From HIMSS TV | Interview by Kate Milliken | Featuring Dr. Jeffrey Chen, ER Physician & No Barrier Clinical Advisor
When Dr. Jeffrey Chen walks into his emergency department (located minutes from the SF international airport) he never knows what language the next patient will speak. Spanish, Arabic, Cantonese, Russian, Turkish. The diversity is the reality of American healthcare. And for years, the system's answer to that reality has been a single iPad connected to an interpreter. In a conversation with Kate Milliken at HIMSS, Dr. Chen explained why that answer is no longer good enough and what AI-powered interpretation is changing at the point of care.
1. The language barrier is a clinical emergency hiding in plain sight
1.1 One iPad. An entire hospital. A broken system.
Dr. Chen's hospital sits next to an international airport. On any given shift, his team encounters patients who speak little or no English or who speak it well enough for daily life but not nearly well enough to navigate a clinical conversation about symptoms, diagnoses or consent. The current standard solution is a single iPad that connects to a remote human interpreter. One device. Shared across an entire facility.
The problem is not the concept. The problem is the friction. When a provider needs an interpreter, they first have to find the iPad, then locate the right language service, then wait for an available interpreter to connect. In non-critical situations that delay is an inconvenience. In the emergency department, it is something else entirely.
1.2 10 to 15 minutes that can be life or death
Dr. Chen is direct about the stakes. In a critical situation, 10 to 15 minutes is not a scheduling delay. It is a window in which a patient cannot communicate their symptoms, a provider cannot confirm their understanding and clinical decisions are made with incomplete information. The language barrier in emergency care is not a diversity and inclusion issue filed away in a hospital's equity report. It is an active patient safety risk that plays out in real time, on every shift, in emergency departments across the country.
1.3 The human cost no one talks about
Beyond the clinical risk, there is a human cost that Dr. Chen calls "LEP burnout". The cumulative toll that language barriers impose on medical staff. Getting an interpreter on the phone is not instant. There are drop-offs, long wait times and moments where no interpreter is available at all. At 3 am, Dr. Chen notes, there is simply very low chances of a Turkish interpreter accessible through even the most established national interpretation networks. The gap is not theoretical. It is a 3 am reality that providers absorb quietly, shift after shift.
Dr. Chen's personal response to that gap was to spend years learning Spanish. Not as a professional requirement but as a human one. He wanted to create a bond with his patients. To be present with them rather than mediated through a device. The fact that a physician felt compelled to learn a second language to compensate for a systemic failure says everything about how serious the problem is.
2. What No Barrier changes at the point of care
2.1 A point-of-care solution built for the way medicine actually works
No Barrier is a HIPAA-compliant, AI-based web application designed to work on any connected device (a phone, a desktop, a shared computer). There is no specialized hardware to track down, no iPad to locate, no queue to join. A provider opens No Barrier, selects the patient's language and begins the conversation. Instant. The patient receives the provider's words in their own language. When the patient responds, No Barrier translates their reply into English so the provider can follow, respond and move forward.
In real time, without interruption, without a third party in the room.
This matters beyond convenience. The third person in the room syndrome. The way a remote interpreter, however skilled, changes the dynamic of a clinical encounter. When a provider is delivering difficult news, the patient's attention splits. They look at the device, waiting for the interpreter to relay what the doctor just said. The emotional connection that a provider works to build (the trust that is itself a clinical tool) is interrupted. No Barrier removes that interruption. The conversation stays between the provider and the patient, where it belongs.
2.2 Not Google Translate. Medically trained, contextually aware
The comparison to Google Translate is inevitable and Dr. Chen addresses it directly. For ease of use, yes. No Barrier is accessible and immediate in the way that consumer translation tools are. But the similarity ends there and the differences are the ones that matter in a clinical setting.
General-purpose translation tools produce linear output. They convert words. No Barrier is built on contextual interpretation. It understands dialect, nuance and the way meaning shifts depending on who is speaking and in what clinical context. A patient from Mexico and a patient from Puerto Rico may use different Spanish words for the same symptom. A word that means one thing in a primary care conversation means something different in oncology. No Barrier is specifically tuned for healthcare language, trained on medical vocabulary and designed to handle the complexity of clinical conversation in a way that no general translation engine is equipped to do.
2.3 When AI is uncertain, it says so
One of the most clinically significant differences between general AI and medically trained AI is what happens at the edge of confidence. General AI systems can hallucinate. Producing fluent, plausible output that is factually wrong. In a consumer context, that is an annoyance. In a clinical context, it is risky.
No Barrier addresses this with a built-in flag. When the AI encounters a term, phrase or contextual ambiguity it cannot resolve with sufficient confidence, it surfaces a signal to the provider. This is not a limitation of the technology. It is a design principle. A medically trained AI that knows when to pause is safer than a general AI that never does.
3. Why No Barrier is a triple win for patients, providers and health systems
3.1 Patients: access to equitable care without compromise
For limited English proficient patients, No Barrier means arriving at a point of care and being understood. Not after a 15-minute wait, not through a disembodied voice on a shared tablet but immediately and directly. The equity argument for language access in healthcare has been documented extensively, including in the NEJM Catalyst research that cited No Barrier. What Dr. Chen adds to that argument is the frontline reality: he once had to deliver the news of a miscarriage to a Spanish-speaking patient, watching her look past him at an iPad, waiting for an interpreter to tell her what her doctor had just said. That moment should not happen. No Barrier is built to ensure it does not.
3.2 Providers: autonomy, presence and an end to LEP burnout
No Barrier does not just solve a logistics problem. It gives every member of a care team (from intake to scheduling to clinical staff) the ability to communicate directly with patients in their language. Dr. Chen's years of learning Spanish to bridge a gap that the system failed to close is a story of individual resilience compensating for institutional failure. No Barrier makes that compensation unnecessary. It gives providers the autonomy to be present, to focus on the patient in front of them and to practice the kind of connected, attentive medicine that drew most of them to the profession.
3.3 Organizations: a cost reduction that compounds over time
Human interpretation is expensive and the cost is growing. The LEP patient population in the United States is not shrinking. The demand for qualified interpreters (telephonic, video and on-site) is increasing. The per-encounter cost, the administrative overhead and the indirect costs of delayed care and extended encounters add up to a significant and expanding line item for any health system. No Barrier offers organizations a path to meaningful cost reduction without compromising access or quality. That is not a tradeoff. It is the point.
Dr. Chen closed his conversation with Kate Milliken at HIMSS with something that stayed with the room. Technology, he said, is going to improve patient care and he is glad that HIMSS chose to feature No Barrier as part of that story. Coming from a physician who has worked the 3 am shift, learned a second language to connect with his patients and watched a grieving woman look past him at an iPad that is not a marketing sentiment. It is a clinical one.
This article is based on an interview conducted by Kate Milliken for HIMSS TV, featuring Dr. Jeffrey Chen, emergency physician and advisor to No Barrier.
.svg){kind=small}
%201.png)