Five Capabilities Health Systems Should Ask from Their Language Service Provider

Language Services Providers (LSPs) who provide access to interpreters (onsite, audio, video) and translation services have played a critical role in a health system’s ability to provide care for their diverse patient populations.

Data for these vendors provide a narrow view into the overall impact of a language access program. This can include per-minute rates by language or modality, language availability, wait times, device availability, or minutes utilized. Don’t get me wrong: these measures matter, but there is much more that LSPs can do to fit into the overall value of a health system’s language program.

“How easy is it for our providers to access interpreter services from every location across our health system? “

“What are the inefficiencies along the patient journey that are leading to unnecessary manual work or delays for our providers? How is this impacting patient satisfaction...or our Length of Stay (LOS) metrics? What about readmission rates?”

“What is our exposure to compliance risk? How does improved access to language services improve throughput?”

"What is our reputation with communities of various patient populations in the areas we serve?”

These are the sort of questions that LSPs must be able to help health systems answer and to then, optimize. A patient’s communicative autonomy and understanding at every step along their patient journey, from admission to post-discharge follow-up, requires careful considerations of all the nuances that come with every interaction they have with the system.

In a 2012 study of 3,071 hospitalized patients with limited English proficiency at a tertiary care hospital, patients who lacked professional interpretation at admission, or at both admission and discharge, stayed 0.75 to 1.47 days longer than patients who received interpretation at both points. Patients who received interpretation at admission, discharge, or both were also less likely to be readmitted within 30 days.

When a service can impact patient flow, safety, experience, overall costs, and revenue, price-per-minute paid to an LSP is only one part of its value. Health systems need a partner that can help turn language access into a measurable, well-integrated enterprise capability.

The following five capabilities help distinguish the two.

1. Analytics that lead to action

A basic utilization report shows how much interpretation was used. For example, overall utilization may look appropriate while one hospital, department, or patient population is using interpreter services less often than expected based on its language needs. Likewise, a strong average speed to answer across all usage can mask longer waits for less commonly requested languages. Looking at utilization alongside patient language mix, location, language, modality, and connection times helps health systems identify those gaps and determine where to focus training, staffing, technology, or workflow improvements. A strategic partner helps connect those patterns to action by showing where and when access is breaking down, why it may be happening, and what the health system can do next.

Health systems should expect reporting that can be segmented by site, service line, language, modality, and time of day. Average speed to answer and fulfillment should be visible by language rather than presented only as a blended average that can hide delays for less common languages. When health system data is available, reporting should also help compare identified language needs with actual interpreter use to reveal possible gaps in adoption.

Useful analytics should answer questions such as: 

• Which locations or departments show lower-than-expected utilization?
• Are clinicians reaching interpreters reliably across the system's actual language mix?
• Where are connection delays, abandoned requests, or device access creating friction?
• How is demand changing, and what does that mean for staffing, modality, and budget?
• What specific actions should the health system take based on the data?

2. Integration into clinical workflow

Language access should be available within the tools clinicians already use. Every separate login, disconnected device, or manual documentation step creates another opportunity for delay or inconsistent use can directly impact provider satisfaction.

Health systems should look for proven EHR and telehealth integration, streamlined authentication, point-of-care access, and a device strategy suited to different clinical environments. Capabilities such as auto-drafted compliance documentation into the EHR can reduce administrative work while creating a more consistent record of interpreter use.

The real measure of integration is whether clinicians can use it under pressure. That requires more than a technical connection. A strategic partner should help design workflows, configure access by setting, support implementation, train staff, and monitor adoption after go-live.

Questions to ask include: 

• How many steps does it take to reach the right interpreter from the clinician's normal workflow?
• Can interpreter access work across inpatient, ambulatory, emergency, virtual care, and contact-center settings?
• How is interpreter use documented in the patient record?
• What implementation and adoption support is included? 
• How will the provider identify and address workflow barriers after launch?

3. Healthcare-only interpreter quality and reliable performance

Availability and quality must be evaluated together. Clinical interpretation requires command of medical terminology, interpreter ethics, privacy, role boundaries, and the pace and complexity of healthcare encounters.

In a six-hospital pilot study of voluntarily reported adverse events, 52.4% of events involving patients with limited English proficiency were associated with communication failures, compared with 35.9% among English-speaking patients.

In a separate randomized controlled trial across two emergency departments, access to in-person, professionally trained medical interpreters significantly increased both patient and provider satisfaction with communication among Spanish-speaking patients with limited English proficiency.

Health systems should ask language service providers to demonstrate: 

• Healthcare-only interpreter training and qualification standards
• Ongoing quality assurance, coaching and remediation processes
• Transparent performance by language and modality
• Reliable coverage for common and less common languages, including American Sign Language (ASL) and Certified Deaf Interpreter (CDI)
• Clear escalation pathways when clinical or service issues occur
• Appropriate privacy, security, and business continuity controls

Language lists and network size can help establish capacity. Consistent clinical quality shows whether that capacity can support safe, effective communication for all.

4. Outcome support tied to health system priorities

Call volume alone cannot show whether a language access program is working. A strategic partner should begin with the outcomes the health system is trying to improve, then help define how language access can support them.

