# 262 The Hard Facts About AI in Healthcare Interpreting with GLOBO CEO Dipak Patel

Understanding the Role of Language Services in Healthcare

Introduction to Deepo Patel and His Background

• The episode features Deepo Patel, CEO of a language solutions integrator focused on healthcare technology and AI.

• Deepo is based near Boston, Massachusetts, and has an engineering background with experience in consulting at Accenture for 15 years.

Career Journey into Language Technology

• Deepo transitioned from consulting to private equity after feeling unfulfilled advising companies that often did not heed his advice.

• He sought a career that would be meaningful to his children and contribute positively to healthcare, leading him to join Global in 2021.

Changes in the Language Services Industry Since 2020

• Since September 2020, Global has intensified its focus on healthcare language services to enhance patient experiences.

• There’s been a significant evolution in technology; AI advancements are reshaping how interpretation services are delivered.

• The healthcare industry faces challenges such as financial pressures and clinician shortages, necessitating innovative language service solutions.

Overview of Global's Technological Advancements

• Global has developed three key platforms:

• HQ: A backend administrative platform for accessing services and reporting data.

• Connect: An app for real-time interpretation services accessible via mobile devices.

• KAI: An AI interpreter launched earlier this year aimed at improving service delivery.

Target Users of Language Services

Understanding the US Healthcare System and Language Services

Overview of the US Healthcare System

• The US healthcare system is complex, with approximately 5,000 hospitals managed by local municipalities and various independent physician practices.

• Language services in hospitals often report to a dedicated language service manager, though this role may not always exist or may be combined with other responsibilities.

Decision Makers in Language Services

• Multiple stakeholders influence decisions regarding language services, including language service managers, procurement officers, and chief patient experience officers.

• A significant portion of patients (1 in 4) speak a language other than English at home, highlighting the need for effective interpretation services.

Role of AI in Interpretation

• Current business models rely heavily on human linguists for interpretation while exploring AI capabilities as a supplementary tool.

• There is skepticism about AI fully replacing human interpreters due to the complexity of certain conversations that require nuanced understanding.

Functions of an Interpreter

• An interpreter's role extends beyond mere translation; they act as conduits, clarifiers, cultural brokers, and advocates during medical interactions.

• Effective communication requires interpreters to clarify ambiguous statements from clinicians and advocate for patients' needs based on their backgrounds.

Patient Journey Gaps

• The patient journey encompasses multiple touchpoints where language services are necessary but often lacking—such as check-in processes and billing discussions.

• Technology can potentially bridge these gaps by providing timely language support throughout the patient's experience.

Development of Kai: A Technological Solution

• The development of Kai aimed to address identified gaps in language services over two years through research on off-the-shelf LLM performance in medical scenarios.

Deployment of AI in Healthcare Interpretation

Overview of Kai's Implementation

• The pilot program involves deploying Kai within an app, accompanied by a medically certified interpreter to ensure accurate communication during clinical interactions.

• The interpreter has three roles: 1) No interjection if Kai is accurate, 2) Interjecting if Kai makes significant errors, or 3) Noting minor inaccuracies that do not affect the conversation.

Assessing AI vs. Human Interpreters

• A common question arises about how AI can match human interpreters; however, there is no standardized assessment for human interpreter quality in U.S. healthcare.

• The speaker compares this to medical coding, which has established standards for assessing quality through chart reviews and scoring systems.

Pilot Program Insights

• Systematic pilots are being conducted across multiple hospital systems to evaluate Kai's effectiveness with the help of certified interpreters.

• Surveys are conducted post-interaction using Net Promoter Score (NPS), revealing a high satisfaction score of 60 from approximately 4,000 interpreted messages across nearly 1,000 sessions.

Future Deployment Plans

• Three hospital systems have shown interest in adopting Kai; formal usage will begin in September when invoicing capabilities will be enabled.

• The focus is also on measuring outcomes related to time savings rather than just cost efficiency when using Kai compared to traditional methods.

