Case Study: Standing Up MedStar’s First Enterprise Video Relay Service Program

Overview

At MedStar Washington Hospital Center, Joshua identified a critical gap in communication access for Deaf patients, visitors, and caregivers. The hospital lacked any public Video Relay Service (VRS) stations and had no reliable method for Deaf patients to communicate with clinical teams during care. The situation raised immediate ADA compliance concerns and created risks in patient safety, care coordination, and operational workflow.

Joshua recognized the urgency and initiated a comprehensive redesign of the hospital’s VRS infrastructure, transforming an overlooked compliance issue into a fully modernized, enterprise-ready communication system.

The Challenge

MedStar faced several intersecting problems:

• Deaf patients and family members had no on-site access to VRS, preventing communication with loved ones or support networks.

• Patients admitted to the hospital did not have a consistent or dependable way to communicate with physicians and nurses during treatment.

• Clinical teams were forced to rely entirely on in-person interpreters, creating gaps in simple communication and care updates.

• The absence of accessible technology created legal risk and compromised patient experience.

• There was no internal policy, governance, or operational model for communication access technology.

• The hospital needed a compliant, modern, reliable VRS ecosystem that supported both patient care and clinical workflow.

Joshua’s Role

Joshua requested and received authorization from the International Services Manager to lead the full project lifecycle, guiding the initiative from concept through contracting, installation, rollout, and long-term governance.

 He oversaw and directed:

•  Solution research and environmental scanning

• Drafting the formal Request for Proposal (RFP)

• Vendor engagement, interviews, and technical evaluations

• Contract negotiation and terms alignment

• Coordination with hospital executives and the IT leadership team

• Policy development and operational workflow design

• Installation and implementation across multiple clinical units

• Verification of ADA compliance and clinical readiness

 This required collaboration with hospital executives, clinical directors, IT leadership, frontline medical teams, and external service providers.

 What He Built

Joshua led a rapid ninety-day initiative that resulted in a complete VRS modernization program, including:

• A fully drafted RFP outlining technical, operational, compliance, and service requirements

• A competitive vendor evaluation that included written proposals and in-person interviews

• Partnership with Sorenson Communications, whose representative flew in to participate in the contracting process

• A cost-neutral solution for MedStar, leveraging FCC revenue models to eliminate hardware and installation costs

• Installation of fixed VRS units in the Emergency Department, main entrance, designated hallways, and a third-floor unit

• Deployment of locked iPads mounted to patient carts for in-room communication

• Dictation-enabled solutions for simple clinical interactions where full interpreter services were not necessary

• Policies governing use, security, placement, and post-discharge device return

• Coordination with hospital executives and IT leadership to align infrastructure, access, and compliance

• A sustainable framework for maintaining and expanding communication access services

The Impact

• Deaf patients and families gained immediate, on-site communication access for the first time in the hospital’s history.

• Physicians and nurses could communicate with patients reliably, improving safety and quality of care.

• Clinical workflow improved through a hybrid model that balanced interpreter resources with dictation tools.

• MedStar achieved ADA-aligned accessibility in a critical service area.

• Installation and equipment were secured at no cost to the hospital.

• Local news outlets covered the initiative, increasing community trust.

• The National Association of the Deaf reviewed and approved the new system, validating its quality and impact.

• A replicable model was created for other MedStar facilities to follow.

 This project captures Joshua’s defining leadership style: recognizing risk before it becomes crisis, bringing clarity to operational gaps, and building systems that strengthen both human experience and organizational integrity. His work modernized a mission-critical service and delivered a sustainable, compliant, patient-centered solution in record time.