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

项目摘要 SBIR第一阶段项目将创建一个概念验证应用程序，用于改善临床互动和使用 患者和临床医生之间的循证实践可能有不同的首选语言。我们称 我们建议的应用程序Miasano（源自世界语中的短语“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局指标（PROM） 在少数民族中较少见。由于语言原因，提供者不得要求患者完成PROM 隔栏.例如，患者将不能理解英语的PROM，并且提供者可能 无法有效地与患者沟通结果。因为语言障碍， 患者可能犹豫不决或根本无法表达他们的健康问题或状况。许多医疗诊所可以 提供口译员以帮助克服语言障碍，但这会造成对口译员可用性的依赖。当 如果口译员在场，则有可能是忙碌的口译员在口译时产生了无意的偏见 PROM问题或将提供者信息传递给患者。这些患者群体经历了更差的 健康成果。这导致了健康差距，因为他们的健康需求没有得到适当的评估 或理解和循证临床护理无法进行。此外，Miasano提供了机会， 通过包括不同语言的PROM，在研究中更具包容性。其中每个人都有着不同 种族/民族背景的人将更容易参与使用PROM的科学研究。 因此，研究纳入方面的差距将减少，并最终消除， 在临床试验中有更好的代表性，并增加研究结果的适用性。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， 允许两个不同的医疗机构之间直接和即时的健康结果和状态的通信。 语言，以患者首选的语言提供健康评估，并以 医疗保健提供者的首选语言，都在同一个应用程序;文本到语音的可访问性和使用视觉 对移动终端的控制，其增强了对可能具有某种程度的 文盲和喜欢口头交流的人。PROM查询可以由移动终端规定， 用户可以通过在屏幕上敲击来响应。卫生保健提供者收到相同的完整的 评估，好像病人已经能够阅读;和定义医疗术语与弹出窗口， 显示通用语言描述是重要的，因为即使对于那些 都很有文化。Miasano与当前临时临床方法的关键区别在于， 患者更喜欢使用英语以外的语言来传达其健康需求，并在 传递重要的健康信息。

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.