InDemand Responds to the National Association of the Deaf on VRI Use in Medical Settings

Site translation by Holly Thomas-Mowery, CI, CT, NIC-M, SC:L.

Recently, the National Association of the Deaf (NAD) posted a video blog (vlog) in response to the rise in video remote interpreting (VRI) that is taking place in medical settings. It is the NAD’s position that VRI doesn’t belong in medical settings except under two circumstances; while waiting for the onsite interpreter to arrive and when onsite interpreters are not available due to scarcity. NAD has an aggressive stance against medical VRI however, like any craftsman, having a multitude of tools and knowing how and when to use them makes any service provider stand above the rest.

While an in-person interpreter is always ideal, there are limiting factors such as availability, cost, immediate need, etc. For most situations, a video interpreter provides the Deaf patient the communication that the federal law requires.  However, VRI is not meant to be a ‘one size fits all’ tool as NAD implies.  VRI might be acceptable for one person at a given time and not acceptable for that same person in a different circumstance.  There are so many variables involved (patient’s language level, medical situation, technology, qualifications of the interpreter, etc.) that the provider is obligated to evaluate the use of VRI on a case-by-case basis.   This article clarifies it further:


The National Association of the Deaf (NAD) supports the use of VRI in a very limited capacity, which is quite understandable.  Sign Language is a three-dimensional language and communicating via a two-dimensional platform does present some challenges.  It’s imperative that the provider use a VRI vendor that will provide them with the highest quality software, hardware and technical support to ensure the clearest picture with few to no drops or pixilation.  In addition, the VRI vendor must use the highest quality, medically experienced interpreting professionals in the business.  These two factors work hand-in-hand to provide effective communication as outlined in the ADA.  These two articles clarify these points further:


What can providers do now to ensure compliance without compromising patient care? On-site interpreters can be expensive for medical providers when factoring in a minimum hourly fee plus the cost of travel for each interpreter. One option is the use of computer technology if…

  • Equipment is high quality and the monitor is large enough to see the interpreter clearly.
  • Audio is loud and clear enough for everyone in the room to access.
  • Internet speeds are high-speed with wide bandwidth and a dedicated connection to provide high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication.
  • Providers receive adequate training on the use of this technology in order to set it up quickly and efficiently.
  • Providers recognize when this technology cannot be used due to medical or situational circumstances (i.e. limited mobility, vision or cognitive issues, or other limitations).
  • Interpreters are highly trained in medical and virtual interpreting and ideally have national certification.

If all of those variables have been met, then VRI is a viable option.  Unfortunately, too many members of the Deaf community have had negative experiences with unqualified video remote interpreters and/or unstable platforms and connections.  Word has spread that VRI (in general) is not a dependable alternative to communicating in vulnerable healthcare situations.  Un-doing this negative stereotype is an uphill battle.


Our philosophy at InDemand is to work collaboratively with onsite interpreters to ensure the best experience possible.  We recommend that the provider have an advocate present to explain communication options and ensure effective communication.  We recommend that providers educate their Deaf patients regarding the VRI vendor they have chosen.  Feel free to use the attached document to educate your Deaf patients about InDemand Interpreting.

2017-05-25T17:51:14+00:00June 26th, 2015|0 Comments

About the Author:

Leave A Comment

jQuery( document ).ready( function() { var ajaxurl = ''; if ( 0 < jQuery( '.fusion-login-nonce' ).length ) { jQuery.get( ajaxurl, { 'action': 'fusion_login_nonce' }, function( response ) { jQuery( '.fusion-login-nonce' ).html( response ); }); } });