Skip to main content

Sutter Health
Diabetes and Cardiovascular Disease Risk Factors
Patients with Limited English Proficiency


Patients with limited English proficiency receive interpretation services via a two-way remote video link.

Language interpretation services are offered via remote video technology that uses existing laptops and clinic intranet to connect providers and patients with an interpreting center. Instead of using in-person or external telephone-based interpreter services, patients see and are seen by interpreters via a two-way audio and video link.

Staff and providers receive cultural competency training and learn how to use the new video interpretation system. Physicians submit a request for interpretation services via an online form, and an interpreter connects to the clinic through a webcam on a computer in the exam room. The remote video link utilizes existing clinic computer hardware, and does not require costly or dedicated-use videoconferencing equipment.

Three California Pacific Medical Center primary care practices in partnership with Sutter Health will participate.


Inadequate interpretation services have been shown to decrease the likelihood that patients will be able to follow doctors’ orders, which creates an indirect hidden cost in health services. Additionally, the use of traditional telephone interpretation methods has limitations, including the inability for the interpreter to see the patient when giving instructions or to get a full assessment of the patient’s body language. Using a video-based system reduces the chance that interpretation services will be perceived as removed and cold by both the patients and providers. The transition to remote video interpreting has the potential to improve patient flow, reduce interpreter wait time, improve the documentation and tracking of interpreter services, and improve interpreter protocols. As interpretation services are improved, both patient-provider communication and satisfaction may be improved, potentially leading to greater adherence to treatment, and better health outcomes.

Summary Results

Patients and providers were provided with remote video interpretation (RVI) or in-person interpretation (IPI) delivered by interpreters from either the Sutter Health System call center or an external vendor. When using an in-system interpreter, the average per-appointment cost of RVI ($44.50) was significantly lower than IPI ($49.50). Furthermore, using an in-system interpreter was significantly cheaper than using an external interpreter for both RVI ($89.00) and IPI ($81.20). Participants receiving RVI reported satisfaction with the service, which increased patient understanding of medications and created awareness of interpretation needs. However, providing RVI did not improve HbA1c, LDL, blood pressure or medication adherence. 


Bilingual Dual-Role Staff Interpreters in the Health Care Setting: Factors Associated With Passing a Language Competency Test
International Journal of Interpreter Education. Online May 2012.
Full Article (subscription may be required)

Using Web-Based Training to Improve Skills Among Bilingual Dual-Role Staff Interpreters
International Journal of Interpreter Education. Online Nov 2011.
Full Article (subscription may be required)

Collecting Patient Race/Ethnicity and Primary Language Data in Ambulatory Care Settings: A Case Study in Methodology
Health Services Research Journal. 2009 Oct; 44(5 Pt 1):1750-61.
Full Article (subscription may be required)

Principal Investigators

  • Maria R. Moreno, MPH (Health Services Researcher, Sutter Health)
  • Regina Otero-Sabogal, PhD (Adjunct Professor, University of California-San Francisco)