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App helps prevent healthcare miscommunication
iscommunication in a healthcare setting can have dire consequences, and is more likely to occur when clinicians and patients don't speak the same language. While some healthcare settings have access to interpreters, others often do not.

In Botswana, the official language is English, but many Batswana speak only the native language of Setswana. To help prevent healthcare miscommunication in the southern African country, a smartphone medical translation app has been developed for healthcare workers for use on either iPhones or the Android operating system.

The app was designed by faculty and staff at the Botswana-UPenn Partnership (BUP), the Biomedical Library and Department of Linguistics at the University of Botswana (UB), the University of Botswana Medical School, the Global Health Programs Office at the Perelman School of Medicine, and DuoChart, an Indianapolis-based company that specializes in translation materials.

When Ryan Littman-Quinn, director of the BUP's Mobile Health Informatics program, learned of DuoChart's Spanish app that is used in some Texas hospitals and clinics, he says he was struck by its innovation and practicality, "especially in global health settings where doctors, staff, and patients don't always speak the same language."

Littman-Quinn reached out to Carmen Hansen-Rivera, founder of DuoChart, about developing a similar app for Botswana.

"She was very enthusiastic about the idea," he says, "and said she would develop the app at-cost and provide it free to the Penn and UB communities, so long as we provided the English-Setswana translation content."

Dineo Ketshogileng, a health sciences librarian at UB, and Thapelo Otlogetswe, head of linguistics at UB and author of the first-ever Setswana dictionary, helped create the content for the app.

Ketshogileng says Otlogetswe was integral for quality assurance on all of the translations and audio recording pronunciations, working closely with students and providing expert advice.

Along with UB medical students, two Penn Medicine students, Elizabeth Riley and Robert Smith, worked on the translation content as part of their seven-week summer internship in 2012.

Mentored by Littman-Quinn and Carrie Kovarik, an assistant professor of dermatology at Penn Medicine, Riley and Smith worked closely with the Botswana team to develop and record the content. They interviewed BUP faculty members, brainstormed ideas to improve the app, reorganized the content, wrote new material, reviewed translations with UB faculty, managed recording sessions, and edited and coded the final recordings. The finished product was sent to DuoChart, which finalized the app.

"Our aim was to create an educational tool that will enable medical students, residents, and physicians to improve their Setswana skills and communicate more effectively with their patients," Riley says.

DuoChart is now one of the apps preloaded onto 170 tablets customized as a part of the BUP's capacity-building projects for UB medical students and faculty rotating in rural areas.

"The team really did a fantastic job customizing the English-Setswana content," Littman-Quinn says. "Since the UB students are taught medicine in English, they weren't necessarily aware of all of the Setswana terms and phrases that can be used for communicating with patients."
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