In the United States, significant disparity exists in the vital healthcare documents being provided to limited English-proficient (LEP) patients. In 2007, a nationwide survey of hospitals by The Joint Commission found that only 50 percent of hospitals had translated informed consent documents. Even then, the translations were often only available in Spanish. Other types of documents were translated even less frequently. Hospitals, with limited budgets for language services, are struggling to allocate resources to create quality, translated documents for their patients. During the 2005 Roundtable on Health Disparity and Information Technology, the Agency for Healthcare Research and Quality (AHRQ) and the Office of Minority Health (OMH) identified a national repository of translated documents as a high priority need to reduce medical errors due to language miscommunication. During Phase I of this grant, we developed and evaluated a new web-accessible platform for documents that demonstrated feasibility in creating, managing, sharing, printing, and speaking documents to patients in foreign languages. This platform, called TDARS (Translated Document Assembly and Retrieval System), allows healthcare organizations to quickly assemble coherent vital healthcare documents, instantly create quality, translated versions that can be printed, and then instruct a computer to read the translated documents to the patients. TDARS offers a high degree of flexibility in customizing documents for each organization, enables documents to be shared among institutions, provides a method to comply with The Joint Commission's document access standards, and can do all this for less than the average cost of translating one document in one language - making a library of documents economically accessible to even the smallest hospitals. During Phase II, our objective is to develop a commercial Software-as-a-Service (SaaS) product for hospitals and other healthcare organizations offered through a subscription-pricing model. We will expand TDARS to include a core set of documents identified as being of greatest need during our Phase I evaluation, making them available in the languages identified as being most common and challenging nationwide (Spanish, Mandarin, Cantonese, Vietnamese, Russian, Arabic, Korean, and Somali). Thirty participating sites will be recruited that represent our target market population of small and medium-sized hospitals.
A national repository of quality, pre-translated documents that can speak the documents to patients could dramatically reduce the disparity of information provided to our limited English proficient patients. Current methods of translating documents are expensive, the quality of translations is inconsistent, and efforts are being duplicated by multiple hospitals. Both the Agency for Healthcare Research and Quality (AHRQ) and the Office of Minority Health (OMH) have indicated that creating such a repository is a national priority.