You may have seen mention recently of what’s being called the Declaration of Health Data Rights. The manifesto is the work of a collection of patients, doctors, representative from the technology sector and concerned citizens. If you haven’t seen it, it goes like this:
“In an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:
• Have the right to our own health data
• Have the right to know the source of each health data element
• Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; If data exist in computable form, they must be made available in that form
• Have the right to share our health data with others as we see fit
“These principles express basic human rights as well as essential elements of health care that is participatory, appropriate and in the interests of each patient. No law or policy should abridge these rights.”
It’s a good first step. But I would like to add one bullet to that list: We the people have the right to have our information made available each in our preferred language. Because until we account for the burgeoning population of limited English proficient (LEP) speakers, any healthcare reform or related technology will be incomplete.
You can read more about the declaration at www.healthdatarights.org
The last thing you want is to lose focus just as you’re nearing completion of your healthcare translation project. This is especially critical when it comes to important patient-facing materials, which, if poorly translated, can have a profound impact on your reputation and your patients’ care.
That’s where Third Party Quality Assurance (QA) must enter the process. Third Party QA helps protect the careful planning and thoughtful execution that has already gone into your healthcare translation project. It also ensures that you are clearly and effectively communicating with your various audiences.
Third Party QA provides that critical final safeguard via a checklist and correction cycle performed by a QA specialist after your content has been translated, proofread and formatted. In addition to checking things like style sheets, headers and footers, and graphics, it also includes one round of moderate client/end-user edits to the translated text.
Everyone is looking for ways to cut costs, but too often what seems like the economical decision today — to forego Third Party QA, for example — will reveal itself as an even more costly alternative tomorrow.
An MIT study just came out, conducted by the Small Business Majority, a nonprofit healthcare advocacy group, that claims that President Obama’s healthcare reforms will benefit small and midsize businesses.
That’s good news as the battle for the plan heats up in Washington D.C. and elsewhere. The upside for business, according to the study, includes the following:
• Reduced costs — Small business would pay less to provide health insurance to employees.
• More jobs — Current trends will supposedly cost 178,000 small-business jobs by 2018, whereas the reform would save about 120,000 of those jobs.
• Better wages — Bringing healthcare costs down would mean more money for wages.
• Better profits — As costs come down, profits will increase.
• Better applicants — Freed from the fear of losing their company coverage, people would be more able to change jobs, increasing the employee pool.
Late last week, House Democrats unveiled the plan. They say it will cover virtually all the nearly 50 million uninsured Americans, institute new responsibilities on individuals and employers to get coverage, end insurance company practices that deny coverage to the sick, and create a new government-sponsored plan to compete with private companies.
We remain hopeful that the benefits of such an approach will also included expanded healthcare translation. As the nation’s population of limited English proficient (LEP) speakers continues to grow, the need for healthcare translation services is only going to grow with it.
Four different bills seeking to establish English as an official language have been introduced to Congress since the beginning of the year. Versions of the same idea have figured in another three bills. Meanwhile, 10 states have introduced similar legislation.
Among them, Tennessee is back in the news, with the Nashville city council deciding to put the measure on the ballot only a scant five months after the city’s voters rejected the idea in an earlier referendum in January.
Proponents of the bill support the move by saying that English is “under attack.” We see it in a slightly different way. Such legislation seems to ignore rather clear demographic trends, which are decidedly multilingual. Hispanic and Asian communities are continuing to grow, as are a range of other groups, including those from Ethiopia and Eastern Europe.
As programs across the country dedicated to helping immigrants learn English face budget cuts due to the recession, these communities risk losing equal access to information and social services. This is especially true when it comes to healthcare, where a failure to provide healthcare translation can have profound results.
Everyone is looking for ways to cuts costs these days. So here’s a tip to keep in mind as you prepare for your next healthcare translation project: The fewer words, the lower the cost. It sounds simple, but it’s true.
In addition to minimizing the number of words in your source documents, take a close look at the specific documents you’ve targeted for translation. Here are three strategies to start:
• Reuse existing content wherever possible.
• Repurpose previously translated content.
• Focus on only the high-priority content, such as for the Web.
You might also consider hiring a professional editor and/or technical writer who can ensure your technical documentation is created with an eye toward brevity and clarity. This will not only reduce the word count, but also yield translations of higher quality.
Finally, use “Controlled English” (CE) to improve readability and usability while cutting word count. There are a number of industry standards and tools available to help build controlled vocabularies and check adherence.
By taking such steps, you create a leaner, more tightly focused translation process, which means lower cost. And that’s always welcome.
In my last post, I shared the opinion of some who believe that the increasing availability of over-the-counter drugs and take-home medical test kits and monitoring devices will mean less interaction with doctors. Other forward-thinking healthcare observers think the availability of healthcare content online may be leading the same direction.
