Medical Record - Preferred Language

If an organization is collecting the patient’s “primary” language – does this meet The Joint Commission’s requirement for the collection of “preferred” language?

Any examples are for illustrative purposes only.

The intent of the Joint Commission requirement to collect the patient's preferred language is to record the language the patient would like to use when discussing health care. The term "preferred" language is consistent with the Centers for Medicare & Medicaid Services Meaningful Use criteria, the Office of Minority Health's National Standards for Culturally and Linguistically Appropriate Services (CLAS), and the Institute of Medicine's Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement report.

The term "primary" language has been used by several organizations, including the Office for Civil Rights (OCR) and the Health Research and Educational Trust Disparities Toolkit. Primary language has been defined by OCR as the language that a Limited English Proficient individual identifies as the language he or she uses to communicate effectively and would prefer to use to communicate (1).  Although the terms "preferred" language and "primary" language differ slightly, the intent behind collecting these data is similar - to identify which language the patient wants to use to communicate with his or her provider.*

Regardless of the term used by the organization, the goal is to identify the language needs of the patient to determine whether an interpreter is required at the patient-level or whether language access services need to be modified at the organization-level. If an organization collects "primary" language, and its policies and staff describe that as the language the patient wants to use to communicate with his or her provider, the organization would be in compliance with the Joint Commission's requirement for collecting preferred language data. If an alternate or abbreviated term is used, for example "pref lang" to accommodate character limitations in an EHR, that would also be acceptable as long as the organization's policies and staff were able to describe the information being collected as the patient's language for discussing health care.

*Of note, The Joint Commission's rationale behind collecting language data is to identify patients that may be limited English proficient and need language access services, not necessarily to document the native or first language of the patient. Although some organizations may choose to collect additional language data based on their services and/or patient population, the intent of the Joint Commission requirement is to determine the language the patient is comfortable using to communicate health care information, which may differ from the patient's native language.

(1) HHS (U.S. Department of Health and Human Services). 2008. Civil rights: Hawaii Department of Human Services Resolution Agreement. Washington, DC: U.S. Department of Health and Human Services.

Additional Resources:
Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care
Last updated on June 29, 2020
Manual: Ambulatory
Chapter: Record of Care Treatment and Services RC

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