News Release

Health Care Interpreter Network Taps Cisco Technology to Meet Needs of California's Diverse Patient Population

Innovative and collaborative effort aims to remove language as a barrier to quality healthcare
Aug 07, 2006

SAN JOSE, Calif., August 7, 2006 - Cisco Systems®, Inc. today announced that solutions from its Unified Communications product portfolio are being deployed in one of the world's first voice and video over Internet Protocol (IP) call centers as a part of the Health Care Interpreter Network (HCIN).

The HCIN represents the work of a consortium of leading public hospitals, health care organizations and technology companies. It addresses the challenge of how to communicate effectively with limited English-speaking patients and deliver quality healthcare in a multi-cultural society.

In California, the most diverse state in the nation, the need for a technology solution like HCIN is particularly acute, as 40 percent of all Californians speak a language other than English at home.* In addition, a survey of health care providers found that over 70 percent reported that language barriers compromise patients understanding of treatment advice and their disease, increase the risk of complications, and make it harder for patients to explain their symptoms.** Combined with proposed regulations requiring health plans in California to develop and implement a language assistance program, it is critical that hospitals and healthcare systems have access to readily-available trained medical interpreter services for limited English speaking patients.

With financial support from the California HealthCare Foundation and other funders, the HCIN began pilot testing in August 2005, and was designed and currently managed by consultants from Paras & Associates, a firm providing managed language services. The HCIN is currently owned and operated by the three public hospitals where it is in operation--Contra Costa Health Services, San Joaquin General Hospital and San Mateo Medical Center. Through their support and implementation of the HCIN in the development process, the hospitals played a crucial role in the network's success.

Using the HCIN, 300 to 400 hospital staff at participating hospitals now have quick and easy access to language interpreter services via video conference or phone. The network currently routes approximately 3,000 video conference and phone calls per month, and interpreters within the participating hospitals respond to 1,200 of these calls in five languages including Cambodian, Hindi, Hmong, Spanish, and Tongan. With IP video and voice interpretation services available thru the HCIN, not only has patient satisfaction and quality of care greatly improved, but the HCIN has also improved medical staff productivity and boosted interpreter program capacity at all participating hospitals. Another benefit IP video and voice interpretive services provide is more effective communications that in turn delivers cost savings to hospitals due to the reduced cost-per-minute charges for language interpreters below that of traditional commercial services.

Additional services the HCIN offers include the ability for a call to be designated as a priority, so an emergency call can jump to the top of the queue. All requests for interpretive language services on the HCIN are answered in under five minutes, with an average connection time of forty two seconds, which is a dramatic improvement over previous waiting periods. The HCIN system can also categorize calls based on a specialized skills request such as requesting a male or female interpreter or one with specialized mental health training. If all interpreters for a specific language are unavailable, the HCIN system automatically routes those calls to an audio-only commercial interpretation service.

By sharing language interpretation services, participating hospitals and healthcare providers in the HCIN can pool their interpreter staffs to broaden the language offerings and capacities of interpreter services. This improves both patient experience and staff productivity. These results are particularly important to public hospitals, as they demonstrate their commitment to innovative improvements in patient safety and prudent stewardship of taxpayer dollars.

The HCIN utilizes the Cisco Unified Communication system, including Cisco Unified Contact Center Express and Cisco Unified CallManager, to create an automated IP-based voice and video call center that is centrally managed and hosted in QuestTM Technology Management's unique and state of the art Managed Services and Replication Center. Quest, a Cisco Gold partner, has been providing HCIN and Paras & Associates with detailed network connectivity design consulting dealing with MPLS networking, customer segmentation through firewalling and Cisco IP voice and video integration. Quest also provides 24x7 network and VoIP platform proactive performance monitoring to help ensure a stable and reliable experience.

The HCIN system has immediate plans to extend both its language support and reach to hospitals across California, including Riverside County Regional Medical Center and Rancho Los Amigos National Rehabilitation Center. There are future plans to expand nationwide, and into other industries with language interpretation requirements such as government and hospitality.

Other organizations involved in the creation and advancement of the HCIN include California Association of Public Hospitals and Health Systems, California Department of Managed Health Care, California HealthCare Foundation, Fujitsu Computer Products of America, Inc., and Health Access Foundation. This collaborative effort underscores how these organizations are innovators in improving health care quality and service delivery.