That may include: 

• Measuring professional interpreter use at high-risk moments such as admission, informed consent, medication reconciliation, and discharge
• Stratifying patient experience and safety data by preferred language
• Examining relationships among interpreter use, length of stay, readmissions, discharge delays, and follow-up
• Establishing a baseline before a workflow change or expansion
• Designing targeted pilots and evaluating results
• Reporting findings in a form that clinical, operational, and executive leaders can use

Published research points to a gap many health systems may recognize in their own data: patients with limited English proficiency report lower satisfaction with their care and worse experiences communicating with their care teams than English-proficient patients. Stratifying patient experience scores by preferred language can help show whether that same gap exists locally, and where it is most pronounced across sites, units, or patient populations.

That kind of visibility can help reframe language access as a patient experience improvement opportunity and give health systems a clearer view of where targeted changes may be needed. Once a gap is identified, leaders can look at what may be contributing to it and respond accordingly. For example:

• Workflow barriers may point to a need to integrate interpreter access directly into the EHR
• Low utilization at certain sites may signal device access or staff adoption issues
• Communication gaps around consent or discharge may highlight a need for translated materials
• Differences across units may indicate where additional training or reinforcement is needed

The goal is to let findings guide the intervention, then use follow-up measurement to determine whether those changes are improving patient experience scores.

Outcomes support requires disciplined measurement and honest acknowledgment that interpretation is one of several factors influencing a clinical result. The language services partner's role is to help quantify its contribution, identify meaningful patterns, and turn those findings into improvement work; not to claim credit for outcomes it cannot isolate.

This also makes the value of language access more visible across departments. Patient experience leaders may focus on whether patients feel heard and included. Quality teams may examine communication-related safety events. Nursing leaders may look at delays and workflow burden. Finance and operations may focus on length of stay, productivity, and total cost. A strategic partner should help connect the same program to each of those priorities without reducing its value to a single metric.

5. Governance and continuous improvement

The clearest sign of a strategic partnership is what happens after go-live. Language needs change, clinical workflows evolve, new sites open, technology stacks shift, and utilization patterns reveal opportunities that were not visible during implementation.

A mature partnership should include:

• Defined executive and operational ownership
• Regular business reviews with agreed-upon measures and next steps
• Staff education and adoption support
• Service recovery and escalation processes
• Recommendations based on population, utilization, and performance trends
• A roadmap aligned with the health system’s clinical and technology strategy

Compliance remains an essential baseline, and the ground beneath it is moving. Title VI of the Civil Rights Act and Section 1557of the Affordable Care Act continue to require covered health programs to take reasonable steps to provide meaningful access for individuals with limited English proficiency. The federal guidance that shaped how many organizations operationalized those obligations has changed in recent years, and further movement is likely.

That volatility, itself, is an argument for the partnership model. A vendor waits to be told what the requirements are. A strategic partner tracks regulatory and accreditation developments, translates them into practical process changes, and helps the health system maintain consistent documentation, staff readiness, and oversight without rebuilding the program each time the guidance shifts.

What to ask in a strategic language access partner

Before selecting or renewing a language access provider, ask for evidence of the partnership model:

1. A sample dashboard showing performance by site, language, modality, and time period
2. An integration plan covering clinical workflows, documentation, devices, training, and adoption
3. Interpreter qualification and quality-assurance standardsspecific to healthcare
4. A measurement plan tied to the health system’s operational and clinical priorities
5. A governance cadence with named owners, review points, and continuous-improvement commitments
6. Transparent pricing that makes fees, assumptions, and scaling costs clear

Per-minute rates still belongs in the decision. It should be evaluated alongside the total program picture, including clinician time, workflow friction, adoption, documentation burden, service reliability, and the costs associated with communication gaps.

Health systems have the opportunity to manage language access as an enterprise performance capability, and that shift raises the standard for language service providers. The strongest partners bring the data, technology, clinical expertise, and ongoing support needed to help a health system improve how care is delivered across languages.

Martti’s full white paper, Language Access as a Strategic Performance Driver, explores this framework and the total-cost considerations behind it in greater depth.

Endnotes

1. ^{Lindholm, M., Hargraves, J. L., Ferguson, W. J., & Reed,G. (2012). Professional language interpretation and inpatient length ofstay and readmission rates. Journal of General Internal Medicine,27(10), 1294–1299.}
2. ^{Divi, C., Koss, R. G., Schmaltz, S. P., & Loeb, J. M.(2007). Language proficiency and adverse events in US hospitals: A pilot study.International Journal for Quality in Health Care, 19(2), 60–67.}
3. ^{Bagchi, A. D., Dale, S., Verbitsky-Savitz, N., Andrecheck, S., Zavotsky, K., & Eisenstein, R. (2011). Examining effectiveness of medical interpreters in emergency departments for Spanish-speaking patients with limited English proficiency: Results of a randomized controlled trial. Annals of EmergencyMedicine, 57(3), 248–256.e4.}
4. ^{Sliwinski, K., Kutney-Lee, A., McHugh, M. D., & Lasater,K. B. (2024). A review of disparities in outcomes of hospitalized patientswith limited English proficiency: The importance of nursing resources. Journal of Health Care for the Poor and Underserved, 35(1), 359–374.}