Miasano: Mobile Health App for Improved Evidence-Based Rehabilitation Outcomes and Multi-Lingual Clinical Interactions

PROJECT SUMMARY This SBIR Phase I project will create a proof-of-concept app for improving clinical interactions and use ofevidence-based practice between patients and clinicians who may have different preferred languages. We callour proposed app Miasano (derived from the phrase “My Health” in the Esperanto Universal Language). Theprimary problem that our app addresses is that patient-reported outcome measures (PROMs) are collectedless often in racial/ethnic minorities. Providers may not ask patients to complete PROMs due to languagebarriers. For example, the patient would not be able to comprehend a PROM in English and the provider maynot be able to effectively communicate with the patient about the results. Because of the language barrier,patients may be hesitant or simply unable to express their health concerns or status. Many medical clinics canoffer interpreters to assist with language barriers, but this creates a reliance on interpreter availability. When aninterpreter is present, there is a possibility that the busy interpreter creates unintentional bias when interpretingPROM questions or relaying provider messages to the patient. These patient populations experience poorerhealth outcomes. This leads to health disparities because their health needs are not being properly evaluatedor understood and evidence-based clinical care cannot take place. Further, Miasano provides the opportunityto be more inclusive in research studies by including PROMs in different languages. Individuals with differentracial/ethnic backgrounds would be more easily included to participate in scientific research that uses PROMs.Therefore, the disparity in research inclusion would be reduced and could be ultimately eliminated throughbetter representation in clinical trials and increased applicability of the research results. Our Miasano appsolution to these problems combines several unique features: User Appropriate Language Switching whichallows direct and instantaneous communication of health outcomes and status between two differentlanguages, providing health assessment in the patient’s preferred language and interpretation of results in thehealth care provider’s preferred language, all in the same app; Text-to-Speech Accessibility and use of visualcontrols on the mobile device which enhances accessibility to the persons who might have some level ofilliteracy and who prefer to communicate orally. The PROMs queries can be dictated by the mobile device andthe user can respond by tapping on the screen. The health care provider receives the same completeassessment as if the patient had been able to read; and Defining Medical Terms with pop-up windows thatdisplay common language descriptions is important as medical terms may not be familiar even to those whoare quite literate. The key differentiator of Miasano from current ad hoc clinical methods is empowering thepatient who prefers a language other than English to communicate their health needs and to be confident whenconveying important health information.