design: Creating solutions for diverse populations
Cultural competency is understood in healthcare as the capacity of
healthcare systems, providers, and technology to deliver care that is
responsive to and respectful of patients’ cultural and linguistic
differences and their sociodemographic and socioeconomic needs. As
healthcare moves to be more globalized and varied, it is the job of
healthcare providers to understand better the structural contexts that
determine patient behaviors, modes of communication, and patterns of
healthcare decision-making. Cultural competence isn’t about a few
translators or just pure cultural awareness. It’s about designing
systems to make healthcare more inclusive, respectful, and
understanding at the point of care and every point along the way.
Cultural competency in healthcare technology is especially important.
Overall, design and usability for software solutions that serve
diverse populations must go beyond the one-size-fits-all model. For an
electronic health record (EHR) system, telehealth platform, or patient
portal – consider the features that should be embedded to promote
equitable, inclusive care: Accommodation for language differences
among patients; Adaptation for communication preferences, such as
text, video, or voice calls; Consolidation of cultural beliefs and
social determinants of health; And most crucially, how to incorporate
features into the final product to ensure that patients from diverse
cultural backgrounds feel represented when using the software. By
increasing cultural sensitivity in software through meaningful design,
the care being delivered is more personalized, effective, and less
prone to unnecessary disparities – ultimately increasing overall
health outcomes for underserved patients or those from marginalized
groups.
This article covers why cultural competency drives
software design decisions and how healthcare providers can improve
patient outcomes by creating culturally competent software solutions.
With more patients representing diverse linguistic, religious, and
ethnic backgrounds, we’ll look at best practices to avoid burdening
patients and improve their experience in terms of use and data
privacy. By examining the barriers that culturally competent software
can overcome, it’s clear that how we design software will become a
significant factor in ensuring truly public health.
Health care culture involves the ability of individuals and
institutions to comprehend, address, and interact with a patient’s
various cultural backgrounds. It involves all these, including
cultural awareness, sensitivity to patients’ beliefs and values, and
adapting care. This skill is vital in healthcare delivery because it
builds trust, communicates better, and fosters more productive
relationships between patients and providers. When the care
professional acknowledges and values cultural differences, they can
provide clinically effective care that is meaningful to the patient,
leading to better health outcomes and increased patient
satisfaction.
The benefit of cultural competence for patients is
undeniable. If medical professionals are aware of and have their
patients’ cultural norms, customs, and interests in mind when
prescribing treatment, patients will be more engaged with treatment,
comply with instructions, and report greater satisfaction with care.
Yet many medical practitioners also have significant problems meeting
the diverse needs of their patients. These include the lack of time to
train personnel on cultural sensitivity, a lack of diversity among
healthcare providers, and the challenges of negotiating difficult
cultural norms and values. Overcoming these hurdles is vital for every
patient group's access and quality of healthcare.
Meaningful cultural competency in healthcare software development must
start from the initial conception, during the stages of software
design and architectural ideas. It’s important to conduct extensive
user research to understand unique communities' cultural, linguistic,
and sociodemographic peculiarities and feed that feedback from diverse
focus groups into the software application’s development. Cultural
competency also needs to weave its way into ongoing design efforts
such as user interface (UI) design, user experience (UX) design, and
so forth. From the design’s early phases to its final deployment and
iteration, inclusivity should be baked into the product by considering
cultural sensitivity, user needs, and other social factors that can
make patients feel a sense of belonging and, in turn, have a positive
effect on their willingness to engage with healthcare services.
From
the perspective of patient engagement and care delivery, culturally
competent design can help patients access information in ways that
adhere to their cultural context. For example, offering an interface
in multiple languages ensures that non-English speakers can navigate
the application without intimidation. Inclusive data fields enable
patients to record data relevant to their cultural background and
health history. Designing software with culturally competent elements
can facilitate patient education and awareness. Visual symbols used
throughout an interface can resonate with individuals from diverse
populations, helping to make the piece more familiar and approachable.
With a sense of direction, healthcare software can be designed to
boost understanding, health literacy, and, ultimately, health outcomes
within diverse communities.
User interfaces designed for different languages and cultural preferences, including text, audio, and visual, will help to ensure that all patients can satisfactorily and proficiently engage with healthcare software. User interfaces should provide multilingual options that account for different cultural contexts. For example, the direction of text should accommodate languages that ‘read’ from right to left, compared with those that ‘read’ from left to right. Icons and symbols that violate cultural norms should likewise be avoided. These considerations can also help create a welcoming environment, which will promote accessibility and help create an optimal experience for users among various populations.
To make user design accessible, the next step could involve adapting UX to cultural contexts for different patient populations, such as color schemes, icons, and imagery that diverse populations can relate to that don’t include designs that unintentionally convey negative connotations. For example, some colors used in design meanings vary between cultures, and some imagery should showcase more diversity of the patients it serves through more thorough user testing with individuals of different cultural backgrounds.
Because every patient comes from a cultural, physical, and spiritual background, a critical aspect of culturally competent software design is the use of patient data to provide care plans with cultural and religious sensitivity. By collecting demographic information alongside health data, a provider could offer care plans and health education recommendations that consider these factors, thereby nurturing better adherence to the plan and better outcomes – given improved understanding and likelihood of improvement on the part of patients.
