While telemedicine services increase access to care in different ways, one of the most transformative effects of telemedicine is that it opens access for patients to receive care that aligns with their ethnic or cultural background. Facilities that previously had limited access to translators and few providers with knowledge of specific culture can now expand their panels to include providers who may be physically located elsewhere but who can bridge the cultural gaps that often keep patients away from medical care.
While medical diagnoses may have the same symptoms regardless of a patient’s background, the ability to effectively treat conditions can be limited by language barriers and patient comfort level. In the past, the solution has been for large entities to provide translators to patients. While translators provide a valuable service, translators alone have been proven insufficient to engender physician trust and manage cultural disparities. This gaps can hinder delivery of high quality care and lower patient satisfaction.
A study published in 2015 in the Internal Journal of Dermatology found that that the challenges of communicating with patients with language and cultural barriers “can lead to compromises in the quality of care.” A study completed in Denmark in 2010 and published in the Journal of Telemedicine and Telecare reported that patients were more comfortable and had better outcomes when communicating with physicians in their “mother tongue” through telemedicine and it was preferred over interpreter assistance.
In the most basic sense, having a translator in the room with a patient draws the patient’s attention away from the physician and limits the direct transference between patient and provider. The nuances of body language and nonverbal communication are frequently lost in this interaction, and this can impact both the patient and the provider. If the provider is focused on a translator rather than the patient, he or she may miss important aspects of the patient’s behavior that could impact the diagnosis.
Smaller healthcare facilities and offices may not have access to a robust team of interpreters, and family may be used as a replacement. Patients may be less likely to communicate fully with a provider in front of a family member, and they do not get to enjoy the same level of confidentiality that is afforded to a patient who speaks the same language as the provider.
Telemedicine services enable practices and facilities to identify providers who may best suit their patient population and connect those patients to them without significant travel. Telemedicine enhances access to culturally competent care by reducing geographic boundaries and enabling facilities to work with providers who bridge the need for certain languages or who have experience with different ethnic backgrounds.
While translators will still have an important place in medical treatment, the ability to deliver multilingual providers enhances care and treatment outcomes by increasing patient comfort level, transference and satisfaction.
Impower, a telemedicine behavioral health agency based out of Central Florida, reported that telemedicine has enabled them to match patients with the right provider, not just any provider. Vice President of Behavioral Health, Amy Blakely, stated that they have had noted positive outcomes by scheduling patients with the providers who they feel will not only meet the patient’s mental health needs but also their cultural needs. They have young female patients who have recently moved to the United States and speak primarily Spanish. The flexibility of telemedicine has allowed them to match those patients to bilingual providers who understand the culture of the patient’s home. By identifying the patient’s chosen language as well as their age and reported cultural needs, they are realizing better treatment compliance and outcomes.
Telemedicine services offer solutions to cultural and geographic barriers that were previously only a healthcare pipedream. Remote services make it possible to locate and contract with distant providers who can elevate the level of care. Telemedicine allows patients to appreciate the nuances of communication that are often lost through a translator, and patients report better outcomes and higher satisfaction levels with these interventions.