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Remote Video/Voice MedicalInterpretations ProjectContra Costa Health ServicesCLAS Standards Met: 1 and 4-7See page 12 for list of CLAS StandardsAPPENDIX HISSUE. Safety net health care providers with limited language interpretation skills servinglow-income and uninsured populations in northern California are overwhelmed in theirefforts to treat immigrant limited English proficient (LEP) populations. The numbers arestaggering; from 30 percent to 60 percent of the patient population in the county healthcare systems of San Joaquin, Contra Costa and San Francisco are LEP. The patient baseincludes at least 20 languages spoken in regular clinical encounters, including Spanish,Vietnamese, Cantonese, Mandarin, Russian, American Sign Language, Hmong, Mien,Farsi, Hindi, Korean, Arabic, Amharic, and others.DISCUSSION. Contra Costa Health Services is a health care organization that operates theContra Costa Health Plan serving more than 65,000 people in Contra Costa County and theContra Costa Regional Medical Center, a 164-bed hospital located in Martinez, California.To help provide interpretation services for its patient population and to assure the provisionof culturally competent care, Contra Costa Health Services has pursued a number ofinitiatives, including the development of the Health Care Interpreter Network (HCIN) and theRemote Video/Voice Medical Interpretations (RVVMI) project. Since 2005, Contra CostaHealth Services, through the RVVMI has worked with two partnering hospitals to providelanguage interpretation services in Spanish, Hindi, Hmong, and Cambodian, and to create amodel of shared interpreter services utilizing the most advanced video and voice-overinternet protocol (IP) technologies.The core of the RVVMI is a successful Internet Protocol Video and Voice Call Center forinterpreter services that automatically and simultaneously routes requests for interpreterswithin the Contra Costa service area, and the San Mateo and San Joaquin hospitals. The callcenter hardware and software is hosted in a Network Operating Center (NOC). The Projecthas established a secure broadband connection between the servers at the NOC and the threeparticipating public hospitals through a private multiple layer switch network provided bySouthwestern Bell Communications. The project has also established the training and qualityspecifications of participating interpreters, liability arrangements, pricing structures,operating processes and possible contracting methodologies to operate this system in asustainable manner.Contra Costa Health Services received grant funding to establish the RVVMI and to coverthe testing of the model and initial equipment purchase at partnering hospitals. However, thecost of the equipment purchase and initial start-up was modest.BENEFITS/RESULTS. Contra Costa Health Services providers and their patients havegained access to trained medical interpreters through a combination of video and telephone48
technologies. Specifically, the RVVMI enables Contra Costa Health Services to access itspartner interpreter resources prior to utilizing high cost contracted interpreter services.Contra Costa Health Services has already realized organizational benefits and cost savings asa result of the RVVMI. The Project’s initial cost for language service within the partnershipwas $.75 per minute, in contrast to the rate of $1.69 per minute for contracted services.During the initial test of RVVMI in 2006, Contra Costa Health Services launched the projectduring their interpretation peak hours (8 a.m. – 5 p.m., Monday through Friday) for Spanishspeaking patients with an immediate reduction in contracted services for the 10-weeks andsavings of more than $25,000.The RVVMI has increased the overall effectiveness and process for interpretation services atContra Costa Health Services, serving a greater number of patients in less time. Thetechnologies employed can successfully route calls from all targeted access points, viavideoconferencing or telephone equipment, to available qualified interpreters. Calls arerouted from Contra Costa Health Services to a partnering hospital, and then connected to acontracted service provider within 4 minutes.Providers and patients who have used these systems have improved satisfaction withinterpreter services. For example, through the HCIN partnership, one full-time Contra CostaHealth Services Spanish interpreter using the video/voice call center completes between 25 to30 patient visits per day. That compares with previous in-person employee interpreters whoprovided a maximum of 10–15 visits per day. In addition, a Contra Costa Health Servicesremote interpreter is available to the entire Contra Costa Health Services system (includingone hospital and 3 satellite clinics), while an in-person interpreter provides service to staff atone site only.LESSONS LEARNED/NEXT STEPS. The RVVMI collaboration has amassed morethan five years of experience in video conference-based medical interpreter systems.Project staff will use this experience to design and grow the call center, to develop sharedtraining sessions and quality assurance measures, and to share interpreter services(especially in languages which may not require full-time interpreters within any onehospital system). In the fall of 2006, Riverside County and Rancho Los Amigos inSouthern California will become the fourth and fifth hospitals to join the RVVMI.WHO TO CONTACT. For more information about the Remote Video/Voice MedicalInterpretations Project, contact José Martín, LMFT, Reducing Health Disparities InitiativeLeader, Contra Costa Health Services via email jmartin@hsd.co.contra-costa.ca.us or at(925) 957-5426.49
Page 1 and 2: MAKING THE BUSINESS CASE FORCULTURA
Page 4 and 5: PREFACEToday there are more than 30
Page 7 and 8: Major Themes• Minority and LEP Co
Page 9 and 10: INTRODUCTIONHighlights:• Overview
Page 12 and 13: NATIONAL STANDARDS FORCULTURALLY AN
Page 14 and 15: hospital’s culturally diverse pat
Page 16: equiring interpretation, clinical a
Page 19 and 20: CLAS BUSINESS CASE PROJECTS AND RES
Page 22 and 23: ProjectOrganizational SettingCLAS A
Page 24 and 25: BUSINESS CASE THEMES,KEY FINDINGS A
Page 26 and 27: specific purpose can result in larg
Page 28 and 29: CONCLUSIONS AND RECOMMENDATIONSThe
Page 30 and 31: APPENDICESAppendix A: Bilingual Emp
Page 32 and 33: continues to provide linguistically
Page 34 and 35: start for the children at YCHC. The
Page 36 and 37: patients. This has become an attrac
Page 38 and 39: information exchange. For example,
Page 40 and 41: • Technology: A dedicated web sit
Page 42 and 43: APPENDIX FMultilingual Health Resou
Page 44 and 45: WHO TO CONTACT. For more informatio
Page 46 and 47: its internal expertise to meet the
Page 50 and 51: APPENDIX IStaff Volunteer Interpret
Page 52 and 53: APPENDIX JTeleSaludMolina Healthcar
Page 54 and 55: APPENDIX KTraditional Safety Net Te
Page 56 and 57: Training for Interpreters in aHealt
Page 58 and 59: and training purposes. From 2001 th
Page 60 and 61: linguistically appropriate services
Page 62 and 63: APPENDIX O- Project MethodologyThe
Page 64: A Family Physician's Practical Guid

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