Hearing-Impaired Face Unique Telehealth Challenges Amid COVID-19: Experts

As more people use telehealth amid the pandemic (see 2101250026), hearing-impaired patients face obstacles communicating with their doctors, experts said in recent interviews.

The pandemic exacerbated challenges such patients face, said Brian Scarpelli, co-chair of the FCC Disability Advisory Committee and ACT|The App Association senior global policy counsel. “This is why the DAC is so important itself as an entity” and constructive dialogue with consumer advocates “is so crucial,” Scarpelli said.

“We need to rely on technology to have communications access, and that technology has to be very effective and very good to be able to have valuable interactive communications,” said Joe Duarte, co-CEO of InnoCaption. COVID-19 is a challenge for people who can't fully hear because people generally can't safely meet in person and have face-to-face conversations, Duarte said.

Captioning services aren't always perfect, and factors such as an accent can result in an error in text recognition. Christian Vogler, director of Gallaudet University’s Technology Access Program, cited such possible dangers as automatic speech recognition misinterpreting a 15 milligram prescription dosage as 50 milligrams. “That can have very, very high-stakes consequences,” Vogler said. Platforms tend to be designed in a way that works for the mainstream hearing population, Vogler said: Medical offices transitioned to virtual communications with platforms that don’t always include interpreting services or captions. “It just hasn’t been successful in COVID so far,” Vogler said.

The FCC worked to keep deaf and hard of hearing individuals connected, including allowing waivers for speed of answer and interpreters to work from home. The Consumer and Governmental Affairs Bureau began contacting InnoCaption Director-Regulatory Affairs Cristina Duarte weekly to find out how to fill in some gaps in communications services, she recalled. InnoCaption launched Deskview for patients to mirror captions from their cellphone onto their computer screen.

The FCC should do “vigilant enforcement” of existing regulations, Scarpelli said. Providers should be proactive in building accessibility into their platforms by design, he said: “They need to step up.”

The FCC sought comment this month on how to best administer the second round of its COVID-19 telehealth program funds, particularly on whether to prioritize applications from providers treating certain at-risk populations (see 2101060048). "Inaccurate and confusing captioning" on news programs resulted in the National Association of the Deaf receiving roughly 1,000 calls in one month, a coalition of advocacy groups said. NAD usually gets about 1,300 calls yearly, it said. Many doctors and hospitals rushed to implement telehealth services during the pandemic without considering the implications for the 48 million U.S. hearing-impaired people, emailed NAD CEO Howard Rosenblum. "Many telehealth services only allow for the medical professional and the patient to see each other, which is problematic when there's a need for sign language interpreters."

Lack of communications access for deaf and hard of hearing patients during the pandemic "can be devastating," the groups said. Patients already make fewer trips to their doctors than hearing patients and "must receive clear and accurate updates" on such items as vaccine distribution, new virus strains, and state and local health officials' recommendations, the groups said. They also urged the commission to prioritize funding for platforms that allow for a third-party interpreter or communication access real-time translation services in telehealth settings. Rosenblum said he's pleased with the Biden administration's decision to have an American Sign Language interpreter at all news briefings. NAD sued the Trump administration to provide ASL interpreters during COVID-19 briefings; the case is pending.