On a recent morning in early February, Lahui Lan Lin, a Mandarin Chinese-speaking patient in the mother-baby unit at UAB Hospital, was sitting in her room, waiting to be discharged. All her discharge papers were in order, and except for one thing, Lin would be headed out the door. Before she could go home, her English-speaking nurse, Pam Garrett, needed to provide Lin with discharge instructions. A year ago, the language differences might have caused frustrating delays, particularly if a Mandarin/English translator could not readily be found. As it was, all Garrett had to do was pick up one handset of a dual-handset telephone beside Lin's bed, dial a few code numbers and request a Mandarin interpreter. Lin picked up the second handset and within seconds, was hearing the discharge instructions being uttered by Garrett in English being translated into Lin's own language by an interpreter. With the recent installation of 200 electric blue telephone consoles at UAB Hospital, language barriers between the facility's healthcare providers and their patients have come tumbling down. Where clearly communicating vital health information to limited- and non-English speaking patients once meant tracking down a live translator, it's now just a matter of a quick phone call. Thanks to the telephone-based language services provided by a company called CyraCom, UAB patients and healthcare providers who don't speak the same language can be linked to translators and communicating in an average of 15 seconds. The CyraCom interpreters are fluent in more than 150 languages and are available 24 hours a day, 7 days a week. The new service will add a new dimension to UAB's ability to provide top-notch healthcare to an increasingly diverse patient population. And the need for clarity in a healthcare setting, for the patients' sake as well as the hospital's, cannot be overestimated. According to a 2006 article in the New England Journal of Medicine (335:229-231), language barriers can have detrimental effects on patients' health simply due to their inability to understand instructions. Patients facing a language barrier are less likely to have a primary care physician or to adhere to medication regimens. They are also more likely to leave the hospital against medical advice. And even a single misunderstood word between patients or their family members and healthcare providers can have devastating consequences. The article cites one instance where English-speaking paramedics mistook the word "nauseated" for "intoxicated" when treating a Hispanic patient. After more than 36 hours in the hospital being treated for a drug overdose, the patient was reevaluated and diagnosed with an intracerebellar hematoma with brain-stem compression and a subdural hematoma secondary to a ruptured artery. The hospital ultimately paid $71 million in a malpractice settlement. "UAB's world-class care attracts patients from Europe, the Middle East, South America and many other locales, and it's not at all unusual for international patients to require language services," said Hans Donkersloot, assistant vice president of UAB Hospital. "The use of highly qualified, simultaneous medical interpreters provided by CyraCom enhances the ease of direct communication between limited and non-English speaking patients and our health care providers." Formed 11 years ago, CyraCom began offering services geared to the healthcare arena in 2003. UAB first piloted the company's patented ClearLink phone system during the fall of 2005 and went "live" with the system in May 2006. The cost per call, said Donkersloot, is in the $20 range. "We pay for the usage only," he explained. According to CyraCom CEO Michael Greenbaum, the company's phone system and translation services are now available in about 1,000 hospitals nationwide. UAB is in the top 10 percent usage-wise and is the leading provider of the company's services in Alabama. "(Foreign language assistance) is a critical issue in making sure UAB gives good medical care," he said. While Hispanic patients create the biggest demand for CyraCom's services at UAB, patients speaking many other languages require such services as well. Turkish, Arabic, Vietnamese and languages native to China, such as Mandarin and Cantonese follow Spanish as some of the most common non-English languages spoken by UAB patients. Last year alone, said Donkersloot, the hospital used 30 languages from the CyraCom index. With its international reputation and history of treating patients from all over the world, UAB has followed a longstanding practice of using in-person translators. According to Donkersloot, the hospital's use of the CyraCom system will not change that. "We see it as a complementary service," he said. "We would never not want to have live translators."