The following is a guest article by Joe Duarte, Co-CEO of InnoCaption.
According to the World Health Organization, 1.5 billion people across the globe live with some degree of hearing loss, and roughly 430 million people require rehabilitation services for their hearing loss. When you apply that number to your average local clinic or hospital, nurses and doctors are likely to encounter at least one hard of hearing person every single day. With the rise of COVID treatment and vaccines this summer, that number increases even more.
As a hard of hearing person myself, I most recently experienced an accessibility barrier when I arrived for my COVID-19 vaccine appointment. Obviously, the entire medical staff was wearing masks, which made lip-reading impossible. I struggled to understand the person who was taking my temperature to check me in. Since I could not understand her, I attempted to show her my appointment confirmation, but she continued to ask questions. I ended up pointing to my cochlear implant on my head to show her I had a hearing loss, which was why I was struggling to understand her. She tried to gesture, but it was not sign language and I still was not understanding what she was trying to say — we were stuck.
I followed her to another control room that was likely set up for people with disabilities. After she had a discussion with a colleague, one of them picked up a chalkboard and wrote, “Is this your second shot?”
I promptly said, “No, it’s my first.” One of the nurses signed, “thank you” in American Sign Language (ASL). That was appreciated as it showed that they were trying and it shows respect for me and the deaf community. I was then put into the queue for the vaccine.
This experience made me wonder, why don’t they have a separate queue for people who are deaf or have hearing loss? Or even communication challenges? We had to resort to a chalkboard to clear up that entire misunderstanding. Haven’t we come further than that?
While it could be as simple as posting a sign at the entrance, “If you need lip reading, see a technician with a clear mask on the left,” they should have at least a few medical technicians with clear masks to support those who need to see the lips for viable communications.
Not Everyone’s Needs are the Same In A Clinic Today
The pandemic has unfortunately created communication barriers when a deaf or hard of hearing person walks into a medical clinic and it’s important to note that not everyone’s accessibility needs are the same. I read lips and the ability to see a person’s expression also plays a role in understanding, so the clear masks help ease communication for me. With that being said, not everyone who is deaf or hard of hearing reads lips – but even if they do not, most will benefit from the ability to see the persons face.
Yet, the issue of a lack of accessibility in healthcare predates the pandemic. While the pandemic has certainly made it worse due to the masks, deaf and hard of hearing individuals frequently face issues when requesting interpreters, captioning, and accessible communication. I’ve heard many stories within the community about deaf and hard of hearing individuals being told their doctors would not talk to them using telecommunications relay services (TRS) because of HIPAA. It is a common misconception that doctors are unable to speak to the patient because of the third party on the line. This causes extreme hardship and barriers to access healthcare for many in the community.
Is there a solution?
First and foremost, doctors’ offices creating procedures which enable the patient to provide their preferred method of contact, whether telephone, text message, email, or patient portal would make a huge difference. Next, ensuring the office knows what their patients’ in-person accessibility needs are and their primary method of communication – on the new patient registrations, offices should ask whether an individual requires accommodations and what those accommodations are. From there, procedures which empower staff to proactively ensure the patients accessibility needs are taken care of (i.e. interpreters booked, clear masks in stock, etc.) will course correct the difficulties many in the community have faced in seeking medical treatment.
I also recommend all clinics and hospitals take these steps:
- Doctor’s offices and medical clinics who are interested in providing accessible care should ensure they know what their patients accessibility needs are. Once they know that, they are able to provide what the patient needs, whether it be a sign language interpreter, real-time captioning, and/or clear masks. When it comes to communicating with their patients over the phone – using your patients preferred method of communication whether it is the phone, a relay service, or even text message, makes communication a lot easier.
- Administrative staff and doctors should be trained regarding the patients’ right to communicate with the office over the phone using TRS. Proactively training staff will likely avoid confusion and ensure a patient who wants to is able to contact the office on the phone like hearing patients.
- A deaf or hard of hearing person who uses their own voice, but has trouble hearing on the phone, may choose to use InnoCaption to get real-time captioning of their phone calls using either CART or Automatic Speech Recognition (ASR) Captioning – whichever they feel best meets their accessibility needs. For those individuals, InnoCaption enables them to make and receive phone calls from their doctors’ offices. For telehealth appointments with a dial-in number, where the doctor’s office will not provide captioning, users can call in using their InnoCaption app.
- A deaf or hard of hearing person who uses American Sign Language can choose to use Video Relay Service to have an ASL interpreter interpret and relay the conversion back and forth between the patient and the office.
- A deaf or hard of hearing person can also call via IP Relay, which enables the patient to type what they would like to say to a Communication Assistant (CA) who then voices to the office. The CA types back what the office is saying to the patient.
I believe this is possible and not utopian at all with the availability of accessible technologies – as long as it is a priority and not an afterthought, those in the medical field should be able to implement accessible practices.
About Joe DuarteI got my first hearing aid at the age of 4 and my first cochlear implant in 2008. I first discovered InnoCaption at a conference when it was still under development. As soon as I tested the technology, I was blown away and knew it had the potential to completely change my life and the lives of many other deaf and hard of hearing individuals. This led me to get involved directly with this budding startup, to help launch the InnoCaption app and share this amazing technology with the world. By using the InnoCaption app every day, I feel empowered and finally on the same footing with my hearing peers in any work that I do. I hope that our app can make this kind of positive impact in the lives of each of our users.