If AI is to be used responsibly and fairly, for example, in socially and culturally diverse settings, the designing of the privacy policies and asking for user consent is best accomplished by having codes and recommendations that respect cultural norms regarding what kind of data is sensitive and should be protected, while possibly allowing access to or use of secondary data for epidemiological study, with consent from an ethics review boards. The design of health software must allow patients to read about what will be done with their data and how it will be stored, and allow them to decide on their privacy freely and the level of care they want. Even giving patients the possibility to use customizable consent to control what kind of health data is shared with whom would allow them to feel more in control and should boost adherence to health services.
This cultural knowledge can be integrated into the code of computerized patient record systems, turning them into tools for culturally competent health professionals. Patients will feel more understood and respected when they see themselves recognized and have their cultural identities included. This will increase their level of engagement, which is essential. Engaged patients are more willing to disclose health concerns, comply with treatment plans, and proactively embrace care.
Creating multilingual interfaces and filling them with culturally relevant content can increase access for non-English speakers and those who, for socioeconomic reasons, have historically been cut off from the same care available to other patients. When new and underserved communities can complete tasks and understand the information presented to them by software in the same language, they can more easily and effectively use the healthcare system, removing barriers to care and improving health outcomes for communities.
By implementing culturally competent healthcare software, we can help close the large healthcare disparities and inequalities in the US. If the software could better address the needs of diverse patient populations, this could help us identify barriers that prevent equitable access to care. If clinicians become more culturally sensitive, it could help providers offer more accurate physical diagnoses and target more focused, personalized health interventions for culturally and socially marginalized populations. Although often invisible, those of us working to manage patients’ medication therapy may be offered opportunities to spearhead meaningful health equity initiatives that could improve health outcomes and fair access to healthcare for all.
The use of culturally competent healthcare application software design can support physicians and other providers to create treatment plans that are not only clinically sound but also consistent with the patient’s cultural value system, such that patients are much more likely to adhere to the care plan when it is consistent with their culture. Physicians not only feel more comfortable and confident about the treatment plan but also, more importantly, patients feel valued and trust their healthcare provider, facilitating constructive communication. Patients connected with their care are more likely to take an active role in their treatment and care, leading to more beneficial health outcomes.
Involving cultural nuances and diverse patient needs during design is
a key obstacle to creating culturally competent healthcare software.
Physicians treat a heterogeneous patient population with diverse
cultural backgrounds and practices, bringing various beliefs, values,
and different healthcare behaviors. Designers must conduct research
and engage with diverse user groups to capture and truly reflect
cultural nuances. However, this process can be cost-prohibitive and
involve lengthy research and development processes that might continue
even after deployment. In other words, this endeavor is both time- and
resource-intensive and susceptible to oversimplifying and
misrepresenting cultural characteristics by generalizing them.
The
second challenge revolves around designing for cultural competency by
finding the right balance between standardization and personalization
of user features. Standardized features are essential in design,
ensuring a consistent user experience while reducing development
costs. However, features that may be standardized could fail to
adequately address the genuine differences between user populations
and how they may respond to the software experience. Finally,
personalization at the individual level addresses these problems but
adds complexity to the process, increasing development costs and time.
Another challenge for developers involves a holistic approach to
reducing biases that may arise in algorithm design and algorithmic
interpretations of collected health data. Such biases perpetuate
inequalities and could skew health assessments. A flexible design
approach must be adopted to ensure that software can be adapted to a
variety of different cultural contexts and that, when coding
algorithms, data inputs are rigorously tested to remove biases while
maximizing relevancy.
Conducting extensive user research, including consultations with
patient groups, adds value to developing culturally competent
healthcare software. When developers actively seek input from diverse
patients on-site, they can learn about their challenges and barriers
(e.g., knowledge and literacy levels) and thus incorporate these
insights into the design and development process. For example, surveys
or interviews with underrepresented cultural and linguistic groups can
highlight the features and functionalities most valuable to their
end-users. Through surveys, interviews, and focus groups with
patients, developers can more effectively improve their design and
development process for the benefit of users.
Cultural and
linguistic experts can guide their designers to incorporate culturally
competent features such as design elements, language use, and
communication styles that resonate with particular populations. The
best AI systems will ultimately be those that ‘test well’ with diverse
user populations, which would require testing with real use cases to
get feedback for iterative refinement. Furthermore, one should enhance
the algorithm by updating and adapting it in light of contextual
changes, such as changing demographics and cultural shifts. Committing
to these best practices would ultimately allow developers to provide
healthcare solutions and embrace cultural intelligence to tailor their
solutions to the populations they serve.
Overall, it is essential to develop cultural competency in healthcare software design for solutions to be effective and inclusive of varied populations. This can be achieved through focusing on user research, collaborating with cultural experts, and ongoing software testing and updating. This would make a significant and impactful path for developers to create accessible and respectful solutions for diverse populations, improving patient engagement, satisfaction, and health outcomes overall. Culture should not be viewed as an obstacle but as an important aspect. Implementing cultural competence will be vital to creating software capable of addressing all populations' healthcare needs while developing better understanding, trust, and care delivery across diverse communities.