Highlights
Empowerment vs. Comprehension
The study found that while Video Remote Interpreting (VRI) significantly increased the likelihood of Deaf patients feeling encouraged to express themselves (OR 1.90), it did not statistically improve their objective understanding of the physician (OR 1.33).
Scalability in Resource-Limited Settings
Conducted in a public hospital in Colombia, this randomized clinical trial highlights VRI as a scalable alternative to in-person interpretation, though it underscores that technological implementation requires specific preconditions to be effective.
The Communication Barrier in Deaf Healthcare
Effective communication is the cornerstone of clinical safety and patient-centered care. For the Deaf community, particularly those whose primary language is sign language, the healthcare system remains fraught with barriers. Historical reliance on ad-hoc methods—such as lip-reading, note-taking, or untrained family members—has been shown to increase the risk of misdiagnosis, poor medication adherence, and patient dissatisfaction. While in-person sign language interpretation is the gold standard, its availability is often limited by high costs and a chronic shortage of qualified professionals. Video Remote Interpreting (VRI) has emerged as a promising solution, leveraging telecommunication to provide real-time access to interpreters. However, despite its growth, robust clinical data comparing VRI to usual communication practices has been surprisingly sparse until now.
Study Design and Methodology
To address the gap in evidence regarding communication quality, researchers conducted a randomized clinical trial at a public hospital in Colombia between August 2023 and October 2024. The study enrolled 210 Deaf adults who use Colombian Sign Language (LSC) as their primary mode of communication. The participants had a mean age of 42 years, with a representative gender distribution (58.6% women).
Participants were randomly assigned to one of two groups:
Intervention Group
Patients received their medical appointments with the assistance of VRI, where an off-site professional interpreter facilitated the dialogue via a video link.
Control Group
Patients utilized the current standard of care (usual communication), which included self-arranged interpretation, lip-reading, written notes, or the use of visual aids and images.
The primary outcome was measured using the Doctor-Patient Communication scale, a validated tool designed to assess various dimensions of the clinical encounter from the patient’s perspective. Both the Deaf participants and the healthcare professionals were blinded to the allocation until the moment of the intervention to minimize bias.
Key Findings: The Nuance of Digital Interpretation
The results of the trial, analyzed between January and May 2025, offer a nuanced look at the efficacy of VRI. Of the 210 participants, 51.4% (n=108) were in the intervention group using VRI. The analysis revealed that VRI is not a universal fix for all communication challenges but rather a tool that excels in specific areas.
Patient Expression and Encouragement
The most significant finding was the impact of VRI on patient agency. Patients in the VRI group were significantly more likely to report that they were encouraged to express themselves during the encounter (Odds Ratio [OR], 1.90; 95% CI, 1.13-3.18; P = .02). This suggests that the presence of a professional interpreter, even via a screen, lowers the psychological barrier to participation and allows patients to voice concerns they might otherwise withhold when struggling with lip-reading or writing.
The Comprehension Gap
Conversely, the study found no statistically significant difference between the two groups in terms of the patient’s understanding of the doctor (OR, 1.33; 95% CI, 0.79-2.23; P = .28). This finding is critical for clinicians and policymakers. It implies that while VRI facilitates the flow of information, it does not automatically translate to health literacy or the successful synthesis of complex medical instructions.
Clinical Implications: Beyond the Screen
The data suggests that the mere presence of a technology-mediated interpreter is insufficient to guarantee clinical comprehension. Several factors may explain this disparity. First, technical issues such as internet latency or poor video quality can disrupt the visual nuances essential to sign language. Second, medical terminology in sign language can be highly specialized; if the interpreter is not trained in medical nuances, the message may be lost even if the transmission is clear.
For healthcare administrators, the study highlights that VRI should be viewed as part of a broader linguistic access strategy. While it offers a scalable solution to the interpreter shortage, it must be paired with physician training on how to interact with interpreted patients and a robust technical infrastructure to ensure seamless connectivity.
Expert Commentary and Limitations
Independent observers note that this trial is a landmark study because it moves the conversation from “user preference” to “communication effectiveness.” However, the study has limitations. Conducted in a single country (Colombia), the findings may be influenced by local sign language nuances and the specific socioeconomic context of the public hospital system. Furthermore, the study did not measure long-term health outcomes, such as changes in physiological markers (e.g., HbA1c or blood pressure) following the interpreted appointments.
The conclusion that critical preconditions must be met—such as high-speed internet and interpreter proficiency—is a call to action for health systems to invest not just in software, but in the environment where that software is used.
Conclusion
This randomized clinical trial demonstrates that Video Remote Interpreting is a valuable tool for improving the patient experience and fostering self-expression among Deaf individuals. However, its failure to significantly improve objective understanding highlights the complexity of medical communication. Clinicians must remain vigilant, using “teach-back” methods and other verification strategies to ensure that the bridge provided by VRI actually leads to informed patient care. As we move toward a more digital healthcare landscape, ensuring linguistic equity for the Deaf community remains a task that requires both technological innovation and human-centered clinical practice.
Funding and Trial Registration
This study was registered at ClinicalTrials.gov with the identifier NCT05966623. Funding details were provided by the participating institutions in Colombia and international health equity grants.
References
Rivas Velarde M, Izquierdo Martinez LC, Dalal J, et al. Video Remote Sign Language Interpreting and Health Communication for Deaf Patients: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(2):e2557189. doi:10.1001/jamanetworkopen.2025.57189
