Registration open for the 2013 IMIA Conference

Registration Opens for the January 2013 International Medical Interpreting Conference: Guadalupe Pacheco, from the Office of Minority Health, USHHS is Keynote Speaker

The International Medical Interpreters Association is happy to announce that Guadalupe Pacheco, Senior Health Advisor to the Director Office of Minority Health Office of the Secretary, U.S. Department of Health and Human Services is the keynote speaker and will speak on the revised National Standards on Culturally and Linguistically Appropriate Services (CLAS) as well as the National Stakeholder Strategy for Achieving Health Equity. “The 2013 IMIA Conference will provide a forum to hear national and international perspectives on the emerging practices of providing quality interpretation services to a growing global village,” said Guadalupe Pacheco.

Medical interpreters have been benefiting from an annual conference since 1996. The field of medical interpreting has grown in ways that few could have predicted. Innovative approaches have evolved into common practices that are being widely disseminated and adapted. Several standards and language access policies have been adopted at the state, national and international levels, spreading awareness about the importance of accurate communication and interpreting services to reduce health care disparities due to language access.

Registration just opened, and for the first time the IMIA has added a super early bird rate that expires July 15th, 2012. IMIA is encouraging early registration, which helps interpreters and other stakeholders better budget their trips. IMIA recommends the following to attendees: register first, book a hotel second, and buy the tickets last, as rates are not always cheaper earlier.

This IMIA led 3-day event has expanded and in just seven months will take place in Miami Beach Florida. “It was important to take the conference out of Boston to bring it to interpreters in other areas”, said Izabel Arocha, M.Ed., CMISpanish, and Executive Director of IMIA, “and Miami Beach seems like a great place to start”. The theme of the conference is Specialized Interpreting-Getting Beyond the Basics: Exploring Quality Interpreting for Multiple Specialtiesreflects on the in-depth level of skills and knowledge asked for by interpreters, and shared at the event.

It will take place in sunny Florida on January 18 – 20, 2013 at the Miami Beach Convention Center. “Florida is a state that is in constant motion and is more diverse than people think due to international tourism, medical tourism, and new residents from all over the world. There is a need for medical interpreters in many more languages, in addition to Spanish. We are happy to work in collaboration with IMIA to make this event a success”, said Gio Lester, President of the Association of Translators and Interpreters of Florida (ATIF). Panels and forums offer interactive discussion on relevant topics of the day, as well as over sixty very interesting workshops for interpreters, from Demystify Simultaneous Interpreting to New Trends in the Provision of VRI Services. To learn more about the conference, and to register, please visit the IMIA website .

About IMIA

The International Medical Interpreters Association (IMIA) is an umbrella association that promotes all standards and best practices in the field of medical interpreting. As an international non-profit organization of medical interpreters, it represents over 2,000 practicing medical interpreters as the ultimate experts in medical interpreting and as the best option for equitable care for minority language patients around the world. It promotes language access as a human right. The IMIA contains the only free international registry of medical interpreters, where they can be found by language, state, or country.

About ATIF

The Association of Translators and Interpreters of Florida-ATIF, a Chapter of the American Translators Association, is a 501(c)6 non-profit professional association incorporated in the State of Florida. Our association was established to provide support to professionals, students and end users of translation and interpreting services. ATIF is dedicated to promoting professional recognition and growth opportunities through educational and training initiatives targeting T&I professionals in the State of Florida. Website: http://atifonline.org

Source: IMIA – imiaweb.org
Photo: IMIA
Event schedule: http://www.imiaweb.org/uploads/pages/682..pdf

Event: “Cloud and Social Networking in Healthcare: What are the leaders doing?”

