A computer-based aid for communication between patients with limited English and their clinicians, using symbols and digitised speech

Background: Problems of communication are an important barrier on the pathway to healthcare for patients with limited or no ability in the majority language of the country in which they live. Solutions involving interpreters who have to be booked in advance, or using unqualified friends or family members to translate, are highly unsatisfactory. Aim: This paper describes a computer-based approach to alleviating the situation. Design/method: A computer-based communication aid was developed and tested. The communication aid is designed to permit an English-speaking healthcare practitioner to select a series of questions which are then presented along with a range of possible answers for the patient to choose from. The questions and answers are presented in the patient's own language in both text and digitised speech accompanied by symbols as well as English text. As a test-case we focused on Somali patients with asthma. Results: 26 simulated consultations with Somali asthma sufferers and healthcare practitioners (three GPs and six nurses) with experience of asthma treatment with this patient group were held with the system implemented either on a laptop with mouse pad, or a tablet with stylus. All the consultations were successfully completed with a high satisfaction rate on the part of both practitioners and patients. Conclusion: Feedback questionnaires suggest some areas for improvement. The proposed system is a practical way of addressing the problem of communication with patients with limited English in the context of clinician-led question-answer dialogues.