Using video conferencing for communicating with deaf patients

Research on Video Relay Interpretation (VRI) indicates that video conferencing can help deaf patients overcome interpretation barriers and enhance communication outcomes with healthcare personnel. However, the video tools used to achieve this can pose challenges for HIPAA compliance.

Go deeper: What is the key to HIPAA compliance?

The importance of effective communication in healthcare

According to Mark Wheately, executive director of the European Union of the Deaf (EUD), the inability of healthcare staff to communicate in sign language forces patients to rely on interpreters instead of direct communication in their native language. When interpreters are not available, patients must either bring family members (who lack medical training) or rely on written notes, which is inadequate. During the COVID-19 pandemic, these challenges were exacerbated by face masks that obstructed the visibility of mouth movements and facial expressions, resulting in increased miscommunication and feelings of isolation.

The Americans with Disabilities Act (ADA) and Section 1557 of the Affordable Care Act (ACA) ensure that healthcare providers do not discriminate against patients based on disability or other protected categories. This includes making services accessible, providing language assistance, and ensuring effective communication through interpreters or video relay services, while also addressing compliance with regulations such as HIPAA.

Read more: The significance of the nondiscrimination rule in health programs and activities

The rise of telehealth and video conferencing tools

A study on the state of telehealth before and after the pandemic revealed that telemedicine use jumped dramatically from limited adoption in hospitals to a 766% surge during the first three months of COVID-19. Despite this rapid expansion, it wasn't enough to make up for the total drop in regular in-person doctor visits during the early pandemic period. 

The integration of VRI, a service that provides real-time sign language interpretation through video conferencing technology, emerged as a solution for maintaining healthcare access for deaf patients.

Overview of popular video tools

• Zoom for Healthcare: Designed specifically for medical settings, offering HIPAA compliance when using the appropriate plan and signing a Business Associate Agreement (BAA). It provides high-quality video and audio essential for clear communication.
  • VRI support: Zoom facilitates VRI by allowing third-party interpreters to join appointments securely. The platform's gallery view lets the patient, provider, and interpreter see each other simultaneously, which is crucial for effective sign language interpretation.
  • Security features: End-to-end encryption and robust access controls protect patient confidentiality, ensuring compliance with privacy regulations.
  • Accessibility: Zoom's support for VRI services makes it a valuable tool for connecting deaf patients with qualified interpreters, reducing barriers to care and enhancing communication during medical consultations.

Go deeper: Is Zoom HIPAA compliant? (Update 2024)

• Google Meet: Part of Google Workspace, can be configured for HIPAA compliance with certain enterprise-level plans and a signed BAA.
  • VRI support: While Google Meet doesn't have built-in VRI services, it allows external interpreters to join meetings. The platform supports multiple participants, enabling seamless communication between the patient, provider, and interpreter.
  • Features: Real-time captions provide visual text support, although they're not a substitute for professional sign language interpreters.
  • Accessibility: By facilitating the inclusion of interpreters in virtual meetings, Google Meet helps make healthcare services more accessible to deaf patients, though providers must ensure they have the correct settings and agreements in place.

Go deeper: Is Google Workspace HIPAA compliant? (2024 Update)

• FaceTime: A video calling app available on Apple devices, known for its ease of use and high-quality video.
  • VRI limitations: FaceTime does not offer integrated VRI services or advanced features to support professional interpreter participation in a healthcare setting.
  • HIPAA compliance: Apple does not provide a BAA for FaceTime, making it non-compliant with HIPAA requirements for handling Protected Health Information (PHI).
  • Accessibility: Due to compliance issues and lack of support for interpreter integration, FaceTime is less suitable for facilitating accessible healthcare communication for deaf patients

Go deeper: Can I use FaceTime and be HIPAA compliant? (Update 2024)

FAQs

What is the key to HIPAA compliance when using video conferencing tools in healthcare?

The key to HIPAA compliance is using platforms that offer necessary security features like encryption and access controls, and securing a signed BAA with the service provider. This ensures both parties are committed to safeguarding protected health information (PHI) according to federal regulations.

Why is effective communication important in healthcare for deaf patients?

Effective communication ensures that deaf patients fully understand their medical conditions, treatment options, and care instructions. It leads to better health outcomes, enhances patient trust, and fulfills legal obligations under the ADA and ACA.

How can healthcare providers ensure effective and compliant use of VRI?

Providers should choose HIPAA compliant platforms with secure encryption, sign BAAs with service providers, obtain patient consent, train staff, test equipment regularly, prepare patients for the VRI process, and maintain privacy by conducting sessions in private spaces.