Sixth National Conference on Quality Health Care for Culturally Diverse Populations: Peer-to-Peer Practice Advancement Sessions The Exchange: Better Communication, Better Health

C-6 Reaching thousands: Using the internet to improve outreach, collaboration, and information dissemination

The Exchange: Better Communication, Better Health
Tuesday, September 23, 2008: 2:00 PM-4:00 PM, Minn Marriott, 8th Floor - Wayzata/Gray's Bay
The Multilingual Health Resource Exchange: A unique, statewide collaborative of often-competing Minnesota health care organizations

The 18 organizational members of The Exchange are Minnesota-based hospitals, health plans, insurers, clinics and others, joined together to reduce disparities and costs related to health education. Over the past six years we have created a substantial online library of multilingual health education materials, as well as a clearinghouse of information on issues that complicate communication between providers and patients, such as language, culture, class, literacy, spirituality, and race.

The Exchange's information pages are open to everyone, but its 3,200 PDF online library of translated health materials is for members only. Member organizations jointly govern the Exchange, share the cost of maintaining the website, and reap the benefits of access to thousands of translations in multiple languages, in an easily searchable and downloadable form. Users include thousands of providers at large Minnesota health care organizations, such as HealthPartners, HealthEast, CetraCare, North Memorial, Children's Hospital and Clinics, Park Nicollet, Fairview, Medica Medi-Sota and UCare. But access is available to many more Minnesota providers through partners such as Blue Cross Blue Shield, Midwest Medical Insurance, Minnesota Academy of Family Physicians Foundation, which provide a password to participants.
The Exchange is membership-based, provider-oriented, and limited to Minnesota. The annual budget is about $50,000. The site is maintained by a St. Paul, MN consulting group, Health Advocates, which also coordinated meetings and manages communication with partners and other interested parties.
Membership stability, user satisfaction surveys, completed projects and collaborative spin-offs are all indicators of the Exchange's success. In a recent user survey, 90 percent of those responding said they found the material they sought, while 94 percent said they found the Exchange easy to understand and navigate.

In our view, the break-through realization with the Exchange has been that such a resource can be funded by a local collaboration of partner organizations, which each pay an annual membership fee of $2500. For less than the cost of developing a pair of health education pieces in multiple languages, members gain access to a steadily expanding library of materials in the languages most commonly spoken in Minnesota. Some of these materials are developed by partner organizations and shared via the Exchange. Others are copyright-free materials that are included in the Exchange online library, where they can be easily found via a keyword search, or by browsing by topic, language, or topic and language. Because we are funded by a number of users, we've been free of the boom-or-bust problems associated with grants delivered by foundations. While modest, our budget is predictable and has grown steadily as we've added new members.

A recurrent issue has been password protection of our library. Some users complain that it adds a step that harried providers are unwilling to take, and thus makes the Exchange less useful than it otherwise might be. At the same time, we've been concerned that if the Exchange is free to everyone, members who currently pay to maintain the Exchange will wonder why they're paying for everyone else's free ride. Our concern is that cutting the password to expand usage would ultimately kill the Exchange.  

This work could be duplicated in other areas. To do so requires a core group of organizers who are genuinely concerned about the lack of translated material for non-English speaking clients, and patience to work through the first few years of building up the library to make it a significant resource.

  • exchange_conf_summary.doc (79.0 kB)
  • Presentation Information:

    Program: Peer-to-Peer Practice Advancement Sessions
    Primary Category: Language Access
    Subtopics: Continuing education/on-the-job learning, Curricula development, Disparity reduction, Health literacy, Translation, Partnerships with community organizations, Implementing disparity reduction programs, Implementing the CLAS standards or other cultural competence frameworks, Patient education

    Region Addressed by Presentation: US - Midwest
    Organization: Non-Profit Organization/Association
    Keywords: Minnesota, translation, health status disparities, collaborative


    Anthony Paul Schmitz , Health Advocates, Saint Paul, MN
      Coordinator, Multilingual Health Resources Exchange; Co-Director, Health Advocates
      Health Advocates
      843 Van Buren Avenue
      Saint Paul MN, USA 55104

      Phone: 651-222-9460
      Email Address:

      Biographical Sketch:
      Anthony Schmitz is co-director of Health Advocates, a Minnesota-based community health consulting firm specializing in cross-cultural, immigrant and international health. Health Advocates designed and coordinates the Multilingual Health Resources Exchange website. In addition, Health Advocates consults on a variety of issues for state and national organizations, including the National Council on Interpreting in Health Care, the University of Minnesota, the Global Health Council and the Minnesota Department of Health.