Communication procurement
Procure the communication outcome – not only the minutes.
Interpreting services are vital. The question is whether the contract that buys them also covers everyday communication, accessible formats, device-neutral access and benefits evidence.
Interpreting contracts buy minutes. This is about buying the outcome around them, and having the data to show it worked.
Where the contract stops, and care carries on
One patient, one visit. Where an interpreter is called, good providers deliver – on demand, by phone or video, often within a minute or two for the common languages. That part works.
Two things sit outside it. The first is the rarer languages. No provider can dial up an interpreter who does not exist, and the patients affected are often the ones with the least English and the fewest people around them to help. This is exactly where prepared content earns its place: written and checked in advance, it is there the moment it is needed, in languages where a live interpreter may be hours away or unavailable.
The second is everything nobody places a call for. A two-minute wait is nothing in a planned consultation and too long at a bedside, on a home visit, or when someone just needs to explain what happens next. Add a community setting with no signal, or a ward where the shared tablet is elsewhere, and the short exchanges happen anyway – in broken English, through a relative or staff member, generic machine translation, or not at all.
- Arrival Language not known yet, so no call can be placed
- Triage Fast questions. A call is possible, but often not made
- Assessment Where an interpreter is booked or dialled in
- Consent Needs an interpreter, and needs evidencing
- Discharge Written instructions the patient takes home
Reached by an interpreting contract alone
Assessment and consent are well served. Triage depends on whether anyone has time to place a call. Arrival and discharge sit outside the contract.
Reached with CardMedic, interpreters included
- Planned interpreted conversations Covered Covered
- On-demand phone and video, common languages Covered Covered
- Rarer languages – live, open conversation Partly covered Partly covered
- Rarer languages – prepared clinical content, instantly Not covered Covered
- The first minutes, before a call can be placed Partly covered Covered
- Short everyday explanation and reassurance Partly covered Covered
- Written information the patient takes home Partly covered Covered
- Easy Read, Read Aloud and sign language Partly covered Covered
- Use with no signal, or in the community Not covered Covered
- Works on any device the ward already has Partly covered Covered
- Data on the whole pathway, not only calls Partly covered Covered
Between them, prepared content, live translation and interpreter access cover the face-to-face communication journey end to end – not only the part someone places a call for.
Filled circle: covered. Half circle: covered in part, or locally and inconsistently. Open circle: outside the contract.
Credit where it is due: good providers now connect on demand by phone or video within a minute or two for common languages, and many supply devices to make that easier. The service is not the problem.
The unit is. However fast the connection, you are still buying minutes of conversation – so the cost rises with use, and everything that is not a conversation stays outside the contract. Faster minutes are still minutes.
If interpreter calling stays switched off
One front door does not take volume from your provider. It finds conversations that were not happening at all.
Some organisations decide not to enable in-app interpreter connection, and the reason is rarely technical. It is usually a question about the existing language services contract, and about who might be seen to be moving what. It is a fair question, so here is our answer in full, and you are welcome to send this page to anyone who needs it.
What connecting actually changes
- Not your provider. The call is answered by the interpreting service you already contract with, under the contract you already hold, at the rate you already pay. We do not supply interpreters and we do not resell them.
- Not your spend. Our licence is fixed and does not rise with minutes. A call placed from inside the app costs you exactly what the same call costs today.
- Only the route to the call. Staff reach the same interpreter from the screen they are already holding, instead of leaving the conversation to find a number, a code or a device.
- Not a white label. We do not present your interpreting service as ours. Staff know whose interpreters they are reaching, which matters for their confidence and for your governance – your provider keeps its standing with your teams rather than disappearing into ours.
Why it tends to raise access rather than cost
Where everything sits behind one door, staff use it. They stop deciding between five routes, three of which they cannot remember, and start choosing the right one for the patient in front of them. Adoption is the whole game, and convenience is what drives it.
