The fissuring of health care, along the lines of “The Fissured Workplace: Why Work Became So Bad for So Many and What Can Be Done to Improve It” by David Weil (2014), may not be entirely negative after all. Outsourcing patient contact services, perioperative or otherwise, to centralized, multilingual third-party entities with nationwide reach may be the need of the hour in an ever-evolving multilingual society seeking health care. In such a context, language discordance among patients, providers, and care settings should not act as a deterrent to maintaining basic universal standards of health care.
Just as customer-care call centers routinely ask customers for their preferred language, it may be time to offer a similar option to patients whenever they are contacted perioperatively or otherwise. Although interpreters can be invited into audiovisual telehealth encounters, it may be more efficient to outsource patient contact services themselves to centralized multilingual third-party entities. This assumes that patient-privacy-compliant conversations follow preapproved, template-based scripts for information gathering and information sharing, adapted to current and future health care needs. Such standardized interactions may not require in-house multilingual health care providers to perform them.
The role of third-party entities
Centralized multilingual third-party entities may thus become existentially essential to maintaining high health care standards, given that there may never be enough in-house multilingual providers to meet the needs of linguistically diverse patients at every health care institution. Outsourced multilingual patient contact services could therefore supplement, and extend beyond, traditional preoperative and postoperative telehealth interactions, helping meet the customized perioperative needs of patients, providers, and care settings, and ensuring effective, safe, and successful perioperative care.
Looking ahead, while human interpreters may always remain essential to meeting the humane needs of patients, centralized multilingual third-party entities could eventually evolve patient-privacy-compliant nonhuman solutions, such as artificially intelligent applications and bots, to deliver multilingual patient contact services, perioperative or otherwise.
Prerequisites for progress
However, a prerequisite for such progress is that electronic health records must ensure that patients’ preferred languages, including sign language and Braille, are mandatorily asked, answered, documented, and prominently displayed (for example, in patient banner bars) during registration for health care encounters. This would prevent health care providers and patient contact services from being deterred by the extra steps currently required to locate language-preference information.
Preferred languages should be ranked by fluency, with documentation of patient-reported abilities in hearing/understanding, speaking/communicating, reading, and writing. While fluency across all four domains is ideal, fluency in hearing/understanding and speaking/communicating may be existentially essential for standardized health care delivery.
The bottom line is that a multilingual society seeking health care requires multilingual services, whether provided in-house or outsourced remotely, to meet both logistical demands and health care standards.
Deepak Gupta is an anesthesiologist.
