Technology and CLAS Standard 12 recommendations

Standard 12. Health care organizations should develop participatory, collaborative 

partnerships with communities and utilize a variety of formal and informal mechanisms 

to facilitate community and patient/consumer involvement in designing and implementing 

CLAS-related activities.

The description of standard 12 boils down creativity, innovation, and improvising in order to develop and maintain ongoing doctor-patient communication.  I believe that technology provides many advantages yet, some challenges as well.  I have broken down my answer in four different sub-topics:

Cost of technology:  Many health care organizations are concerned about the cost involved in adopting and implementing CLAS.  This is an issue that many organizations may want to take on or others may not have the financial capacity to do it all.  Another problem related to this may be that even if the organization purchases the technology, patients may not be willing to utilize it.  If the technology is welcomed and utilize properly it can have tremendous positive impact on the care for patients and the doctor-patient communication.  Technology can go either way, cost reduction or high cost for an organization.

Communicating with rural and urban communities through technology: Technology becomes very valuable and a necessary when serving rural communities. Rural communities have other challenges such as transportation and shortage in general practitioners and specialists.  However, here are some of the must innovative and creative initiatives with telemedicine, videoconference, and tele-translators.  The way I see it is that health care organizations are applying Standard 12 in a creative way in order to design and implement CLAS-related activities.  Through technology health care organizations are promoting participation, collaboration with communities and utilizing a variety of formal and informal mechanisms to facilitate doctor-patient communication.

Considering cultural Taboos:  The Hmong community in the USA (An Asian ethnic group from the mountainous regions of China, Vietnam, Laos, and Thailand) do not allow pictures or video because it is believe that their souls will be stolen as are indigenous from Guatemala.  Other cultures may not see technology as a way of seeking and receiving medical care.  So the challenge here is educating people and doctors about technology and how it can help improve their quality of life by receiving information that they would not have access to any other way (specially people living in rural areas).

Education: As many things that we do, people need and want to be informed about things.  Educating the public and health care organizations about the necessary of technology in medicine is very important.  But also educating/informing them about the challenges such as utilization, technical training required, and limitations must take place before the technology is introduced.

To summarize, technology like anything else has it limitations, it can never substitute in-person encounters between doctors and patients.  I want to give a few examples of how technology and in-person encounters have helped some health care organizations reduced cost and improve patient’s satisfaction.

Substantial reductions in outsourced language interpretation services and subsequent savings in related costs. Many health care organizations that address the threshold issue of language services have found very efficient ways to make better use of their own bilingual staff or volunteers, thereby reducing substantial costs of outsourcing interpretation services.

•Contra Costa Health Services was able to reduce its per minute interpretation costs from $1.69 per minute for contracted services to $.75 per minute through a project with remote video interpretation.

•L.A. Care created an alternative approach to interpretation services through which providers and patients access language services via telephonic dual headsets or handsets. The project reduced L.A. Care’s reliance on expensive contract interpretation services, reduced the reliance on friends and family members for interpretation, as well as decreasing the use of gesturing and other ineffective communication methods.

• Holy Cross Hospital uses 175 employee volunteers who speak 60 different languages to provide interpretation services for patients, families, physicians and staff employees. The program achieved significant cost savings by avoiding additional costs for contract interpretation services ranging from $320,000 to $190,000 depending on the circumstances.

References

1.  MAKING THE BUSINESS CASE FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES IN HEALTH CARE: CASE STUDIES FROM THE FIELD Alliance of Community Health Plans Foundation 2007 Support

2.     The Office of Minority Health - http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15

3. Communication Current – National Communication Association, August 2010. http://www.natcom.org/CommCurrentsArticle.aspx?id=1348