to disseminate information and reduce disparities for the new limited English proficiency populations in your care as a result of the healthcare reform. We’re here to help. As a vital partner to many health systems and plans we provide both process and cost efficiencies when it comes to translating your healthcare documentation. If you haven’t ordered the latest version of the Healthcare Guide to Translations you can access it here. You can also contact us to set up a personal 30 minute webinar on centralization best practices.

LEP Communication is So Much More Than Just Translating Words

Localization Services for healthcare are so much more than simply translating a document into another language for Limited English Proficiency (LEP) patients. There are multiple things to consider beyond the words – cultural adaptation, method of delivery and the final look and feel of published materials all contribute to message assimilation.

Here are a few topics to keep in mind as you prepare your strategy for your LEP healthcare communications:

  • Translation and Localization: Translated communications to ensure essential meaning is captured and conveyed accurately and effectively. 
  • Transcreation: Creative adaptation and writing of marketing, sales, and advertising copy in the target language. Ideal for cultural adaption of key messages and brand attributes.
  • Cultural Assessment: A written report assessing your campaign elements such as key messages, value propositions, slogans, examples and icons for cultural appropriateness in each market. 
  • Website and Digital Localization: Complete localization of website graphics, display messages, navigation and copy including linguistic and functional testing.
  • Social Media, Mobile, Online Advertising: Fast and culturally accurate translation for support of your online communities as well as mobile learning modules. 
  • Multimedia Localization: Video, animation, Adobe Flash and rich media presentations services including voice, captioning and subtitling. 
  • Multilingual DTP: Full service formatting services for print and graphics including data sheets, brochures and technical information.

Make sure you check out our website for Healthcare Industry Education and Resources including webcasts, informative guides and industry news to help stay current on the information that impacts you.

Independence Day and Immigration

A headline from the Orlando sentinel “What we think: Immigration is America’s story” caught my eye last week

It starts with reminding us “On this 237th birthday of the United States of America, with a debate raging in Congress over immigration policy, it’s worth remembering that we are a nation of immigrants. Everyone in the last 600 years, except Native Americans, either came here from somewhere else, or is the descendant of someone who came or was brought here.”

The article continues to discuss the pending immigration bill. I promise – I won’t go into a political discussion here! But continuing along this vein, at this time each year there are numerous articles reminding us of our rich history here in the US as well as the continuing growth in diversity. I also loved learning more about Portland Oregon’s formative years and our deep Chinook Native American history from a recent article in the Oregonian.

There is no part of our nation that has not been touched by our immigrant background. Everywhere immigrants have enriched and strengthened the fabric of American life.

-John F. Kennedy, 1958

As opposed to past decades and generations, we truly are a global society today. It’s not only the immigrants living in the US we live and work with – its people, communities and corporations all over the world. VIA is proud of the role we play in furthering communication and to that end, we support written translations into 125 different languages each year.

Growing Gardens of Hope

We talk about diminishing disparities and improving health literacy for multilingual populations on a routine basis in this blog. Approaching this from a slightly different perspective, I’d like to share Patricia Leigh Brown’s article “Seeking Serenity in a Patch of California Land” that ran in the New York Times this week which highlights a California city’s innovative approach to wellness for immigrant families.

Fresno recently created seven community gardens for immigrants, refugees and residents of impoverished neighborhoods with mental health money from the state. Gardens include the Hmong Village Community Garden, the Slavic Community Garden, the Punjabi Sikh Sarbat Bhala Community Garden and more.

Patricia shares that spending state money this way has been controversial. While, some think of it as frivolous in an era of ever diminishing resources, others believe there is true healing power in the gardens:

The thinking of community leaders and health professionals is that gardens can help foster resiliency and a sense of purpose for refugees, especially older ones, who are often isolated by language and poverty and experiencing depression and post-traumatic stress. Immigrant families often struggle to meet insurance co-payments, and culturally attuned therapists are in short supply.

In addition, it may very well be a highly cost effective solution – as many immigrant and refugee cultures do not have a tradition of formal mental health treatment. The article quotes Rocco Cheng, a psychologist and a director of the California Reducing Disparities Project, a statewide policy study, who tells us “Therapy is a Western concept. The Hmong do not have a word for mental illness.”  But, he said, they are well able to grasp the idea of mental, physical, spiritual and emotional wellness.

As we redesign the healthcare delivery and reimbursement systems with a focus on outcomes over the next few years, I applaud new ideas and novel approaches to meeting all patients, regardless of their age, illness, language or culture, in a meaningful way. This truly is a unique way to look at patient engagement.

VIA assists with OHSU Intercultural Customer Service Initiative

Oregon Health Science University (OHSU) is committed to continuously improving the patient care environment and patient experience across all levels of the organization and all patient touch functions. I’m delighted to share an opportunity they recognized in the Environmental Services department.

