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California turns to AI for health and social services translation

California turns to AI for health and social services translation

California turns to AI for health and social services translation

(TNS) — Have the flu, have the flu, get the flu, get the flu, be the flu, be the flu, get the flu, get the flu. In Spanish, there are at least a dozen ways to say that someone has the flu, depending on the country.

Translating “cardiac arrest” into Spanish is also complicated because “arrest” means being detained by the police. Likewise, “intoxicated” means that you have food poisoning, not that you are drunk.

The examples of how translation can go wrong in any language are endless: words take on new meanings, idioms come and go, and communities adopt slang and dialects for everyday life.


Human translators work hard to keep up with changes, but California plans to soon entrust that responsibility to technology.

State health policy officials want to leverage emerging artificial intelligence technology to translate a wide range of documents and websites related to “health and social services information, programs, benefits and services,” according to state records. Sami Gallegos, a spokesperson for the California Health and Human Services Agency, declined to elaborate on what documents and languages ​​would be involved, saying the information is “confidential.”

The agency is seeking bids from IT companies for the ambitious initiative, though its timeline and cost are still unclear. Human editors overseeing the project will oversee and edit translations, Gallegos said.

Agency officials said they hope to save money and make critical health care forms, applications, websites and other information available to more people in what they call the most linguistically diverse state in the country.

The project will begin by translating written material. Agency Secretary Mark Ghaly said the technology, if successful, could be applied more broadly.

“How can we potentially not only transform all of our documents, but also our websites, our ability to interact, and even some of our call center inputs, around AI?” Ghaly asked during an April briefing on AI in healthcare in Sacramento.

But some translators and academics fear that the technology lacks the nuances of human interaction and is unprepared for the challenge. Leaving this delicate work in the hands of machines could create errors in writing and understanding, they say, ultimately making information less accurate and less accessible to patients.

“AI cannot replace human compassion, empathy and transparency, or meaningful gestures and tones,” said Rithy Lim, a medical and legal interpreter based in Fresno for 30 years who specializes in Khmer, the primary language of Cambodia. .

Artificial intelligence is the science of designing computers that emulate human thinking through reasoning, problem solving, and language understanding. A type of artificial intelligence known as generative AI or GenAI, in which computers are trained using massive amounts of data to “learn” the meaning of things and respond to prompts, is driving a wave of investment, led by companies like Open AI. and Google.

AI is rapidly being integrated into healthcare, including programs that diagnose diabetic retinopathy, analyze mammograms, and connect patients with nurses remotely. Promoters of this technology often make the grandiose claim that soon everyone will have their own “AI doctor.”

AI has also changed the game in translation. ChatGPT, Google’s neural machine translation and open source are not only faster than older technologies like Google Translate, they can also process huge volumes of content and draw on a vast database of words to almost mimic human translation .

While a professional human translator may need three hours to translate a 1,600-word document, AI can do it in one minute.

Arjun “Raj” Manrai, assistant professor of biomedical informatics at Harvard Medical School and associate editor of the New England Journal of Medicine AI, said the use of AI technology represents a natural progression in medical translation, given that Patients already use Google Translate and artificial intelligence platforms to translate for themselves and their loved ones.

“Patients are not waiting,” he said.

He said GenAI could be particularly useful in this context.

These translations “can offer real value to patients by simplifying complex medical information and making it more accessible,” he said.

In its bidding documents, the state says the project’s goal is to increase “the speed, efficiency and consistency of translations, and generate improvements in language access” in a state where 1 in 3 people speak a language other than English, and more More than 200 languages ​​are spoken.

In May 2023, the state’s Health and Human Services Agency adopted a “language access policy” requiring its departments to translate all “vital” documents into at least the five primary languages ​​spoken by Californians with limited English proficiency. At the time, those languages ​​were Spanish, Chinese, Tagalog, Vietnamese and Korean.

Examples of vital documents include application forms for state programs, notices about eligibility for benefits, and content from public websites.

Currently, human translators perform these translations. With AI, more documents could be translated into more languages.

A survey conducted by the California Health Care Foundation late last year found that 30% of Spanish speakers have difficulty explaining their health problems and concerns to a doctor, compared to 16% of English speakers.

Health equity advocates say AI will help close that gap.

“This technology is a very powerful tool in the area of ​​language access,” said Sandra R. Hernández, president and CEO of the foundation. “In good hands, you have many opportunities to expand translation capacity to address inequalities.”

But Hernandez cautioned that AI translations must have human supervision to truly capture the meaning.

“The human interface is very important to ensure that cultural nuances and accuracy are reflected,” he said.

Lim recalled a case where a patient’s daughter translated preoperative instructions to her mother the night before surgery. Instead of translating her instructions as “you cannot eat” after a certain time, she told her mother, “You must not eat.”

The mother had breakfast and the surgery had to be rescheduled.

“Even a few words that change meaning could have a drastic impact on how people consume information,” said Sejin Paik, a doctoral candidate in digital journalism, human-computer interaction and emerging media at Boston University.

Paik, who grew up speaking Korean, also noted that AI models are often trained from a Western point of view. The data that drives the translations filters languages ​​through an English lens, “which could lead to misinterpretations of the other language,” she said. Amid this rapidly changing landscape, “we need more diverse voices involved, more people thinking about ethical concepts and how to better forecast the impact of this technology.”

Manrai pointed out other flaws in this nascent technology that need to be addressed. For example, AI sometimes makes up sentences or phrases that are not in the original text, potentially creating false information, a phenomenon AI scientists call “hallucination” or “confabulation.”

Ching Wong, executive director of the Vietnamese Community Health Promotion Project at the University of California-San Francisco, has been translating health content from English to Vietnamese and Chinese for 30 years.

He provided examples of nuances in language that could confuse AI translation programs. Breast cancer, for example, is called “breast cancer” in Chinese, she said.

And “you” has different meanings in Vietnamese, depending on a person’s classification in the family and community. If a doctor uses “you” incorrectly with a patient, it could be offensive, Wong said.

But Ghaly stressed that the opportunities outweigh the drawbacks. She said the state should “cultivate innovation” to help vulnerable populations gain greater access to care and resources.

And he was clear: “We will not replace humans.”

©2024 KFF Health News, distributed by Tribune Content Agency, LLC.