Efficiency Gains Observed

• An example highlights a hospital system where nutritionists experienced a 20% reduction in time spent communicating with patients after implementing AI interpretation tools like Kai.

• Providers often resorted to personal devices for translation due to lack of proper interpretation resources; this emphasizes the need for effective solutions in patient-provider communication.

Patient Experience Focus

• The discussion centers around improving patient experiences by ensuring efforts are made to communicate effectively in their preferred language.

Understanding Friction in Technology Adoption

The Importance of Reducing Friction

• The adoption of technology hinges on minimizing friction; excessive steps can deter users, regardless of the technology's quality.

• Current video interpretation systems require clinicians to input extensive information, creating unnecessary barriers to access interpreters.

Streamlining Access to Interpreters

• Integrating interpreter access into Electronic Medical Records (EMRs) allows for one-button access, significantly reducing friction for healthcare providers.

• AI is utilized to monitor the quality of live calls with human interpreters, addressing common vendor concerns about service quality.

Quality Monitoring in Interpretation Services

Vendor Quality Assurance Practices

• Most vendors claim they hire top interpreters and monitor call samples for quality assurance but lack comprehensive tracking methods.

• The company discussed claims to assess every call's quality through three key metrics: interpreter appearance, background noise, and accuracy.

Key Metrics for Call Quality

• Professional appearance and appropriate backgrounds are crucial as patients may not recognize that interpreters work for a separate entity.

• Upcoming features will include monitoring background noise and call drop rates, enhancing overall service reliability.

Technological Integration Challenges

Building a Comprehensive Solution

• Developing an effective interpretation solution involves integrating components from major tech providers like Google and Microsoft while allowing flexibility in coding.

• The interpretation process consists of voice-to-text, text-to-text, and text-to-speech stages; each stage requires adaptable solutions.

Enhancements Through Engineering Techniques

• Improvements stem from prompt engineering—how questions are framed affects AI responses—and post-training evaluations ensure ongoing accuracy enhancements.

• Continuous feedback loops help refine tools based on real-time performance assessments during live interactions.

Future Considerations in AI Utilization

Sensitivity Around Data Usage

• There are significant sensitivities regarding data usage from interpretations; future collaboration with hospital systems will be essential for data sharing agreements.

Evolving Perspectives on AI Costs

AI in Interpretation: Challenges and Developments

The Complexity of AI in Language Interpretation

• The discussion highlights the importance of accurate prompts in language interpretation, comparing the source language to a prompt that requires careful handling for effective communication.

• Emphasizes the necessity of human oversight ("human in the loop") to refine AI-generated interpretations, particularly noting its effectiveness in written translation compared to spoken interpreting.

• Points out that longer conversations pose significant challenges for AI's ability to maintain coherence and relevance during interpretation tasks.

Limitations and Future Directions

• Acknowledges the vast diversity of languages (over 300 dialects in the US), making it increasingly difficult for AI systems to perform effectively across different languages beyond Spanish or German.

• Questions arise regarding other companies launching AI interpreter apps without sufficient evidence from prior sessions or diverse language testing, stressing a systematic approach is essential.

Research-Based Approach to AI Integration

• The speaker emphasizes a research-based methodology for integrating AI into interpretation services, ensuring thoughtful implementation while avoiding potential pitfalls.

• Plans are underway to test additional languages with medically certified interpreters monitoring AI operations, highlighting the need for caution even in administrative contexts where clinical discussions may inadvertently arise.

Balancing Innovation with Caution

• Observations reveal a divide between those who dismiss AI's potential entirely and those who advocate for its unrestricted use; a balanced approach is deemed necessary as technology evolves over decades.

• The speaker expresses skepticism towards startups claiming they have solved medical interpreting with AI due to their lack of access and experience compared to established organizations.

Strategic Partnerships and Security Concerns

• Highlights that established organizations possess unique advantages over startups, including extensive field experience and technical capabilities necessary for developing robust solutions.

• Discusses trends toward consolidating language service vendors within hospital systems, suggesting future partnerships between startups and human interpretation companies will be crucial.

