Found in translation: Phrazer bridges language barriers to care

Chances are, a migraine in Somalia resembles a migraine in South Carolina.

But describing those symptoms to a doctor who can’t speak your language can cause its own special brand of headache.

GeaCom Inc., a startup based in Duluth, Minnesota, is developing an interactive, hand-held device that can provide instant translation between doctor and patient, monitor vital signs and store data in an electronic medical record.

Founder and CEO Mat Johnson said the device, called Phrazer, can help reduce medical errors by eliminating linguistic barriers between caregiver and patient.

“It’s the biggest need in medicine today,” Johnson said. “It’s time to get this right.”

Founded in 2007, GeaCom’s management team includes Art Fry, the famed scientist at 3M Cos. who invented the Post-It note.

The company recently raised $812,000 from the sale of equity, according to documents filed with the Securities and Exchange Commission. GeaCom also won the high-tech division of the Minnesota Cup competition.

Experts say linguistic miscommunication between caregivers and patients can lead to improper diagnosis and treatment. It’s also a major reason behind a growing disparity in quality of healthcare between English-speaking and non-English speaking patients in the United States.

“Language barriers can have deleterious effects,” Dr. Glenn Flores, a professor of pediatrics, epidemiology and health policy at the Medical College of Wisconsin, wrote in the New England Journal of Medicine. “Patients who face such barriers are less likely than others to have a usual source of medical care; they receive preventive services at reduced rates; and they have an increased risk of non-adherence to medication.

“Among children with asthma, those who confront language barriers have an increased risk of intubation,” Dr. Flores, who also directs the Center for the Advancement of Underserved Children, wrote. “Such patients are less likely than others to return for follow-up appointments after visits to the emergency room, and they have higher rates of hospitalization and drug complications.”

Often, language barriers can lead to disastrous results. Dr. Flores cited a case in which a Spanish-speaking 18-year-old stumbled into his girlfriend’s home, told her he was “intoxicado,” and collapsed.

When the girlfriend and her mother repeated the term, the non-Spanish speaking paramedics took it to mean “intoxicated.” But “intoxicado” means “nauseated” in Spanish.

For 36 hours, doctors treated the man for a drug overdose. In reality, the patient suffered from intracerebral hematoma, or bleeding of the brain. The hospital ultimately paid $71 million to settle a malpractice lawsuit.

Hospitals provide limited interpretation services to non-English speaking patients. A 1996 study published in the Journal of the American Medical Association (JAMA) interviewed Spanish speaking patients at UCLA Medical Center in Los Angeles.

The study found that 22 percent of patients said an interpreter was not used but should have been used. When both the patient’s English and the examiner’s Spanish were poor, an interpreter was not called 34 percent of the time, and 87 percent of the patients who did not have an interpreter thought one should have been used.

“Interpreters are often not used, despite a perceived need by patients, and the interpreters who are used usually lack formal training in this skill,” the JAMA study concluded. “Language concordance and interpreter use greatly affected patients’ perceived understanding of their disease, but a high proportion of patients in all groups had poor knowledge of their diagnosis and recommended treatment.”

In 1998, the Office for Civil Rights for the U.S. Department of Health and Human Services issued a memorandum that said the denial or delay of medical care because of language barriers constitutes discrimination, and requires that recipients of Medicaid or Medicare funds provide adequate language assistance to patients with limited English skills.

But such assistance continues to be spotty. Johnson of GeaCom thinks Phrazer can help.

The device is programmed with software and sensors that allow caregivers to interact with patients. The first step is determining what language the patient speaks.

Patients can identify country of origin on a map on Phrazer. The device also uses facial and voice recognition technology that can help identify the patient’s language.

Phrazer asks questions about symptoms and medical histories that patients answer by tapping buttons on the screen. The device also provides video that explains procedures like CT scans and X-rays. Most importantly, patients can provide their consent to medical treatment on Phrazer.

“People can get and take information the same way every time,” Johnson said. “It brings medical literacy to the patient anywhere.”

The device also contains sensors that record and monitor vital signs like heart rate, breathing, and blood oxygen levels and alerts caregivers to any immediate medical issues.

Getting patients comfortable with the technology will be a challenge, Johnson said.

Also, it’s not clear whether doctors and patients can effectively use Phrazer in a timely manner in cases of emergency or catastrophic injury. Johnson, though, claims Phrazer would be a good device in Haiti and South America where earthquakes and natural disasters are common.

GeaCom hopes to sell the $10,000 device in the United States and foreign markets in 2011.