SIGNA

Solving the doctor-patient language barrier

Challenge

Out of 63.2 million U.S residents (including native-born, legal immigrants, and illegal immigrants), 41% speak English 'less than very well' or not at all. This figure doesn't even represent tourists visiting the country with the same level of language skills. What would happen if they had to visit the doctor? What if there was an emergency and they couldn't provide the doctor with enough information? 

Hospitals in the U.S and in the world have a deficit of translations, resulting in many patients sub-optimally using their children as translations or in worst-case scenarios, body language. This scenario can potentially lead to misdiagnosis and lack of information, making it hard for the doctor to properly treat the patient. 

OBJECTIVES

1. Provide a tool that helps with diagnosis when a translator is not present
2. The solution must be usable for people with different levels of reading literacy

PROJECT SCOPE

Mobile  Web Application

TOOLS

Adobe Illustrator, InVision, Sketch, Github, Vue.js

ROLE

UX Designer (Research, Interface design, Interaction design, design system, usability testing)

Jailene Cabrera + Feijie Zhou

DURATION

1 year

Research

* Research was completed taking into consideration HIPAA compliance and limited to personal resources

USER INTERVIEWS

We managed to interview two women that immigrated to the US with a limited level of English. They both had children that were first-generation Americans. Their children were their main source for translation during doctors appointments.

“ ..late, don't come at all, in a rush to leave, not available at every point of the appointment if they do come”

"... sometimes they don't have enough interpreters ... sometimes they don't show up or they show up too late to the appointment and I still end up needing help."

EXPERT INTERVIEWS

We had conversations that included Med/nursing students that had completed internships at medical centers. Additionally, we communicated with a doctor in the UK who confirmed that these issues are also true in the UK & provided insight to the design.

SECONDARY RESEARCH

There is limited information that is openly available on the issue however, we used online resources to enforce decision making and backing up theories. Additionally, we did a competitor analysis that primarily focused on "Canopy Speak". Their app focused on the translation of the doctor saying something to the patient during the consult. There is nothing for the patient to communicate to the doctor on their app.

THE PATIENT EXPERIENCE

Storyboards - the Canopy Speak experience

**Storyboards were written entirely in English for the intended stakeholders to understand.The patient's dialogue should be imagined as a non-English language

As a way to understand our primary competitor and currently available solution, we created some storyboards following two successful stories of patients who use the app as a way to get diagnosed. It should be noted that we didn't storyboard unsuccessful experiences.

1. Where does the app make sense in the patient experience? 
2. What scenarios do we see that the app can be useful? 
3. What does the patient experience look like using an app? 
   

Current Patient Journey

We created a journey map to show where the patient struggles the most during the process as a visual to illustrate where our focus to help improve. 

Primary moments of frustration: 

1. When the patient is unable to properly communicate what is wrong. Having to use a child or body language to explain symptoms
2. When symtpoms worsen, persist or are unresolved due to poor treatment or misdiagnosis

Ideation + Prototyping

INITIAL CARD PROTOTYPES

Separated into 3 main card types: Questions,Symptom and Descriptions (additive to symptoms)

Takeaways

1. Large learning curve
2. A lot of physical materials (messy)
3. Confusing and overwhelming

APP EVOLUTION

Paper Version

We created a paper prototype that mixed ideas of selecting specific body parts in order to make a large list of symptoms less overwhelming. We incorporated ideas from both Canopy speak and Refugeye app. The content still felt dense and too bulky for the intent.

Digital Version

Focused on only providing symptoms for specific body parts and making it more accessible to use by segmenting in that way. Additional items can be added as feedback and tested are incorporated. This allows for the core of the item to be explored.

Desired Impact

Simple graphics

Intuitive + minimal learning curve

Increased diagnosis accuracy

Improve communication + decrease stress

Visualizing Symptoms

VERSION 1

• More details + body language
• Lack of simplicity
• Some symptoms hard to recognize/understand
• Genderless

VERSION 2 + 3 

• Focus on the targeted body part

• Black and white to maintain simplicity

• Inspired by emojis and recognizable graphics

• Rounded/ no sharp lines

• Introduction of color (max 2. per image)
• Rounding the bottom of the icons
• Elongate card to fit descriptive word
• Rounding the card edges

Solution

Patient app Journey

CURRENT STATE

• General head and back symptom illustrations
  
• Completed MVP prototype of the above workflow based on head and back symptoms created
• Illustrations of both male and female patients
  
  • (future step) intention to include a non-binary patient which will include both male and female symptoms necessary.
    

Next Steps

• User testing
  • how intuitive is it? 
    
  • how easy is it to understand the symptoms? 
  • maybe simplify it for the first go around for COVID symptoms? 
• Producing a genderless version of the cards and adding the option of a non-binary person with the option to select if the person gets periods
• Create symptom cards for other body parts
  
• Creating a better way to browse 
  • while still considering patients who are unable to read