Can We Trust Translation Apps In Medicine?

Doctors have been treating patients that don’t speak their own language for hundreds of years; both as individuals, and on a larger scale as part of organisations like the Nobel Prize-winning Doctors Without Borders.

Navigating the language barrier accurately is more important than ever when it comes to health care, as lives are often at stake, and complex procedures need to be explained. So far, doctors have used a combination of professional interpreters and patients’ bilingual relatives to communicate in other languages, but now technology could be changing that.

Automated translation via apps such as Google’s Translate and Microsoft’s Translator has promised to make breaking the language barrier simpler and easier than ever, but can we trust them in life or death situations?

How do doctors communicate with foreign patients?

If a doctor doesn’t happen to be bilingual, they will often use telephone interpreters to talk to patients. As anyone in the industry will know, telephone interpretation has long been the go-to solution for those who seek fast, accurate interpretations but don’t wish to hire the services of a face-to-face interpreter. In fact, translation authority Global Voices hail telephone interpretation as “one of the most convenient forms of interpretation available”, because of its comparative convenience and cost-effectiveness when measured against face-to-face interpreting.

In the mid-1990s, telephone interpreters were used in 15% of hospitals in the United Kingdom, but for the most part doctors around the world would rely on a patient’s bilingual family or friends to do any necessary translation for them. This practice, however, was widely discouraged by the International Medical Interpreters Association in a paper called ‘A Medical Interpreter’s Guide to Telephone Interpreting’, which encouraged hospitals around the world to pick up the practice.

In 2008, University of Nottingham lecturer Natasha Thom published a paper in Nursing Times which furthered this position. The paper, titled ‘Using Telephone Interpreters to Communicate with Patients’, argued that though friends and family members may be patients’ “chosen advocates” it is “not appropriate” for doctors and nurses to rely on them.

Thom’s reasoning? The fact that “Interpretation is a complex skill.” Thom cited the Canadian Association of Occupational Therapist Jose Luis Gonzalez’s work on the accuracy of interpretation to back up her argument. Gonzalez’s respected 2005 paper points out that while untrained interpreters may have a good understanding of the English language, they lack a crucial understanding of the role of the interpreter, which is about more than conveying words, but rather their true meaning.

Trained interpreters also understand that they need to provide “specific information about the client’s sociocultural characteristics” alongside other linguistic concerns. For example, a patient nodding and smiling does not necessarily guarantee that they agree with what you have said; they may have simply misunderstood.

By 2015, NHS England was offering telephone interpretation as standard. But this was around the time translation apps started to gain traction.

Are interpretation apps already used in medicine?

Convenience has been the main selling point of translation apps from the start. Simply speaking or typing a phrase into your phone and instantly seeing a translation is much easier than spending years mastering a second language yourself, and more convenient than keeping a professional translator on call for whenever they are needed.

It is no surprise, then, that some medical professionals are already using translation apps to communicate with their foreign language-speaking patients. iMedicalApps.com argues that though most United States healthcare facilities now offer live translating services, these “can be expensive, challenging to use, and often delay care.”

As an alternative, they recommend an app called MediBabble, which boasts medical phrases in Cantonese, Mandarin, Haitian Creole, Russian and Spanish, translated and fact-checked by both medical and translation experts, and recorded by full-time in-person medical translators.

MediBabble is not the only healthcare-specific translation app on the market. AppCrawlr’s list of the best medical translations apps for iOS is full of programs like Medical Words, MedSpeak: Cantonese Lite, MediPass Chinese, and iLingo Translator—and if you think those names sound a little too casual for something as serious as medical interpretation, you might be right.

Are medical interpretation apps good enough?

Though there is clearly a market for medical interpretation apps, they so far are not necessarily a step forward from in-person and telephone interpreters. In iMedicalApps’s revealing review of MediBabble; it praises translation apps for being cheaper alternatives to live interpretation but not for being more effective. When it comes to something as important as healthcare, the cheaper option is rarely the better one.

Though translation technology has come a long way, the fact is that medical translation apps still suffer many of the same drawbacks as simply talking to a patient’s bilingual friend or family member: they cannot give you absolute confidence that a patient has understood what you are telling them, and they cannot tell you anything about the patient’s socioeconomic background, which informs their points of reference and could change the context of what they are saying. That means there’s a greater margin for error.

Still, none of this means the development and improvement of medical translation apps is a dead end. MediBabble’s attention to detail and collaboration with full-time interpreters is impressive, and it definitely points to a future where medical translation technology could be a viable alternative to human translators.

So can we trust translation apps in medicine? Maybe someday, but only if they get better.