- The existence of more than 50 languages and dialects in Lincoln/Lancaster County is the most significant challenge in providing MTI services. Participants reported that the community was/is not adequately prepared to manage the resulting healthcare and MTI implications.
- The current system of MTI services is fragmented and has vastly outpaced the community’s human and financial resources.
- There exists a low level of knowledge in the broader community about the extent of language diversity in Lincoln/Lancaster County, and its impact on the healthcare system.
- There is no clear consensus on who bears the responsibility for assuring adequate communication between a patient and a healthcare provider. However, there was agreement that the responsibility does not lay with any single entity but with a broader community coalition of health providers, insurers, policymakers, MTI providers, and patients.
- There are no community guidelines or standards to guide the systematic development and implementation of MTI services in Lincoln and Lancaster County. As a result, there is no clear strategy to target human or financial resources, leading to an unbalanced supply of MTI professionals among language/dialect groups.
- There is some confusion and inaccurate assumptions about the distinction between medical translation and interpretation. While some MTI professionals can provide interpretation services, and others can provide translation services, there is a very small percentage that can do both well.
- The impact of MTI on Lincoln and Lancaster County has not been well articulated to local, county, state, and federal policymakers, including the Lincoln City Council, Lancaster County Board of Commissioners, Nebraska Legislature, or U.S. congressional representatives.
- MTI has far reaching, yet under-recognized, implications in the provision of a broad array of medical and health-related services. These implications are most evident in the fields of dental care, pharmacy, and emergency services (ambulance, fire, police).
- Given the highly specialized nature of medical care and terminology, the overall quality of MTI services is troubling. The reliance on untrained family and friends to provide MTI services raises serious questions related to patient safety, quality of care, and medical liability. In addition, this practice raises ethical concerns related to confidentiality and cultural/family dynamics.
- The time and cost associated with MTI services are particularly salient among private physician practices. The cost for MTI services and the increased time needed to communicate with clients needing MTI services were viewed as prohibitive among this group. Public healthcare providers were less likely to raise financial or time concerns.
- The quality of MTI is viewed as directly proportional to the cost of the service. While MTI professionals from a reputable firm were viewed as having the best MTI skills, most healthcare providers find the cost to be prohibitive.
- Bilingual staff is often expected to provide MTI services outside their scope of ability and without added compensation. In particular, this practice was noted among public school liaisons, police officers, and healthcare providers.
13. The MTI needs of undocumented individuals continue to raise questions of an ethical and moral nature.
