Using EMR to Improve Interpreter Access

To increase physician usew and documentation of interpreter services, St. Mary’s Hospital in Madison, WI, added a physician Best Practice Alert into Epic, the electronic medical record system the hospital uses, to highlight the need for an interpreter, inform physicians of how to access an interpreter, and inform physicians of a newly created space in Epic that allows them to document interpreter services easily. The Best Practice Alert is automatically triggered at registration for any patient who states a preference for receiving health care in a language other than English.

In developing the alert, St. Mary’s Hospital focused on the post-partum unit and other busy limited-English proficiency (LEP) areas. It tracked use and documentation of all interactions (daily rounds) with physicians (not only initial assessment) and initiated staff interpreter “reminders” to physicians about documenting after working with a limited-English patient. As a result of this alert, use of interpreter services increased from 32.5 percent in October 2010 to 65.5 percent in August 2011, and documentation of services increased from 15.5 percent in October 2010 to 44 percent in August 2011. From this process, St. Mary’s Hospital learned that leadership support is necessary, that it is important to “communicate, communicate, communicate with physicians,” and that there is a need for continued monitoring.