Ashley Rogers, MD, Dedicates Expertise to Ensuring Equity in Healthcare for Spanish-Speaking Cancer Patients

As a bilingual pediatric oncologist, Ashley Rogers, MD, sees firsthand how Spanish-speaking patients and their families struggle in a medical setting — whether that’s understanding a complicated diagnosis or working through a lengthy treatment protocol. That’s why Dr. Rogers has dedicated her expertise in cancer, patient-centered care and multiple languages to increasing access for Spanish-speaking patients in the Children’s Hospital Colorado Center for Cancer and Blood Disorders.

Before the COVID-19 pandemic, Dr. Rogers worked as one of the primary Spanish-speaking providers for children with leukemia and lymphoma. When the pandemic hit, she saw an opportunity to increase outreach and access through telehealth. Instead of coming in, families who had a difficult time making the trip could have medication administration meetings and discharge follow-ups via telemedicine. She found that families not only appreciated this, but that she was able to do better for her patients and identify what they needed in a more convenient way for families.

“I wanted to find out if this was what families needed, and if this would be helpful,” says Dr. Rogers. “As a clinician, I often have my thoughts of what families need, but I wondered if having a designated Spanish-speaking provider who could do outreach outside the clinic through telemedicine would make a difference.”

Creating a medical home for Spanish-speaking families through research

Research shows that families who do not speak English can feel that it's more difficult to access medical care, and they may settle for an incomplete understanding of their child’s care. In addition, survival rates among children with certain cancers differ based on the socioeconomic status of their parents. Given that Spanish-speaking patients and families are at higher risk of experiencing challenges in accessing or understanding their healthcare, and that many of the families experiencing socioeconomic insecurity were also Spanish-speaking, all of which can lead to poorer medical outcomes, Dr. Rogers saw an area where she might be able to make a difference.

She focused her study on alleviating some of the burden of a devastating cancer diagnosis by providing bilingual support. With her ability to care for Spanish-speaking families in their preferred language, Dr. Rogers hypothesized that we could enhance communication and outreach to families with low English proficiency so that families would feel more comfortable establishing a medical home at Children’s Colorado.

Dr. Rogers began interviewing families and writing a protocol to ensure more access to specialty care. Her focus is on patients who have been in the clinic for approximately six months or more, as they have a better understanding of how the clinic works and can give more detailed feedback on areas of success and possible improvements. Through the interviews, Dr. Rogers collects data on the barriers that families experience, whether telemedicine or home calls are more helpful, and how challenges can be addressed.

“I've just had the most amazing experience with families, hearing how honest and transparent and vulnerable they've been to share these stories about their children,” Dr. Rogers says.

Throughout her interviews, Dr. Rogers has found that many families feel supported in their journey, whether that’s due to friendly staff who take the time to learn about their children or through the presence of a bilingual provider or interpreter. Often, children or other family members will act as the interpreter, and Dr. Rogers emphasizes that even if the family wants that, it’s important to offer and use in-house interpretation resources as much as possible to create a positive experience.

“A lot of times teenagers, in particular, express that they are sort of the interpreter for their family, and we need to help those teenagers be patients,” Dr. Rogers says. “We need to take ownership and provide other means of helping the family, so they can have comfort in their team’s care.”

While Dr. Rogers and her colleagues provide many communications in Spanish, such as calendars, reminders for appointments, medication notes and more, she aims to build a home telemedicine visitation program to provide more support and improve equality of care.

“Even though we've really improved our language access,” she says, “there are still some things that I think we could triage to help families feel loved and comforted.”