By Suzi Birz, principal, HiQ Analytics, LLC
If you’ve ever traveled to a foreign country in which you
don’t know the language, you know how quickly you can become confused. When a
patient with limited English proficiency arrives in an emergency room with an
injury or illness, that confusion quickly turns to discomfort and
frustration—sometimes even fright. In the emergency room at Johns Hopkins
Hospital in Baltimore, Maryland, patients requiring a translator during the
nighttime hours might wait as long as 60 minutes for a translator to travel from
home to the hospital, causing not only a reduction in patient but also a
decrease in patient satisfaction. Enter Dr. Robot.
Dr. Robot, the InTouch Health RP7, from InTouch Health in
Santa Barbara, California, has been roaming the halls at Johns Hopkins, allowing
remote presence of physicians at patients’ bedside and being used in a variety
of other pilot programs.
Knowing that speed is of the essence in the emergency room,
where physicians, nurses and family members often must make quick decisions,
Alex Nason, director of telemedicine at Johns Hopkins Medicine, recognized that
Dr. Robot could also enable the hospital’s on-call translator to reach the
patients faster than if the translator had to travel to the hospital. In
December 2006, a program was launched addressing the Spanish-speaking
population, which accounted for roughly 60 percent of the ER’s interpretation
requests. Between 10 p.m. and 7 a.m., Dr. Robot provides the presence of the
live translator to the patient.
Tina Tolson, RN, MSN, Johns Hopkins Hospital’s nurse manager
for the emergency department said, “the patients, nurses and physicians
appreciate the accessibility to a translator that the robot offers.”
How does it work?
Generally, the process starts with the triage nurse.
“We call the translator and provide the information,” Tolson
explained. The translator has a laptop computer with a joystick at home. Using
this setup, the translator activates the robot and using the hand controls
wheels the robot to the patient location. “Dr. Robot can even unplug himself
from the wall outlet.”
In just a few minutes, the patient sees the translator’s face
on a screen that occupies the top of the robot, in the position of the head. The
translator can see the patient and the nurse.
“The patient and the caregiver converse with the translator
doing the interpretation. Since the translator can see the patient, he can ask
questions like point to where it hurts,” Tolson added.
“The patient does not lose the personal contact with the
interpreter because he or she can still see the interpreter’s face,” she
continued. “If the patient has to go to another location, for instance a room or
critical care, the robot goes along.”
With this mobility, the translator can speak to the patient’s
family even if they are in another room. When Dr. Robot’s services are no longer
required, he wheels himself home.
Tolson noted: “Someone just has to plug him in.”
What is a patient’s reaction?
Patients are scared or skeptical at first. The key is in
demonstrating that there is a live translator operating the robot.
“Feedback from the translator is that it takes about one
minute for patients to become comfortable talking to the robot and to recognize
that there is a live person behind that TV screen image,” Tolson said.
What is the impact on patient safety?
Spanish-speaking patients now have nearly immediate access to
a trained translator enabling the care process to continue without barrier of
language and without barrier of time delay. The “trained” part of trained
translator is an important distinction. Previously, if the translator was on the
way and the situation warranted getting started, staff would hunt around for a
staff member with the appropriate language skills. But, the language skills are
not the entirety of serving as a translator.
“Having access to a trained translator is a fantastic resource
for the caregivers and the patients,” Tolson noted.
If the pilot is successful, Johns Hopkins Hospital hopes to
expand to more languages and to make the robot available during the day as well.
This would enable any of the interpreters in the station to operate it and have
quicker access to patients.
“This is a wonderful resource to patients and nurses,” Tolson
concluded. “Telemedicine has a positive impact on patient satisfaction and
For more information visit the Web sites of Johns Hopkins Hospital and InTouch Health.
© 2007. AMN Healthcare, Inc. All Rights Reserved.