Create an app that aids non-English speaking patients in navigating clinical appointments and other clinical translation needs, whilst providing more than a typical translator app.
Non-English individuals on average have a decreased quality of healthcare due to the lower access preventative care services and less access to care compared to their English speaking counterparts. This language barrier, as well as oftentimes cultural barrier, increases the health disparities in these underserved communities which perpetuates further disadvantages that these groups face. However, by creating various resources available such as readily available translators will be an additional step in helping diminish these issues. Which is why creating an app that addresses these language barriers with adequate features that serve these gaps, needs to exist.
Role
This was an individual project where I was the sole user experience researcher and designer.
Methods
Literary and secondary research, user interviews, business analysis, user journey mapping, wireframing, systems mapping, low fidelity prototyping, high fidelity prototyping, and usability testing.
Approach
As this is a topic that contains and requires extensive background research to truly understand the gravity of the work, I dove into literary research as my primary step and shortly after reached out to non-English speakers to conduct interviews. From there, I blended the information together to ideate and analyze existing apps, and then created journey and systems maps to wireframe and further prototype. After conducting usability tests with users, tweaked the design to better fit their needs to finish with the final product.
Non-English speaking patients have significantly higher adverse event rates than English speaking patients.
What is the problem?
Non-English speakers face the greatest health disparities in healthcare, one of which being the inability to bridge the language gap between healthcare professionals and patients thus creating further preventable adverse health events.
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.
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
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.
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.
Livia: New resident in the US and is in need of medical attention, is tech savvy and able to download apps and utilize them easily.
Ruba: Long time resident and hasn’t gone to a clinical appointment in several years but wants to start going again now, has very limited tech abilities and would like assistance on understanding medical documents he receives.
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.
To see the prototype in action, click the button below!
