Translation and Localization Resources | SimulTrans

The Vital Role of Human Translators Under Section 1557 of the Affordable Care Act

Written by Adam Jones | October 31, 2023

SimulTrans’ medical clients often come to us looking for a translation solution that complies with Section 1557 of the Affordable Care Act (ACA).

Section 1557 plays a crucial role in eliminating discrimination in healthcare in the United States. To achieve this, the law mandates that healthcare providers and medical device manufacturers offer high-quality translations of documents for patients. While technology has come a long way in automating translations, there's still no substitute for human input to ensure that the translations meet the high standards the law requires.

Understanding Section 1557

Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in healthcare programs and activities. For many individuals with limited English proficiency, this means healthcare providers must offer translated documents that allow them to fully understand their rights and access healthcare services.

The Importance of High-Quality Translations

Quality is paramount for translations of healthcare materials. The consequences of misunderstanding healthcare information can be life-threatening. A single mistranslation or misinterpretation can result in the wrong treatment or a lack of access to vital services. This is why Section 1557 requires translations to be accurate, clear, and easy to understand.

The Limits of Automated Translation

Translation technology is not infallible. Automated translation tools have their limitations. They may struggle with context, idiomatic expressions, and medical jargon. Translating healthcare documents often requires a deep understanding of medical terminology and the cultural nuances of the target language.

The Role of Human Editing

Human editing is the crucial step in the translation process. Skilled translators with expertise in healthcare terminology and cultural nuances review and refine the machine-generated translations. They ensure that the translated documents are not only accurate but also culturally sensitive and appropriate.

  • Contextual Understanding: Translators can comprehend the context in which the translated document will be used. This context-awareness helps them choose the right words and phrasing, making the document more effective.
  • Cultural Sensitivity: Healthcare is deeply personal and often intertwined with cultural beliefs. Human editors ensure that translations are culturally sensitive, respecting the patient's background and beliefs.
  • Medical Terminology: Healthcare documents are filled with complex medical jargon. Human editors have the expertise to accurately translate these terms, which are critical for a patient's understanding and treatment.
  • Idiomatic Expressions: Language is filled with idiomatic expressions that automated tools might misinterpret. Human editors can identify and correct these, ensuring clear and concise communication.
  • Legal Compliance: Healthcare documents often have legal implications. Human editors can ensure that translated documents meet all legal requirements and standards.
  • Quality Assurance: The final step in human editing involves quality assurance, which includes proofreading and ensuring that the translation is free from errors, omissions, or inaccuracies.

Human Translator Requirements

A proposed HHS rule defines machine translation and sets out requirements for the involvement of human translators.  It states,

The Department proposes regulatory language requiring a covered entity that uses machine translation to have translated materials reviewed by a qualified human translator when the underlying text is critical to the rights, benefits, or meaningful access of an LEP individual; when accuracy is essential; or when the source documents or materials contain complex, non-literal, or technical language.

It defines a “qualified translator” as one who:

(1) Has demonstrated proficiency in writing and understanding both written English and at least one other written non-English language;

(2) Is able to translate effectively, accurately, and impartially to and from such language(s) and English, using any necessary specialized vocabulary or terms without changes, omissions, or additions and while preserving the tone, sentiment, and emotional level of the original written statement; and

(3) Adheres to generally accepted translator ethics principles, including client confidentiality.

This mirrors the text of CFR Title 45 Subtitle A Subchapter A Part 92, requiring a translator who:

(A) Adheres to generally accepted translator ethics principles, including client confidentiality; 

(B) Has demonstrated proficiency in writing and understanding at least written English and the written language in need of translation; and 

(C) Is able to translate effectively, accurately, and impartially to and from such language(s) and English, using any necessary specialized vocabulary, terminology and phraseology.

In the world of healthcare, there's no room for error. The use of skilled human editors ensures that translated materials are not only linguistically accurate but also culturally sensitive and appropriate, meeting the highest standards of quality. Through the combined efforts of technology and human expertise, SimulTrans bridges the language barrier in healthcare and upholds the principles of Section 1557.