What grows is the total number of supported conversations – overwhelmingly the everyday exchanges that previously happened in broken English, through a relative, or not at all. That is why cost per interaction falls while interpreter volume holds: the denominator grows.
It increases your control, rather than reducing it
Most organisations can see booked interpreting minutes and very little else. They cannot see the conversations where nobody placed a call, which is where the risk lives. One front door produces a single record of what was needed, which route met it and where escalation happened – across language, literacy, cognition, hearing and vision, not just the billable part.
That record belongs to you and exports to you. It is also what a reasonable-adjustments duty, an Accessible Information Standard self-assessment or a serious-incident review will ask for, and it is the thing most services cannot currently produce.
And if the answer is still no, nothing about the deployment depends on it.
Content, accessible formats and live translation work exactly as normal. The workflow still tells staff when a conversation needs a professional interpreter and points them to your existing booking route instead. Nothing quietly degrades, and no part of the licence is priced on the assumption that you will switch it on.
It can be enabled later, once the contract question is settled or at renewal. Several organisations have started that way. We would rather you deployed without it than delayed communication support for everyone while a commercial conversation runs its course.
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How the categories work
Interpreting frameworks are usually built around large service contracts, with entry requirements a clinical technology company may not meet. That can leave the main supplier deciding what else gets near the pathway.
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What the specification misses
Everyday conversation, accessible information, content that works offline, access on any device, routing between providers, and any way of measuring whether it worked. These usually sit outside the buying decision.
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How the two models are paid
A per-minute service and a fixed-fee platform are paid for different things. Both are legitimate; they simply suit different parts of the problem.
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The AI question
Machine translation is now widely offered, and often billed per minute like a human interpreter. Doing it properly in healthcare does cost real money – clinical safety work, data protection, hosting, testing and support. But those are mostly fixed costs. They do not go up much when the service is used more. So a per-minute price is worth asking about: what is it measuring, does it fall as the technology gets cheaper, and where has the supplier told you it should not be used?
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What patients experience
Gaps, delays and inconsistent access across language, reading, hearing, sight and memory – usually in the interactions nobody is counting.
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A better model
Buy the communication outcome, keep your professional interpreting capacity, and allow routing to more than one approved provider.
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A practical route now
Buy CardMedic through a valid technology route, require practical connection details from the existing provider, run an evaluated deployment and write open integration and outcome measures into the next procurement.
A specification written around interpreting minutes will buy interpreting minutes well. Whether it also covers the rest of the pathway is a separate question, and worth asking deliberately.
Operating models compared
A comparison of models, not suppliers. Each line is verified against procurement documents, customer experience or published evidence.
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What determines the route?
Traditional single-supplier model
Often the services available within one contract
CardMedic communication layer
Patient need, clinical context and organisation-defined rules
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Communication options
Traditional single-supplier model
Principally contracted interpreting modalities
CardMedic communication layer
Governed content, accessible formats, Live Translate and professional interpreters
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Provider choice
Traditional single-supplier model
Commonly centred on one prime supplier
CardMedic communication layer
One or multiple approved providers where commissioned
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Device access
Traditional single-supplier model
Often a supplier app, account or supplied handset
CardMedic communication layer
Any browser or app, on phones, tablets and desktops the ward already has
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Offline resilience
Traditional single-supplier model
Varies by supplier and modality
CardMedic communication layer
Approved content and configured capability offline on supported platforms
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How it is paid for
Traditional single-supplier model
Normally paid for services consumed
CardMedic communication layer
A fixed licence that does not rise with interpreter minutes
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How machine translation is charged
Traditional single-supplier model
Often sold as an AI interpreting product, still billed by the minute
CardMedic communication layer
Included in the licence, with its limits stated and the interpreter route kept open
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Management information
Traditional single-supplier model
Minutes, calls and service levels
CardMedic communication layer
Need, adoption, modality, escalation, access and benefits evidence
Where we stand
We argue for a different buying model, so it is fair to ask how we intend to behave within it.
More on how we work with others, including with language service providers.