Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 20, 2020
Date Accepted: Feb 6, 2021
Designing an App to Overcome Language Barriers in the Delivery of Emergency Medical Services: User-Centered Development Process
ABSTRACT
Background:
Digital technologies are mushrooming in health care. Involving end users at all stages of the development process may help to ensure such technologies are usable and can be implemented. There have been some technical approaches to overcome language barriers in medical care but not yet in the prehospital emergency care setting. In an emergency situation, language barriers may have dangerous consequences for the patients.
Objective:
We aimed to develop a digital communication tool that addresses paramedic needs in the specific circumstances of prehospital emergency care and helps paramedics to overcome language barriers when providing care to foreign-language patients.
Methods:
In an action-oriented, participatory research process, we actively engaged paramedics in the development of the communication tool, alongside software designers, to accommodate their needs in complex and volatile rescue mission situations.
Results:
We have developed an app with 600 phrases supporting 18 languages. All phrases can be played back audibly or displayed as a text. The nature of the paramedic work environment places specific demands on the communication options used and needs of such devices. The paramedics indicated the requirement to also cater for children as patients with appropriate wording, as well as their carers, and other third parties. In addition to medical history taking questions, we included the option to ask for consent and to provide specific additional information. The tool is rapid to use and the comprehensive content is adapted to diverse scenarios and partly age- and sex-specific. The app includes a function to document patient responses and the conversation history. For evaluation in a clinical study, the app is run on a smartphone with extra speakers. The use of prototypes proved valuable for the verification that the developed phrases, structure and functions discussed in theory were of value and genuinely needed in practice, and that the various device control elements were intuitive.
Conclusions:
The active involvement of paramedics in the device development process allowed us to understand and subsequently consider their experience-based knowledge. Software designers could understand the paramedics’ needs and consider these in the menu navigation and design principles of the app. We argue that the development of any medical software product should actively involve both end users and developers in all phases of the development process. Clinical Trial: German Clinical Trials Register (No. DRKS00016719); World Health Organization Trial Registration Data Set, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00016719
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