These leading organizations offer their insight and valuable perspective below on the impact and success of the HCIN system below. Leaders from each of these organizations will be speaking about their involvement in HCIN and a demonstration of the technology will be held today at the San Mateo Medical Center. More information can be found at:

California Association of Public Hospitals and Health Systems:

"In our support and implementation of HCIN, California's public hospitals are health care industry leaders," said William B. Walker, M.D., Director of Contra Costa Health Services, one of HCIN's co-owners. "We are innovators in improving health care quality and service delivery to our patients." William B. Walker, Director and Health Officer, Contra Costa Health Services/ Chair of California Association of Public Hospitals and Health Systems

California Department of Managed Health Care:

"It is crucial that we develop new cost-effective ways to provide language assistance in health care settings, in anticipation of the new pending requirements for health plans in California to provide trained interpreters to its limited English speaking members. Internet-based video technology is one of the best low-cost, high-tech solutions I have seen to give patients a confidential and dignified way for limited English speaking patients to communicate effectively with the doctor." Cindy Ehnes, Director of the Department of Managed Health Care, whose agency is developing the regulations. (

California HealthCare Foundation:

"Language often is a barrier to high-quality health care, particularly for under-served populations. This innovative network offers providers access to critical language resources when they need them; patients are able to communicate more effectively in the exam room; and hospitals are able to partner with other facilities to better leverage resources." Sam Karp, vice president of programs at the California HealthCare Foundation, an original funder of the HCIN project (

California Pan-Ethnic Health Network:

"New laws on language access are going into effect this year and HCIN offers a way for health care organizations to meet their obligations under the law to provide equal access." Martin Martinez of the California Pan-Ethnic Health Network (community advocacy organization and early advocate of HCIN) (

Cisco Systems:

"The HCIN is an important step in delivering better quality care and outcomes for patients regardless of their language or origin. It serves as an innovative, scaleable approach that can be modeled and implemented in communities nationwide." Dr. Jeffrey Rideout, Vice President of Healthcare and Corporate Medical Director. (

Fujitsu Computer Products of America, Inc.:

"The HCIN is a terrific example of how technology companies and the public sector can work together to enhance healthcare and patient safety, a service we all benefit from when it can be dramatically improved. Fujitsu's work with the California Association of Public Hospitals will help set the standard for healthcare programs designed to provide outstanding patient care and safety to diverse communities." Joel Hagberg, Vice President, Marketing and Business Development, Fujitsu Computer Products of America. (

Health Access Foundation:

"Good health care requires good communication between the patient and the health care provider, and this technology proves that we can cost-effectively provide such access to good care for all Californians, regardless of what language they speak. With this innovative technology solution, health insurers and providers no longer have an excuse to rely on children or random passers-by for interpreters, or to not have these essential services provided." Anthony Wright, executive director for Health Access, the statewide health care consumer advocacy coalition, which incubated the HCIN and continues to pilot video medical interpretation technology(

Paras and Associates:

"We wanted to help hospitals "do the right thing" and provide skilled interpreters in every patient encounter. Our challenge was to make the interpreters almost instantly available at every bedside or exam room in the hospital, with a video and audio quality like in-person interpretation, in a system that was cost effective to the hospitals. We are very pleased that systems like HCIN can now offer a true resolution to this intractable problem." Melinda Paras, President and CEO of Paras and Associates and architect of the HCIN system. (

QuestTM Technology Management:

"Quest is proud to have provided the technology that first brought Paras & Associates' Health Care Interpreter Network (HCIN) design to life in 2005. With thousands of hospital requests for interpreter services routinely being routed through Quest's unique Managed Services and Replication Center, I am convinced we have taken a quantum leap towards solving America's language barrier challenge not only in hospitals, but all across business and other walks of life." Tim Burke, CEO and President, Quest (

San Joaquin General Hospital:

"HCIN makes substantial improvements in patient safety and the quality of patient-provider communications. It also shows public hospitals' prudent stewardship of taxpayer dollars, as it improves staff productivity and boosts interpreter program capacity for all participating hospitals." Ken B. Cohen, Director of San Joaquin County Health Services. (

San Mateo Medical Center:

"When I first heard about the Health Care Interpreter Network (HCIN), I thought it sounded like a good idea. But I underestimated the impact this technology could have. At San Mateo Medical Center, this has been one of the single best steps we have taken to improve the quality and safety of our care." Nancy Steiger, , RN, MS, CEO of San Mateo Medical Center (

*(Source: Race and Ethnicity in California: Demographics Report Series-No.14, June 2003, California's Use of English and Other Languages: Census 2000 Summary, Center for Comparative Studies in Race and Ethnicity, Stanford University)

** (Source: Hablamos Juntos: We Speak Together, Hablamos Juntos: Improving Patient-Provider Communication for Latinos).

About HCIN

HCIN is a system of shared remote interpreter services operated by Northern California public hospitals. Utilizing one of the world's first Video/Voice over IP Call Centers to create access to trained interpreter services, participating healthcare providers in this model are using interpreters at their own hospitals or at colleague hospitals through videoconferencing and various telephone technologies. The Video/Voice Over IP Call Center is currently operating at San Joaquin General Hospital, Contra Costa Health Services (at the Contra Costa Regional Medical Center and Concord Health Center) and San Mateo Medical Center. Additional hospital systems which will be testing the Health Care Interpreter Network over the next several months include Riverside County Regional Medical Center and Rancho Los Amigos National Rehabilitation Center More information can be found at: