The Future of Healthcare: “Language barriers are a significant contributing factor to health disparities in the US.” With Scott W. Klein, CEO of LanguageLine
We see healthcare issues through the lens of language. To us, it’s not shocking that there are massive health disparities for minorities living in the U.S. For example, it’s astounding that 45 percent of Hispanic boys and 53 percent of Hispanic girls living in the U.S. are predicted to develop diabetes in their lifetimes. In general, ethnic minorities here are twice as likely to develop a chronic disease compared to their non-Hispanic white counterparts. Language barriers are a significant contributing factor to these disparities. They impact access to quality care and result in higher readmission rates for people with limited English proficiency. I would work to reduce these barriers to care by increasing access to qualified medical interpreters — no more relying on family members, children, or untrained staff. When healthcare organizations use qualified medical interpreters, fewer errors are made, fewer unnecessary tests are ordered, and quality care improves. Likewise, when patients receive their discharge instructions and patient educational materials in the language they speak, they are less likely to return to the emergency room. Ensuring effective communication for limited English proficient and deaf and hard-of-hearing patients will improve quality of care, reduce readmission rates that are another factor in high healthcare expenses, and improve patient satisfaction. All of this would drive down healthcare costs.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Scott W. Klein, President & CEO of LanguageLine Solutions. Scott W. Klein joined LanguageLine Solutions as President and Chief Executive Officer in 2012. He is a seasoned executive with many years of leadership experience and success with achieving profitable growth in a variety of industries and has also held executive positions with SuperMedia, Inc., Information Resources, Inc., Consumer Industries, Retail & Energy division of Electronic Data Systems Corporation, PCMall, Inc., and PrimeSource Building Products. A graduate of Syracuse University, Scott holds a bachelor’s degree in accounting.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
I’ve worked in a lot of different industries and for a lot of different businesses. When I worked for Pepsi, it made me crazy if anyone drank anything other than Pepsi. At the end of the day, though, nobody died as a result of their soft drink decision.
But at LanguageLine, if we don’t do what we do well, people can potentially lose their lives. I was attracted to the fact that all of LanguageLine’s team members have a much higher sense of purpose for what they’re doing than anywhere else I’ve ever been.
There’s no more important venue for what we do than health care. What I always think about is what it would be like for me if I was traveling with my wife in a foreign country and something happened to one of us and we had to go to a hospital where no one spoke English. It would be disorienting and terrifying. I would feel powerless. Empathy is what fuels our business. I always keep that in mind: what it must be like for a limited-English speaker to interact with our healthcare system.
When I came to LanguageLine in 2012, the business was delivering a very valuable service, but many felt the company was in decline. I saw an opportunity to take a legacy business that some thought was past its prime and reverse that trend by introducing innovation and transformation to it. Thankfully, we’ve been able to greatly expand the footprint of what we do as an organization over the past seven years.
Can you share the most interesting story that happened to you since you began leading your company?
When we first launched video interpreting, a hospital was using it for a very sensitive procedure with a non-English speaker. Seeing that interaction take place was transformative. Going through a process like that, the patient couldn’t move, he was awake, all this activity was going on around him, and he couldn’t speak English. Yet, he was able to make eye-to-eye contact with the interpreter and be kept in the loop of what was going on. It was really something special.
One thing that was quite unusual for me was that shortly after joining the company, I started interacting with our healthcare clients and listening to their stories of just how important our solutions were to their success or failure. Their desire to work with us to continually enhance the patient experience was unusually collaborative. It’s not a buyer-seller relationship. Instead, it’s a relationship that revolves around collaboration and joint implementation to get the best result for the patient.
Can you tell our readers a bit about why you are an authority in the healthcare field?
We founded the over-the-phone interpreting industry in 1982, and now we work with 13 of America’s top 14 medical facilities. Today, we’re the largest provider in the language-access industry — larger than our next 10 competitors combined. We have well over 10,000 highly trained, highly skilled linguists who work for us, which is more than four times the amount of our nearest competitor. Listing these numbers may sound haughty, but this is an industry where size truly does matter because we are able to immediately scale to our clients’ needs, no matter how unanticipated those needs may be. To give you an example, yesterday we handled over 100,000 Spanish interpretation calls in a single day. Those calls were answered in an average of six seconds, as compared to an industry standard of 30 seconds.
What makes your company stand out?
It’s the repetitions. We handle more than 36 million interactions each year. Within those interactions, we are helping to ensure justice, save lives, welcome newborns, and build futures. We live for the experience of watching barriers come down and seeing people understand people. We get to see people become empowered in real time.
The reason the repetitions matter is that we have 27,000 clients and we’re getting feedback from them on an almost daily basis. We’re constantly baking that feedback into our future plans.
Can you tell our readers about the innovations you’re bringing to the healthcare industry, and how do you expect this innovation might disrupt the status quo? What pain point is this trying to address?
I’ll answer the last part first. One in five of our neighbors here in the U.S. speak a language other than English at home. One in nine is considered limited English proficient, meaning they are entitled to language assistance by law when seeking health care. A million residents are considered “functionally deaf,” while 10 million are hard of hearing. Without language access, all of these people are on unequal footing when it comes to addressing their health needs. This is one key pain point. When done right, language access restores their equal footing. It positively affects health outcomes, increases patient satisfaction, elevates staff productivity, and manages costs.
