Within minutes of Asiana Air Flight 214 crash that killed two people and left dozens critically injured Saturday, local hospitals faced another problem: language barriers.
The first wave of crash victims arriving to San Francisco General Hospital all spoke Korean -- and presumably, so did many of their family members. Medical staff suddenly had to scour for all the Korean speakers among their ranks.
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SF General triaged the situation with human interpreters, according to a 7 p.m. update on the hospital's media hotline. Spokeswoman Rachael Kagan said the hospital already has several Korean speakers on staff, which evidently was enough to accommodate the sudden influx. The hospital also partners with Alameda County Medical Center, which provides it with a supply line of polyglot speakers who can translate medical patois.
"Note: We do not need volunteer interpreters," she wrote in an e-mail. She added that the second wave of 17 patients all spoke English.But if SF General has enough staff resources to handle a crisis like this one, it might be an anomaly.
Many of its peers -- including San Mateo Medical Center -- rely on a video conferencing interpreter called Health Care Interpreter Network (HCIN), which uses the "mutiplier effect" to connect hospitals to interpreters within a much larger network. Its members speak about 15 languages among them, plus American Sign Language. An additional audio system includes about 170 languages.
It turns out that language barriers don't just crop up in crises like the Asiana crash. A February study by the UCLA Center for Health Policy Research showed that patients with limited English proficiency often had trouble communicating with doctors. They represent up to 36 percent of California's newly insured population with the passage of the Affordable Care Act, and hospitals are legally bound to serve them. Since many don't have the staff resources to do it -- or can't afford to pull staff away from other duties -- non-profit partnerships might be their only option.
And HCIN, which is based in Emeryville, might be the best of those, since it relies on the social media credo that higher volume begets better resources. Launched in 2005 and beta-tested in three California counties -- San Mateo, Contra Costa, and San Joaquin -- HCIN has made significant progress addressing a problem that's long bedeviled medical providers throughout the US. San Mateo and Contra Costa.
Executive director Frank Puglisi characterizes it as a more efficient system than the old practice of deputizing family members or random personnel to parse through medical jargon.
A 33 year veteran of county hospitals, Puglisi says that in the old days, he and other providers were so pinched that they sometimes had to call local restaurateurs to help translate. "When I was at San Francisco General in the '70s, before we had any Vietnamese interpreters in place, we had to scramble for any potential resource," he said. "Back then it was a Vietnamese restaurant down the street. We'd call and ask if they could either send someone or put someone on the telephone."
San Mateo Medical Center CEO Susan Ehrlich says that hospitals traditionally relied on those stop-gap measures as a way to save costs, but that they aren't appropriate. She's become a fervent promoter of the interpreter network.
If hospitals still treated immigrant populations on a catch-as-catch can basis, their problems would be insurmountable. San Mateo and Contra Costa Counties both see sizable populations of Russian patients, while Salinas Valley hospitals see patients who only speak indigenous Mexican languages. HCIN is trying to meet increased demand for "languages of lesser diffusion," such as Somali, Creole, and Mixteco.
"Has anyone solved the problem 100 percent?" Puglisi asked. "Absolutely not. But we've made significant inroads."