• Interphraser Overview
• The Problem
• The Interphraser Solution

The Interphraser Solution

The Interphraser system is made up at least two units: an operator and at least one respondent. Each unit should have a processor, memory, screen, audio output system, and the technology to communicate with the other unit. The Interphraser software is very portable and can be installed on many devices including:

• a handheld unit slightly larger than a cell phone
• a netbook
• a tablet or pad-type computer
• a laptop computer
• a netbook
• desktop computer hardwired to a server

Two (or more) devices complete a flexible wired or wireless (Bluetooth or 802.11) communication loop thus eliminating necessary reliance upon a telephone line, internet access, or a hospital or clinic network.

Netbook in tablet mode (Windows XP)	Netbook in open mode (Windows XP)	Desktop Shuttle X50 (Linux)

Practically, that means one could have two equal units (one for the clinician and one for the patient), a "regular" unit for a doctor and a ruggedized larger unit for the patient, or two large tablets fixed permanently onto a cart in an "A-shape."

An additional possible deployment would be a small smartphone that the clinician carries in their pocket while they travel from ward to ward. When they want to communicate with a patient, they would then connect up with the respondent unit that is by the patient. That respondent unit could be a small handheld tablet or a larger unit mounted on a cart that is rolled to the patient.

Nokia N800s (Linux)		Interphraser handheld rugged version (under development)

One deployment shown is on two Nokia N800 Internet tablets that communicate wirelessly via 802.11 (one for the doctor and one for the patient).

The Interphraser medical database contains more than 1900 clinical phrases in each of ten languages (English, Spanish, Russian, Korean, Farsi, Tagalog, Vietnamese, Mandarin, Cantonese, and Armenian) for a total of 19,000-plus phrases written at below a third grade reading level and avoiding jargon wherever possible. Each phrase has been translated by a professional translator, checked by an editor, and proofread. The final phrase is recorded by a native speaker with a bilingual director. A particular phrase, a set of phrases, or an assessment form can be displayed and can be found in several ways, including by letter (A,B,C …) symptom (headache), illness (diabetes), or event (snake bite).

Navigation by Category	Navigation by Index	Navigation by Index: The letter C

In use an English-speaking doctor with a patient that speaks another language (e.g. Korean) will choose a category such as "pain." A list of phrases will appear that have pain as a keyword. The doctor can select one of those phrases such as, "Do you have chest pain?", and a signal will be sent to the patient's unit to display that phrase in Korean and to play a recording of a native speaker saying that phrase.

	"Do you have chest pain?" in Korean.

If the phrase is a question, then a set of possible answers will also be displayed on the patient's screen. If the patient can respond, then they can select one of the possible answers. That answer will then be sent back to the doctor's unit and displayed in the doctor's language.

The user can also choose to play commands explaining how the system works and how to respond as shown below in Mandarin and Spanish.

Operator Screen (Medical)	Respondent Screen: System explanation in Mandarin	Respondent Screen: How to respond in Spanish

The Interphraser keeps a record of every phrase asked and answered, date and time-stamped that can be printed out or uploaded to the patient's file. If the patient cannot respond by touching their own screen, then the doctor can respond for them by selecting the answer on the doctor's unit. The history will indicate which unit provided the response.

In addition, every phrase that is displayed has an associated cryptographically calculated checksum that is also stored in the history. If someone attempts to change the record, they will not be able to match the checksum. The Interphraser system is thus tamper-resistant and tamper-evident. In other words, it is hard to change the interview history, and it is obvious when someone attempts to change that history.

The Interphraser uses a unique verification system for every phrase displayed, which is patent pending and that ensures that the phrase selected to be displayed on the patient's screen is what the doctor intended and is self-reinforcing, self-validating, and self-repairing. Similar verification and self-correction occurs when the patient's answer is sent back to the doctor's unit. Bear in mind that the Interphraser is not just a "translation" solution. It is a communicator that can also go between any combination of languages loaded, so it will work just as well going from English to Urdu, or Dari to Dari (for the hard of hearing or deaf), or even German to Arabic. The Interphraser software can therefore work in any country with people speaking any combination of languages.

As mentioned in The Interphraser Overview there can also be many possible phrase-sets that range from travel, healthcare, public safety, business, to hotel service and more. The list of possibilities is practically endless.