Miasano: Mobile Health App for Improved Evidence-Based Rehabilitation Outcomes and Multi-Lingual Clinical Interactions

项目概要 该 SBIR 第一阶段项目将创建一个概念验证应用程序，以改善临床交互和使用 可能有不同偏好语言的患者和临床医生之间基于证据的实践。我们打电话 我们提议的应用程序 Miasano（源自世界语通用语言中的短语“我的健康”）。的 我们的应用程序解决的主要问题是收集患者报告的结果测量 (PROM) 在少数种族/族裔中较少见。由于语言原因，提供者可能不会要求患者完成 PROM 障碍。例如，患者无法理解英语的 PROM，而提供者可能会 无法与患者有效沟通结果。由于语言障碍， 患者可能会犹豫或根本无法表达他们的健康问题或状况。很多医疗诊所都可以 提供口译员来协助解决语言障碍，但这会产生对口译员可用性的依赖。当 口译员在场时，忙碌的口译员有可能在口译时造成无意的偏差 PROM 问题或向患者转达提供者消息。这些患者群体的生活状况较差 健康结果。这导致了健康差异，因为他们的健康需求没有得到适当的评估 或无法进行理解和基于证据的临床护理。此外，Miasano 还提供了机会 通过纳入不同语言的 PROM，使研究更具包容性。具有不同的个体 种族/族裔背景将更容易参与使用 PROM 的科学研究。 因此，研究包容性的差异将会减少，并最终可以通过以下方式消除： 更好地代表临床试验并提高研究结果的适用性。我们的 Miasano 应用程序 这些问题的解决方案结合了几个独特的功能： 用户适当的语言切换 允许两个不同的人之间直接、即时地交流健康结果和状态 语言，以患者喜欢的语言提供健康评估，并以患者喜欢的语言提供结果解释 医疗保健提供者的首选语言，全部在同一个应用程序中；文本到语音的可访问性和视觉效果的使用 移动设备上的控件，增强了可能具有一定程度的用户的可访问性 文盲和喜欢口头交流的人。 PROM 查询可以由移动设备决定 用户可以通过点击屏幕来响应。医疗保健提供者收到相同的完整信息 评估就好像患者能够阅读一样；以及通过弹出窗口定义医学术语 显示通用语言描述很重要，因为即使对于那些了解医学术语的人来说也可能不熟悉 很有文化。 Miasano 与当前临时临床方法的关键区别在于赋予 喜欢使用英语以外的语言来表达其健康需求并在以下情况下充满信心的患者 传达重要的健康信息。

PROJECT SUMMARY This SBIR Phase I project will create a proof-of-concept app for improving clinical interactions and use of evidence-based practice between patients and clinicians who may have different preferred languages. We call our proposed app Miasano (derived from the phrase “My Health” in the Esperanto Universal Language). The primary problem that our app addresses is that patient-reported outcome measures (PROMs) are collected less often in racial/ethnic minorities. Providers may not ask patients to complete PROMs due to language barriers. For example, the patient would not be able to comprehend a PROM in English and the provider may not be able to effectively communicate with the patient about the results. Because of the language barrier, patients may be hesitant or simply unable to express their health concerns or status. Many medical clinics can offer interpreters to assist with language barriers, but this creates a reliance on interpreter availability. When an interpreter is present, there is a possibility that the busy interpreter creates unintentional bias when interpreting PROM questions or relaying provider messages to the patient. These patient populations experience poorer health outcomes. This leads to health disparities because their health needs are not being properly evaluated or understood and evidence-based clinical care cannot take place. Further, Miasano provides the opportunity to be more inclusive in research studies by including PROMs in different languages. Individuals with different racial/ethnic backgrounds would be more easily included to participate in scientific research that uses PROMs. Therefore, the disparity in research inclusion would be reduced and could be ultimately eliminated through better representation in clinical trials and increased applicability of the research results. Our Miasano app solution to these problems combines several unique features: User Appropriate Language Switching which allows direct and instantaneous communication of health outcomes and status between two different languages, providing health assessment in the patient’s preferred language and interpretation of results in the health care provider’s preferred language, all in the same app; Text-to-Speech Accessibility and use of visual controls on the mobile device which enhances accessibility to the persons who might have some level of illiteracy and who prefer to communicate orally. The PROMs queries can be dictated by the mobile device and the user can respond by tapping on the screen. The health care provider receives the same complete assessment as if the patient had been able to read; and Defining Medical Terms with pop-up windows that display common language descriptions is important as medical terms may not be familiar even to those who are quite literate. The key differentiator of Miasano from current ad hoc clinical methods is empowering the patient who prefers a language other than English to communicate their health needs and to be confident when conveying important health information.