Overcoming Communication Barriers in Clinical Care: A Digital Translation Platform

JMIR Form Res. 2024 Oct 16. doi: 10.2196/63095. Online ahead of print.

Abstract

Background: Language barriers in healthcare can lead to misdiagnosis, inappropriate treatment, and increased medical errors. Efforts to mitigate these include using interpreters and translation tools, but these measures often fall short, particularly when cultural nuances are overlooked. Consequently, medical professionals may have to rely on their staff or patients' relatives for interpretation, compromising the quality of care.

Objective: This formative pilot study aims to assess the feasibility of Translatly, a digital translation platform, in clinical practice. Specifically, the study focuses on evaluating: 1. how healthcare professionals overcome language barriers and their acceptance of an on-demand video telephony platform, 2. the feasibility of the platform during medical consultations, and 3. identifying potential challenges for future development.

Methods: The study included ethnographic interviews with healthcare professionals and an observational pilot to assess the use of the Tranlatly platform in clinical practice. Translatly was developed to make real-time translation easy and accessible on both Android and iOS devices. The system's backend architecture uses Java-based services hosted on DigitalOcean. The app securely exchanges data between mobile devices and servers, with user information and call records stored in a MySQL database. An admin panel helps manage the system, and Firebase integration enables fast push notifications to ensure that healthcare professionals can connect with translators whenever they need to. The platform was piloted in a German university hospital with 170 volunteer non-professional translators, mainly medical students, supporting translation in over 20 languages, including Farsi, Dari and Arabic.

Results: Ethnographic research conducted by interviewing healthcare professionals in Frankfurt am Main and other German cities revealed that current practices for overcoming language barriers often rely on family members or digital tools like Google Translate, raising concerns about accuracy and emotional distress. Respondents preferred an on-demand translation service staffed by medically experienced translators, such as medical students, who understand medical terminology and can empathize with patients. The observational pilot study recorded 39 requests for translation services, 16 (41%) of which were successfully completed. The translations covered 6 different languages and were carried out by a team of 10 translators. Most requests came from departments such as infectious diseases (5, 31.25%) and emergency (4, 25%). Challenges were identified around translator availability, with 23 (59%) of requests going unanswered, which was further evidenced by user feedback.

Conclusions: The pilot study demonstrates the feasibility of the Translatly platform in real-world healthcare settings. It shows potential to improve communication and patient outcomes by addressing language barriers. Despite its potential, challenges such as translator availability highlight the need for further development.