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.
Whether you’re on the provider side of the business, or on the health plan side, your audiences represent the widest range of languages and cultures in the history of U.S. healthcare. Your challenge of communicating with those audiences is exponentially increased by the range of languages, worldviews, traditions, communication preferences, and all the other nuances involved with those different cultures.
Which means translation is not as simple as just transferring your communications, word for word, from one language into another. And, between the demands of keeping current with the regulatory landscape, containing costs, meeting business objectives, and managing risk, you have less time to do more work than ever before.
So we wrote a primer on healthcare translation and localization to try and make your job a little bit easier. In this booklet we outline the best practices based not only our deep experience, but also drawn from a wide range of industry sources, to take the uncertainty out of addressing language access challenges for written and web-based communications. Most of all, we hope the information in this booklet is a practical aid, providing a framework to help you get the most from your healthcare translation and localization efforts.
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.
For many healthcare organizations the fiscal year is coming to an end and this is when understanding your overall costs of translation is essential for next year’s budgetary request and approval. If you are juggling invoices from several language service providers, consolidating reports and trying to make heads or tails of what was spent on translations, then it may be time to consider a centralized approach.
By partnering with one translation provider and standardizing your process, your organization will benefit in many ways and reducing costs is just the beginning.
Leveraging technology like translation memory can save you up to 15% or more when used across all written material.
Savings also come from reduced internal costs. Your staff will spend less time managing the pre- and post-translation steps such as preparing documents for translation, managing terminology documents and formatting the material.
You will save time by having greater budgetary control by utilizing technology like VIA’s 24×7 online language portal. The portal allows for a single record of all documents that have been translated and is easily exportable to Excel.
No more fragmented or differing processes from one department to another. Standardizing the process will drive cost efficiencies across multiple languages.
Your messaging and preferred terminology will be consistent across all material ─ whether it is marketing, educational or legal documents.
Increased control over document management eliminates the headaches of multiple versions of documents living in multiple places at once, and is key to staying sane as your translation workload grows.
The list continues. If any of the above benefits speak to your specific needs then I think it might be time to contact VIA.
We will listen to your challenges and understand your overall goals to map out a centralization plan that will work for you.
Today is World Refugee Day, established by the United Nations to honor the courage, strength and determination of women, men and children who are forced to flee their homes under threat of persecution, conflict and violence.
Like me, you may be surprised to learn that there are over 43.7 million refugees and internally displaced people around the world. Many of whom find their way here to the U.S. in need of food, shelter and care. Our hearts go out to these men and women as we think of what it must be like being the mother or father of a sick and hungry child and having to decide between risking your life staying in a conflict or leaving behind everything in search of safety.
Several of these people don’t speak English as a first language and may find it incredibly difficult to find the help they need. At VIA, we believe that bridging the language gap is key to ensuring culturally diverse communities can have equal access to much needed healthcare. For more information on how to address The Growing Challenges of Health Literacy read our brief.
Every selling year goes by and I get at least a dozen bid opportunities from requesting healthcare orgs seeking quality vendors like VIA that offer translation services. The RFP process is a standardized process of vetting the vendor to wisely choose the right fit for their health organization’s needs.
Everyone has the same basic requirements; quality process in place, fast turnarounds and Translation Memory. The questions are generally the same each time and I’d imagine each bidder uses the same set of answers RFP to RFP. Sometimes you win, sometimes you lose.
So how do you vet the good from the bad vendors, especially when the messaging from each of the vendors is the same?
I can’t stop thinking about my happy customers who did their due diligence without having to coordinate a full fledge RFP. After all, the time utilized is exhaustive not only for the requestor but equally so for the bidder.
Do you like your vendor?
Do they have dedicated support? Are they smart? Do they visit you?
Do they use translation tool like style guides or glossaries?
Do they nickel and dime you by charging for post job changes?
I really believe the human element is critical to the success of the relationship. Having a vendor with good tools makes it even better. Do you have a partner that understands your needs? Do they regularly work on the types of materials you translate? Do they understand your member base or know your population? Do they translate at a 5th grade level that is not too literal? Do they respond to your inquiries quickly? Do they fix mistakes within 24 hours?
So here’s what I suggest:
Run a few jobs through them. Review the results. Question the subjectivity of the work. See how they respond. Do they charge you for corrections?
I understand that organizations especially large ones are quite fond of their process of seeking vendors. Contracts folks are great at attaining the best rate but are they attuned to finding the right partner that you will enjoy working with on a weekly basis? The only way to really know is to try them out. My suggestion is to have your new vendor do a few jobs for you, so you can test the waters and feel out what knowingly is right for you and your LEP readers.
