In Compliance, Translation/Localization

When the topic “Language Access Compliance in Healthcare” comes up, most people immediately think of medical interpreters facilitating communication in Spanish or Arabic or Chinese. Others may picture an American Sign Language interpreter helping a deaf patient seek care. Some may even think of translated documents … especially Informed Consent forms! But rarely does accessibility for the blind and low vision population come to mind.

There’s a Lot of Documents in Healthcare!

The most recent American Community Survey data shows that there are around 7.5 million individuals with vision difficulty in the U.S. These individuals face a system primarily geared toward the sighted:

  • Welcome to the facility! Follow the colored lines on the floor to get to your department!
  • New patient? Here are some forms to fill out.
  • Having surgery? Here are your pre-surgery instructions.
  • Need outpatient or prescription medication treatment? Here are some information materials on the recommended course of action.
  • Heading home? Here are your after-care instructions.
  • Taking a prescription? The instructions are printed on the bottle and the warnings and side effects are stapled to the bag.
  • Want the results of your lab work? Check our online results system.
  • Have a question? Use our online portal to email your doctor.

What’s the Law Say?

Medical care involves a lot of visual cues and written documentation. And since both the Americans with Disabilities Act and the Nondiscrimination in Health Programs and Activities regulations implementing Section 1557 of the Affordable Care Act require healthcare facilities to offer auxiliary aids and services for their blind and low vision populations, healthcare providers must become familiar with the types of auxiliary aids and services available to facilitate effective communication.

Section 1557 includes the following list of auxiliary aids and services that a healthcare entity might provide to accommodate those with vision impairment:

  • Qualified readers;
  • Taped texts;
  • Audio recordings;
  • Braille materials and displays;
  • Screen reader software;
  • Magnification software;
  • Optical readers;
  • Secondary auditory programs;
  • Large print materials; and
  • Accessible electronic and information technology.

See 45 CFR 92.4

The above list mainly contains two types of assistance devices: those that rely on sound to communicate written information and those that magnify written information. One of the items on the list, however, is unique: Braille.

What is Braille, Exactly?

Much like American Sign Language is a unique language based on English, but not the same as English, Braille is a written language that is based on English, but isn’t necessarily the same.

The most common type of Braille is “contracted Braille.”  In this form of Braille, there are hundreds of characters representing letters, words, and punctuation. The characters are arranged in cells. A full Braille cell consists of six raised dots arranged in two parallel rows each having three dots. Braille is “read” by touch, allowing blind individuals to read any type of written document printed in Braille.

Why Print in Braille?

Sighted individuals have access to a world of medical information and documentation in printed form, from the informational pamphlets in the lobby or waiting room to the aftercare instructions the doctor provides on your way out the door. Section 1557 indicates that healthcare entities “shall take appropriate steps to ensure that communications with [disabled persons] are as effective as communications with others.” 45 CFR 92.202(a). Likewise, the Americans with Disabilities Act requires healthcare entities to accommodate those with disabilities, including providing auxiliary aids and services, to ensure effective communication. Braille is listed as a suggestion for both statutes. While audio options are great for online content, for printed items that any sighted person would be able to access, Braille is a great option for accessibility.

As you consider how you communicate with your blind and low vision patients and their caregivers, it’s a good idea to take an inventory of the documents you have printed in Braille. If your most commonly used documents aren’t on that list, it might be a good time to have them printed in Braille.

Did you know Vocalink Global offers Braille printing services? Connect with us today for more information!

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