Development and usability testing of MediLanguage: A digital tool for use by Turkish-Dutch patients in language-discordant consultations

Background: Currently, no digital tools support migrant patients with limited language proficiency (LLP) in the host country’s language(s) or healthcare providers (HCPs) in selecting effective communication strategies, such as professional interpreters or digital translation tools, for consultations. Such an aid is crucial for improving communication and health outcomes for LLP migrant patients.
Aims: Set in the Netherlands, this study aims to systematically develop and test the usability of MediLanguage, a digital tool with features including the Language Support Starter—a decision aid designed for LLP Turkish-Dutch patients and Dutch-speaking HCPs. It helps them choose appropriate communication strategies to overcome language barriers and make informed, collaborative decisions.
Methods: Guided by the Spiral Technology Action Research Model, the development began with a needs assessment through semi-structured interviews, based on the Extended Technology Acceptance Model. We conducted 78 interviews with ethnically diverse LLP migrant patients (n = 25), informal caregivers (n = 26), and HCPs (n = 27) in languages including English, Dutch, Turkish, Syrian Arabic, Mandarin, Moroccan Arabic, and Tigrinya. Using these insights, we created a functional prototype of MediLanguage targeted at LLP Turkish-Dutch patients. The prototype was refined through three evaluation rounds, including expert reviews (n = 2) and usability testing with HCPs, patients, and caregivers (n = 15). HCP testing was conducted in Dutch, while patient and caregiver testing was conducted in Turkish.
Results: MediLanguage received positive feedback from users, especially valuing the information in the Language Support Starter about communication strategy pros and cons. Challenges included UI design issues like button sizes and excessive textual content. After three rounds, MediLanguage was refined into a user-friendly tool featuring enhancements such as a digital dictionary and embedded translation functions for use during consultations.
Discussion and Conclusion: The final MediLanguage version is patient-centred, accessible in real time, with an intuitive interface that prepares LLP Turkish-Dutch patients for shared decision-making about language barrier strategies. Although initially developed for Turkish-Dutch patients, it holds potential for adaptation to other migrant languages.

PLAIN LANGUAGE SUMMARY
MediLanguage is a digital tool developed in the Netherlands to help migrant patients with limited Dutch skills and healthcare providers talk about communication during consultations. Together with migrant patients, patients’ family members, developers, and experts from academia and practice, we built a decision tool within MediLanguage called the Language Support Starter. The Language Support Starter helps patients learn about different ways to overcome language barriers. It is a digital decision aid that equips patients with information about different translation methods. Patients and providers can use it together during consultations to choose the best translation method to overcome language barriers.