Inventions Let Doctor, Patient Talk : Communications: Physicians must sometimes treat people who don’t speak English. Now, there might be some solutions.
Despite the impressive technology around them in hospital emergency rooms, doctors often must resort to the most basic solutions when they do not speak the same language as a patient. Sometimes that can mean asking a hospital kitchen worker or gardener to drop everything and rush to the emergency room to help interpret.
Some Orange County doctors say they would welcome alternatives to overcoming those language barriers, and a few entrepreneurs have surfaced hoping to fill that need.
A former San Jose policeman, for example, has developed a 24-hour telephone service that offers interpreting for 143 languages, and a Laguna Hills inventor has designed a phone service that uses a computer to ask patients questions in their native languages.
“There’s no question there’s a terrific need for translating services, especially in the middle of the night,” said Dr. Robert H. Bade, medical director for the Emergency Medical Services program of the Orange County Health Care Agency. “Virtually every hospital I know of relies on volunteer translators from within their personnel pool.
“I have to say a significant proportion of what it takes to make an accurate diagnosis is getting an adequate history of what’s going on with the patient,” said Bade, who worked in emergency rooms for 20 years.
Jeffrey Munks, founder of an interpretation service that has been acquired by American Telephone & Telegraph Co., saw the problem up close when he was working as a police officer in Northern California.
“I would go to hospitals with an accident victim who spoke only Vietnamese or Cambodian, and the doctors were unable to ask even where it hurt.”
Munks said he and a partner started the phone line in 1984 but that their customer base was limited until AT&T; acquired the company in 1989. Munks, who lives in Monterey, quit the police to become director of marketing and sales for AT&T; Language Line Services .
The interpreters often hear dramatic tales of communication gone awry, Munks said. About 18 months ago, for example, he said, paramedics treating an elderly Chinese woman who had taken a drug overdose called an interpreter to help communicate with the woman’s family. The interpreters learned that the woman had visited an emergency room less than a week before with a migraine headache but that the doctors there had misunderstood her and thought she was hearing voices.
The AT&T; service provides a phone number that medical personnel can call to get help in languages ranging from the more expected ones to such tongues as Urdo, an Indian dialect. Questions and answers can be exchanged by handing the telephone receiver back and forth, or it can be done with a speaker phone.
Hospitals pay an initial fee of $500 to sign on for the service, and there is a minimum continuing monthly charge of $25, plus $1.94 a minute for each call.
Biomedical engineer George Migliarini of Laguna Hills took another approach to the problem--a computerized phone interpretation service.
Migliarini had a battle himself with the language barrier 10 years ago, when he came to the United States from Argentina. Migliarini, who repairs hospital high-tech equipment, said he had long watched doctors and patients struggling to communicate.
“It’s all confusion in the emergency room,” Migliarini said. “Normally you don’t have any bilingual person available, especially when the emergency occurs at 3 a.m.”
Migliarini is trying to market a device that uses computer software and a small speaker that can be attached to a telephone. The software is housed in a central computer able to serve an entire hospital or even a small city. To use the system, a doctor calls a number that connects him with the computer. Then the doctor enters numbers corresponding to questions listed in a brochure. These might be, for example, “Do you have diabetes?” or “Are you presently taking any kind of medication?” The questions, rendered in the patient’s native language, are phrased so that he or she can answer with a nod of the head.
Migliarini has developed programs for Spanish, Vietnamese, Korean, Cantonese, Japanese and Tagalog, the Philippine tongue. The basic system is priced at $5,000, with charges beyond that varying according to the number of languages and phone lines that would be ordered.
Patrick Bird, director of imaging services at Saddleback Memorial Medical Center, Laguna Hills, where Migliarini works, said Migliarini’s system has been tested with good results and that the hospital is considering buying it.
Health-care officials say an interpretation system would be useful outside the emergency room too. Patients also encounter problems communicating with physicians during other visits, said Dr. John Millard, an emergency specialist at South Coast Medical Center, Laguna Beach.
Dr. Michael McDaniel of the South Coast Radiology Medical Group said he once had to resort to pantomime to find out whether a woman was pregnant.
“It took a long time, and it was sort of embarrassing in terms of the antics we went through trying to learn if she might be pregnant or not,” McDaniel said. “We didn’t happen to have a translator handy or available. If we had had access to George’s machine, we could have solved the problem in three minutes.”