9 July 2012, London, United Kingdom.

Friday, June 15th – DocCom, provider of the first cloud-based enterprise social networking platform exclusively for healthcare, today announces that it is partnering with Microsoft to co-host an exclusive event for healthcare professionals that will explore the practical issues, potential pitfalls and transformative opportunities of cloud and social networking for healthcare. The half-day forum, entitled “The Cloud and Social Networking in Healthcare: What are the leaders doing?” is being held on Monday 9th July at Microsoft’s London offices in Cardinal Place. Attendance is encouraged from Medical Directors, CEOs and CIOs from NHS Trusts, and frontline clinicians and healthcare managers are also welcome to attend. Spaces are strictly limited and can be reserved by emailing events@doccom.info to register.
DocCom and Microsoft are hosting this key event to provide healthcare decision-makers with expert analysis of the practical application and benefits of cloud and social technologies in a clinical context, offering clear guidance on how healthcare organisations can harness the future of secure healthcare communication. DocCom will be presenting an overview of its cloud-based enterprise social networking solution for healthcare, which is built on the latest Microsoft Development Stack for enterprise grade security and compliance. The half-day session will feature key user case studies from DocCom’s customers, including Peter Aitken, Lead for Improvement at NIHR CLAHRC Southwest Peninsula, who will talk about the importance of Insight when trying to change human behaviour in healthcare; Kevin Cleary, Medical Director East London NHS Foundation Trust and Former Medical Director NPSA, who will be demonstrating how networks can improve safety by disseminating safety information; and Dr Clare Wedderburn, Associate Dean at Dorset GP, who will be exploring how the new relationships between acute and primary care will impact coordination and communication. With a strong focus on security and information governance issues, Nick Umney, Technical Specialist for Cloud at Microsoft, will give his insight on the opportunity cloud presents for healthcare, while Dr Jonathan Bloor, co-founder and medical director of DocCom and Dr Jonathon Shaw, co-founder and managing director of DocCom, will share their vision of how secure social networking can be used to make healthcare a safer and more efficient place.

Founded by doctors, DocCom is taking the very best social networking technology and applying it to the unique requirements of healthcare professionals – empowering healthcare teams to securely find, collaborate, communicate and share with each other effectively, and giving healthcare organisations the tools and insight to solve specific business problems in safety and efficiency. A 2011 NHS staff survey revealed that only 26 per cent of respondents felt that communication between senior managers and staff is effective, and less than a third (30 per cent) reported that senior managers act on feedback from staff. This backs up research carried out by DocCom which found that 90 per cent of Medical Directors have a problem communicating with their doctors. This frustration, caused by the lack of fit-for-purpose online communication platforms, has led to some staff taking the initiative to engineer their own “workaround” solutions, including use of third-party, non-healthcare-specific software and, in some cases, inappropriate use of social networking platforms such as Facebook – with potentially calamitous implications for data protection and patient confidentiality.

“Social networking and cloud technologies are now a fact of modern life, and innovators in the healthcare industry are now realising that these platforms can deliver immense benefits to healthcare teams, if harnessed in a secure, reliable and responsible way,” comments DocCom co-founder and medical director Dr Jonathan Bloor. He continues: “Effective communication saves lives, time and money. The impact of the human and financial costs associated with the poor organisational and cross-industry communication in healthcare is being clearly felt across all levels of healthcare delivery, from frontline staff to senior management. This event is aimed at helping medical directors and healthcare IT professionals to understand how an enterprise social networking system that is fully standards-compliant – and supported and endorsed by key healthcare management – can significantly improve clinical safety and efficiency within their own organisations.”

About DocCom
DocCom provides the first enterprise networking solution specifically designed to help healthcare professionals to connect, communicate and collaborate. DocCom is combining the best attributes of social and enterprise networking to create secure, cloud-based, healthcare-focused tools that can be accessed anytime, anywhere, and via any device – supporting busy people delivering critical care. DocCom’s secure software solutions are designed by doctors who understand the unique privacy and operational challenges involved – making life easier for healthcare teams and clinical practice safer and more effective.

Can better content save lives?

Lori Thicke about Translators without Borders doing medical articles with Wikipedia.

Source: Translators Without Borders

How (not) to contact a translation company

This article has been at the back of my mind for ages and at the bottom of the articles priority list, but after receiving the same email from the same translator eight times since 9:00 this morning (it’s 1 p.m. now, just to give you an idea) and though I know it will not stop those translators who have been spamming us for months (yes, spamming), I feel it needs to be written – some may find it basic and I apologize in advance to them, but it seems it’s not that basic for many.

So here we go. Of course it is perfectly normal for translators to send their CVs to agencies, to get known, to say “Hey guys, I exist” in an industry where gaining visibility is anything but easy. We receive about two to three spontaneous applications per day, and sometimes a true gem may be found among them, someone who becomes one of “our” translators. By no means do we want to stop receiving applications, quite the contrary. So, just to be clear, I am not questioning the “why” of applications here; we are on your side. But what matters is the “how” – and here, take our word for it, is where many translators get it wrong.

When agencies don’t answer, most translators think it is because we are drowning in applications every day. I’m talking here about spontaneous applications. For most of the smaller, specialized agencies, like us, three unsolicited applications on average per day is not exactly ‘drowning’ and we at GxP do actually take the time to read every single one of them. However, when the application is clearly sent via a mass-mailing system and the contents do not match our needs at all, why should we reply? It feels like being spammed with something we don’t need.

So here’s tip 1: don’t send out mass-mailings to agencies. You’re just spamming them when doing so – at least that’s how it may feel for them.

Logically, the second tip is to personalize the email as much as you can. I always reply to applications starting with “Dear [title plus last name or first name]“, even if the translator applying does not match our needs at all. After all, it’s only normal to reply to someone who took the time to research the company, who we are, our names, etc. Starting an email with things like ” Dear Sirs”, “Dear Mrs or Miss” etc. is, um, off-putting. If you can’t find the name of the person who is going to receive your email, then be creative, something like “Dear [Agency name] Team” for example – something nice, warm and attention-getting. Personally, I’m much more likely to read until the end of an email starting with “Dear GxP Team” rather than one starting with “Dear Sir or Madam”.

So, tip 2: personalize the email as much as you can, which means doing a minimum of research about the agency.

Which brings me to the third point: also research what the agency does. If an agency clearly states on their website, ProZ profile, etc., that they are doing only medical translations and you are specialized in architecture and household appliances, applying is probably a waste of your time – and theirs. Even worse, it shows you did not research the agency at all and if they ever coincidentally get a job from an end-client that fits your areas (you never know, a medical devices company might need a different text translated), they might not contact you because you will be remembered as a “spammer”. So, take the extra few minutes to research what exactly the agency does.

Of course a medical translation agency does not only need medical translators. Sometimes, their own clients need a contract translated, user manuals, etc. Use your best judgment; if there’s a link, even small, between your area of expertise and theirs, it may be worth a shot to apply. If you do, be sure to phrase it this way, for example: “I see you work in the medical field – I myself am a legal translator, but if your clients ever need agreements/contracts translated, feel free to contact me…” etc.

Tip 3: research the working fields and areas the agency works in and trust your common sense : if your fields have nothing to do with theirs, applying may be a waste of time. Ask yourself whether your expertise may still be useful to them (e.g., medical instruments manufacturing companies still need contracts, user manuals, marketing brochures, annual financial reports, etc. to be translated). If this is the case, say so in the application email to show you have done your homework, that you are aware your fields are not entirely compatible but that they might need you sooner or later.

Next is the content of the actual email. Don’t recite your CV; remember, you’re enclosing it. Keep the email short and to the point, you want to make the PM curious enough about you to want to open your CV attachment. So, if you’re applying to a legal translation company and you’re a former lawyer, then that info is the only thing you need to put in the email. Ditto if you weren’t a lawyer in a former life, but already have some large or highly specialized projects behind you – put the most mouth-watering ones in the body of the email. In short, what makes you different from another translator?  The same goes for your language pairs – where you learned English is irrelevant (“I spent 2 years as an au pair in London when I was 18″), but your working pairs should be right there – personally, it’s very annoying having to search everywhere in the email and the CV to find a translator’s language pairs. They are the first elements that differentiate you from other translators, so highlight them.

