VRI is a controversial subject within Deaf and interpreting communities, especially in medical settings. While some believe VRI does not belong in medical settings, others argue that if used responsibly, it can be very effective. I believe and advocate for the latter.

Recent articles about VRI and Deaf patients have focused only on the negative aspects of VRI in healthcare settings. I thought it is important to address these concerns in an effort to provide what I consider to be a more fair and balanced viewpoint.

It is in the best interest of providers to select interpreting services that ensure patients have access to effective communication using medically qualified interpreters, technology that works effectively and staff who have been properly trained.

VRI has Been Accepted as Effective Communication

The use of VRI has been approved as an effective form of communication in healthcare, which means the burden falls to providers to deliver VRI that meets technical standards, ensure staff is trained and able to use the technology and that interpreters are medically qualified.  

Interpreters Must be Medically Qualified, Trained and Experienced

One important component I see missing in recent articles covering VRI is the need for specialized interpreters, namely interpreters who are medically trained and experienced. Section 1557 of the Affordable Care Act (ACA) requires interpreters meet concrete standards and have documented proof of testing that they are qualified to interpret in a healthcare setting. Testing standards include:

  • Adherence to ethical principles, including confidentiality
  • Proficiency in both English and another spoken language
  • Ability to accurately and impartially deploy specialized medical terminology and phrasing as necessary

Even still, we believe there’s more work to be done in providing additional guidance and requirements for medical and mental health encounters.

 VRI Technology Must Work Properly

Periodically, technical issues can occur when using video remote interpreting technology. Freezing pictures and choppy connections can arise, and it is critical that VRI vendors work hand-in-hand with providers to mitigate the problem.

Preventing and minimizing technology barriers starts prior to VRI deployment by testing the healthcare facility network and, if the VRI provider makes any network recommendations, it is essential that the health system consider these updates and integrate the changes before implementation. The VRI device and interpreters may be top notch, but health facilities must ensure they have a network that is strong enough to support the use of VRI.

The Department of Justice (DOJ) has weighed in on their technical requirements for VRI:  Real-time, full-motion video and audio over a dedicated high-speed, wide bandwidth, video connection or wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry or grainy images, or irregular pauses in communication. 

Staff Must be Trained Effectively

A recent article opens with a Deaf patient who is in pain asking for an interpreter but was “instead brought a video screen with an internet link to a remote interpreter to help…”  The article explains how the minutes ticked by and staff were unable to operate the video interpreting service, forcing the patient to write notes back and forth with his doctors.

Providers need to ensure staff are trained on how to properly use VRI equipment upon implementing the technology and that language access training is part of the onboarding process for new employees. This is paramount to effective communication with interpreters.

VRI Moving Forward

In the future, I hope to see articles that offer a more balanced or positive perspective of video remote interpreting services, as I can tell you from years of experience, that VRI has been and continues to be a successful means of communication when ethically used.


(translation provided by Susan Elizabeth Rangel)