HIPPA: Who can act as an interpreter during an emergency?

[gauss]

What is the name of your state (only U.S. law)? Massachusetts

Hi,

I am a volunteer at a local hospital's emergency department. (For the sake of privacy and reputation, I don't plan to reveal the name of that hospital.) I came across an interesting situation a couple days ago during my volunteer shift. A woman who didn't speak English seemed to be distressed, and seemed to be asking for directions based on her gestures (pointing left then right). A group of bilingual people (Spanish and English speaking) just happened to be standing nearby.

My question is, in that situation, am I allowed to ask random bilingual people if they would tell me what she's saying?

A coworkers speculates that it is illegal to ask a random person to interpret because there's no way to KNOW that what she is saying is not medical, which presumably would violate HIPPA. In the contrary, I am aware that people die in the emergency department frequently. For all I knew she could have been asking how to get back to l loved one's room who had minutes to live.

Please inform me of the law if you can. Thank you.

 

[OHRoadwarrior]

First it is HIPAA. Second it is legal as long as they authorize it.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/consumer_ffg.pdf

 

[ecmst12]

There would not be anything illegal about it but might not be a good idea. The hospital should have a policy for this situation.

 

[ajkroy]

Medical interpretation is different than just layman's interpretation. I have many bilingual students doing clinical internships at hospitals and they cannot interpret unless they are certified to do so, even though they are well aware of and covered by HIPAA. You don't want a doctor telling you have ankylosing spondylitis and the interpreter telling you that you have a swollen lymph node by mistake.

Most hospitals have interpreters on staff. If they don't, they have access to a 24-hour hotline that is staffed with medical interpreters that speak hundreds of languages and dialects. They just call the number, put the patient on another line, and the medical professional will speak through the interpreter on the phone.

 

[ecmst12]

Of course if this was not a patient, just a visitor looking for a room, that would not be medical interpretation. And the above situation wouldn't really have anything to do with HIPAA - if the woman would have revealed medical information to the "interpreter", she is allowed to do that, knowing that the information would then be relayed to the staff.

 

[gauss]

additional information

This happened in the entrance of the emergency department where patients and visitors alike are in street clothes (no gowns or wrist bands yet). I think this makes the situation more ambiguous.

The best thing I could do might be to learn how to ask a few questions in Spanish: 1. Are you looking for directions? 2. Is this a medical question? (If "no," then a bystander might be able to interpret.) That's my proposed solution. I'm also a trainer, so if that solution is liked, I could pass this along to my trainees.

 

[LdiJ]

This happened in the entrance of the emergency department where patients and visitors alike are in street clothes (no gowns or wrist bands yet). I think this makes the situation more ambiguous.

The best thing I could do might be to learn how to ask a few questions in Spanish: 1. Are you looking for directions? 2. Is this a medical question? (If "no," then a bystander might be able to interpret.) That's my proposed solution. I'm also a trainer, so if that solution is liked, I could pass this along to my trainees.

I disagree a bit, and will expand...a simple inquiry to determine whether the issue is directions, a medical issue, or an emergency happening in the parking lot is very different than a possible HIPPA violation. Learning to ask a few simple questions is very different than being able to understand the answers to those questions.

I speak several languages. English of course, Spanish, Italian and some French...I can even muddle a bit in Portuguese if absolutely necessary. My fluency varies depending on how much I am using any one of them at any particular time. The more I use them, the more fluent I am. The less I use them, the less fluent I am.

My point is that I would certainly attempt to help if I saw a situation that required help. However, I would not attempt to help beyond the emergency unless BOTH parties wanted my help.

Again, is easy to learn a few simple phrases/questions, its NOT easy to understand the answers to those phrases/questions in an emergency or emotional situation.

 

[gauss]

I disagree a bit, and will expand...a simple inquiry to determine whether the issue is directions, a medical issue, or an emergency happening in the parking lot is very different than a possible HIPPA violation. Learning to ask a few simple questions is very different than being able to understand the answers to those questions.

I speak several languages. English of course, Spanish, Italian and some French...I can even muddle a bit in Portuguese if absolutely necessary. My fluency varies depending on how much I am using any one of them at any particular time. The more I use them, the more fluent I am. The less I use them, the less fluent I am.

