As a patient or care provider, health-related communication can be challenging. For apparent reason, it is imperative that discussion and understanding between both parties remains crystal clear. For Deaf and hard-of-hearing patients across the U.S. and around the world, there is an evident accessibility gap in the healthcare system.
In a sense, healthcare has its own distinct language composed of the medical terminology and the translation of the technical terms to layperson speak. While this linguistic dance is complex at best, there is a simple communication solution. Speech-to-text transcription can have a significant impact when it comes to ensuring the quality of this critical flow of information and the subsequent care.
Whether access to healthcare is a privilege or basic human right, Deaf and hard-of-hearing people should not be overlooked.
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Space for optimism is emerging in the form of innovations like Ava’s dynamic AI-driven captioning app and the increased integration of the Deaf community into healthcare institutions. However, there are still more opportunities for improvement and collaboration afoot.
What is the Deaf gap in healthcare?
When we talk about the Deaf gap in healthcare, we're delving into a world that sees the Deaf community served up short on access to clear and efficient communication in the healthcare system. This, in turn, can lead to deprivation of vital health information as well as timely health interventions.
What does this shortcoming look like on a practical level? Research reveals that patients with hearing loss make fewer visits to their primary care providers and more visits to the emergency room. Deaf and hard-of-hearing people may also be less familiar with symptoms of serious health issues such as a stroke or heart attack and less aware of available health screenings. The result of these barriers to care is that the Deaf community is at higher risk for adverse health outcomes.
Some healthcare practitioners optimistically imagine that Deaf patients may be able to lip read. Research suggests that those who are able to do so, only understand around 30% to 45% of what is said. During the Covid-19 pandemic, while mask-wearing has been mandatory in many settings, this avenue for at least partial communication has been diminished.
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Health accessibility progress in motion
Legal frameworks such as the Americans with Disabilities Act (ADA) and the Affordable Care Act (ACA) certainly take aim at closing the Deaf gap in health inclusion. They outline a requirement for equal accessibility in all places where the general public interacts. For healthcare locations, interpreters must be available and effective accommodations should be provided for patients who need them. Some of the most common accommodations that patients often rely on include interpreters, written notes, diagrams, text messaging, or even video relay service (VRS).
Still, loopholes can be found in the equivocal phrasing of these pieces of legislation, which is perhaps why healthcare providers have historically missed the mark. For example, estimates put hourly rates for the average sign language interpreter familiar with medical terminology at around $38 per hour. This rate does not account for travel expenses or minimum service time — a prohibitive cost addition for any healthcare provider to balance without proportionate support.
Average Sign Language Interpreter with
Medical Terminology Skills Hourly Pay
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Making healthcare accessible and affordable for Deaf people
Caption software providers like Ava are zeroing in on the need to meet the unique demands of interpretation within a healthcare setting. Ava’s professional caption app, Ava Scribe, is designed to offer caption accuracy in health-related scenarios for both in-person and telehealth interactions. This kind of innovation holds the power to drive down the costs of improving healthcare accessibility for the Deaf community and increase uptake in the process.
Earlier this year, the United Nations hosted an expert group meeting in Geneva, Switzerland, to explore and highlight the obligation that member nations have in closing the Deaf gap in healthcare. They also recently recognized September 23rd as the International Day of Sign Languages, endorsing sign language as a human right and equal in status to spoken languages.
This cultural move towards healthcare inclusion can also be increasingly seen within our institutions. The University of Rochester is a prime example. The institution has a Deaf Wellness Center, which affords access to treatment appointments conducted in sign language and offers Deaf and hard-of-hearing related educational opportunities for healthcare providers keen on contributing to greater inclusion.
Healthcare inclusion in universities must extend beyond an introduction. Proactivity within educational institutions means offering thorough training for future healthcare providers on how to work with Deaf and hard-of-hearing individuals. Additionally, within the mental health field, there is a dire need for healthcare workers to be fluent in sign language.
School systems can partake by introducing curricula about intersectionality and training can be provided on how to work with people that have disabilities. Universities can also encourage Deaf students to pursue careers in the health field to increase the number of providers familiar with ASL. Calling attention to the health inequities and health care barriers Deaf and hard-of-hearing people face daily requires acceptance, advocacy and meaningful action.
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Healthcare organizations and hospitals must recognize that Deaf and hard-of-hearing require different accommodations. A reliable list of interpreters should be on hand for patients with such needs. Additionally, a live caption application should be in the hands of every employee in a healthcare setting. With proper collaboration efforts from both the healthcare communities and Deaf communities alike, significant barriers to care can be broken and necessary progress will prevail.
Healthcare, accessible technology & Deaf inclusion
It is important not to overlook the language barrier that remains for those within the Deaf community who do not speak or write in English. Many healthcare providers are unaware that American Sign Language (ASL) is structurally and grammatically more akin to French or Italian than English, making translation problematic. This can also make live caption transcription challenging for patients to follow.
Meanwhile, a cross-sectional study found that Deaf patients who were able to communicate with their primary care provider in ASL were more likely to successfully access preventive care. This highlights that a range of solutions are required to close the Deaf gap in healthcare once and for all. All in all, it is imperative that healthcare and technology work together and hand-in-hand with the Deaf community to realize this vision of enhanced accessibility now and for the future.