Dr. Daniel B. Chonde
Radiology Resident Seeks Health Equity through Technology and Wins Award
As COVID-19 surged in spring 2020, Daniel Chonde, MD, PhD, a fourth-year radiology resident at Mass General Imaging and health equity advocate, saw bottlenecks in radiology services and determined that language barriers and wait times for translation services were slowing patient flow in community health centers.
To solve the problem, he worked with the MESH Incubator at Mass General to develop RadTranslate™, a freely available, AI-powered web application that provides verbal patient instructions in multiple languages for radiology procedures.
The device-agnostic web application was rapidly created and piloted in the hospital’s ambulatory clinic in Chelsea. During a 63-day test period, six technologists who used RadTranslate reported that it was user-friendly, reduced care delays, increased efficiency, and made their job easier. All non-Spanish-speaking technologists at the pilot clinic voluntarily switched exclusively to RadTranslate for Spanish-speaking patients, Dr. Chonde notes. At the same time, the app recorded 1,267 uses across the country.
“Brilliant!” is how Steven Locke, MD, describes the initiative. Locke chairs the MMS Committee on Information Technology (CIT), which annually holds a contest for medical students and residents. Dr. Chonde and RadTranslate received the 2021 Resident Award. “It’s an incredible synergy of a brilliant project and one that is exactly on target for CIT to align with the mission of the Medical Society to address issues of diversity and health care disparities,” Locke says.
The ingenuity of RadTranslate, Dr. Chonde’s ability to bring it rapidly to fruition, and his commitment to health care equity so impressed CIT members that they invited him to join the committee, adding to Dr. Chonde’s expanding portfolio of projects aimed at improving equity in health care.
VS: What gave you the idea for RadTranslate?
Dr. Chonde: My ultimate goal is to make sure every patient who walks into the imaging suite receives appropriate, safe, and equitable care. When it is 2 a.m. in a busy emergency room and there is a huge backlog of chest x-rays to be performed, the only option for translation may be an old conference phone. In that situation, care can be delayed and suboptimal. That environment was the genesis of RadTranslate.
As co-chair for the education subcommittee of our department’s equity initiative, I had worked with Marc Succi, who directs the MESH Incubator at Mass General, and also organized a socially conscious technology initiative, DIversityxMESH, to apply the concepts of MESH to inequities in health care through hackathons. To illustrate to my subcommittee how a hackathon worked, I posed the issue of the need for translations. This amazing subcommittee of administrators, nurses, technologists, and doctors began brainstorming what the ideal solution would look like, and within 20 minutes the concept of RadTranslate was fleshed out. The hackathon was postponed due to COVID, but the idea was filed in the back of my head.
Then during COVID-19, Marc and I were called in to help with the Mass General imaging site in Chelsea. They needed a lot of interpreters, and imaging was running behind. Increased demand and shortages of interpreter services were prolonging image acquisition, reducing image quality, and limiting triage of suspected COVID patient with limited English proficiency at our ambulatory triage clinics. Marc and I had the perfect solution.
VS: How is RadTranslate different from other online translators?
Dr. Chonde: When you use real-time web translation applications, you have no idea if the translation is correct, and that is why their use is frowned upon in medicine. We worked with the nurses and technologists who will be using the app, to figure out exactly what instructions they give to patients and how they would want the user interface laid out. We then worked with medical translators to ensure the phrases are correctly translated. In this way we created something that was acceptable from an operations standpoint and end-users wanted to use.
VS: How long did it take to create RadTranslate?
Dr. Chonde: We put it together in about four days. We built the website while the technologists and clinical ops people figured out what phrases and instructions needed to be translated. Bilingual staff made the prototype Spanish audio; interpreter services gave it a second look.
People can do things incredibly fast if there is a need. For this, there was an urgency.
VS: What are your plans for the $5,000 prize from the CIT award?
Dr. Chonde: The money went right into furthering our equity work. We have created scripts for chest radiology, screening mammogram, and fall risk. We’ve expanded to work with pediatrics, radiation oncology, and other departments that require giving patients verbal instructions. Our language selection continues to grow. Users can submit requests for phrases and languages. Keeping it free is of the utmost importance so any clinic, anywhere, can use it. If you have a tool and you want people to use it, you need as few obstacles as possible. Looking through a lens of equity, it should be available to everyone.
VS: What led you to radiology?
Dr. Chonde: I consider myself a physicist. I majored in particle astrophysics as an undergrad at MIT — an abstract field with no human element. For my PhD in biophysical and medical physics, I worked on the prototype of a simultaneous PET-MR scanner, and I tasted the opportunity of working with patients. From there, I went to medical school, so that I would know what questions to ask when figuring out which widgets are best for which patient. Since then, my definition of science has broadened. I’m drawn to equity work because it provides the opportunity to help people who are often overlooked.
VS: What other health equity initiatives have you been involved with?
Dr. Chonde: With the Radiology Departments of Vanderbilt University and Emory Hospital, I helped create a radiology bootcamp focused on medical students of color in collaboration with the Student National Medical Association, the Latino Medical Student Association, and the Association of Native American Medical Students. At Mass General, I’ve organized events to celebrate the diverse heritage of members of the Radiology Department, including a Diversity Week and a 2020 Juneteenth celebration. I currently chair the diversity, equity, and inclusion committee of the American Roentgen Ray Society.
VS: Can you tell us about The Peoples’ heART?
Dr. Chonde: While working at outpatient centers, I look at the environment. I realized that the choice of art in a clinical space also is an equity tool. A transgender person in a waiting room who feels “other” might feel better if there’s a rainbow sticker on the wall. What if we used art to have conversations about equity? It doesn’t need to be an original Picasso or Warhol.
I saw some places that really needed rehabbing. I spoke with the person who runs rotating exhibits at MGH. I was seeking bright, bold art that reflects the diversity of a community — veterans, the Black experience, people going through gender transition. This became The Peoples’ heART, a hospital-community partnership with community organizations and individuals to bring art installations to our clinical settings and the communities we serve. We started in Chelsea. I want to reimagine our clinical spaces through art, design, and equity.
RadTranslate fits into this same space. It changes the health care experience for people in that community.
To learn more about RadTranslate, watch the entertaining and informative three-minute video that Dr. Chonde created for the CIT award application.
