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

背景：由于流离失所、移徙，以及旅游业和全球化进程，医疗保健中的语言障碍越来越普遍。口译员在医疗保健中的语言调解有相当大的缺点：例如，在自发咨询中往往没有口译员，口译费用的覆盖范围不稳定，翻译的质量参差不齐，并且作为咨询期间的第三人，他们可能会干扰医患关系的建立。近年来，我开展了几个项目，研究如何利用数字辅助技术解决语言调解问题，并开发了一些干预措施，这些干预措施已经在世界范围内使用。目的：本项目将实现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。通过混合方法的方法，将在评估中解决有关患者健康结果和效率（例如，急诊室就诊，咨询时间，要求的实验室检查等）和咨询情况变化（例如，讨论的主题，患者满意度）的未解决问题。该研究的核心是一项对照、非随机试验，并与患者、移民代表和其他利益相关者进行焦点小组讨论。初步工作：研究伦理委员会已经批准了这项研究。此外，已从蓝十字蓝盾基金会获得第三方资金，用于支付应用程序必要的技术调整以及其他支持语言的费用。通过在家庭医学系进行的“非英语患者体验研究- NESPES研究”，对口译员的经历和由此产生的访问障碍进行了广泛的初步研究。也有进入缅甸社区的实地通道。主办机构：密歇根州立大学家庭医学系，人类医学院，东兰辛和谱健康家庭医学住院医师中心大急流城。作为访问学者，在密歇根州立大学拥有自己的工作空间和学术研究环境，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.