Health lingo is a service designed to optimize LEP patient care by customizing health information accessibility in order to inform and empower patients to have a direct hand in their health experience.
Health Lingo is a system, however, the main component of the health lingo system is the language and literacy exam that can be completed in a doctor's office, or in the comforts of someone’s own home.
The exam tests 5 distinct areas which include vision, hearing, memory, health literacy, and language. Areas such as vision, hearing, and memory can determine your sensory needs when it comes to receiving health information.
Getting started, patients can select their continent of origin, then are able to select their country of origin. In this case, the patient has selected Egypt as an example.
The program then states that the national language of Egypt is Arabic and that all information will be available to the patient in Arabic. Patients are then directed to either create an account or login. In this example, the patient is logging in and is directed to the patient dashboard where patients can do everything from view their medical history, prepare for the appointment, access the exam, improve their health literacy or get in contact with their provider.
The exam starts with testing a patient's vision needs.
Unlike a regular vision exam where patients read off a letter for the purposes of receiving a prescription, Health Lingo's vision exam is designed to be more specific to health information.
To begin the vision exam, patients are given a few directions such as if you wear reading glasses, wear them during the exam, tilt your screen long ways and hold it at a comfortable and consistent distance and finally, keep both eyes open.
And so with this portion of the exam, you’re able to increase and decrease the text size of a word or paragraph to whatever feels readable, legible, and comfortable for a patient.
After each section patients are given an explanation of the purposes of each section of the exam and what section they should expect next.
This states that the exam is intended to help your health providers determine if receiving primarily visual-based information is the most accessible way for you to receive health information.
The hearing test functions similarly to the vision test, by allowing patients to indicate what sound is most comfortable for them.
The hearing exam includes directions such as if you have a pair of headphones wear them, find a quiet spot to take the test and lower the volume to 50%. Similar to the vision exam, patients can increase and decrease the sound to find what is most comfortable to them.
Similar to the vision and hearing portion of the exam, the memory test aims to mimic specific health situations by testing both short and longterm memory.
In order to test short-term memory, patients are shown a series of cards with different illustrations and asked to remember a specific group. The cards are then flipped asking patients to recall where one group was located.
To mimic a long-term memory test, patients are shown a doctor’s note and asked to remember as much of it as possible. This specific note says things like the name of the medicine, along with directions on when and how to take it. After some time and a few more questions, the patient is asked to then recall a piece of information from that note in this instance a patient is asked about the time and frequency of taking this medicine.
Health literacy is tested next, not only by testing health literacy in English but also by testing health literacy in the patient's native language. Testing both can help providers identify a patient's needs and how to best provide them with accessible health information.
Patients are asked to do things like label body parts by choosing a word from the word bank. Patients are also asked to label the highlighted organ in red. Another example is patients being asked to select the Arabic word and its English equivalent match. In this instance that word is diagnosis.
The final part of the exam tests a patient's language proficiency. Similar, to all other portions of this exam, the language portion is also specific to health situations.
In this example, patients are asked to translate an Arabic sentence in English simply by choosing words from the word bank and arranging them in the correct order. This example is something simple like “ I didn’t like this medicine” it can also be things like I’ve been having pain in my stomach or can you refer me to a psychiatrist?
People understand and respond to language differently depending on the medium whether they read it or hear it can make a large difference. Accents and pronunciations can determine a lot and so for some parts of this portion of the exam, audio is used to mimic a healthcare scenario. After listening to this audio patients are asked to indicate what they just heard. Similar sentences are given to patients to choose from. Similarly, patients are presented with audio they then have to write using the word bank provided. Here, the patient has indicated what I heard to be “ I am worried about the pain in my left leg”
Based on all of the information gathered with this exam, patients fall somewhere on this spectrum and the exam helps providers determine where that is exactly. Based on where patients fall on this scale, health providers can begin to provide more accessible health information based on a patient’s current status and their status as it evolves.
The scale shows both language proficiency and health literacy. So for example, the exam might indicate that a patient is C1 meaning that the patient demonstrates a fair understanding of spoken English, can be understood when speaking, however must often rephrase to be understood while simultaneously demonstrating limited health literacy in the English Language.
Health providers play a very large part in this process, and this is what a doctor’s dashboard could look like through health lingo. Under "My appointments" providers can begin to see a patient’s language and health literacy level. They can also keep track of their patient's exam progress and begin to have a closer look at what their patient’s needs may be.
For a closer look. Providers can view a patient’s profile to have a closer look at their progress across any time frame, and their current level. Providers can also see the last time any patient has completed their exam and contact them through the app, through email, and through video call as well.
This is a look at what a current health report looks like versus what a health report could possibly look like with Health Lingo. Health reports could include simple language, pictorial information, and simple vocabulary translations for patients in their native language.
In an effort to make this seamless and consistent wherever a patient goes. Patients can receive a health language and literacy ID that shows things like a person’s name, native language, emergency contact information along with all the information identified from a person’s exam.
Another component of the health lingo system is the education component. While it’s important to identify where a patient is and meet them where they’re at, the education component gives patients the option to improve their health literacy in order to be more involved in their care.
From their dashboard patients can access the education section. This section starts by giving patients a quick explanation stating that “Education modules are available to you based on common information and terminology you should know, along with critical information based on your last visit with your provider. The information is for you to use if and when you would like to but don’t worry if you can’t remember everything. The information remains here for you to refer back to whenever you would like.”
Health providers can assign patients different learning modules, including general information along with specific health information based on their last visit or any health conditions. Here, the patient has selected a module specific to their last visit.
This module focuses on acid reflux and provides an overview of what it is by giving patients an explanation of acid reflux and what they can expect. The module doesn’t stop there. Shown here is a more visual representation of acid reflux, showing it in terms of anatomy as it relates to the entire body as well as how it relates to a stomach not affected by acid reflux. Below there are also icons representing things to avoid if you have acid reflux.
A large part of this system is focused on the accessibility of health information for LEP patients but what about the accessibility of the digital user experience for LEP patients?
The section begins by giving users a quick explanation stating that The accessibility panel allows you to customize your experience within the platform to what feels comfortable for you. You have the ability to customize things such as your page alignment, the language you view the information in, the font size, the contrast, and much more. Most importantly, we want you to feel comfortable while utilizing this platform.
One of the most unique options is being able to customize how content is aligned on your page depending on what feels comfortable. Whether that is left-aligned, right-aligned, or some sort of combination. Another really important feature is being able to toggle back in forth between having the content in only Arabic, having both languages, or switching to English. Diacritics are an important part specifically to the Arabic language, the Arabic script does not have vowels instead there are small vocalization marks in the script that can completely change the meaning of a word. Allowing users to have diacritics can help aid in patient understanding and readability. It's also really important to give users the option of different, perhaps more readable fonts. While it’s not necessarily something they may need in English, it’s likely a patient could be dyslexic in one language and not the other. Being dyslexic in their native language is not out of the question.
CVS + HEALTH LINGO
I decided to imagine what a partnership with CVS could look like. CVS became CVS health a few years ago it was their way of committing to the future of health, even going as far as to stop selling cigarettes in order to make the name change. What’s forever been known as a pharmacy has shifted to a prominent healthcare entity. I came to the conclusion that this aligned with a lot of my goals with health lingo.