Translational competency development and research on digital approaches to overcome language barriers in healthcare - TRICORDER

背景：由于流离失所、移民以及旅游和全球化进程，医疗领域的语言障碍变得越来越普遍。口译员在医疗服务中的语言调解有相当大的缺陷：例如，在自发会诊中，口译员往往无法获得口译员，口译费用的覆盖范围不确定，翻译质量参差不齐，在会诊期间作为第三人，可能会干扰医患关系的建立。近年来，我开展了几个关于利用数字辅助技术解决语言调解问题的项目，并制定了已在世界各地使用的干预措施。目标：该项目将实施和评估一个应用程序，用于获取英语水平有限的患者的急性病史。通过混合方法，解决有关患者健康结果和效率的未解决问题(例如，急诊室就诊、会诊时间、要求的实验室测试等)。会诊情况的变化(例如，讨论的主题、患者的满意度)将在评估中得到解决。这项研究的核心是一项对照的非随机试验，伴随着与患者、移民代表和其他利益相关者的焦点小组讨论。前期工作：研究伦理学委员会已经批准了这项研究。此外，还从蓝十字蓝盾基金会获得了第三方资金，用于支付应用程序必要的技术改编费用以及其他受支持语言的费用。通过在家庭医学部进行的“非英语患者经验研究--NESPES研究”，对口译员的经验和由此造成的准入障碍进行了广泛的初步研究。主办机构：密歇根州立大学家庭医学系、人类医学院、东兰辛与光谱健康家庭医学住院中心大急流城。密歇根州立大学拥有自己的工作空间并嵌入学术研究环境的访问学者资格认证，由经验丰富的研究人员监督。

Background: Language barriers in medical care are becoming more and more prevalent due to displacement, migration, but also as a result of tourism and globalization processes. Language mediation by interpreters in medical care has considerable shortcomings: For example, in spontaneous consultations they are often unavailable, the coverage of interpretation costs is unsettled, the quality of translations varies, and as a third person during consultations they can interfere the doctor-patient relationship building. In recent years, I have conducted several projects on approaches to address language mediation with digital assistive technology and have developed interventions that are already being used worldwide. Aims: This project will implement and evaluate an app for obtaining acute medical history of patients with limited english language proficiency. Through a mixed methods approach, unmet questions about relevant patient health outcomes and efficiency (e.g., emergency room visits, consultation duration, requested laboratory tests, etc.) and changes in the consultation situation (e.g., discussed topics, patient satisfaction) will be addressed in the evaluation. The core of the study is a controlled, non-randomized trial accompanied by focus group discussions with patients, migrant representatives and other stakeholders.Preliminary work: The Research Ethics Boad has already approved the study. Furthermore, third-party funds have been obtained from the Blue Cross Blue Shield Foundation covering the expenses for necessary technical adaptations of the app as well as for additional supported languages. A broad-based preliminary study on experiences with interpreters and resulting access barriers was conducted through the "Non-English Speaking Patient Experience Study - NESPES Study" conducted at the Department of Family Medicine. There is also field access to Burmese communities.Host institutions: Department of Family Medicine, Michigan State University, College of Human Medicine, East Lansing & Spectrum Health Family Medicine Residency Center Grand Rapids. Accreditation as a visiting scholar with own workspace and embedded in academic research environment at Michigan State University, supervision by experienced researcher.