My point is that I would certainly attempt to help if I saw a situation that required help. However, I would not attempt to help beyond the emergency unless BOTH parties wanted my help.

Again, is easy to learn a few simple phrases/questions, its NOT easy to understand the answers to those phrases/questions in an emergency or emotional situation.

I was referring to "yes or no" questions.

Example: Learning to ask in Spanish, "Are you a patient or is this about a patient? Yes or no? Si or no?" If the answer is, "no," then my understanding is that any random bilingual person can translate the question being asked. If the answer is, "yes," (and it's a medical question) then I believe a medical interpreter would be required by law. This way, there's no wait unless necessary.

That seems like the best solution to the problem in the topic so far IMO. Please feel free to comment on this or add additional suggestions.

(Hotline idea: I'm not sure that volunteers have access to a 24 hour hotline. It would be nice if we did. If we did, then I'm pretty sure that they wouldn't want us calling it all the time when we can't understand a guest asking for directions to the bathroom or something non-medical. We would need to find a way to screen questions before calling.)

 

[I'mTheFather]

Surely, the hospital has a policy that covers just such an occurrence. Why not ask a supervisor/administrator/etc?

 

[cbg]

You are overthinking this to an extreme degree. If they voluntarily tell you anything medical then it's not a HIPAA violation because they are allowed to tell their own medical information to anyone they want, including strangers on the street (or in the lobby).

Also, if you are a volunteer this is not your problem to solve.

 

[gauss]

Surely, the hospital has a policy that covers just such an occurrence. Why not ask a supervisor/administrator/etc?

I don't think there's a clear policy of what we CAN do. My experience has been that when I research things like this on my own and come up with a good solution, others tend to adopt that, and then it becomes procedure. I think my solution of learning some simple questions in Spanish is that solution.

If it were NOT a solution, then we would probably get stuck ignoring or saying "I don't speak Spanish" to people, who would then have to wait 10 or more minutes for an interpreter, which is plenty of time for someone to die. I don't want to feel as though I'm blowing someone off in that situation, or have them remember me for doing it. Spanish speakers shouldn't be put in that position either IMO.

 

[Proserpina]

I don't think there's a clear policy of what we CAN do. My experience has been that when I research things like this on my own and come up with a good solution, others tend to adopt that, and then it becomes procedure. I think my solution of learning some simple questions in Spanish is that solution.

If it were NOT a solution, then we would probably get stuck ignoring or saying "I don't speak Spanish" to people, who would then have to wait 10 or more minutes for an interpreter, which is plenty of time for someone to die. I don't want to feel as though I'm blowing someone off in that situation, or have them remember me for doing it. Spanish speakers shouldn't be put in that position either IMO.

If the patient is going to die within 10 minutes, a translator isn't going to help one iota.

If someone is that close to death, it's generally pretty damn obvious to ER staff.

 

[I'mTheFather]

I don't think there's a clear policy of what we CAN do.

Yeah, I wasn't really suggesting that they have a policy regarding what you CAN do, but rather a policy about how to handle the need for an interpreter. As already stated, you are overstepping here. The hospital should be directing your actions in this scenario.

My experience has been that when I research things like this on my own and come up with a good solution, others tend to adopt that, and then it becomes procedure. I think my solution of learning some simple questions in Spanish is that solution.

I am rarely so blunt, but that's a dumb idea. You will waste more time trying to communicate with someone with whom you simply cannot communicate, than you would by finding a random person or employee who can translate.

If it were NOT a solution, then we would probably get stuck ignoring or saying "I don't speak Spanish" to people, who would then have to wait 10 or more minutes for an interpreter, which is plenty of time for someone to die. I don't want to feel as though I'm blowing someone off in that situation, or have them remember me for doing it. Spanish speakers shouldn't be put in that position either IMO.

Ask any random person to translate. I cannot imagine any circumstance in which a HIPAA violation would be a concern. What exactly are you doing as a volunteer that would make that a concern?

 

[cbg]

And as already pointed out, IF THE PERSON VOLUNTEERS THEIR OWN MEDICAL INFORMATION IT IS NOT A HIPAA VIOLATION!!!

You and your co-workers are making up things to worry about.

 

[realfilm]

How would you even know the interpreter is telling you the truth in what the other person is saying being you dont know that language.