Europe has a long history of migration, made even easier with the European Union’s free migration policies for European citizens. While this creates opportunities for individuals and enables cultural exchange between communities, it is not problem free. When it comes to healthcare, migrants may face language and cultural barriers in addition to being unfamiliar with how healthcare is delivered in their new home. Elderly migrants who live in care homes face even steeper challenges and often deal with social exclusion and families that are frustrated in their efforts to get reliable information and interact with caregivers.
To help address some of these challenges, the EU is testing a knowledge-based information agent application called Project KRISTINA.
The Project’s mission is to perform the research and development necessary for a human-like, socially competent, and communicative “agent” for use on mobile devices. The vision is for KRISTINA to become a trusted information provider and healthcare mediator in the users own language. It’s creators envision pushing the frontier in dialog management, multimodal communication analysis, and communication. The application will undergo prolonged testing beginning in Germany for elderly Turkish migrants and for North African migrants in Spain.
Project coordinator Prof. Leo Wanner, a computational linguistics researcher at the Pompeu Fabra University in Barcelona, Spain, explained to Horizon magazine, “Helping people overcome barriers when they arrive in an unfamiliar country is not just about translating the language – it is rather about communication that requires social, cultural and background knowledge. This is what our socially intelligent conversation agent is trying to do.”
Video is a Key Component
Prof. Warnner also emphasized the importance of communication beyond voice. ‘It is often much easier to understand someone if you can see them because what is being said in a conversation extends far beyond the spoken word,” he said. “It is about the tone of the voice, the facial expressions, and the gestures. But there are social idiosyncrasies that vary between cultures.”
Project KRISTINA aims to create as natural of an experience as possible, even going so far as to respond to the user’s tone of voice, the healthiness of their appearance, and signs of depression.
Focus on Family Medicine
In a press release, the project KRISTINA team outlined the importance of the solution’s application in family practice. “Family doctors explicitly mentioned their need to ensure a preventive care for all migrants, especially because this aspect is often underestimated by these patients. People coming from different regions and areas out of Europe could refuse the assistance where symptoms are not evident or when they are not associated with evident illness. On the other hand, from the migrant’s perspective, European healthcare systems are complex and sometimes the administrative procedures seem insuperable obstacles. The result is the ineffective or delayed assistance with worsening situations requiring an immediate intervention.”
Healthcare for Immigrants is a Concern in the United States as Well
While the US doesn’t have a Project KRISTINA in the works, medical care providers are finding other ways to leverage telemedicine to meet the needs of patients. Mediconecta is a telemedicine platform that was launched in 2011 and serves patients across Latin America, including in Costa Rica, Venezuela, Chile, Ecuador, Peru, and Mexico. It is often covered through those patients’ insurance.
Since early 2016, doctors from the network have also been attending Hispanic patients in the United States. It’s part of an effort to serve Latin American immigrants who can’t afford the high costs of healthcare in the United States or those who simply prefer to see a doctor from their home country. Most doctors are general practitioners, but pediatricians, psychologists, nutritionists and family planning and sexual health specialists are also available. Each conversation costs just $25. Doctors cannot diagnose patients, prescribe medications, or order tests, but they can give general advice, try to calm fears, and make recommendations about who should see a medical professional, and let patients know what to expect.
“For many people, especially for first-generation Hispanics, the possibility of having a doctor from your home country is attractive,” says Daniel Silberman, who co-founded the network in Miami. “Accessing healthcare is a complex issue, especially if you don’t have the resources or are uninsured. But almost everyone has the internet.”
Increasing access and providing a better healthcare experience for immigrants is just one of the many examples of how telemedicine is changing healthcare for the better. Innovative technology like Project KRISTINA and new services like Mediconecta will help expand and improve care for those who find traditional systems challenging.