Hospital stay is unpleasant, there are emotional pressure affected by physical health status. In addition, that is amplified when patients are unable to express their need and be understood.
Many current hospitals rely on untrained staff, or a patient's relative or friend, even at hospitals with established interpreter programs. Physicians and hospital staff often ignore hospital policies on using qualified interpreters, typically because of time pressures, lack of knowledge about the availability of interpreters or procedural difficulties in arranging for them.
Why It Matters?
In 2013, approximately 61.6million people in the United States speak a language other than English at home and over 41 percent (25.1 million) have limited English-language skills that considered Limited English Proficient (LEP). Research demonstrates that the use of unqualified individuals results in increased medical errors, less effective patient-clinical provider communication and poorer follow-up and adherence to clinical instructions, as well as possible conflicts with patient privacy rights. The presence of a readily accessible, qualified language services workforce is necessary for a high-quality program.
I want to advances accessibility to professional language services by minimizing coordination in order to adapt to the patient’s language and cultural preferences to facilitate more accurate communication that goes beyond literal translation and ultimately elevates their experience.
I approached to patients and doctors to observe and understand what the entire process that patients will go through and how do doctors interact with patients, and what are the exciting solutions care providers have when they encounter communication problems with patients?
I went to Flushing, China Town and Elmhurst to understand how do patients look for help. I interviewed with Chinese patients while they are one of the fastest growing demographic groups in the United States.
Patient User Journey
I draw out the user journey map to identify different situation that patient will encounter while their time in hospital, also before and after hospital visit. I decided to focus on on-site scenarios to have deeper research on what can facilitate more accurate communication between patients and care providers.
Many hospitals and doctors turned to a phone service and now toward to video. Where patient can quickly get help in several languages. But the on-site medical interpreter still the best choice by far.
“Onsite is so much more direct, fast, clear, personable, hence easy. It is always the first choice, by far.” — Jean P., Medical Intrepreter
Nurses & Physician:
1. Some hospitals use family members for interpreting
Due to the lack of medical knowledge, family members or friends cannot guarantee the accuracy of the translation, even leading to misdiagnosis and increase in the risk of worse medical event.
2. Phone interpreting is not personable
Many hospitals and doctors turned to a phone service. Where patients can quickly get help in several languages. But people who work for those language services often aren't certified medical interpreters. Patients would have to wait for the care team to dial the number, call forwarding and wait for interpreter to answer. In addition, patients might lose 50% of sound to start with, then add equipment quality, background noise, distance of speakers from the speakerphone... and it even worse when elderly patients don’t hear very well.
3. In-person medical interpreter is the best choice by far
In-person interpreting is so much more direct, fast, clear and personable. It provides patients with more humanized care and can discover the nuance of patient’s emotion. Especially when patients are in a sensitive situation, for example: in the end of life situation, you have to talk with patient or patient family in person with professional training. But because of time pressures, lack of knowledge about the availability of interpreters or procedural difficulties in arranging for them, physicians and hospital staffs underuse qualified onsite-interpreters.
There are 21.5M people who don’t speak English. There are also a huge community of trained medical interpreters but 50% of the time they are just waiting for doctor and encounter many mismatches. What if patient can arrange medical interpreters by themselves before they go to hospitals?
I made low fidelity prototypes base on ideal user scenario. I prototype with patient and family members in order to see if my concept works and answer my questions to generate more conversations: What do they need to know to find an interpreter? What they care? What’s their relationship? I made different versions to test with people to see what’s their reaction and observe their behavior. To discover how could this fit in the current system and able to adapt their needs?
I made prototypes based on 3 core values that I identified as important to patients and family members. Which are Match, Trust and Relationship. I tested with users and modified the best patient to interpreter matches and figure out what creates trust between them? How do patients build a better relationship to healthcare?
I designed MatchPret, a service that gives patients better access to professional language service for their hospital visits.
Assume that you are going to arrange an interpreter. You can first choose the language for displaying. Then you can filter by the language you are requesting, hospital you are going to, and speciality you need. If you need any additional helps, you can call the service directly. Many patients can’t differentiate the speciality with medical terminology. So you can also address your general condition by indicating with body image and emoji. It’s also an critical information for interpreters to be prepared for better interpretation.
Next, you will match with interpreters that adapted your language and cultural preferences. It keeps the record, so you can find the same interpreter next time if you like them. And you can see their ratings and choose either professional interpreter or hospital volunteer.
When you choose an interpreter, You can compare them by seeing their profile statement and professional experience by hearing their voice and seeing their certificates. To create trustworthy experience, MatchPret will review the interpreters and provide credentials. And you can also see people’s reviews and their experience with interpreters. Before you send the request you can make sure when is your visit and select who is it for.
You can easily build relationships with interpreters but too much personal involvement will create risk for both. To find that balance, MatchPret provides an agreement to protect both patient and interpreter’s rights and patient’s confidential information.
I did a small pilot with 6 family members and 2 medical interpreters. I provided users with interaction prototype and mocked up the scenario based on their experience and being the middle man to deliver the messages to see how do they interact with each other by using this and see if it works for them.
Patients feel comfortable by using Machpret to match interpreter, it provides a better way for them to find helps and think it’s reliable. Interpreters are interested in the new way of interaction between them and patients. Instead of be managed by agency, they can directly interact and communicate with patient that maintain their professional behavior.
Although I got many good feedbacks, It's just beginning. Taking this idea further, I need to approach to more people to keep revising the service that able to be provided by agencies and hospitals in the near future. I would like to discover more possibilities that this service could provide. To navigate interpreter for emergency that it can be an efficient used for inpatient and can reduce the request cancellation loss. Find best way to put it into the current system and able to connect all the resources to provide the access.
I believe MatchPret can push healthcare industry further to create an accessible language service and facilitate more accurate communication that ultimately elevates patient experience.
“It directly connects interpreter with patient”
— Medical interpreting trainer, Memorial Sloan Kettering Cancer Center
“It would be awesome if we could provide this to our customers... Would you be able to build this for us? Can I hire you?”
— Mike, Managing Partner at interpretation agency
“You sould go patent it. It has potential and could be used out of medical settings as well.”
— Manager, Memorial Sloan Kettering Cancer Center