As Dr. Thomas Lee, a physician entrepreneur and consultant, put it. “[A] significant part of health care is essentially a content business.” Until recently, that content was only accessible if one made a trip to the doctor’s office, a not always convenient and often expensive means for gathering information.
The reality is that the means for producing, distributing, accessing and consuming content is changing. One need only consider the spate of newspaper and magazine closings in the last year and the diminishing profits of big box book stores to see that a change is afoot.
So how will this affect healthcare? Well, it is probably too early to tell for sure. One thing that seems certain, however, is that increasing amounts of medical consultative material will be made available online, and with tools like Google it will be ever easier to find.
For us, the question, just as with expansion of OTC drugs and medical test devices, is this: Are language requirements a part of the puzzle? Can limited English proficient (LEP) patients expect to benefit from these increased online materials? That will be the true test.
Healthcare is complicated, increasingly so these days as we attempt to work out what a reformed system might look like. In my previous post a couple of days ago I talked about the efforts being taken on the part of health plans and some states to simplify the health plan materials offered to patients.
It is no surprise, then, that healthcare translation can also prove to be a complicated enterprise, with a lot of moving parts and plenty of opportunities to introduce unwanted confusion into the process and the final materials.
A key feature of keeping the healthcare translation process on track is ensuring you have effective project management informed by a tested methodology. A good project manager helps you organize your healthcare translation or localization project. It’s a very labor intensive process, which means that a poorly designed translation project can be very expensive to fix. By getting it right the first time, you can save money and time.
When effectively done, your project management team will make sure that the clear lines of communication are always kept open. Also valuable is a dedicated account manager to go to with questions and problems. The best agencies and translators create project-specific glossaries and work with you on them in advance. Finally, they also understand and appreciate the need for an internal review. How does your translator stack up?
There’s no disputing it: Many people simply don’t understand medical expenses, including the terms of their own health plans and what they have to pay out-of-pocket for care. In a McKinsey & Co. survey of consumers conducted in January, 75 percent of respondents answered “I don’t know” when asked about the cost for treatment for a heart attack in their health plan. In another survey, this one sponsored by eHealth Inc. in 2007, only 36 percent even knew that “HMO” stands for “health maintenance organization.”
In her story in the Wall Street Journal Anne Wilde Mathews cited efforts on the part of many health plans to simplify materials. Some states like Texas, Vermont and New York are getting involved, with lawmakers and regulators pushing new efforts to make health insurers’ consumer communications clearer. According to Mathews, Rhode Island’s health insurance commissioner wants to make insurers write all documents at an eighth-grade level.
Aetna, meanwhile, is reworking its materials to read at a fifth-grade level, while Cigna is responding by prohibiting employees from using industry acronyms and jargon. This will no doubt be helpful.
But what seems conspicuous by its absence in these discussions is the issue of English language proficiency. How much of the confusion cited in these studies is due to inadequate healthcare translation of plan materials? If we hope to have truly well-informed patients, we must not forget their translation needs as well.
In a recent post on the Neupert On Health blog, Microsoft’s Peter Neupert frames the healthcare situation as an economic question. People do, obviously, talk about the costs of health care a great deal; there’s nothing new in that. But Neupert takes it step further, encouraging us to apply the principles of economics to the health reform debate.
“If we acknowledge,” he says, “that health, that is the delivery of health care services and the prevention of illness, are economic activities ― then we can ask the question about what is the best way to organize that economic activity to create value.”
As language service providers (LSPs), we are asked every day to help our clients streamline their communications with their customers to save money and bring value. In other words, speaking to customers in a language they understand is a necessary ingredient of that economic activity.
So I remain surprised, given the growing population of limited English proficient (LEP) patients in the U.S., that language requirements do not as a matter of course figure in the economic discussions surrounding healthcare reform. After all, if we cannot clearly and effectively communicate with all patients, there seems little hope that real value can follow.
Our access to information and our feelings about what we expect to know before making a decision, be it buying a car, choosing a college for our child, or even seeing a movie, has changed dramatically in recent years. Patients are increasingly expecting more information before making healthcare decisions.
In keeping with that trend, Qforma, a medical information firm, has created a database that lists about 6,000 medical specialists in a range of disciplines from more than 300 communities across the USA with more expected to be added down the road.
The idea is that unlike the doctor lists compiled by surveys like Angie’s List, Qforma’s attempts to capture subtle differences in doctors’ practice patterns to determine which doctors most influence their peers. The goal is to help patients make a more informed decision when it comes to choosing a doctor.
The Qforma database has its critics. As a language service provider, I of course wonder if all this valuable information is also available in languages other than English. When you consider that recent census numbers say that one in seven people in the U.S. is Hispanic and one in 23 is Asian, failure to meet the needs of this growing limited English proficient (LEP) group seems like a missed opportunity.