During the coronavirus (COVID-19) pandemic, it may not be safe to go to your doctor’s office — even for a routine visit. Your doctor may ask you to stay home and discuss your health through video conferencing — this is called “telehealth.” Even though your appointment is done virtually, your doctor must still provide you with an interpreter or captioning so you can understand your doctor during your appointment. The best way for you to use telehealth is for you to see your doctor, the interpreter, and/or captions on the same screen. However, doctors have varying telehealth systems — do you know what you can request and what your doctors are still required to provide during the pandemic?
A coalition of deaf and hard of hearing consumer advocacy organizations, deaf healthcare providers, and other experts worked together to provide the below guidelines for deaf and hard of hearing people and healthcare providers to use during the coronavirus pandemic.
Both guidelines were developed by:
- Association of Late-Deafened Adults (ALDA)*
- Association of Medical Professionals with Hearing Loss
- Christopher J. Moreland, M.D., MPH, Associate Professor of Medicine, UT Health San Antonio
- Gallaudet University Deaf Health Communication and Quality of Life Center
- Gallaudet University Technology Access Program/Deaf Hard of Hearing Technology RERC
- Gallaudet University, Teresa Blankmeyer Burke, Ph.D., Bioethicist & Philosopher
- Hearing Loss Association of America (HLAA)*
- National Association of the Deaf (NAD)*
- National Association of State Agencies of the Deaf and Hard of Hearing (NASADHH)
- Robert C. Nutt, MD, MPH, Physician, Developmental & Behavioral Pediatrics, Atrium Health / Levine Children’s Network, Concord, North Carolina
- Samuelson-Glushko Technology Law & Policy Clinic at Colorado Law (counsel to TDI)
- Telecommunications for the Deaf and Hard of Hearing, Inc. (TDI)*
(*consumer advocacy groups that advocate for the rights of deaf and hard of hearing people)
If your doctor did not provide access during your telehealth appointment, please contact [email protected].
TRANSCRIPT: Now, with the coronavirus (COVID-19), it may not be safe to go to your doctor’s office. Your doctor may ask you to stay home and talk to your doctor through online video. This is called “telehealth.” Your doctor must still give you an interpreter or captioning so you can understand your doctor when you use telehealth. This video is to help you navigate telehealth appointments. If the doctor does not provide what you need to access a telehealth appointment, please contact: [email protected].
There are four accessible ways to use telehealth with your doctor: You can see your doctor and the interpreter on the same screen. Captioning is available if you need it. You can see the captions (CART) on the same screen with your doctor. You have two screens, one to see the captions and/or the interpreter, and a second screen to see the doctor. If you are not able to use #1-3, you can use VRS or IP-CTS to call your doctor. Keep in mind, your doctor cannot force this option on you if #1-3 are available. Instruct your doctor what kind of access (which of the 4 ways) fits your needs. Your doctor should accommodate your needs. Out of all four options, you and your doctor should also be able to type to each other using a “chat” feature. This way you can catch any misunderstandings. Typing is a good backup if there are problems with the audio and video.
Your doctor should know how to connect with you on telehealth. Your doctor also should send you instructions with the link so you know how to connect. The doctor is responsible for giving this information to the interpreter or captioner. When you start the telehealth appointment with your doctor, you should see the doctor clearly on the screen. And you should see the interpreter clearly. And if you asked for captions, you should see the captions clearly. And you can use the chat feature to type to your doctor. Typing can be a backup if the video or audio is not clear. Doctors know how to use their telehealth system, but not all doctors know how to use interpreters or captioning. Give your doctor the telehealth guidelines to help them understand what they must do. Remind your doctor to make sure the interpreter is certified/licensed to work in your state and to hire the interpreter/captioner. Even if you are only using captions, it is important to see each other. You both should be able to see the interpreter, captioning, and the chat box.
If your doctor is not able to include the interpreter and/or captioning on the telehealth screen, then there are other options you can use as a temporary solution. If you ask the doctor for an interpreter, the doctor may tell you to download a VRI app, perhaps on your phone as a second screen. Your doctor should tell you how to connect to the telehealth and VRI apps. Keep in mind, it may mean two separate apps. Your doctor must make sure they can hear the interpreter clearly and the interpreter can hear the doctor clearly. If your doctor does not already have a contract with a VRI company, let your doctor know which interpreters you prefer to use. The interpreter should be familiar with medical vocabulary. If you are using captioning, you can access the captions on a separate web page. Your doctor must make sure their audio is connected to the remote captioner. If your doctor does not already have a contract with a captioning company, let your doctor know which captioners you prefer to use. If you or your doctor are not sure where to start, try using streamtext, sourcebook, or DCMP’s list of vendors. You can also search online for CART providers. Another option is to use relay services (such as VRS or IP-CTS). Your doctor cannot force this option on you if options #1-3 are available. It is your decision. Keep in mind these differences/limitations: many relay interpreters and captioners are not trained or able to handle medical discussions. With VRI, you can ask for medically trained interpreters and captioners. With relay services, you cannot. The doctor will not be able to review the captions. You must already be registered for relay services, which can be an issue in a health emergency. If a relay call is the only option during a telehealth appointment, the doctor can call you at your relay phone number or the doctor can give you their phone number to call through VRS or IP-CTS. Five VRS providers include Convo, ZVRS, Sorenson, Purple, and GlobalVRS. Five captioned telephone service (IP-CTS) providers include CaptionCall (available on iOS), ClearCaptions (available on iOS), Hamilton CapTel (available on any web browser), InnoCaption (available on both iOS and Android), and Sprint Web CapTel (available on any web browser).