So, tip 4: Keep the email short and simple, but to the point. The basic, yet important facts about you as a translator should be right there: language pairs, specialties and experience in these fields. No need for a long list of past projects in the email; this is what your CV is for. Just include the most “mouthwatering” experience you have. Remember, what you want is to capture the attention of the PM reading your email, so that they want to learn more about you and open your CV. The first few seconds after they open your email are the most important: this is when they decide if they want to know more.

Last but not least: don’t spam. If an agency doesn’t reply, it’s pointless to send the same copy-paste email over and over and over again (even more so if they have actually replied at one point). Pointless and extremely annoying. And copy-pasting the entire email you sent and putting it in a LinkedIn invitation is even more annoying. If you want to connect on LinkedIn or other sites with the PM you already contacted, don’t copy-paste the email you already sent to that person. Keep the invitation text simple, it’s an opportunity for you to remind them that you exist: “Hi, I contacted you a while ago about my translation services. I’d like to connect with you here as well and look forward to having you in my professional network”. You’re trying to get the person to be interested in your services, so don’t do it online using an approach you wouldn’t use if you had met that person in the flesh at a translation conference.

Tip 5: Keep a clean and up-to-date list of your prospects in which you enter whom you have contacted and when, whether they replied, and what the reply was. Send a follow-up email every six months for example, in the event you don’t receive a reply, but make sure it’s a different email (“I was wondering if you had received my email from last January in which I offered my translation services”). Don’t resend the exact same text you have already sent – and the same goes for social network invitations.


On the topic of translators’ CVs, I can only recommend these two very useful resources from my friend Marta Stelmaszak from Wantwords (she’s the expert for translators’ CVs!):
CVs and Cover Letters that Work (Webinar replay)
Download her e-book: How to write a translator’s CV

Barcelona conference presentation – Social Media Marketing for translators : why, what, how…

Last weekend I attended the ProZ.com International Conference 2012 in Barcelona. It was really fantastic seeing old friends again and making new ones, and to finally have a chance to see some of the wonders the city of Barcelona has to offer.

The conference was also the opportunity to give my presentation on social media marketing and online reputation – 1 hour is terribly short to cover the topic, but some basics were thrown at the audience and hopefully all attendees got something to chew on. The purpose, as outlined in the introduction, is not to make anyone a Social Media expert (and in an hour, that’s impossible), but rather to help translators in the decision-making of investing in that marketing strategy – or not – by giving them as many elements, pros and cons as possible to help them decide whether it’s something their own business could use/need  – and of course, for those who decide it may be something for them, make them curious to find out more and take the next step.

The presentation felt relaxed and was quite interactive. I don’t like to push the Q/A at the very end, attendees can just interrupt me if they want to rebounce on something I just said. IMO it is simply more comfortable and informal that way. Hopefully people feel this as well, because it not only creates a relaxed atmosphere, but it also makes the presentation more lively and ultimately (hopefully) fun. And well, egoistically, I have to admit it’s much more fun for me as  it makes each presentation different from the previous one and the audience has often really interesting, original and unexpected questions, comments or experiences to share. So, no routine. As always, I wish it could have gone on for another 3 hours – and hope attendees do as well!  ;)

A really big thank you to all of you for our attention and patience, I hope you all left the room with a clearer idea of this wide Internet marketing world and some (more) elements at hands to make your decision – if that’s the case, then I did the job in Barcelona (if that’s not the case, feel free to contact me via e-mail and shout at me ;))

An interesting thing happened during the session and in the plane back from Barcelona – or at least I consider those thoughts interesting. It occured to me that, compared to a year ago, I was focusing less on actual Social Media and always more on SEO, online reputation / online presence – that was the case at the Germersheim University a few weeks ago when I gave that same presentation and, to an extent, at the conference in Warsaw in April. This is definitely material for a future article (and sooner than later), but for the past 3-4 months, it seems social networks themselves are loosing the importance they had a year ago in online marketing – they are still important, no questioning that, but SEO and online image in general seem to grow more and more important. Social sites actually always were SEO and online reputation tools but this was maybe not always clear, or hidden behind the WOW factor of social sites. I have this feeling that perspectives are changing – client don’t ask “How can I be on Facebook for my business?” anymore because it’s Facebook and it’s hype. They ask today “Why would I be on Facebook for my business?”.

