Personal health records go portable; hospitals tap into translation services by video

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Five of the nation's largest employers plan to offer employees access to their own portable electronically based medical records that they can use when they travel, see a new doctor, or change jobs to retain information about their healthcare, including medications.

Five of the nation's largest employers plan to offer employees access to their own portable electronically based medical records that they can use when they travel, see a new doctor, or change jobs to retain information about their healthcare, including medications.

Approximately 2.5 million workers and their dependents from Applied Materials Inc, Intel Corp, Pitney Bowes Inc, Wal-Mart Stores Inc, and British Petroleum America Inc will have their health records accessible by mid-2007. An independent, not-for-profit organization, Omnimedix Institute (Portland, Ore), will compile the records. The hope is that by cutting out some of the paperwork, these corporations can decrease administrative costs, duplication of care, and medical/medication errors. Additionally, it is hoped that the personal health records (PHRs) will engage employers to help encourage their workers to adopt healthier lifestyles.

According to a survey on health records conducted by the Markle Foundation, a grant-providing entity that advocates technical and policy changes for the public interest, Americans like the idea of using electronic health records (EHRs). Of those surveyed, 65% would like access to their own medical information on an electronic network, and 97% felt that doctors need access to all their medical records to provide the best care. The Markle Foundation is helping to define the PHR, with the main goals of improving quality of care, reducing medical errors, lowering costs, and empowering patients.

A recent survey conducted by the Health Research & Education Trust (HRET) and The National Health Law Program sought to better understand how different health systems are meeting the language needs of their limited English proficiency (LEP) patients. Approximately 80% of US hospitals frequently treat patients with LEP. Hospitals were queried on the most frequent languages encountered, and the top 6 languages were Spanish (93%), Chinese (47%), Vietnamese (39%), Japanese (37%), Korean (37%), and Russian (37%). Hospital staff members noted that interpreters often are not available, and bilingual staff may not speak the same language or dialect as patients. Additionally, unintended Health Insurance Portability and Accountability Act (HIPAA) violations may occur.

Holy Name Hospital in Teaneck, NJ, is one of several US hospitals that has begun to offer language interpretation services through on-camera and audio translation.

Two companies that provide this service are the Language Access Network (>150 languages, ~12 languages in the on-camera version) and the Language Line Services (>170 languages, ~7 languages in the on-camera version). The video interpretation systems allow patients and medical personnel to communicate in a timely manner, 24 hours a day, 7 days a week. This service also prevents long waits in hospital emergency departments, which could lead to negative outcomes if health information is unavailable or misinterpreted.

Both companies use a television screen and camera mounted on a mobile unit. To use the Language Access Network, the health system contacts the company to obtain the core languages to serve the most patients.

If a patient speaks a different language, a partner company can supply an audio interpreter using the same equipment. American Sign Language (ASL) also is available, with more languages to be incorporated in the video version in the future. The cost of the service ranges from an average of ~$2.00/minute to ~$3.35/minute for ASL.

Language Access Network has installed a system in 2 Walgreens pharmacies in Columbus, Ohio, to serve Somali customers. Patients at The Ohio State University Medical Center emergency department use the video service almost daily, and it has received positive reviews from patients and staff.

Dr Kaufman is president of PRN Communications, Inc, a consulting/medical writing and editing firm.

SOURCES Frekling, K. Electronic medical records coming. The Associated Press. December 7, 2006. Available at: http:// http://www.philly.com/mld/inquirer/business/16181290.htm?source=rss&channel=inquirer_business/. Accessed January 8, 2007.

Enrado P. Five major employers announce personal health record initiative. Healthcare IT News. December 8, 2006. Available at: http:// http://www.healthcareitnews.com/story.cms?id=6032/. Accessed January 8, 2007.

Americans see access to their medical information as a way to improve quality, reduce health care costs [press release]. Washington, DC: Markle Foundation; December 7, 2006. Available at: http:// http://www.markle.org/downloadable_assets/news_release_120706.pdf. Accessed January 8, 2007.

Yonek J, Greising CH. Overcoming the language barrier. Hospitals & Health Networks. Available at: http:// http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=hhnmag/pubsnewsarticle/data/2006november/061114hhn_online_yonek&domain=hhnmag/. Accessed January 8, 2007.

Brin DW. Video service breaks language barriers. Wall Street Journal. November 2, 2006:B4.

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