Using Technology to Reduce a Healthcare Disparity

Using Technology to Reduce a Healthcare Disparity

Nilmini Wickramasinghe (Epworth HealthCare, Australia & Deakin University, Australia)
DOI: 10.4018/978-1-5225-7489-7.ch014

Abstract

Superior healthcare delivery requires good communication. For people who have English as a second language, this is particularly challenging. Given the advances in technology, most especially with Web 2.0 and cloud computing, the following proffers a technology-mediated solution to address communication barriers that result when delivering healthcare to non-English speakers or limited-proficiency English-speaking patients. This solution serves to reduce healthcare disparities, satisfy meaningful use requirements, and provide superior healthcare delivery that is efficient, effective, and efficacious.
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Background

Recent discussions on healthcare disparities (Gibbons, 2011) all note the significant potential benefit technology can make in trying to provide an equal experience to all Americans. Sadly, while there are many good points about the US healthcare system, there also exists a considerable racial and ethnic disparity in the delivery of healthcare across the US (Gibbons, 2011). The underlying root causes for these disparities are all amenable to interventions using IS/IT (information systems/information technology). The thesis of this paper is that technology is well suited to assist is that of limited English proficiency (LEP).

More than 23 million Americans today have limited English proficiency, which in turn has a negative impact on their ability to receive and comprehend appropriate healthcare delivery (Youdelman, 2008; Flores et al., 2008). Integral to the delivery of care is communication between doctor and patient; however, language barriers typically lead to problems such as delay or denial of services, issues with medication management, and underutilization of preventative services (Green et al., 2005; Jacobs et al., 2004; Ghandi et al., 2000; Karliner et al., 2004). The literature suggests that the quality of communication between Although Title VI of the Civil Rights Act 1964 has always required that entities receiving federal funds provide language services to those with LEP, the law has not often been enforced in healthcare settings (Jacobs et al., 2006). However, awareness of the need to provide language services in healthcare has increased in recent years (Gibbons, 2011).

Current Problem

In 2001 The Institute of Medicine has published two key reports “To err is Human” and “Crossing the Quality Chasm”. Taken together these reports highlight that patient safety should be one of the essential components of high quality healthcare and that patients should not be harmed by the care that is intended to help them. These profound statements have had far reaching impacts to policy reform and efforts to address patient safety and quality of care delivered today. The role of language barriers and their impact on adverse events is thus now also receiving heightened attention. Especially given that research is consistently highlighting that adverse events affect LEP patients disproportionately more and result in serious consequences to the patient.

Approximately 57 Million people or more than 20 percent of the US population speak a language other than English and this figure is growing while approximately 8.6 percent of the population is defined as LEP. Thus at least 8.6 percent of the US population is at risk for adverse events because of barriers associated with language issues. This adds further cost pressures to an already strained healthcare system

To address this problem a technology mediated solution is proffered to provide multi-lingual support at in-take and registration for LEP patients.

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