Interesting shift in perspectives here – but again, this is material for a future article.

In the meantime a big thank you to Patricia for the organization of this great conference, and a big thank you to all – it was simply fantastic being there with all of you. See you next year at the Porto 2013 Conference!

“Ein Quantum Telemedizin ist nicht genug”

Ein Beitrag von Dr. Axel Wehmeier, Leiter Konzerngeschäftsfeld Gesundheit, Deutsche Telekom AG

Kardiologen kontrollieren das EKG ihrer Herzinsuffizienz-Patienten via Internet, Diabetologen prüfen Blutzuckerwerte online, Krebsspezialisten tauschen sich per Video aus und holen bei Kollegen eine Zweitmeinung ein: Telemedizin ist keine Zukunftsvision mehr. Die Praxisbeispiele zeigen: Telemedizin hilft dem Patienten, unterstützt die Ärzte.

Endlich gibt es auch eine Grundlage für die Abrechnung telemedizinischer Leistungen. Mit dem Versorgungsstrukturgesetz vom 1. Januar steht der Begriff Telemedizin erstmals im Sozialgesetzbuch V. Die Bundesregierung hat den Ausschuss, der den einheitlichen Bewertungsmaßstab (EBM) festlegt, verpflichtet, bis zum 31. März 2013 zu prüfen, inwieweit telemedizinische Leistungen in den Katalog aufgenommen werden können. Hiermit hat die Regierung die Option geschaffen, Telemedizin abzurechnen. Dies eröffnet neue Perspektiven.

Ein Beispiel: In Deutschland leben zwei bis drei Millionen Menschen mit Herzschwäche. 2010 war dies der zweithäufigste Anlass für eine stationäre Behandlung und die dritthäufigste Todesursache. Herzinsuffizienzpatienten, die sich telemedizinisch betreuen lassen, sind davon überzeugt. Sie müssen keine langen Anfahrten oder Wartezeiten in Kauf nehmen, stattdessen erstellen sie zu Hause selbstständig ein EKG und übersenden die Werte. Im Notfall erhalten sie rund um die Uhr Hilfe von einer Person, die ihre Gesundheitssituation kennt. So fühlen sich die Patienten sicher und gut betreut. Sie fragen sich daher: Warum gibt es nicht viel mehr solcher Anwendungen?

Wir brauchen die Telemedizin als Ergänzung zur bisherigen Versorgung schneller als gedacht. Der Städte- und Gemeindebund sagt: Auf dem Land fehlen bald 20.000 Mediziner. Schon jetzt muss ein Hausarzt in dünn besiedelten Gebieten mehr als doppelt so viele Einwohner versorgen wie sein Stadtkollege. Bis 2015 werden rund 50 Prozent der niedergelassenen Landärzte in den Ruhestand gehen, gleichzeitig entscheidet sich eine wachsende Zahl Absolventen für eine Karriere außerhalb der Arztpraxis. Parallel wächst die Zahl der über 60-Jährigen bis 2020 um 20 Prozent.

Lösungen wider die Versorgungsschere sind bereits im Praxisbetrieb – etwa das bundesweit erste flächendeckende Telemedizin-Netzwerk für Hoch-Risiko-Herzpatienten in Cottbus und Brandenburg. Patienten mit chronischer Herzschwäche werden dort rund um die Uhr aus der Ferne medizinisch betreut. Aber zu viele Patienten – ob in Fallingbostel oder in der Uckermark – müssen oft noch weite Wege zurücklegen.

Wenn wir die medizinische Versorgung langfristig sichern wollen, wird ein Quantum Telemedizin nicht genügen.


