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

项目总结 这个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 患者和临床医生之间的循证实践，他们可能有不同的首选语言。我们打电话给 我们建议的应用Miasano(源自世界语中的短语“我的健康”)。这个 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) 在种族/少数民族中较少发生。服务提供者可能不会因语言原因而要求患者完成PROM 障碍。例如，患者将不能理解英语的舞会，而提供者可能 不能有效地与患者沟通结果。由于语言障碍， 患者可能会犹豫不决，或者根本无法表达他们的健康担忧或状况。许多医疗诊所可以 提供口译员来帮助解决语言障碍，但这会造成对口译员可用性的依赖。当一个 如果有口译员在场，则有可能是因为口译员很忙，在口译时无意识地造成了偏见 PROM问题或将提供者的消息传递给患者。这些患者群体经历了更贫穷的 健康结果。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 或理解和循证的临床护理不能进行。此外，Miasano提供了一个机会 通过包括不同语言的PROM，在研究研究中更具包容性。个体具有不同的 种族/民族背景将更容易被纳入使用PROM的科学研究中。 因此，纳入研究的差距将会缩小，并最终可以通过以下方式消除 在临床试验中有更好的代表性，研究结果的适用性更强。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 允许在两个不同的人之间直接和即时地交流健康结果和状态 语言，以患者首选的语言提供健康评估，并在 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功能的使用 对移动设备的控制，以增强可能具有以下级别的人员的可访问性 文盲和喜欢口头交流的人。PRMS查询可以由移动设备口述，并且 用户可以通过轻触屏幕进行响应。医疗保健提供者收到相同的完整 评估，就像患者已经能够阅读一样；以及使用弹出窗口定义医学术语 显示公共语言描述很重要，因为医学术语可能不熟悉，即使是那些 都很识字。Miasano与当前特别临床方法的关键区别在于使 患者喜欢使用英语以外的语言来交流他们的健康需求，并在以下情况下保持自信 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.