Understanding the Role of Language Interpretation in Healthcare

The Importance of Data Collection and Insights

• The discussion highlights the challenges faced when using multiple companies for language interpretation, which can lead to potential issues. There is an opportunity to collect extensive data from these interactions that could provide valuable insights.

• Beyond just providing language interpretation services, there is a need to gather additional insights about patient satisfaction and communication effectiveness during healthcare interactions.

Vision for Global's Future

• The speaker emphasizes that Global aims to go beyond being merely a language interpretation company. Their mission focuses on enhancing mutual understanding between patients and clinicians, particularly for those who may struggle with medical jargon.

• An example is provided where even fluent English speakers may not fully comprehend their doctor's explanations. This underscores the necessity of conveying insights back to both clinicians and patients regarding understanding levels.

Addressing Diverse Patient Needs

• The conversation touches on the importance of translating discharge instructions into multiple languages, as well as creating audio files for illiterate populations to ensure all patients understand their care instructions.

• Technology plays a crucial role in facilitating clear communication at every step of patient care, but it must be implemented thoughtfully to avoid errors that could jeopardize patient safety.

Concerns About AI in Interpretation Services

• There are fears surrounding potential failures of AI-driven interpretation services within hospital systems, which could lead to negative publicity and operational shutdowns. A careful approach is necessary to mitigate these risks.

• Hospital systems appreciate investments in medically certified interpreters and measures taken to ensure security and privacy while utilizing technology effectively.

Impact of Government Policies on Language Services

• Discussion shifts towards the implications of government policies, such as the Trump administration's executive order declaring English as the national language, on demand for interpretation services across healthcare settings.

• Some shifts have been observed in how languages are utilized during interpretation services, including increased usage during late-night hours potentially indicating emergency room visits due to avoidance behaviors.

Financial Pressures Affecting Interpretation Services

• Conversations reveal financial pressures faced by government-funded healthcare entities impacting their ability to utilize various forms of interpretation services effectively.

• Despite some decreases in demand for certain types of language services, providers recognize their value and continue prioritizing them despite governmental enforcement concerns.

Sustaining Growth Amid Challenges

• Recognition is given for Global's consistent growth reflected in lists like Inc. 5000 and Deloitte Technology Fast 500; maintaining this growth organically poses significant challenges over time without acquisitions or external funding sources.

Insights on Language Services in Healthcare

Company Culture and Motivation

• The speaker emphasizes a strong sense of camaraderie within the company, stating that everyone is motivated by a shared goal: improving patient care and clinician support.

• There is a collective commitment to driving innovation in the healthcare space, indicating that personal experiences influence their professional dedication.

Focus on Connect Times

• The speaker discusses the initial focus on connect times for interpreters, revealing that industry expectations were set at one minute, which they deemed unacceptable.

• Aiming for an interpreter connection time of 10 seconds or less has become a priority; currently achieving this for Spanish but still working towards it for other languages.

Industry Trends and Quality Assessment

• The speaker notes an increasing trend among companies to assess call quality consistently, suggesting that this will be a standard expectation in the near future.

• They highlight the importance of partnering with forward-thinking companies to innovate solutions for language services over long-term contracts.

Future Growth Strategies

• Discussion about potential growth avenues includes acquisitions and IPO possibilities within the industry, acknowledging recent market fluctuations due to AI impacts.

• The speaker expresses uncertainty about immediate IPO prospects but suggests that understanding AI's role will be crucial before any public offerings occur.

Strategic Focus Areas

• Currently, the company is concentrating on five key areas rather than spreading resources too thin across multiple initiatives.

• Key focuses include delivering high-quality interpretation services quickly and demonstrating how AI can enhance these services effectively.

Standardizing Quality Framework

• The need for a standardized quality assessment framework in language services is discussed; collaboration with hospital systems is seen as essential to develop this methodology.

• An innovation council has been established to address quality concerns related to AI implementation in healthcare interpretation services.