Dr. Axel Wehmeier, Leiter Konzerngeschäftsfeld Gesundheit, Deutsche Telekom AG – 13/06/2012
Quelle Text und Bild: ehealthserver.de (http://www.ehealthserver.de/entwicklung/380-ein-quantum-telemedizin-ist-nicht-genug)

TWB Kenya Healthcare Translation Training Program

An overview of Translators without Borders and its work in the Kenyan Healthcare Translation Training Program, featuring an interview with co-founder Lori Thicke

Language Barriers to Health Care in the United States

This perspective article was written and published back in 2006 by Glenn Flores, M.D. in the New England Journal of Medicine (N Engl J Med 2006; 355:229-231 – July 20, 2006) yet it remains dramatically and sadly true today, 6 years later.

A 12-year-old Latino boy arrived at a Boston emergency department with dizziness and a headache. The patient, whom I’ll call Raul, had limited proficiency in English; his mother spoke no English, and the attending physician spoke little Spanish. No medical interpreter was available, so Raul acted as his own interpreter. His mother described his symptoms:

La semana pasada a el le dio mucho mareo y no tenía fiebre ni nada, y la familia por parte de papá todos padecen de diabetes.”(Last week, he had a lot of dizziness, and he didn’t have fever or anything, and his dad’s family all suffer from diabetes.)

“Uh hum,” replied the physician.

The mother went on. “A mí me da miedo porque el lo que estaba mareado, mareado, mareado y no tenía fiebre ni nada.” (I’m scared because he’s dizzy, dizzy, dizzy, and he didn’t have fever or anything.)

Turning to Raul, the physician asked, “OK, so she’s saying you look kind of yellow, is that what she’s saying?”

Raul interpreted for his mother: “Es que si me vi amarillo?” (Is it that I looked yellow?)

“Estaba como mareado, como pálido” (You were like dizzy, like pale), his mother replied.

Raul turned back to the doctor. “Like I was like paralyzed, something like that,” he said.

If Raul received inappropriate care owing to his misinterpretation, he would not be alone. One interpreter, mistranslating for a nurse practitioner, told the mother of a seven-year-old girl with otitis media to put (oral) amoxicillin “in the ears.” In another case, a Spanish-speaking woman told a resident that her two-year-old had “hit herself” when she fell off her tricycle; the resident misinterpreted two words, understood the fracture to have resulted from abuse, and contacted the Department of Social Services (DSS). DSS sent a worker who, without an interpreter present, had the mother sign over custody of her two children. Clearly, catastrophes can and do result from such miscommunication.

Some 49.6 million Americans (18.7 percent of U.S. residents) speak a language other than English at home; 22.3 million (8.4 percent) have limited English proficiency, speaking English less than “very well,” according to self-ratings. Between 1990 and 2000, the number of Americans who spoke a language other than English at home grew by 15.1 million (a 47 percent increase), and the number with limited English proficiency grew by 7.3 million (a 53 percent increase, see graph). Percentages of Americans Who Speak a Language Other Than English at Home or Who Have Limited English Proficiency.). The numbers are particularly high in some places: in 2000, 40 percent of Californians and 75 percent of Miami residents spoke a language other than English at home, and 20 percent of Californians and 47 percent of Miami residents had limited English proficiency.

Yet many patients who need medical interpreters have no access to them. According to one study, no interpreter was used in 46 percent of emergency department cases involving patients with limited English proficiency. Few clinicians receive training in working with interpreters; only 23 percent of U.S. teaching hospitals provide any such training, and most of these make it optional. Data collection on patients’ primary language and English proficiency is frequently inadequate or nonexistent. Although no federal statutes require the collection of such information, no statute prohibits it, either.

Language barriers can have deleterious effects. Patients who face such barriers are less likely than others to have a usual source of medical care; they receive preventive services at reduced rates; and they have an increased risk of nonadherence to medication. Among patients with psychiatric conditions, those who encounter language barriers are more likely than others to receive a diagnosis of severe psychopathology — but are also more likely to leave the hospital against medical advice. Among children with asthma, those who confront language barriers have an increased risk of intubation. Such patients are less likely than others to return for follow-up appointments after visits to the emergency room, and they have higher rates of hospitalization and drug complications. Greater resources are used in their care, but they have lower levels of patient satisfaction.

