Remote interpretation during in-person medical encounters: Perspectives from professional Spanish-language interpreters.

OBJECTIVES: Professional interpreters are critical for effective communication between providers and non-English-preferring patients, 62% of which are Spanish-preferring in the US. Yet research-to-date has not typically included interpreters' experiences. We examine perspectives of national sample of professional Spanish-language medical interpreters providing remote interpretation during in-person medical encounters. METHODS: We partnered with a national interpretation services company serving thousands of inpatient and outpatient healthcare organizations across the country. We recruited professional US-based Spanish-language interpreters. We interviewed 19 (of 32 eligible) interpreters (response rate 59%). We conducted content and thematic analysis. RESULTS: Remote interpreters during in-person medical encounters work set shifts of back-to-back calls across care settings with little-to-no information prior to being connected. Interpretation complexity varies by topic handled, patient characteristics, and whether patient is alone, and the provider uses their Spanish skills. Interpreters differentiated their approach based on patient needs, acting often as patient advocates (keeping patients calm, clarifying explanations, conveying needed details). With providers, interpreters engaged in strategies to build rapport and support communication. Interpreters believed they enhanced communication, improved visit flow, and helped address complex patient needs. They raised the need for provider training on effectively using interpreters (pacing, focused questions), consistent organizational supports (procedures concerning breaks, transferring calls), and reassessment of policies (providing interpreters patient information before calls). CONCLUSIONS: During in-person medical encounters, professional interpreters connecting via audio/video are critical to meet Spanish-preferring patients' needs. Interpreters' role extends beyond mere interpretation; they employ subtle, unique techniques with the provider and with the patient to enhance mutual understanding and facilitate effective patient-provider communication. PRACTICE IMPLICATIONS: Remote professional interpreters' perspectives on their work environment and challenges they face can inform provider training and development of policies, practices and institutional supports that enable effective communication, enhance patient understanding, and ultimately lead to better care experiences and high-quality patient care.