Publication date: 9 September 2021

The original article link: https://www.health.govt.nz/our-work/digital-health/digital-enablement/digital-enablement-stories/much-needed-online-asian-language-interpreter-service-being-piloted

The combined Asian population is predicted to be New Zealand’s second largest group within the next five years. But interpreter services have not kept up with this growth, and some Asian people being unable to access gambling and mental health and addiction support services as a result.

Asian Family Services, a subsidiary of the Problem Gambling Foundation of New Zealand, is trialling an interpreter service that takes an ‘Uber eats’ approach. Interpreters will be able to use a website to show when they are available and what languages they offer, and health agencies will be able to book the interpreter at the agreed time. The actual service will usually be delivered via videoconferencing.

The initiative has received funding from the Ministry of Health’s Digital Enablement Programme, which provides support for innovation in digital health care. The programme has a particular focus on co-investing in projects that improve access or participation for people who do not access health services and need to. It’s all about improving equity.

The Ministry is working closely with project teams, sharing learning between participating organisations as a community of practice and looking for opportunities to help others learn from these initiatives as they adopt and promote these or similar services elsewhere. The projects are examples of the types of innovation that will be supported by the better access to information enabled by the Hira programme.

Hira will be an ‘ecosystem’ of data and digital services that will enable consumers to access and control their health information through their choice of website or application using a digital device such as a smartphone, tablet or computer. New Zealanders will be more empowered to manage their health, wellbeing and independence. Organisations can work together to share information so that people don’t have to repeat personal details multiple times. Clinicians can harness digital technologies to improve services. The sector and digital innovators can design and contribute innovative data and digital services, making Hira more powerful.

Asian Family Services national director Kelly Feng says while there is an increasing demand for mental health and addiction support services from the Asian population, there are only a limited number of culturally and linguistically appropriate health services available.

‘This is a huge barrier for people trying to access support services. It means, for example, that a person who has been referred to community support or for a package of care may not be able to get the help they need – because it is only offered in a language they don’t understand.

‘Offering this digi language support interpreter services to health agencies can be the first steps to break the language barriers and improve access.’

Researcher and project lead Dr Bo Ning says recent research on Asian mental health and wellbeing, funded by the Health Promotion Agency, found nearly 48 percent of Asian people questioned said they couldn’t access language or cultural support regularly when using health services in New Zealand.

‘We heard anecdotally from one of our clinicians about a Chinese women who was having difficulty communicating with her GP because of the language barrier. She had to call her son in Britain, from the GP’s office, to interpret!’

The project – digital language services – is being undertaken in partnership with an IT company, who is building a platform called digi language support (DLS). The platform will be promoted to stakeholders like general practices or non-governmental organisations, who are servicing high Asian populations but do not have the capacity to support them with their language and therefore need to use interpreters. The pilot is for Auckland-based primary and community-based services.

Kelly says the aim is to recruit about 20 service provider agencies who need interpreter services, and about 100 interpreters who can provide those services.

‘Both will use the same platform – the interpreters put their available times and languages online, and the participant agencies put their information online, and a request for interpreter services. If there’s a match, the job will be delivered.

‘The services will use whatever video platform participants are happy with – such as Zoom or Teams. The service is also available over the telephone if there are technology issues, although video is preferred.’

Kelly and Bo are currently focused on developing policies and procedures outlining how the project will work, as well as ‘how to’ materials for participating agencies.

‘We will have multilayers of training, promotion and marketing – including an online video demo – so people really understand how it works,’ says Kelly.

While an urgent service is available, the participant agency will generally book the service beforehand. For example, a general practice would receive a booking from a patient they know has limited English and would book the interpreter service for the time of that appointment. Patients can also request the service to be booked, when they make their primary or community care appointment.

If needed, interpreters can translate an information page for a patient before the appointment, so they have relevant information before they come in.

‘For example, if a patient shouldn’t eat breakfast because they are having a particular test, the interpreter can let them know that. There is no point them coming in having eaten, and then the test can’t be done. That just wastes everyone’s time and money.’

The pilot will run for about 12 months, during which time the digital languages service will be free to participant agencies. The aim is to fund 1400 interpreter jobs during that time. After that, agencies using the service will need to pay, and that will be priced up. The service will always be free for the patient – it is their right to be able to communicate with services, says Kelly.

Kelly and Bo expect the biggest challenge to be working with agencies and patients on how the service works, and getting their buy-in; as well as recruiting the interpreters.

‘We know there is an interpreter workforce out there,’ says Kelly, but 100 is quite a large number and will take time. And then it is the languages we cover, because Asian is quite complex, with a large number of different languages and dialects spoken in New Zealand. We might not be able to cover every single language straight away, but we will keep building that capacity.’

Bo says, while the focus of the pilot is on mental health and addiction, it could potentially be used much more widely.

‘If this model works, it could be used for all health services, and wider – Police, refugee services, the whole public service.’

The evaluation will include feedback from the agencies and consumers taking part. The project aims to improve access to primary and community care services, participation in those services, and patient experience.

Kelly says, for her, the most exciting thing about the digital language service is the difference it could make to someone’s life.

‘I hear all the time about Asian people falling through the gaps and not being able to access services. It is quite devastating to see some of the things happening in the Asian community – like our suicide rates going up. I would like to see how we can at least solve some of the problems, take away some of the barriers.’