Addressing the diverse communities your organization serves in their own language, culture and literacy levels can be difficult at best. Between managing day-to-day delivery of services and controlling operating and outreach expenses, healthcare professionals are left with little time to focus on language access issues and even less budget to implement language access programs. Whether it’s vital documentation or marketing outreach materials, it takes a lot of time and effort to translate your organization’s information effectively. Luckily there are ways to simplify this process—from file formats to translation memory, even the tiniest tweak can save your organization heaps of time and stretch your budget so you can serve the greatest number of LEP (Limited English Proficiency) populations in your community.
Below are a few steps we recommend to get the most out of your time, money and translation projects:
Use Translation Memory. Translation memory software is a databank that captures previously translated text so you will be able to recycle translation from one document to the next.
Use a Glossary, Term List and Style Guide. Language is subjective and there are many ways to translate the same sentence. Many translation dollars can be saved by defining style and dialect preferences upfront.
Centralize Translation Ordering. By building and maintaining a centralized repository of health education content, you can streamline the translation process and establish consistent terminology use and corporate style across all geographies.
Want to know more? Sign up for a free virtual workshop and we will give you the latest tips, tools and tried and true best practices to help you reap the maximum benefits from your healthcare translations.
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.
April is National Minority Health Month and the theme for 2013 is “Advance Health Equity Now: Uniting our Communities to Bring Health Care Coverage to All.” One of the biggest barriers we see to health equity is health literacy. Not only does it make navigating eligibility under the Affordable Care Act (ACA) challenging for someone who hasn’t been in the system for a number of years and/or someone with Limited English Proficiency (LEP), it is also affecting member acquisition, satisfaction and retention, as well as critical access to information on wellness, prevention and disease management.
The need for awareness and adherence to health literacy principles has become a public health concern estimated to cost the U.S. economy between $100 and $238 billion annually. Health literacy is a broad issue for 90 million people in the US that affects their ability to stay healthy. Only 12 percent of adults in the US today have proficient health literacy skills according to the National Assessments of Adult Literacy (NAAL). This means that nine out of 10 adults may lack the skills they need to manage their care and improve their health. Furthermore, 14 percent of adults have below basic health literacy and are more likely to report their health as poor, as well as lack health insurance.
Education, language, culture, access to resources, and age are all factors that impact a person’s health literacy. Ensuring that health education messages are understood, comprehended and adhered to starts with creating content at an eighth grade or lower literacy level, speaking in first person and using short sentences. It’s also important to incorporate pictures, bullet points and simple easy to understand graphics. Lastly, incorporating cultural nuances for LEP populations will increase readers’ understanding of the material.
Not a month goes by without one of my new customers asking me to prepare an estimate for them in Chinese. Which always leads to my question, “Do you want Simplified or Traditional Chinese?” and instantaneously my question begs another question from the requester, “What’s the difference?”
Well there is a difference and it took me a couple of years and a little cheat sheet next to my phone to eventually save it to memory. Simplified Chinese, simply put and no pun intended, is the written language of Mainland China. Traditional Chinese is the written language of Hong Kong and Taiwan.
You see that was easy! Well not really because in healthcare how do you know what your audience wants? The hospitals and health plans I work with predominantly request Traditional but I’m beginning to see more Simplified with certain systems and geographies in the West and the Hawaiian Islands. So why do both? What’s the difference?
When it comes to Chinese it is important to understand that there is a distinction between the spoken and written forms of the language. There are dozens of dialects in China but the most widely spoken ones are Mandarin and Cantonese. We’ve discussed the two Chinese writing systems, Traditional and Simplified. Neither script is directly linked to a particular dialect. A Mandarin speaker for example may write in the Traditional or Simplified script. Interestingly enough, it is not uncommon for people who cannot communicate verbally in Chinese to be able to understand each other through writing.
Chinese is one of the oldest written languages, dating back thousands of years. A number of reforms have been implemented to standardize it. The most important one took place in 1956 when the government introduced the Simplified Chinese script in an effort to promote literacy throughout the country. As its name implies in this new script the characters were simplified by reducing the number of strokes. Generally speaking it is much easier for someone who reads Traditional Chinese to read Simplified Chinese than other way around.
So now we know the history but what is best for your audience? The easiest decision is selecting both but that can be costly, especially if you have a tight budget and numerous materials to translate. If in doubt, select Traditional. If you know that your audience may be less educated, select Simplified.