Clinicians develop strategies to address virtual care disparities for patients with limited English proficiency

We really had to put ourselves in the shoes of the patient and go through all the workflows to make sure that language and health literacy needs were taken into account.

Esteban A. Barreto, PhD, MA
Director, Equity and Community Health Assessment, Massachusetts General Hospital

BOSTON- Although telephone and videoconference visits provided many patients with safe access to medical care during the worst of the COVID-19 pandemic, these virtual care platforms unwittingly disenfranchised a large segment of the community. population, especially those with limited English proficiency. Clinicians at Massachusetts General Hospital (MGH) have implemented several strategies to address these disparities, and they describe their efforts to an article Posted in The American Journal of Managed Care.

With the explosion in the use of telemedicine to deliver care during the COVID-19 pandemic, the MGH team deployed three strategies at its academic medical center: increasing access to virtual platforms and technologies to patients with limited English proficiency, addressing privacy concerns of immigrant patients, and integrating interpreters into virtual platforms.

“With an increased reliance on virtual care for healthcare during the pandemic, it’s important to ensure that we don’t increase disparities for patients who have language barriers,” says lead author Aswita Tan- McGrory, MBA, MSPH, Director of Disparities Solutions Center and Administrative Director of the Mongan Institute at the MGH. “Furthermore, addressing the challenges with these three strategies will actually increase care and access for all patients.”

Tan-McGrory and her colleagues have addressed access to virtual platforms and technology by providing patient education in multiple languages, encouraging patient portal registration through multilingual tip sheets and videos, and using tablets and bilingual trainees. Easy-to-understand patient education materials in multiple languages ​​that the team uploaded to a public online repository received 3,388 page views as of August 19, 2021 and could be used at various points of care, such as virtual visits .

Strategies to address privacy issues included developing a streamlined script that addresses patient concerns about privacy and what is shared with Immigration and Customs, as well as identifying a platform secure virtual environment that does not require a patient to download an app to their phone or computer to join. Finally, the integration of medical interpreters into virtual visits has been achieved through actions such as modifying the electronic health record scheduling software to allow both a clinician and an interpreter to join a video visit. .

“We really had to put ourselves in the shoes of the patient and go through all the workflows to make sure the language and health literacy needs were taken care of,” says lead author Esteban A. Barreto, PhD, MA , Director of Equity and Community Health Assessment at MGH. “Our findings suggest that as health systems continue to meet these needs, patients with limited English proficiency should be able to take an active role in managing their own health, which, in turn , can have a positive impact on their health.”

Co-authors include Lee H. Schwamm, MD, Christopher Kirwan, PhD, and Joseph R. Betancourt, MD, MPH.

About Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is Harvard Medical School’s first and largest teaching hospital. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and includes more than 9,500 researchers working in more than 30 institutes, centers and departments. In August 2021, Mass General was named No. 5 in the US News and World Report list of “America’s Best Hospitals”.

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