Patient-Centered Care for All

Tokyo takes on the challenge of creating a language-friendly environment for non-Japanese speakers in need of medical assistance.


In line with its image as a city that has been named the most livable in the world, Tokyo is at pains to ensure that non-Japanese speakers do not experience communication barriers when accessing medical care. The numbers of foreign visitors and residents are certainly growing. Long before the Japanese government in 2016 finally achieved its long-held goal of attracting 20 million overseas visitors in a single year, foreigners had ceased to be anything of a rarity on the city streets. At times, of course, some of those non-Japanese find themselves suffering from injury or illness. And having to cope with the medical needs of the burgeoning numbers of patients who do not speak Japanese has led to the services provided by Mayumi Okauchi.


A registered nurse, Okauchi works as International Patient Coordinator in the Patient Support Center at Tokyo Metropolitan Hiroo Hospital, an expansive medical institution located near the center of the capital. One of the functions of the support center is coordinating efforts when dealing with non-Japanese patients, and Okauchi is responsible for assigning interpreting work to the hospital’s linguistic specialists in addition to coordinating documentation and support services.


Most members of the team have extensive medical knowledge. Okauchi and two colleagues tackle Japanese-English interpreting, while two other interpreters handle Japanese-Chinese translation. They are most frequently called upon to assist non-Japanese speakers appearing at the reception desk, managing a language barrier at a difficult time. The second-most frequent call on interpreter services is to provide interpreting assistance during medical examinations.


In addition to those dedicated linguistic specialists, the hospital is able to draw upon other considerable human resources so that non-Japanese patients and their families can visit the hospital with complete peace of mind. The hospital has many staff it can call on as needs arise for English, Spanish, Chinese or other languages. In a survey the hospital conducted last year, it found that around 170 of its 700 staff members were able to speak a language other than Japanese.


Hiroo Hospital has long been at the forefront of efforts to reach out to international patients in Tokyo. As a reflection of those efforts, the hospital in March 2017 received the Japan Medical Service Accreditation for International Patients (JMIP). Since 2011, this certification has been managed by the Japan Medical Education Foundation, with the backing of the Ministry of Health, Labour and Welfare, to encourage medical institutions to create systems to support foreign patients. To qualify for JMIP recognition, an institution has to demonstrate that it has appropriate systems in place for supporting non-Japanese residents and overseas visitors.


At Hiroo and other medical facilities around Japan, there is another tool for facilitating medical communication between patients and health professionals when interpreters are unavailable. It is a medical guidebook produced in 12 different languages, including English, Chinese and Korean, that follows a standard format for each language, making use of illustrations to allow symptoms and complaints to be clearly identified next to appropriate terms in the target language.


A decidedly more sophisticated option comes in the shape of video remote interpreting (VRI). This involves an interpreter—sitting at some remote location—offering real-time translation on-screen between the patient and health professional. Okauchi and her team are able to utilize a VRI system covering eight languages, including Chinese, Korean, Spanish
and Portuguese.


There are considerable merits to VRI since it offers real person-to-person communication. “In Japan, we’re not yet as advanced in this area as Australia,” comments Okauchi. “That country has an excellent system for remote medical interpreting in over 100 languages. That’s the kind of direction where I’d like us to be heading.”


Okauchi is able to empathize with foreign patients as she helps to develop the system for communication with non-Japanese speakers at Hiroo Hospital. She studied English in the U.S. and honed her skills working in a medical coordinating position at a clinic there. Having experienced many of the same difficulties herself, Okauchi says that she knows what it is like to be a foreigner.


With the number of foreign patients at Hiroo Hospital expected to grow, it is necessary for the staff to become better adept at accommodating them. The hospital is working to ensure that both patients and staff have positive experiences during their interactions there. At Hiroo Hospital, Okauchi makes it very clear that the focus is on patient-centered care, and that is evident in her positive approach in dealing with all patients and staff: “I enjoy communicating with people,” she says.


Photo Captions

-The Tokyo Metropolitan Hiroo Hospital features a multilingual communication system.

-Non-Japanese speakers can point out the location of their symptoms using English-language illustrations (similar to this one) in multilingual guidebooks.

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