Is video interpretation compromising care for the hearing loss population?

The convergence of hearing impairment and language barriers presents unique communication challenges to patients and practicing otolaryngologists. Limited data exist comparing interpretation methods for patients with hearing loss. Patients with hearing loss rely on visual cues, lip-reading, written communication, and/or comprehensive interaction techniques, which may encounter limitations by remote services. Herein, we examine patient and otolaryngology provider satisfaction, cost, and encounter efficiency between virtual and in-person interpretation among adults who speak Mandarin and Cantonese.

This study is a prospective, randomized controlled trial in patients with moderate-to-severe bilateral hearing loss, Limited English Proficiency, and a primary language of Mandarin or Cantonese. Fifty-two patients were randomized to either in-person or virtual interpretation conditions. Patient satisfaction was measured using an 8-item Likert scale assessing communication effectiveness, encounter efficiency, and overall quality. Otolaryngology provider satisfaction was measured using a 1-item Likert scale. Encounter time, cost, and communication difficulty were measured and compared using independent sample t-tests.

Patient and otolaryngology provider satisfaction scores were significantly higher with in-person interpretation (p < 0.05 for 7 of 8 patient items; physician mean score 4.9, p < 0.001, r = 0.54) compared to virtual interpretation (physician mean 3.8) conditions, while overall quality of the encounter remained the same. There was no significant difference in the length of encounters or in the number of times patients requested interpreter repetition between groups. A difference in average cost existed for in-person interpretation ($14.50) compared to video interpretation ($25) services for an average length appointment.

Patients and otolaryngologists reported higher overall satisfaction with in-person compared to virtual interpretation services. In-person interpretation yielded better comprehension in the hearing loss population among Mandarin and Cantonese-speaking patients and demonstrated a cost advantage over virtual interpretation.