• Interpreters;
  • language barriers;
  • Emergency Department;
  • policy;
  • safety net


To measure the impact of a policy change from use of telephonic and face-to-face interpreting to use of a video-interpreting network on Emergency Department (ED) care.

Data Sources/Study Setting

Observational study of ED care at two California hospitals.

Study Design

We compared tests ordered, time in the ED, and admission rates for English- and Spanish-speaking patients presenting with chest pain and abdominal pain before and after the policy change.

Data Collection/Extraction Methods

Data were extracted from electronic medical and billing records.

Principal Findings

Mean time in the ED, mean number of laboratory tests, radiology services, electrocardiograms, and echocardiograms, and rates of hospital admission for both language groups at both hospitals went down in the post-video-interpreting network period compared with the pre-video-interpreting network period. The percentage of patients leaving the ED against medical advice (AMA) increased in one hospital for both language groups; this increase was statistically significantly smaller in the Spanish-language group compared with the English group (= .04).


The studied video-interpreting network had minimal impact on health care outcomes in the ED.