Remote medical interpreting has become the most popular method for healthcare institutions to provide language accessibility services. However, interviews with numerous providers have revealed a frequent issue: the low overall audio quality in remote interpreting sessions and frequent call drops.

This article explores current methods of remote medical interpreting, common challenges faced, factors affecting interpretation quality, and how No Barrier addresses these issues.

Remote Medical Interpreting Methods

Over-the-Phone Interpreting (OPI)

Phone-based interpreting utilizes the Public Switched Telephone Network (PSTN) infrastructure.

Advantages:

• PSTN is known for its consistent call quality and reliability
• Widely accessible

Disadvantages:

• Lower audio quality - also known as "narrowband" audio
• Lack of visual cues

Spectrogram¹ of a normal adult male voice - consistently reaches 10,000 Hz

The spectrogram shows a male voice with frequencies reaching up to 22 kHz, with strong content up to 10 kHz.
However, when transmitted through a traditional phone network, everything above about 3.4 kHz is cut off. This means all the green areas in the upper part of the image - representing the voice's higher frequencies - are lost.

The result is a voice that sounds less crisp and natural, missing the subtle qualities that the higher frequencies provide - which is why phone voices often sound muffled compared to the full-spectrum voice we see visualized here.

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2. Video Remote Interpreting (VRI)

Internet-based interpreting can be used for both video and audio interpreters.

Advantages:

• Supports wideband, AKA "HD voice" - which can provide noticeably better audio quality than traditional PSTN
• Video capability for improved communication

Disadvantages:

• Network stability varies depending on factors like Wi-Fi signal and bandwidth, which can lead to delayed communication
• Potential for connectivity issues on the public network
• The process of transmitting sound over the web is complex and may occasionally create variations in quality
• Video consumes more bandwidth than audio-only traffic (anywhere between 6 to 40 times more data usage depending on technical factors)

Common Challenges in Remote Interpreting

Audio Quality Issues

Poor audio quality in medical encounters can lead to misunderstandings, the need for frequent repetition, and a generally poor experience for both the patient and the provider. According to providers, interpreters often sound "far away," and the returning audio is unclear, necessitating frequent requests for repetition.
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Call Drops and Connectivity Problems

Another phenomenon reported by providers is frequent call drops. Unstable connections can result in interruptions to the flow of communication, potentially causing critical information to be missed.
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Factors Affecting Interpretation Quality

Several factors can impact the quality of remote medical interpreting:

• Interpreter location (domestic vs. international)
• Quality of interpreter's equipment (computer, headset, internet connection)
• Robustness of the vendor's application and infrastructure
• Healthcare institution's network infrastructure
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How No Barrier Addresses the Infrastructure Challenges

No Barrier has implemented several strategies to optimize the remote interpreting experience as part of its AI-enhanced medical interpreting service:

1. US-based servers: Ensuring proximity to reduce latency
2. Consistent high-quality audio: AI interpreter always delivers clear audio on the healthcare institution's local device, in a consistent manner
3. Optimized internet traffic: Employing various techniques to minimize latency despite using internet networks

Conclusion

While remote medical interpreting has greatly improved language accessibility in healthcare settings, audio quality and connectivity issues remain significant challenges. No Barrier's innovative approach, combining AI technology with optimized infrastructure, addresses many of these concerns, potentially setting a new standard for remote medical interpreting services.

By continually refining and improving remote interpreting technologies, we can ensure that language barriers do not compromise the quality of healthcare provided to patients with limited English proficiency.

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Resources:
¹ Why remote interpretation doesn’t work for interpreters - here

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