Research shows that patients with limited English proficiency have worse experiences with virtual healthcare

People with limited English proficiency have a worse experience with virtual health care visits than those who are proficient in English, according to a new study led by a team of researchers from Brigham and Women’s Hospital. The study highlights the importance of designing telehealth platforms and processes that can better serve people who face language barriers on a daily basis.

The study, published in JAMA network openedanalyzed results from the 2021 California Health Interview Survey of 24,453 patients, 9% of whom reported having limited English proficiency. The survey was conducted in six languages.

People with limited English proficiency were about 40% more likely than those who spoke English well to rate video health care visits as worse than in-person health care appointments. They were 20% more likely to describe their experiences with telephone health care visits as worse than in-person visits, although this finding was not statistically significant.

“Setting up a video visit may require a high-speed internet connection and a device. You may need to create a login for a new platform. If you are someone with limited English proficiency, you may need an interpreter. There are a lot of different pieces to navigate,” said lead author Jorge Rodriguez, MD, a physician investigator in the Brigham’s Division of General Internal Medicine and Primary Care.

“If you are a patient who does not speak the language in which the technology is built in, it is already quite a challenge to get onto the platform.”

Previously published studies have shown that marginalized groups are less likely to access virtual care initially. The Brigham study also showed this; 37% of patients with limited English proficiency reported using telehealth services, compared to 50% of patients who were proficient in English.

What is unique about the JAMA network opened Analysis shows that even when people with limited English proficiency gain access to virtual care, their experiences are generally worse than those of people without language barriers.

Rodriguez said survey respondents may have rated their experiences with phone visits as better than video visits because phone calls are less challenging to set up than video calls. Additionally, clinical teams may find it easier to engage an interpreter service than to add an interpreter to a video call.

A bad experience with a telehealth visit can not only cause frustration, but can also impact health outcomes. For example, someone who has a bad experience with a video visit may be more reluctant to book healthcare appointments in the future. “The findings have implications from a patient satisfaction and patient engagement perspective, which could have implications for access to healthcare and the adoption of technology in general,” Rodriguez explains.

To bridge the gap between marginalized patients’ experiences with telehealth versus in-person care, Rodriguez recommended national efforts to expand access to the internet, computers and smartphones, to video platforms that are easy to navigate in any language, and systems that provide a enable seamless access. to interpreters. Rodriguez added that a more immediate solution is multilingual digital navigation systems who can help patients by phone or in person register for video platforms, respond to technical issues and more.

Mass General Brigham has implemented a Digital Access Coordinator program, which is part of the United Against Racism initiative. The DAC program helps patients navigate Patient Gateway, telehealth and other digital tools. The digital team has also made it possible for physicians to add a virtual interpreter to an Epic integrated virtual visit.