Environmental Services employs several hundred people and is one of the departments that have multiple patient interactions each day. This department is one of the most diverse at OHSU, with over 65% of employees identifying their first language to be something other than English. After observing the various native and non-native housekeepers to evaluate their language skills, OHSU found that many were struggling to follow the AIDET (Acknowledge, Introduce, Duration, Explain, Thank) protocol.  As a result, they developed a training initiative in partnership with the Department of Applied Linguistics of Portland State University then worked with VIA to translate the documents at the appropriate literacy level into the top nine language groups spoken by the staff.

The translated handouts were used in conjunction with the English versions during 23 training sessions and they helped the non-native English speakers to fully comprehend the materials. Following the training, these handouts were laminated and distributed to each housekeeper in English and the language of their choice.

Participants provided feedback that the initiative increased their confidence and competency with the tasks they are asked to perform. In particular, they said that practicing the AIDET script in their own language along with English would make it easier for them to do their job well. As a result, they were able to provide better service and help OHSU to deliver health equity to its all patients regardless of their cultural or linguistic background. This was reflected one month after the training initiative when the November 2012 HCAHPS overall raw scores improved.  Read the full case study to learn more.


Cultural Competency Continuing Education Courses Becoming More Prevalent

I just read an article that a bill for Cultural Competency (House Bill 2611) is heading to the House floor in Oregon which would allow the state’s medical licensing boards to require that health professionals must take cultural competency continuing education courses to remain licensed. Cultural competency training for health professionals is already the law of the land in six states including Washington and California, according to the U.S. Department of Health and Human Services. Five other states, as diverse as New York, Ohio, Georgia and Arizona are also currently considering adopting the practice.

Cultural competency, along with providing patient materials which can be fully understood in their native language at the appropriate literacy level, can greatly improve not only health literacy and patient engagement, but overall cost to individuals and our healthcare system at large. In “The HealthCare Blog” Judith Hibbard and Jessica Green share ample evidence that the behaviors people engage in and the health care choices they make have a very clear effect on both health and costs, both positively and negatively. Their study reported in the February issue of Health Affairs, highlights this role that patients play in determining health-related outcomes:

We found that patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care (also known as ‘patient activation,’ measured by the Patient Activation Measure) had health care costs that were 8 percent lower in the base year and 21 percent lower in the next year compared to patients who lacked this type of confidence and skill. These savings held true even after adjusting for patient differences, such as demographic factors and the severity of illnesses.

For more information check out our webinar: Culturally Competent Healthcare: Strategies and Tools for Making a Difference.



Learnings from DiversityRx

It was great to see all of our customers and colleagues at DiversityRx this week. I’m always impressed with the deep passion and compassion of the individuals dedicated to reducing disparities and improving health literacy. There was an impressive line-up of speakers sharing information and insights. Topics ranged from the need for early development of cultural competencies in pre-college and Med school to the other end of the life continuum – understanding the needs of culturally diverse aging communities and ultimately, palliative care.

This year’s theme “Quality Health Care for Culturally Diverse Populations: Achieving Equity in an Era of Innovation and Health System Transformation” was explored in depth. Workshops focused on patient engagement, training and staff development, utilization of quality improvement tools, qualitative data analysis, improving access and care though collaboration and partnerships, the role of eHealth and technology, religious diversity, and recognizing our biases – conscious and unconscious. All topics had the over-arching goal of improving health literacy, access, satisfaction and outcomes for our culturally diverse communities.

The conference was rounded out with sessions addressing our dynamic era of  transformation: advocacy, policy; initiatives from the HHS Office for Civil Rights, and opportunities for advancing equity afforded by the Affordable Care Act. There are too many topics to highlight here – I suggest you check out the DiversityRx web site for more information and to join the conversation.


ACA Opens the Door to Newly Eligible Populations

It seems like it was just yesterday when we were in the midst of a national election and speculating if the Affordable Care Act was going to move forward as planned.   Fast forward just three months to February and the Final Rule for Essential Health Benefits was issued.  Expanded access through Medicaid expansion and Insurer Markets is a reality and open enrollment is approaching fast.

This expanded access will reach populations that haven’t previously had coverage, and the learning curve will be huge.   I’ve lived in the healthcare system my entire career and I still find the flow charts explaining access to be a bit of a spaghetti diagram.  And that’s just the start—once people determine their eligibility, they will need to make decisions about health plans, navigate enrollment forms, select providers, etc.   This is an excellent opportunity not only to provide care, but also to provide education to new members on wellness, prevention and disease management.  As the immigrant population will comprise a significant percentage of the newly eligible, providing these materials to consumers with limited English proficiency will be critical to improving the experience, outcomes and ultimately population health.

Health literacy is a big concern in our healthcare system affecting both escalating costs and outcomes.  It is particularly prevalent among the elderly, and members of minority or ethnic groups who already face language and cultural barriers.  A few things to keep in mind when creating and translating materials are:  target 6th-8th grade literacy levels, write clearly in active voice, use short sentences, use clear headings, incorporate cultural nuances for LEP populations, and use graphics to help explain concepts. We also find that Q&A formats work well.

I firmly believe it’s up to all of us to simplify the increasing complexity of the health care system!


Want to learn more about health literacy and how to prepare your health plan for the changing healthcare marketplace? Download and watch our recent webinar, 2012 Health Plan Preparedness.