Table 4 Implementation process domain: focuses on the active strategies and actions taken to adopt, execute, and sustain an intervention
From: Operationalizing machine-assisted translation in healthcare
Areas that impact the implementation gap | Barriers to implementation | Potential solutions |
|---|---|---|
I. Integration | Lack of guidance on the effective integration of MAT | Aligning with Existing Workflows: Embed MAT features directly into current EHR or translation software to minimize disruptions for translators and clinicians |
Co-Designing with End Users: Collaborate with translators and clinicians to tailor prompts, interfaces, and error-check features based on real-world needs | ||
Retrospective Testing: Use secure offline data to identify errors and refine the model prior to live deployment | ||
Prospective Testing: Pilot small-scale rollouts for a single language or document type to gather feedback and measure error rates | ||
Plan for Deployment Infrastructure: Employ centralized data storage (e.g., BigQuery) with detailed logging to enable auditing, troubleshooting, and secure PHI handling | ||
Fine-Tuning to Meet Deployment Needs: Continuously update the LLM with new translator-approved data, targeting challenging note types or languages first | ||
Measuring Real-World Impact: Track turnaround time, adoption rates, and patient outcomes to gauge the model’s overall value and display these in data dashboards (e.g., Looker Studio) | ||
J. Evaluation | Lack of guidance on the effective evaluation of MAT | Translation Quality: Apply frameworks like MQM periodically to assess accuracy, fluency, and style on a sample of translated documents |
Operational Metrics: Track turnaround times, the percentage of language-concordant materials, and error rates to inform iterative improvements | ||
Clinical Outcomes: Monitor readmission or mortality rates in specific patient cohorts to gauge the real-world effects of MAT on care quality | ||
Patient Understandability and Actionability: Use tools like PEMAT and patient advisory boards to ensure translations are clear, actionable, and culturally appropriate |
