Health systems are finding new growth opportunities by experimenting with investment and innovation programs or accelerators.
For example, Providence Health & Services launched a venture capital fund to support innovative, consumer-driven technology in 2014. Providence Ventures invests in companies that specialize in online primary-care services, data analytics, care coordination and patient engagement, chronic disease management, clinician experience and wellness services.
“Consumers are now comparison shopping, reading reviews and purchasing health care online,” said Providence Venture’s Aaron Martin, managing partner and senior vice president of strategy and innovation, in a news release. “This trend will only accelerate as it has in every other industry. Consumers will demand more value, quality and convenience from the health care provider they choose.”
Language service needs
One of the major challenges facing Washington state-based Providence is the increase of limited English proficient and deaf patients seeking medical treatment throughout its health system, creating a need for expanded access to immediate language services.
According to a recent report by the U.S. Census Bureau, 60.6 million people nationwide — or 21 percent of those ages 5 or older— speak a language other than English at home, and more than 300 languages are spoken in the United States today. As a result, providers like Providence have faced an influx of patients requiring language assistance.
LEP patients are twice as likely to suffer adverse medical events as are English-speaking patients, and the average length of stay for LEP patients is 0.75 to 1.47 days longer than English-speaking patients when these individuals are not provided with a qualified interpreter. In addition, 30-day readmission rates are significantly higher for LEP patients. (See Mary Lindholm, M.D., et al., “The Effect of Professional Interpretation on Inpatient Length of Stay and Readmission Rates.”)
Providence once relied on telephone and on-site interpreters to communicate with LEP and deaf patients. But according to Cyndy Daniel, assistant emergency department manager for Providence Milwaukie Hospital near Portland, Ore., telephone interpretation was not well-suited for the fast pace of emergency care.
“Telephonic interpreters would be hit-or-miss,” Daniel said. “Some patients wouldn’t speak loud enough, and we would run into a variety of issues that anyone can have with phone communication.”
For scenarios in which a telephone interpreter was not an option, such as end-of-life discussions, group settings and deaf patients, the health system also worked with third-party agencies to provide on-site or face-to-face interpreters. But on-site interpretation had its own problems.
“Nine times out 10, when we would contact an [American Sign Language] interpreter to provide assistance, there wasn’t anyone available or the interpreter would not show up,” Daniel said. “This resulted in exchanging information with a patient through note writing, which was incredibly cumbersome and time-consuming.”
Providence partnered with InDemand Interpreting, a language services improvement company and video remote interpreting provider for health care. The health system subsequently made an equity investment in the company. [Melhman works on a fund that is an investor in InDemand, and he also sits on the board, according to the fund's website.]
“We look to invest in passionate, amazing management teams who are building disruptive technologies, like video remote interpreting, to help solve important problems that our health care system and patients care about,” said Martin.
Providence clinicians now have immediate access to video interpreters in more than 200 languages, including American Sign Language, 24 hours a day, seven days a week. A provider is able to select the patient’s requested language, designate if a female or male interpreter is preferred, and connect within seconds to a live, medically trained interpreter who appears on the screen.
Since the inception of its relationship with InDemand, Providence has deployed more than 300 VRI devices throughout its facilities. The VRI service is available on iPads, Surface Pro tablets and wheeled carts that can be moved to a patient’s bedside or to demanding, high-traffic areas like the emergency department.
Gaining staff buy-in for the new VRI technology was not difficult, according to emergency department medical director Corey Bergey, D.O., at the Providence Medford Medical Center in Oregon. “The reliability of VRI is very beneficial. As soon as we select a language, we know we’re calling ‘Maria’ or another real person, and we can see them on the screen, and they can see our patient and his or her mannerisms,” said Bergey.
“Particularly for the emergency department, we can’t anticipate when we might need an interpreter or a third-party on-site interpreter,” she added. “The new video remote interpreting modality is so much faster than over-the-phone interpreters, as we receive immediate support.”
Daniel, who has been a nurse for almost 42 years, is confident VRI is one of the most effective technological innovations she’s encountered.
Since August 2015, InDemand has facilitated nearly 15,000 interpreting encounters in 60 languages for Providence. Don Vernam, Providence information services site manager, said he believes the VRI rollout has been beneficial for the health system.
Providence has plans to expand the use of InDemand’s VRI service across the health system and for home care.
Ezra Mehlman is a principal at Health Enterprise Partners, a health care information technology and services–focused growth equity fund based in New York City that is an investor in InDemand. He also is a board member for the company, as well as an adjunct professor at Columbia Business School. He is a contributor to Futurescan 2016–2021: Healthcare Trends and Implications, a publication developed by the American Hospital Association’s Society for Healthcare Strategy & Market Development and the American College of Healthcare Executives.