SBR Health’s initial customer was a large teaching hospital that approached us with an interesting problem. Like all healthcare facilities, it had a responsibility to patients who needed help communicating with their providers. State and Federal laws, as well as accreditation standards, require that patients with Limited English Proficiency (LEP) be provided with interpreters. Many of the smaller institutions deal with these needs by contracting with telephone-based interpretation agencies, but the larger facilities have their own cadre of trained interpreters who can be dispatched to meet in person with the doctor and patient.

Our prospective customer’s problem was getting the interpreter, doctor, and patient all in the same place at the same time. Too often the interpreter would go to the exam room to find the doctor was running late. Eventually the interpreter would need to leave for his next appointment, only to have the doctor arrive and be unable to proceed without the interpreter. This was enough of a problem when only three people were involved, but when an entire surgical team had to wait before they could obtain informed consent, things could get very expensive and potentially life-threatening.

The solution our customer sought was to move the interpreters to an outlying suburb where space was plentiful and have the interpreters deliver their services via video to where the doctors and patients were located. There was only one problem: the system needed to work at all times and all places, not just when everything was going normally in a wired-up exam room, but even after an earthquake, in a triage tent set up in a university parking lot. Furthermore, the system needed to be simple enough to be used on a laptop by someone with no training, but sophisticated enough to make connections to an interpreter without requiring the services of a dispatcher.  As we worked on implementing a solution for this customer, we validated our core premise that the success of any technology depended only 10% on the technology itself and 90% on how it was integrated with the organization’s workflow and protocols. Working closely with the Guest Services and IT teams, we first developed new workflows based on the desired operational model. Then we used rapid development techniques to prototype clinician and interpreter-specific interfaces, incorporating the desired workflow methodology into each. This allowed us to test the user interaction and ease of use, iterating as needed to create the optimal solution.

As our first customer realized, the ability to effectively communicate is paramount for optimum patient treatment, and in emergency situations, the delay of treatment or inaccurate information obtained by poorly communicated pre-conditions can result in patient harm, unnecessary complications, and in extreme cases, adverse outcomes.

We were able to addresses the shortcomings of remote interpretation services through the use of low-cost video technologies, any device/any network deployment, skills based routing, intelligent queuing, n-way video calling, and a video-based distributed call center. Now we are setting out to redefine how video is used across the Arc of Patient Communications™.