Conversations with Perry and Friends: Dipak Patek, CEO of Globo

Dipak Patel, CEO of the healthcare language and interpretation company Globo, joined Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, for the latest episode of "Conversations with Perry and Friends" to discuss why communication — not just clinical care — determines whether patients get healthy outcomes. Patel has led Globo for four years, following earlier stints running a medical coding company, nine years as an investor in revenue cycle companies and 15 years as a managing director at Accenture, where he advised hospital systems, insurers and pharmaceutical companies.

Patel noted that nearly 400 languages and dialects are spoken in the United

States, adding another complication to communication between patients and healthcare professionals that is already burdened by jargon and the inherent complexity of many medical issues. Patel spoke about the experience of his mother, who spent nearly a decade navigating the U.S. healthcare system for an undiagnosed neurological condition. Her first language was Hindi, and Patel spoke about the language barriers looming in all the matters that go with getting medical care — scheduling appointments, understanding discharge instructions, interpreting phone calls about test results, deciphering medical bills.

Cohen asked Patel why managed care pharmacists and payer leaders should care about communication barriers as much as providers do. When communication breaks down, Patel said, financial risks emerge. Patients who need but don’t receive language are more likely to be readmitted to the hospital, less likely to keep appointments, and less likely to adhere to medications, driving up utilization and emergency room visits. He also pointed out that interpreter access feeds directly into HEDIS [Healthcare Effectiveness Data and Information Set] scores and Medicare star ratings, since regulators place test calls to check whether health plans can connect a member with an interpreter within a set time frame.

Patel told Cohen that poor communication because of language barriers can lead clinicians to order more tests.

“If you don't have a way of communicating and understand what's going on, what do you do? You run more tests. If you run more tests, who does that cost money? That’s the payer," he said. He urged health plan leaders to audit their networks, treat interpretation as more than a bare-minimum compliance box, and consider incentives or penalties tied to how well providers serve limited-English-proficient populations.

Patel also spoke about what clear, accurate translation can mean for hospitals and health systems; if patients understand clinicians, it can improve efficacy of treatment and improve outcomes. He also spoke to Cohen about patients seeking information elsewhere and greater levels of skepticism that can undercut trust. “And so, what’s one of the foundational elements of trust? Communication, being able to communicate with someone so that they understand," Patel said.

Patel described Globo's approach as a mix of in-person, phone and video interpreters — the company works with roughly 10,000 interpreters worldwide — layered with an artificial intelligence tool the company has tested across more than 10 health systems. He acknowledged that AI interpretation currently works best for Spanish and even then not for every dialect and is best suited at this point for lower-stakes communication about administrative issues.