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Tell Me Where it Hurts: Better Communication between Doctors and Newcomers

Bridging the communication gap between non-native patients and their doctors with a software program for improving diagnosis accuracy.

Photo of Aziza Ismail

Written by

What problem does the idea help to solve and how does your solution work? (2,000 characters maximum)

Urgent and emergency care is fraught with communication challenges. New and inexperienced staff interact with patients whose cultural, educational and language barriers may prevent them from communicating effectively.

  • Miscommunication is a leading cause of medical error.
  • Medical error is the third leading cause of death in the US. (Nearly 250,000 people die each year due to preventable medical errors.)
  • Language barriers are a top reason newcomers do not seek healthcare.
  • Vulnerable groups (e.g., immigrants, refugees, expatriates/migrants) are at risk of miscommunication.

There is no easy way to reduce miscommunication between English as a Second Language (ESL) patients and doctors during medical examination procedures. In fact, nine out of ten US adults have inadequate health literacy, and the share is higher among underprivileged populations. Most people don’t have a medical background, so they don’t know necessarily how to describe their health problem or know what information to provide their doctor and sometimes this can be a life-threatening situation. Obtaining a reliable History of Present Illness usually leads to the right diagnosis. However, patients overwhelmingly feel vulnerable when speaking about their health history. They sometimes don’t know what to say or how to say it, leaving critical information unspoken. People who have language and cultural barriers have nearly 50% higher risk and severity of medical error. Improving communication at the first clinical encounter would help prevent errors at the outset.

LiteraSeed provides a software application to improve communication between ESL patients and providers in describing the patient's present symptoms and history. This in turn empowers medical providers to quickly diagnose and provide treatment, and enables equitable access to less costly and more effective healthcare services.

Geography of focus (500 characters)

We will initially focus on refugee and immigrant communities in the United States that speak English as a second language. These populations feature language and cultural differences that impact access to timely and effective healthcare services.

LiteraSeed’s initial clinical target is women’s health, specifically, pregnancy-related complications. We believe that focusing the initial market on this population may allow the solution development to be generalized globally.

Building Bridges: What bridge does your idea build between people on the move and neighbors towards a shared future of stability and promise? (500 characters)

We are helping newcomers obtain and have equitable access to quality healthcare services by breaking the language and cultural barriers that hinder communication between ESL patients and their doctors. Our focus is communication in the first clinical encounter where doctors ask the patient about their present symptoms and history. A more accurate description of the ailments and history of the condition will enable doctors to provide a speedy and more accurate diagnosis.

What human need is your idea solving for? (1,000 characters)

Getting the right care at the right time so people can go back to living their lives at their best possible health, and having the right interventions before preventable health conditions escalate. Better health is essential to living a life of joy, hope and dignity. Being informed, active and having your voice heard and listened to by your healthcare provider so they can respect your decisions enables being treated with respect and dignity and gives hope to people during the most vulnerable moments along their healthcare journeys.

What will be different within the community of focus as a result of implementing your idea? (1,000 characters)

Potentially, life-saving intervention before health conditions escalate. Improved healthcare and patient safety, reduced unnecessary healthcare costs, greater efficiency of care and patient experiences.

What is the inspiration behind your idea? (1,000 characters)

The motivation for this project is the tragic and preventable death of the founder's young relative while waiting to receive treatment in an Emergency Department. Improved communication could have resulted in the child receiving life-saving care.

Describe the dynamics of the community in which the idea is to be implemented. (1,000 characters)

We intend to focus initially on pregnant women within refugee and immigrant communities. This is a vulnerable group, which we intend to support them in their journeys navigating healthcare during pregnancy and postpartum. Specifically, we want to help them communicate to their doctors when they are having specific signs and symptoms of high-risk pregnancies so they can get more timely and appropriate care. 700 women in the United States die each year due to pregnancy-related complications. 60% of these deaths are preventable. Improving recognition and communication of signs and symptoms can help identify at-risk patients and enable timely intervention.

Language and cultural barriers of newcomer mothers may make them more hesitant than their counterparts to share their health concerns, and have their concerns overlooked. We want to help capture their voices so they can confidently communicate issues with their healthcare providers with the support of our software to do so.

How does your idea leverage and empower community strengths and assets to help create an environment for success? (1,000 characters)

Deep understanding of the language and cultural challenges in navigating healthcare will enable us to develop a solution that could be more widely applicable.

What other partners or stakeholders will work alongside you in implementing the idea, if any? (1,000 characters)

We plan to work with the Refugee Women's Health Clinic that is a part of the Maricopa Integrated Health System in Phoenix, Arizona.

What part of the displacement journey is your solution addressing

  • Arriving and settling at a destination community

Tell us how you'd describe the type of innovation you are proposing

  • Technology-enabled: Existing approach is more effective or scalable with the addition of technology

Idea Proposal Stage

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

Group or Organization Name

LiteraSeed, LLC

Tell us more about your group or organization [or lived experience as a displaced person?] (1000 characters)

LiteraSeed’s extended team consists of highly capable, fast-moving clinicians, researchers, software architects, engineers, developers, and subject matter experts who leverage their expertise in healthcare, software development and human subjects research.

We are a Phoenix-based new startup organization. Currently LLC with plans to convert to a Delaware C-Corp.

Website URL:

Type of submitter

  • We are a For-Profit Startup or Startup Social Enterprise

Organization Headquarters: Country

United States

Organization Headquarters: City / State

Phoenix, Arizona


Join the conversation:

Photo of Sidra Dara

Hi Aziza Ismail this is a brilliant initiative, I wanted to inquire more about how does ESL function exactly, is the software a pictorial representation of the maternal journey or translates the language of the non-English speaker? Do you think it can be replicated in other languages/countries?

Photo of Aziza Ismail

Thank you, Sidra! Yes, we'll be using pictorial representations with plain, easy to interpret English text. We'll work with interpreters who speak the relevant languages for the first version to ensure accuracy. I do think it can be replicated into other languages and that the pictures and plain text will help. We've aimed to simplify this as much as possible to ensure the most pertinent information that will help the doctor make a diagnosis will be collected.

Photo of Sidra Dara

In Pakistan, people belonging to different region not only have different languages but they also have different dialects. This has made communication a bit difficult in the rural areas, and I do think that your idea does have potential. We have been using pictorial representation for communication at some occasions and it does seem to work. It'll be great to see how your initiative spans out. Best of luck!

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