Understanding language barriers within patient portals: workarounds and opportunities for Spanish-speaking caregivers

Objectives: To explore how Spanish-speaking caregivers navigate translation barriers in patient portals and to assess their perspectives on improving language accessibility. Materials and methods: This qualitative study was conducted at a pediatric academic health system. Semi-structured interviews were conducted with Spanish-speaking caregivers of children with chronic conditions, and inductive thematic analysis was used to generate themes. Results: Twenty caregivers participated. Three key themes emerged: (1) Caregivers rely on online machine translation tools, which can be inaccurate and time-consuming; (2) Caregivers frequently depend on children and family members for translation, raising concerns about comprehension and appropriateness; (3) Caregivers expressed strong interest in timely and accurate translation features within patient portals to enhance accessibility. Discussion: Spanish-speaking caregivers develop workarounds to access medical information, but these strategies pose risks to patient safety and exacerbate digital health inequities. While AI-powered machine translation offers a potential solution, concerns about accuracy, regulatory compliance, and equitable implementation must be addressed. Conclusion: Spanish-speaking caregivers face significant challenges in accessing health information through patient portals. Health systems should prioritize integrated translation solutions, leveraging AI-driven tools while ensuring accuracy and equitable implementation to improve language accessibility.