Automated Notification System for WIC Reminders (ANSWR)
Situation
The Women, Infants and Children (WIC) program is a federally funded program administered by the U.S. Department of Agriculture. WIC provides federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding and nonbreastfeeding postpartum women, and to infants and children who are found to be at nutritional risk. In the state of Oregon, the Oregon Health Authority’s Office of Family Health is responsible for managing the WIC program.
In order to encourage higher attendance at appointments, WIC had previously been utilizing a scheduler tool that used a hardware autodialer to deliver appointment reminders via phone. According to Kim Word, who manages the WIC data system for the state, the old autodialer was becoming cumbersome and not as effective as it needed to be. “Every WIC clinic was responsible for generating its own appointment reminder calls,” she states. “It required a manual process every night at each local agency to run the autodialer. In some areas, there were not enough phone lines to get all the calls made before it got too late in the evening. And there was also the issue of maintaining hardware and software in each clinic.” In addition, calls were delivered in English or Spanish only, yet Oregon’s WIC clinics had clients who spoke many different languages. WIC management felt there was an opportunity to streamline the reminder process by replacing it with a centralized system that could also better accommodate other languages.
Challenges/Opportunities
WIC released a public request for proposal for its Automated Notification System for WIC Reminders (ANSWR) and ultimately chose U.S. Netcom to handle the project. The company specializes in creating notification solutions and has telecommunication centers that could handle the large volume of calls that needed to be made each evening. It also offered the capability to deliver reminders via text message and email. What it didn’t have is the internal expertise to translate or record the necessary scripts into multiple languages. For that important component, U.S. Netcom turned to MAGNUS for help. “We had used other interpretation services before and were not satisfied,” notes Kim Gustafson, U.S. Netcom’s vice president of business development. “I had learned about MAGNUS through a trade show and their staff seemed very knowledgeable, so I decided to give them a try.”
Action/Intervention
Word’s data team researched the top languages spoken by clients in WIC’s clinics statewide and identified eight that covered a significant portion of the population. In addition to English and Spanish, they included Russian, Chinese, Burmese, Vietnamese, Somali and Arabic. One other language, Trukese, was a rare tongue that was only spoken primarily on the Micronesian island of Chuuk (formerly known as Truk) but would nevertheless serve a small but significant population in certain service areas of the state.
Scripts were written in English for appointment reminders and missed appointment calls. Because the goal was to move beyond voice calls and add email and text message reminders, scripts were written for those as well. WIC operates over 125 clinics statewide, and most have unique names with which patients identify.
In all, each language had nearly 20 different variations on the scripts that needed to be accommodated in translation — requiring over 100 discrete recordings in each language. MAGNUS went to work translating the scripts and scheduling native speakers to authentically record the voice messages at the MAGNUS in-house recording studio. MAGNUS also handled post production tasks to convert the audio files to the specific requirements of U.S. Netcom’s proprietary system. The recordings were then delivered to translators in each clinic where the different languages were spoken. The translators vetted the accuracy and appropriateness of each recording.
“What I really appreciated about the MAGNUS team was they understood that translations involve more than just speaking a different language,” Gustafson notes. “They understand the nuances of different dialects and how culture flavors the way words are used and pronounced. They are even knowledgeable about the variations between how the older and younger generations in some cultures speak the language. That was really important to this project.”
The expertise of MAGNUS in cultural nuances was important to the success of the Vietnamese language recordings: Native speakers felt that the voice used was too harsh to deliver the message in a culturally appropriate manner. MAGNUS quickly found another voice-over talent that delivered a more sensitive tone to the messages. In the case of Trukese, finding an authority on the language was especially difficult. Through extensive research and diligent legwork, including networking with leaders on the island, MAGNUS was able to find an expert in Trukese who was familiar with the U.S. healthcare system to complete the project on time and on budget.
Results
The Oregon WIC Program rolled out ANSWR in English and Spanish voice recordings to replace the state’s autodialer system in August 2010. English and Spanish text and email messages started up in December that same year. Because of patient confidentiality issues — WIC needed to get permission to contact patients via texts and emails, as well as obtain their contact information — it took until June 2011 to collect the data it needed to reach every current patient. But early statistics collected for the period December 2010 through April 2011 demonstrated that even during early implementation, ANSWR earned WIC a 2 percent increase in show rates. ANSWR has also eliminated the need for local agencies to maintain special equipment or phone lines, and local agencies no longer need to perform manual autodialer functions. During the period noted above, WIC was saving over 150 staff hours every month. ANSWR has been fully deployed in English, Spanish, Russian, Vietnamese and Chinese, and is rolling out to three of the other languages — all except Trukese. WIC staff is holding that set of messages for a later date. ANSWR makes an average of 2,000 calls per night.
“We are very happy with the increase we’ve had in show rates so far,” states Word. “The text message reminders have been hugely popular. Our patients have been commenting that WIC is getting with the times. ANSWR has been a real boost to our PR.”
Client quote:
“The quality of the work performed by MAGNUS was outstanding and their responsiveness was excellent. The attention to detail and timeliness were on target with our deadlines. I was greatly impressed with the MAGNUS team.”
-Kim Word, MPH, Oregon WIC Program
“The MAGNUS team understands the importance of culture and how demographics can affect the understanding of a language, even among native speakers. They are experts at finding the right solution, with an extensive talent pool. We had one requested language that was very rare and complicated. MAGNUS went to the ends of the earth to find an authority who could translate it accurately.”
— Kim Gustafson, VP Business Development, U.S. Netcom
What This Case Study Could Mean for You
- MAGNUS has the breadth and depth of experience to ensure that you get your message delivered, read and understood in almost any language. MAGNUS excels in delivering accurate, culturally appropriate translations that are sensitive to the demographic nuances of your unique target market.