Our strategy is to be able to deliver whatever language solution our clients need. We do that by offering them 360 degrees of coverage. We have over-the-phone interpretation, which gives our clients access to over 240 spoken languages. We can provide video interpretation in 34 spoken languages, plus American and British Sign Language. On top of that, we can deliver an onsite interpreter in just about any language that’s spoken in the United States. We couple that with a full suite of translation and localization services for the written word, as well as our testing and training solutions.
Here’s the other pain point we address: Typically when we start to engage with a new client, they quickly figure out that they can get all of their language needs taken care of by one company and they can stop doing business with — in some cases — dozens of other providers. This creates tremendous efficiency for them.
We work with healthcare providers to make sure the proper modality is being used at the appropriate time. For example, you don’t need an onsite interpreter to help someone register at a hospital. That can easily be done over the phone. You don’t need an onsite interpreter at triage or at the point of service delivery. However, if you have some bad news for a family about a loved one that might be very ill, a phone or video solution might not be appropriate. Having one of our interpreters right there in the room might be better. Whatever the need, we have the proper modality to solve the problem in the fastest, most cost-effective way.
Are you working on any new projects right now? How do you think they’ll help people?
We typically don’t discuss our future plans to make sure we maintain all of our competitive advantage. We do have a number of game-changing initiatives underway that are getting very positive feedback thus far. However, we have a strict policy of “we release no solution before its time.”
What are some things you wish someone told you before you started?
At the beginning of my career, I frequently mistook activity for progress. I wish I understood earlier on how to focus on the most important things rather than gravitating toward those things that were easy to accomplish.
I wish I had known earlier in my career the importance of process and process improvement. That was a huge step change for me when I started going through Six Sigma training 30 years ago. I remember during my first week, it was as if someone turned the lights on in a dark room. I began to look at everything differently as a result.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the U.S. healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us a few reasons why you think the U.S. is ranked so poorly?
The U.S. has more of the world’s best hospitals than any other country. On Newsweek’s list of the best hospitals in the world, four of the top 10 are in the U.S.: Mayo Clinic, Cleveland Clinic, Johns Hopkins, and Mass General. People come from all over the world to receive the very best care from our healthcare centers.
This issue is cost. While the quality of care in the U.S. is the best, the cost remains incredibly high, which is one of the primary reasons why our system is ranked so low. Ensuring access to preventative and primary care is critical to keeping costs down. Too often, patients who are uninsured wait until they are sicker — and therefore more expensive — before receiving the care they need. Language barriers only increase the odds that they’ll defer care until the situation becomes grave.
You are a healthcare insider. If you had the power to make a change, can you share a few changes that need to be made to improve the overall U.S. healthcare system? Please share a story or example for each.
We naturally see healthcare issues through the lens of language. To us, it’s not shocking that there are massive health disparities for minorities living in the U.S. For example, it’s astounding that 45 percent of Hispanic boys and 53 percent of Hispanic girls living in the U.S. are predicted to develop diabetes in their lifetimes. In general, ethnic minorities here are twice as likely to develop a chronic disease compared to their non-Hispanic white counterparts.
Language barriers are a significant contributing factor to these disparities. They impact access to quality care and result in higher readmission rates for people with limited English proficiency. I would work to reduce these barriers to care by increasing access to qualified medical interpreters — no more relying on family members, children, or untrained staff.
When healthcare organizations use qualified medical interpreters, fewer errors are made, fewer unnecessary tests are ordered, and quality care improves. Likewise, when patients receive their discharge instructions and patient educational materials in the language they speak, they are less likely to return to the emergency room. Ensuring effective communication for limited English proficient and deaf and hard-of-hearing patients will improve quality of care, reduce readmission rates that are another factor in high healthcare expenses, and improve patient satisfaction. All of this would drive down healthcare costs.
It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas?
More states should take advantage of the federal match for interpreter services, as only about a dozen states provide Medicaid reimbursement for medical interpreters.
Ideally, Medicare would also reimburse hospitals for interpreter services. Many hospitals view it as an unfunded mandate. More hospitals would be incentivized to ensure access to qualified medical interpreters if they knew they would be reimbursed for it.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
This may sound simplistic, but I make absolutely sure to read the newspaper every day. Staying current is absolutely essential to success in any industry. People often put off staying current because they think they’re too busy to do it. But to stay relevant in any industry, you have to be solving contemporary problems. This is especially true of health care because it’s an area where all walks of life intersect. Participating in the news cycle is essential to maintaining relevance.
About LanguageLine Solutions
LanguageLine Solutions has been the leader in innovative language-access solutions since 1982. The company sets the global standard for phone, video, and onsite interpreting, as well as translation, localization, and testing and training for bilingual staff and interpreters. LanguageLine is trusted by more than 28,000 clients to enable communication with the limited English proficient, deaf, and hard-of-hearing communities. LanguageLine provides the industry’s fastest and most dependable access to more than 9,000 professional linguists in more than 240 languages — 24 hours a day, seven days a week, 365 days a year.
Thank you so much for these insights! This was so inspiring!