A third person in the room changes both the conversation and the note. The first one is immediately noticeable. The second is easier to forget.

She is 71 years old, has lived in Norway for twelve years and understands more Norwegian than she speaks. Her daughter has been to the doctor's office before and is happy to offer her help again – it's just faster that way. You have eleven minutes left of the consultation, and you need to provide a test answer that means something.

You make a choice. The choice, and the reason for it, is an assessment you have already made. The question is whether it exists somewhere afterwards.

The obligation lies in the requirement of due diligence

It is easy to believe that the obligation to use an interpreter arises solely from the interpreter law. But that is not the case in the healthcare and social services sector. The Norwegian Directorate of Health is clear that the obligation stems from the requirement of due diligence In the Health Personnel Act § 4 and § 10, and in the Patient and User Rights Act §§ 3-2 to 3-4. In addition, § 3-5 of the Patient and User Rights Act provides the patient with the right to information adapted to their own circumstances – including age, maturity, experience, and cultural and language background. This applies regardless of whether the service is public or private.

The Customs Act § 6 contributes with the evaluation standard itself: emphasis should be placed on whether the parties to the conversation can communicate effectively without an interpreter, and on the seriousness and nature of the matter. The Directorate of Health translates this into a practical rule that is easy to remember: in cases of doubt about whether communication is being conducted effectively without an interpreter, it will often be necessary to use an interpreter.

The border also runs in the opposite direction. If the patient does not want an interpreter, you basically cannot impose one. Instead, you should make an expert assessment of what this means for the health situation and the consequences of not having one.

The daughter in the waiting room

Section 4 of the Interpreter Act prohibits public bodies from using children for interpreting or other forms of information dissemination. Exceptions are provided for emergency situations and for cases where, in the interest of the child and the circumstances, it must be deemed appropriate. The preliminary work sets the bar high: for complex information, or where the situation could be distressing for the child, children must not be used.

For adult relatives, there is no equivalent prohibition, but the advice is clear. The Directorate of Health writes that relatives or other persons should not be used in place of a qualified interpreter. Most people who have been in that situation know the reasons: the role, the relationship, and everything the patient might not say when the daughter sits in the chair next to them.

This is also something the patient should be informed about. The information obligation includes that the interpreter has a duty of confidentiality, that the interpretation can take place in person or via screen and phone, that the service covers the expenses, and that children should not be used as interpreters.

The three lines that should be in the journal

Here is the recommendation in concrete terms. Those providing healthcare must, when appropriate, document it. evaluation of interpreter needs and any interpreting that has been carried out in the patient's medical record – The Norwegian Directorate of Health refers to the Health Personnel Act § 39 and section 40 and to the patient record regulations section 4. It should also be recorded if the patient or a relative has objected to the use of an interpreter where you believe there is a need.

Three lines, that is, not three sections: that the need was assessed, what was done, and what might have been an obstacle.

Two things are included: GPs and other healthcare professionals should record interpreter needs in referrals – otherwise the next step in the process begins again. And the patient can also record their need for an interpreter in the core journal; you can assist with this during the consultation.

Patient record regulation § 7 points in the same direction without mentioning the interpreter with one word: the record should show that advice and information were given to the patient and their closest relatives, and the main content of the information. When the conversation has passed through a third person, the question of whether the information reached them is one of the most relevant ones in the entire note.

What the third voice does to the text

An interpreted consultation takes longer and gives shorter answers. You ask the question, it is translated, the patient answers, it is translated back. What you end up with when you have to write is often a distillation – and the distillation is yours, not the patient’s choice of words.

It’s worth being aware of this. «The patient describes the pain as burning» is different from «the patient reports pain». The first is the patient’s own description, relayed through an interpreter. The second is your summary. Both may be correct, but they are not as valuable to the person who reads the note in half a year.

The Medivox fits in

Medivox transcribes the clinical conversation into text and structures it according to templates you build yourself. For interpreted consultations, the template is the most important element: one field for assessing interpreter needs, one for how the interpretation was conducted, and one for the information provided. Then the three lines above are actually written, because they are there waiting for you.

Dictation is the core function, and it works best right after the consultation – while you still remember what the patient said, not just what you concluded. An interpreted conversation takes time. The note afterwards doesn’t have to do that.

All data is pseudonymized before it is processed further, and all data processing takes place in Norwegian data centers. You own the journal and make the final assessment – Medivox documents the assessment you have already made.

This is connected to something bigger. We have written about The groups that rarely come to the fore when healthcare is digitalized, and about what it does to trust when you look down at the screen along the way. In an interpreted consultation, both aspects are heightened: there is one voice to follow along with, and less attention to give away.

A date worth noting

Section 7 of the Tolk Law requires that it be used qualified interpreter when there is a duty to use an interpreter – that is, an interpreter who meets the requirements for inclusion in the National Interpreter Register. At the same time, it is stated in the same paragraph that until December 31, 2026 is an exemption from this requirement, and that the King may extend the exemption by regulation.

The exemption is related to the fact that the register is still being built up, and that access to qualified interpreters varies between languages and regions. This is a practical recognition, not a downgrading. But the date is there, and for businesses that use interpreters regularly – section 9 of the interpreter law sets the limit at approximately once a week – it is a natural opportunity to review their own booking and usage procedures.

If someone were to ask you today how interpreter needs are assessed and documented in your workplace: would the answer lie in a routine, or in how each individual tends to do it?

Frequently Asked Questions

When do I have a duty to use an interpreter? The obligation follows from the requirement of due diligence in the Health Personnel Act § 4 and § 10 and from the Patient and User Rights Act. In the assessment, emphasis is placed on whether you can communicate effectively without an interpreter, and on the seriousness of the matter. In case of doubt, the main rule is to use an interpreter.

Can relatives interpret for the patient? Children under 18 years of age should not be used as interpreters, with limited exceptions for emergency situations. For adult relatives, the advice from the Directorate of Health is that they should not be used in place of a qualified interpreter.

What should be written in the record about the interpreter? Whether the need for interpretation was assessed, what was possibly carried out in the form of interpretation, and whether the patient or a relative has opposed the interpretation where you believe it is necessary.

Who covers the costs of the interpreter? The health and care service covers the costs of interpreting services that are necessary to provide adequate services, and the patient must be informed about this.

Can speech-to-text be used in an interpreted consultation? Dictation is the core function of Medivox, and the note is dictated after the consultation, not during it. The template you have built determines whether the fields for interpreter needs and information are actually filled out.

Use Medivox for free – Get started completely free

Would you like to see how a template for interpreted consultations can be set up? Contact us – we go through the setup together with you, with no commitment period.

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