Inadequate communication can have tragic consequences: in one case, the misinterpretation of a single word led to a patient’s delayed care and preventable quadriplegia. A Spanish-speaking 18-year-old had stumbled into his girlfriend’s home, told her he was “intoxicado,” and collapsed. When the girlfriend and her mother repeated the term, the non–Spanish-speaking paramedics took it to mean “intoxicated”; the intended meaning was “nauseated.” After more than 36 hours in the hospital being worked up for a drug overdose, the comatose patient was reevaluated and given a diagnosis of intracerebellar hematoma with brain-stem compression and a subdural hematoma secondary to a ruptured artery. (The hospital ended up paying a $71 million malpractice settlement.)

In 1998, the Office for Civil Rights of the Department of Health and Human Services issued a memorandum regarding the prohibition, under Title VI of the Civil Rights Act of 1964, against discrimination on the basis of national origin — which affects persons with limited English proficiency. This memorandum states that the denial or delay of medical care because of language barriers constitutes discrimination and requires that recipients of Medicaid or Medicare funds provide adequate language assistance to patients with limited English proficiency. In 2000, a presidential executive order was issued on improving such persons’ access to services. Thirteen states currently provide third-party reimbursement (through Medicaid and the State Children’s Health Insurance Program) for interpreter services. Unfortunately, most of the states containing the largest numbers of patients with limited English proficiency have not followed suit, sometimes citing concerns about costs. Although the Office for Civil Rights issued guidelines in 2003 that seem to allow health care facilities to opt out of providing language services if their costs are too burdensome, Title VI provides no such exemption.

Ad hoc interpreters, including family members, friends, untrained members of the support staff, and strangers found in waiting rooms or on the street, are commonly used in clinical encounters. But such interpreters are considerably more likely than professional interpreters to commit errors that may have adverse clinical consequences. Ad hoc interpreters are also unlikely to have had training in medical terminology and confidentiality; their priorities sometimes conflict with those of patients; and their presence may inhibit discussions regarding sensitive issues such as domestic violence, substance abuse, psychiatric illness, and sexually transmitted diseases. It is especially risky to have children interpret, since they are unlikely to have a full command of two languages or of medical terminology; they frequently make errors of clinical consequence; and they are particularly likely to avoid sensitive issues. Given the documented risks associated with the use of ad hoc interpreters, it is of concern that the 2003 guidance from the Office for Civil Rights states that such use “may be appropriate.”

Later this year, the California legislature will consider a bill prohibiting state-funded organizations from using children younger than 15 years of age as medical interpreters. Leland Yee, the California speaker pro tempore, proposed the bill, prompted by his experiences interpreting for his mother and, later, as a child psychologist. The bill requires organizations receiving state funding to establish a procedure for “providing competent interpretation services that does not involve the use of children.”

Although this legislation may emerge as a state model, as an unfunded mandate, it will have limited power to improve care. Perhaps the time has come for payers to be required to reimburse providers for interpreter services. The provision of adequate language services results in optimal communication, patient satisfaction, outcomes, resource use, and patient safety. A 2002 report from the Office of Management and Budget estimated that it would cost, on average, only $4.04 (0.5 percent) more per physician visit to provide all U.S. patients who have limited English proficiency with appropriate language services for emergency-department, inpatient, outpatient, and dental visits. This seems like a small price to pay to ensure safe, high-quality health care for 49.6 million Americans.

SOURCE INFORMATION

Dr. Flores is director of the Center for the Advancement of Underserved Children and a professor of pediatrics, epidemiology, and health policy at the Medical College of Wisconsin and the Children’s Research Institute of the Children’s Hospital of Wisconsin, Milwaukee.

Glenn Flores, M.D.- New England Journal of Medicine 2006; 355:229-231 July 20, 2006 – original article: http://www.nejm.org/doi/full/10.1056/NEJMp058316

Translation Tools Could Save Less-Used Languages

Tom Simonite – Wednesday, June 6, 2012, Technology Review (published by MIT)

Languages that aren’t used online risk being left behind. New translation technology from Google and Microsoft could help them catch up.

