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Telehealth Tougher When English Isn't First Language

Telehealth Tougher When English Isn't First Language

Telehealth is revolutionizing health care in America by making it easier than ever to reach a doctor"but not everyone is benefitting, a new study reports.

People with limited English skills are more likely to have worse experiences with telehealth visits than people whose first language is English.

Folks who struggle with English were 40% more likely to rate video health care visits as worse than in-person appointments, according to results published May 9 in JAMA Network Open.

They also were 20% more likely to describe phone visits as worse than in-person visits, although that finding was not statistically significant.

Beyond struggling to understand what's being said, a person with poor English might have trouble setting up their computer for the visit in the first place, said lead researcher Dr. Jorge Rodriguez, a clinician-investigator at Brigham and Women's Hospital in Boston.

"Setting up a video visit can require high-speed internet and a device. It may require creating a login for a new platform. If you're someone with limited English proficiency, you might need an interpreter to be involved. There are a lot of different pieces to navigate,"he said in a news release.

"If you're a patient who doesn't speak the language that the technology is built in, just getting onto the platform is challenging,"Rodriguez said.

For the study, researchers analyzed results from the 2021 California Health Interview Survey.

More than 24,000 patients were surveyed, of whom 9% were identified as having limited English skills. The survey was conducted in six languages.

People who struggle with English are less likely to try to access virtual care in the first place, results show. About 37% of people with limited English said they had tried telehealth, versus 50% of people proficient in English.

Researchers are concerned that beyond frustration, a poor experience with telehealth could affect a person's overall health.

For example, someone who has a crummy video visit may not bother trying to see a doctor for care in the future.

"The findings have implications from a patient satisfaction and patient engagement standpoint that could have implications for health care access and uptake of technology in general,"Rodriguez said.

To bridge this gap in telehealth access, he recommends that the United States:

  • Expand internet, computer and smartphone access across the nation.

  • Create video platforms that are easy to navigate in any language.

  • Provide systems that facilitate seamless access to interpreters.

  • Offer multilingual digital navigators who can help patients register for video platforms or handle technical problems, either in person or over the phone.

More information

The Health Resources & Services Administration has more about telehealth.

SOURCE: Brigham and Women's Hospital, news release, May 9, 2024

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