Could automated translation improve communication of key medical information for low-level English fluency individuals in primary care?

Problem

Refugee, asylum seeker, migrant and low-level English fluency patients face barriers to accessing primary healthcare services, often the first port of contact between these groups and the NHS. This can create significant difficulties, leading to excess morbidity and mortality, due to a delay in receiving the required standard and route of treatment. Many factors influence healthcare provision for these individuals, with a predominant issue being substantial language barriers without adequate interpretation service. Quality of primary care can be compromised by inadequate history taking and miscommunication decreasing time to safety net, creating a lack of trust and confidence between the patient and healthcare provider.

Research shows that focusing on aiding information being recorded and communicated to healthcare providers could alleviate the communication barrier specifically. eConsult is a tool widely used in primary care to gain information ahead of the appointment. Evidence demonstrates an improvement in communication between healthcare professionals and patients when it is used, but this is currently unassessed in those of low-level English fluency.

The purpose of the study is to gain insight into the experience of communication of medical information for low-level English fluency individuals (including those from a refugee, asylum seeker and migrant background) to healthcare professionals, and to assess whether automated translation could form an effective part of an intervention (such as eConsult) to facilitate the communication of information of medical information.

Approach

A mixed method design will be used to gather data from three groups: low- level English fluency individuals, support workers with experience with this group, and healthcare professionals with experience with this group. Part of the interview will be framed around taking participants through translated open and closed questions from the primary care “eConsult” service, then assessing their perceived efficacy of this. Co-researchers from these groups that would use the intervention will feed into the topic guide design and the research process, providing expertise by experience. Data will be analysed using a thematic analysis with a framework approach to determine the main themes.

Findings

These will be used to draft intervention plans to develop draft plans with the co-researchers for an intervention to aid this using a person-centred approach. Focus groups will then be held to gain feedback on the content, interface, and format of these plans.

Consequences

These insights will be used to develop a tool to improve communication of key medical information between low-level English fluency individuals and primary healthcare professionals. This could be incorporated into the healthcare services available to aid communication, both preceding and during primary care appointments, potentially improving access and reducing health inequalities for this important group.