Sometimes you may feel like there’s nothing worth reading on the Web, but at least there’s plenty of material you can read and understand. Millions of people around the world, in contrast, speak languages that are still barely represented online, despite widespread Internet access and improving translation technology.

Web giants Microsoft and Google are trying to change that with new translation technology aimed at languages that are being left behind—or perhaps even being actively killed off—by the Web. Although both companies have worked on translation technology for years, they have, until now, focused on such major languages of international trade as English, Spanish, and Chinese.

Microsoft and Google’s existing translation tools, which are free, are a triumph of big data. Instead of learning as a human translator would, by studying the rules of different languages, a translation tool’s algorithms learn how to translate one language into another by statistically comparing thousands or millions of online documents that have been translated by humans.

The two companies have both departed from that formula slightly to serve less popular languages. Google was able to recently launch experimental “alpha” support for a collection of five Indian languages (Bengali, Gujarati, Kannada, Tamil, and Telugu) by giving its software some direct lessons in grammar, while Microsoft has released a service that allows a community to build a translation system for its own language by supplying its own source material.

Google first realized it needed to give its system a grammar lesson when trying to polish its Japanese translations, says Ashish Venugopal, a research scientist working on Google’s translation software. “We were producing sentences with the verb in the middle, but in Japanese, it needs to go at the end,” Venugopal says. The problem stemmed from the system being largely blind to grammar. The fix that the Google team came up with—adding some understanding of grammar—enabled the launch of the five Indic languages, all used by millions on the subcontinent but largely missing from the Web.

Google’s system was trained in grammar by giving it a large collection of sentences in which the grammatical parts had been labeled—more instruction than Google’s translation algorithms typically receive.

Venugopal says that, so far, the system can’t handle the underserved languages as well as Google’s existing translation technology can handle more established languages, such as French and German. But, he says, offering any support at all is important for languages that are relatively rare online. “It’s an important part of our mission to make those other languages available on the Web,” he says. “We don’t want people to have to decide whether to publish their blog in their own language or in English. We want to help the world read your blog.”

Microsoft is also interested in helping languages not in common use online, to prevent those languages from being sidelined and falling from use, says Kristin Tolle, a director at Microsoft Research. Her team recently launched a website that helps anyone to create their own translation software, called Translation Hub. It is intended for communities that wish to ensure their language is used online.

Using Translation Hub involves creating an account and then uploading source materials in the two languages to be translated between. Microsoft’s machine-learning algorithms use that material and can then attempt to translate any text written in the new language. Microsoft piloted that technology in collaboration with leaders of Fresno, California’s large Hmong community, for whose language a machine translation system does not exist.

“Allowing anyone to create their own translation model can help communities save their languages,” says Kristin Tolle, a director at Microsoft Research. Machine translation systems have been developed for roughly 100 of the world’s 7,000 languages, says Tolle.

“There is a lot of truth to what Microsoft is saying,” says Greg Anderson, director of nonprofit Living Tongues, which documents, researches, and tries to support disappearing languages. “Today’s playing field involves a digital online presence whether you are community or a company—if you don’t have a Web presence, you don’t exist, on some level.” Anderson says that sidelined languages making a comeback are usually those from communities that have embraced online life using their language.

Margaret Noori, a lecturer at University of Michigan who works to preserve the Anishinaabemowin or Ojibwe, a native American language, agrees, but adds that preserving a language involves more than the Web. “There is a reason to be online in today’s world, but it absolutely must be balanced by songs sung only aloud and ceremonies never recorded.”

Microsoft’s Translation Hub is also aimed at enabling the translation of specialist technical terms or jargon, which general purpose online translation tools do not handle well. Nonprofits could, for example, use it to translate materials on agricultural techniques, says Tolle, and the technology can also be useful to companies that wish to speed up translation of instruction manuals or other material.

“Companies often want to have their data available to them privately and retain their data—not to provide it to someone else that will train a translation system,” she says. Volvo and Mercedes have expressed an interest in testing Microsoft’s Translation Hub, says Tolle.

Tom Simonite – Wednesday, June 6, 2012,
Source:  Technology Review (published by MIT)