Improving patient compliance and treatment adherence in digital health through language accessibility
The digital health revolution is well and truly underway on a global scale. Nowadays, there is a full gamut of smart technology aimed at improving the health of millions of patients across the world: from wellbeing apps to at-home or portable diagnostics and implantable drug delivery mechanisms.
The recent Covid-19 pandemic, in particular, spurred the adoption and implementation of telemedicine, as it allowed patients to access services remotely via virtual consultations with their healthcare providers. And this trend is continuing today.
According to a study carried out by the management consulting firm McKinsey in July 2021, “telehealth utilization has stabilised at levels 38x higher than before the pandemic. (…) This utilization has been relatively stable since June 2020.”
(Source: Telehealth: A quarter-trillion-dollar post-COVID-19 reality).
Here in the UK, £150 million of funding has been allocated by the government for adoption of digital health technologies in the NHS, and the latest data from NHS Digital shows that 30% of appointments at GP practices in England in September 2021 were remote consultations.
As this data indicates, not only is there a substantial need for digital health services, but a willingness to adopt it amongst the general population.
Advantages of digital health tech
The advantages of digital health technology are countless for both patients and healthcare providers (HCPs):
- From the HCPs’ perspective, it reduces the need for paper-based records, it provides a reduction in healthcare costs, and it can be used to track patient outcomes and treatment compliance (e.g., remote patient monitoring devices, or being able to check if prescriptions have not been refilled).
- From the patients’ point of view, it empowers them to take greater control of their own health and wellbeing, providing them a private, secure and convenient way of accessing information (e.g., offering them direct access to their medical records, and helping them stick to treatment schedules).
Moreover, some studies suggest that digital health technology can actually improve treatment outcomes by virtue of increasing medication adherence (Ridho, A. et al, 2022).
What can be improved
While digital health technology brings many advantages to both patients and HCPs alike, there are also a number of other factors that need to be taken into account to ensure its success:
- Information governance (i.e., the handling of sensitive information in a secure and confidential manner). One of the reasons why some people may be reluctant to use digital health are the potential breaches in data privacy. For a major increasing uptake of healthcare tech to happen, these worries need to be addressed, and the necessary measures have to be set in place to prevent data breaches.
- Digital literacy. Another potential barrier that needs to be overcome is the need to ensure that people have access to the technology they need, and that they know how to use it, to access the digital health services that they require (e.g., via digital platforms, through mobile devices, etc.)
- Language accessibility. According to the Bureau of Internet Accessibility, “accessible language is language that accommodates people of all ages and abilities, including those with cognitive disabilities, people with low literacy skills, and speakers of English as a foreign language”. By using a language appropriate to your digital health technology’s intended audience, you guarantee that the health information that you want to provide is conveyed in a clear way, so that it can be understood fully and quickly.
The first two are the ones that get talked about the most, and usually have dedicated services and departments. However, the last one is often overlooked but can also be responsible for a large proportion of potential users not utilising your service or technology.
Why is language accessibility important for digital health
Patients may feel less confident about their treatment plan if they don’t understand it, which may put them at risk for non-adherence. Studies have shown that this risk is very high when patients cannot read or when they don’t understand the written basic instructions given by their HCPs (e.g., Williams et al, 1995; Schillinger et al, 2003).
For example, according to the Williams et al. study in a total of 2659 patients presenting for acute care in two urban American hospitals, 41.6% of those patients were unable to comprehend directions for taking medication on an empty stomach, 26% were unable to understand information regarding the schedule of their next appointment, and 59.5% could not understand a standard informed consent document. Furthermore, 61.7% of the Spanish-speaking patients had inadequate or marginal functional health literacy.
Needless to say, the consequences of non-adherence for treatment outcomes are critical. As studies have shown, the correlation between health literacy and patient adherence is highly significant (Miller TA, 2016). For that reason, it is important to provide health resources and information in multiple languages, especially those spoken in the community where the digital health tech will be used.
Patients who are unable to understand or speak English may have a hard time understanding their doctor’s instructions or answering questions about their health. As a result, digital health platforms are increasingly being used by clinicians to deliver this type of patient education. They can provide resources and information in multiple languages, including images and audio files, which makes it easier for patients to access the information they need at any given time.
How to guarantee good language accessibility in digital health
When it comes to language accessibility, each form of digital health tech will pose its own particular challenges. For that reason, it is beneficial to seek the services of a professional language consultant, who can advise you and help you improve the accessibility of your digital app or platform from a linguistic and cultural point of view.
However, here are a few basic guidelines that you may find useful:
- Use language that can be easily understood by people with all levels of literacy. Give clear, concise and logical instructions. Think of who will be using your app or service, and adapt the register to that particular audience. For example, if your audience is comprised of people with a lower level of health literacy, your language should not be overly complex: make it simple, yet accurate.
- Ensure that your application or digital health service can be read in a number of different languages. Medical translation services can help bridge this gap by translating documents from one language into another, so that patients can access the medical information that they need about their care options, which makes it easier for them to make informed decisions.
- Make use of multimedia to make your message easier to understand: e.g., video/audio files, graphics, animations, etc. If you do, make sure that you also provide subtitles and close captions for people with hearing loss. A good translation consultancy should be able to help you with those too.
- Ensure that the language is medically accurate. If you are going to translate your materials into a different language, make sure that you use qualified translators that understand the nuances of medical terminology. You’ll be surprised to know that, more often than not, there’s not always a 1-2-1 correlation between different languages, especially with medical terminology. As such, you’ll want to avoid the use of AI or computer-generated translations, or generalist translators that don’t have the necessary qualifications or experience working in this field.
How we can help you improve your language accessibility
At Synaptic Translations, we understand that ensuring that your digital health technology complies with language accessibility can be overwhelming. For that reason, we’ll be happy to assess your digital health app or services to ensure that it is accessible from a linguistic point of view, with an approach truly tailored to you. We’re exclusively a medical translation studio, so our approach is to only use appropriately qualified language professionals, with experience in the medical field, so you can rest assured that all the information will be translated accurately and with your target audience in mind.
Contact us here and we can set up a conversation with you about the best way forward.
J Med Internet Res 2022;24(2):e33062