Overcoming Communication Barriers in Clinical Care: A Digital Translation Platform (Preprint)

Abstract

Language barriers in healthcare can lead to misdiagnosis, inappropriate treatment, and increased medical errors. Efforts to mitigate these include using interpreters and translation tools, but these measures often fall short, particularly when cultural nuances are overlooked. Consequently, medical professionals may have to rely on their staff or patients' relatives for interpretation, compromising the quality of care.

This feasibility pilot study aims to evaluate, through interviews with German healthcare professionals, current methods of overcoming language barriers in clinical practice and proposes the use of the digital translation platform Translatly, which connects foreign-speaking healthcare professionals with patients and staff via real-time video telephony for efficient translation during consultations.

Translatly was structured with a robust system architecture to facilitate real-time translation and ensure functionality across Android and iOS devices. The system's backend architecture uses Java-based services hosted on DigitalOcean. It includes an OAuth-secured REST API for managing data exchange between mobile apps and servers. User data, interaction records and call histories are stored in a MySQL database. A ReactJS admin panel is used for system management, and Firebase integration provides efficient push notifications to quickly connect healthcare professionals with translators. The platform is therefore designed for on-demand translation calls. Once a translator accepts an incoming call with a translation request from the medical team and the patient, the interface facilitates a transition into the communication session. The platform has been piloted at a German university hospital with 170 translators, mostly medical students, supplemented by medical staff, supporting translations in a wide range of languages, including Farsi, Dari, Arabic and 19 others.

Ethnographic research conducted by interviewing healthcare professionals in Frankfurt am Main and other German cities revealed that current practices for overcoming language barriers often rely on family members or digital tools like Google Translate, raising concerns about accuracy and emotional distress. Respondents preferred an on-demand translation service staffed by medically experienced translators, such as medical students, who understand medical terminology and can empathize with patients. The observational pilot study recorded 39 requests for translation services, 16 of which were successfully completed. The translations covered 6 different languages and were carried out by a team of 10 translators. Most requests came from departments such as infectious diseases and emergency.

The pilot study of the Translatly digital translation platform demonstrated effective technology integration and multilingual capabilities in healthcare, improving communication and reducing language barriers. Despite its potential, challenges such as translator availability highlight the need for further development.