Wokeyi

An app that reduces the language barrier in NSW healthcare

Role

Solo student project

Type

Mobile application (ios), Tablet application

Timeline

Apr-

Tools

Figma, Miro, Illustrator, Procreate and paper

This is a solo project that aims to reduce the language barrier in NSW healthcare settings


Overview

My first hand experience…

My inspiration came from my grandpa's hospitalisation, where language barriers were a major issue. Doctors frequently called me for translation, but communicating over the phone was difficult due to my grandpa's hearing impairments. This made him feel powerless and passive in his treatment. He didn't know what medications he was taking and doctors made all decisions, leading to frustration and non-compliance.

Problem

Language barriers present a significant challenge to providing effective healthcare treatment for patients who have limited English proficiency. This issue lead to patients becoming passive participants in their treatments, increases the likelihood of errors in assessments and medications, and creates difficulties in follow-up care. Despite the clear need for interpreting services in healthcare settings, only slightly more than a quarter of patients currently receive such services.

HMW reduce the language barrier for Chinese elderly in NSW healthcare settings?

Solution

An app that voice-to-voice translation to help speed up the translation process in a busy hospital setting. Additional pictorial card and fixed phrase features to support users who are unable or uncomfortable to verbalise their feelings.

User Group

Since statistics indicate that a significant portion of the Limited English Proficiency (LEP) population primarily speaks Mandarin and Cantonese. Therefore, the app will prioritise the design and functionality for these languages initially, with the intention of expanding to include more languages in the future.

Hypothesis

1.  Voice-to-voice translation makes translation easier and quicker for users in cases of emergency

2. Using Fixed terms and pictorial cards, a familiarised form of communication in healthcare practices, will enhance accessibility and usability

2.  A portable kiosk will help individuals with no mobile phones

Limitation

Due to ethical guideline for university projects, I cannot interview members of vulnerable groups. All the research will be based on first hand experiences, as well as secondary qualitative researches.

Research Process

Context

Australia is a diverse country. Large proportion of population struggle to speak English fluently and the number are significantly higher in elderly communities. Despite that many of the adverse events in healthcare were due to language barriers, some health practices would avoid using professional interpreters due to the inconveniences, funding problems and lack of ethic.

Desk Research

To collect feedbacks and experiences of LEP patients in hospital environments, secondary qualitative research was used. Majority of the patients expressed the adverse events in healthcare were due to language barriers. Language barriers can also impact the social relationship between health staff and patients which can reduces treatment adherence.

Empathy Map

An empathy map was used to categorise my first hand experience and desk research. This method can also help ignite new insights on how an LEP patient may feel through positioning myself in the persona’s scenario.

Outcome:

Based on this, we found that in healthcare, there are preference in using ad-hoc interpreters like family and friends. Gestural communication were also often used accompanied by verbal. Furthermore, language barrier in healthcare may result in patients:

  1. feeling overwhelmed in a environment where they’re unfamiliar with.

  2. feeling rejected and passive when they can’t be voiced

  3. Frustration and upset being not understood. Sometimes may lead to aggression

  4. Decrease trust and willingness to adhere treatment

Storyboard and User Journey

To visual my research, storyboard and user journey were used to visualise the pain points faced by George. This also enable me to identify prioritisation and common grounds that I should address. As illustrated, the language barrier problem becomes more complex during medical assessment. We found that:

  1. Sudden aggressive behaviours can alarm and upset the health professionals

  2. Cultural habits and beliefs can heighten communication barriers

  3. Frequent calls to family and friends can disrupt their personal life

  4. Ad-hoc translation decreases accuracy

  5. Patient experiences more negative emotions when they’re sick/in pain

  6. Feeling like a burden due to reliance of others in communication

Persona

Based on the research, persona were created to represent the requirements of the LEP Chinese elderly community. A secondary persona of health practitioners were included to define objectives for increasing the use of the design in healthcare settings.

Market Analysis

This method analysis the existing forms of interpreting service/product. The goal is define the opportunities for my design through analysing strengths and weaknesses.

As illustrated, Ad hoc was favoured in healthcare due to its conveniences and it’s their ability to provide trust and emotional support. However, there are many concerns relating to accuracy of translation using this form of interpretation. Moreover, only one form of the interpreting services had standardised/codified system for pain and sensory. Codified systems are very important when designing for LEP communities due to the culture complexities.

Affinity Map

Affinity map help me categorise my research. By sorting my research into topics, it help me identify prioritisations and the ‘How Might We’ question that I wanted to address.

Government initiatives

Why aren’t they taking action?

Design Consideration

Summary of pain points and requirement that I want to target in my design.

Development

Ideation

Due to the complexity of the language barrier issues in healthcare, I’ve formed three design solutions tailor to different specific problem. As I also have graphic background, concept three is different approach to the first two concepts. I landed on concept one in the end because I believe it will be the best alternative when professional interpreting services aren’t available. More importantly, it can empower the LEP community and increase patients’ independence.

1st Iteration

I first created quick sketches on cardboard and then visualised the details on paper. After deciding on a general structure, I’ve transferred my favourite sketches into low-fidelity wireframe for feedbacks.

Removing unnecessary features

After discussing with my mentor, I’ve decided to remove the feature where users can book interpreters. Initially I included that feature because there was a lack of policy in healthcare in promoting the free translation service . I thought including the feature can help enhance the dissemination of the services to LEP patients.

Another feature that I’ve removed was the ‘emotional scale’. I questioned the relevance of emotional scale in healthcare in the real world. Not many healthcare would assess patients’ emotions as oppose to pain assessment.

2nd Iteration

Final Prototype

Shout out to my mentor Joshua Bailey!

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