Ensuring Accessible Telehealth for Deaf & Hard of Hearing Patients

Virtual health visits have increased dramatically since March 2020, and the trend is here to stay.

Healthcare has seen significant benefits from telehealth, especially for patients with barriers that prevent them from getting regular care (such as lack of transportation, living in a rural area, or limited mobility). But while the rapid adoption of virtual health has opened many doors, it still presents significant challenges for Deaf and hard of hearing (HOH) patients. For this community, care providers must have adequate language support services to bridge the technological gaps that exist.

Unique Challenges for Deaf & HOH Patients in Virtual Care

According to a 2016 report, almost one in five people in the U.S. has hearing loss in both ears. This presents a significant problem as the use of telemedicine increases. In order to participate in a telehealth appointment, the patient must be able to hear what the physician or care provider is saying on the other side of the screen.

Many telehealth platforms are designed for a two-way conversation between the patient and the provider. They are not built to accommodate a third participant, so a medically qualified interpreter can’t always be present on the video call.

While some patients can read lips, it’s important for healthcare facilities not to rely on this as the only option to communicate with a Deaf or HOH patient. In fact, even the best lip readers can only accurately interpret about 30% of spoken words in the English language. Additionally, asking the patient to communicate via writing or typing is not recommended. Not only is it an unideal communication experience, but American Sign Language (ASL) is grammatically very different from written and oral English. Signing represents a concept, not just a single word.

Video conference platforms with captions are also not adequate for patient-provider interactions. This is especially true if they are automatically generated through artificial intelligence (AI) software. AI has advanced significantly but still may miss information or cause errors that can lead to serious consequences for a patient’s care.
Many providers instead rely on written information in the absence of qualified medical interpreters. Unfortunately, this is also not an adequate solution for everyone. More than one-third of Americans (an estimated 90 million adults) have low health literacy, which means they struggle to comprehend and process basic information related to their care. This is especially true for someone who speaks English as a second language (ESL). You might not think of someone who is Deaf or hard of hearing as ESL, but American Sign Language is very different from oral and written English.

When the patient is unable to hear, read, or clearly understand the provider, they miss out on important information that is vital to their care.

Consider the Patient Journey

To improve telehealth for your Deaf and hard of hearing patients, start by thinking about the patient journey. It’s more than just the interaction on-screen during the exam. A comprehensive look at their journey can help you identify roadblocks and challenges at each stage, including:

• • Scheduling
  • Appointment reminders
  • Online registration
  • Patient-provider interaction during the appointment
  • Follow-up appointments or referral scheduling
  • Aftercare instructions
  • Medication instructions

Language solutions for telehealth need to provide adequate support for each step. Medically qualified interpreters with access to video phones (VP) or other tools can provide support throughout the patient’s journey in your health system.

Adapting with Versatile Solutions

The best language support solutions for Deaf and hard of hearing patients provide five things:

• A wide range of language solutions in multiple languages, including ASL
• On-demand video interpreting services that you can access from anywhere in your healthcare system at any stage of the patient journey
• Medically qualified interpreters who can convey accurate information between provider and patient for the best care and optimal outcomes
• High quality interpreting that is compliant with both the Americans with Disability Act (ADA) and Affordable Care Act (ACA)
• Cooperate with high-speed/broadband internet so that a strong connection can be maintained throughout the duration of the appointment.

Language support for virtual care must also be flexible to accommodate different situations. Various facilities and providers within each facility may have different protocols or workflows that require your language provider to adapt.

No One Left in the Dark

Historically, Deaf and hard of hearing individuals have faced great disparities in healthcare due to cultural and linguistic barriers. As we move toward the future of virtual care, we must consider the needs of this community in order to improve outcomes and provide better quality care.

GLOBO is a healthcare-focused language solutions provider that helps organizations communicate across 350+ languages, providing robust data and insights through a revolutionary cloud-based platform, GLOBO HQ.