The Clinical App for Non-English Speakers

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What is the purpose?

As opposed to inequality, inequity instead provides the needed additional resources to those who are underserved and in this instance, other resources such as creating an all inclusive app that addresses non-English speakers’ unique care needs and level the healthcare plane.

What is something that needs to be created in order to address this issue? How can the patient journey for non-English speaking patients be improved and equitable?

Problem Statement

Non-English speaking patients want to be able to communicate with English speaking healthcare professionals at clinical appointments or other clinical situations because these patients aren’t proficient in English and want to have an application that encompasses all the translating needs at non-English speaking patient has.

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Hypothesis:

If there is an all in one app that meets the needs of non-English speaking patients, this will be one step towards providing equitable care and prevent additional preventable adverse events.

Create a clinical app that provides needed support to non-native English speakers in a clinical setting.

Features:

• ability to change the app to their native language upon starting up app and creating a profile
• clinic maps with clinics in their native language
• translator requests in their native language
• have their medications and medical history in their native language to show at a medical appointment
• translation function to type and translate to English
• insurance with explanation in everyday terminology
• currency understanding

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Why is this important?

Miscommunication was reportedly the cause of 59% of serious adverse events in hospitals, which can be prevented with additional measures put into place. Poor quality communication between patients and healthcare professionals leads to decreased medication adherence, lower patient care satisfaction, diminished patient centered care, and overall negative clinical experiences

Professional interpreters improve communication, appropriate use of resources, and overall increase in patient and clinician satisfaction.

Reduction of disparities in health care resources is shown when professional interpreters are used. In-person professional interpreter services is the most studied example but deeply limits the different languages a healthcare facility can offer to patients but remote interpretation (through videoconferencing) still brings about the same benefits of an in person professional interpreter, however, reduces travel time and also allows for more languages available to patients

Overall, having professional interpreter/ translator services offered and available at a touch of a finger to patients, brings greater interpersonal relationships between patient and healthcare professional which decreases the percentage of preventable adverse events.

Market Analysis

Upon looking for an app that allows non-native English speakers to communicate in a clinical setting, not many searches come up.

• The ones that exist are sparse and lack necessary features that Mother Tongue offers to patients such as direct connection to a translator outside of clinical or medical appointments.
• These apps provide a medical based translating service that is similar to non-medical based translating apps
• Doesn’t provide services to address in person or remote access to professional translators.

Overall, Mother Tongue is a clinical translating app that provides additional resources that existing apps on the market don’t have. And these resources are backed by statistics that would allow for the app to thrive in this market.

Apps that exist:

• Universal Doctor Speaker (IOS/ Android): Verified Medical Translations with Audios, Offline Capability, Search Function, and Categorized Translations
• Care to Translate (IOS/ Android): Playlist or Search Function dedicated to specific languages, Healthcare Professional and Patient Mode
• Medibabble (IOS Only): Pre-Translated Questions and Symptoms, Physical Exam Section to Help Educate Patients, Offline Capability and Pre-Written Content Written by Physicians

These apps all provide similar if not the same features to already pre-existing translation apps used in traditional translating situations. They don't add features such as requesting for a translator which has been shown and proven to be the best case of providing equitable and comparable healthcare to English speaking patients in the U.S. Besides just providing care in a patient's preferred language, an in person translator is better than using a translating app that will be robotically translated with erroneous messages.

This is why an app like Mother Tongue must be created to provide translator requests to available translators and this doesn't only include for in person meetings with translators but also virtual and remote meetings as the pandemic has created the explosion of great remote opportunities.

User Research Insights

• Want ability to find translators easily
• Easy scheduling
• Find clinics with their language quickly whilst still sure that their insurance is covered by the clinics
• Keep track of appointments fast and quickly

“Finding translators that are covered by my insurance is tough and I’d like a central place to look for translators.”

“It’s tough to sort and navigate the web when English content continues to come up and it’s hard for me to understand”

Because of the limited content that non-English patients have in their native language, searching for relevant content becomes difficult as oftentimes English content is the most abundant content displayed in the US.

Insurance and monetary means of paying for such services are also skewed and need to be adjusted in the search criteria that allows patients to find healthcare facilities that provide services at an affordable rate.

User Interviews

100% of users interviewed said they wanted a resource to easily find translators and request for them.

• One interviewee said they’d prefer to book a translator themselves
• Especially one they’ve worked with before

User interviewees were asked questions that were targeted in knowing more about their experience with healthcare facilities and how they navigated finding facilities that provide their needs with translating services.

• Health disparities in those who aren’t able to communicate in English

Because of these rates of disparities and the percentage of non-English speaking patients in the US, this should not be blindsided and instead addressed to bring equity to the field.

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Design features

• Map feature to find clinics that speak in their desired and needed language
• Book appointments with translators
• Message translators when needed
• Dictionary of common health, insurance, and English terms

Design needs

• Ease of use
• Insurance information to apply insurance to translating services
• Communication with translators
• Provide overall space for patients to get insight on translating services

Because of the complexity of all the various moving parts in the topic of this app design, extensive consideration of the different aspects that will impact the translation services of patients journey. Hence taking into account patient user journey is necessary, with the difficulty it is for patients to navigate the American healthcare system as it is.

Design Process

Initial ideation of all the various pain points and issues that arose needed a solution to be addressed. Features such as a map function that only shows the clinics that were in the patient’s insurance network and also provided language services they required is towards designing for a more equitable patient journey for non-English speaking patients.

After compilation of all the various features and pain points that needed to be addressed

Creating an informational flow chart of how the data and information should flow and also creating information structure

Creating designs that were representative of those features needed to be included

The importance of user input and research for inclusive designs that are catered to users cannot be stressed enough. As I was creating these designs, input and impressions of users were also taken into account, and participants were asked on their thoughts of the initial designs.

First Time User Experience

First impressions:

• Enjoyed having bottom navigation bar
• Thought design was nice and simplistic
• Easy to use
• Great features
• Would like to have payment information as well

Although, Mother Tongue truly does close the gap in the language barrier for non-English speaking patients, there is still a tech accessibility gap, as not all patients have access to smartphones with capabilities to download such applications.

Thus because of this, I will be working to develop the desktop and mobile website versions of the app, so those who may want to access the great features of Mother Tongue can continue to at a public library or through a healthcare facility.