"I Should Know, But I Dare Not Ask": From Understanding Challenges in Patient Journeys to Deriving Design Implications for North Korean Defectors' Adaptation

2026-03-13

AI Summary

This study addresses the communication barriers faced by North Korean defectors within South Korea’s healthcare system, where linguistic and sociocultural differences often impede effective symptom articulation during clinical consultations. Through in-depth user interviews and patient journey mapping, the research systematically identifies key pain points in their healthcare interactions and introduces Medibridge—a novel mobile-based pre-consultation system that leverages AI-driven role-play simulations to generate structured “help notes” for use in real clinical encounters. By integrating AI-mediated dialogue rehearsal into health interventions for displaced populations, this approach significantly enhances participants’ clarity in symptom reporting, reduces cultural anxiety, and bolsters communicative confidence, as demonstrated in evaluations with 15 defectors. The work establishes a new paradigm for inclusive health technologies tailored to marginalized groups navigating complex medical systems.

Technology Category

• Humans and AI: AI for Accessibility
• Data Mining & Knowledge Management: Conversational Systems for Recommendation & Retrieval
• Natural Language Processing: Conversational AI/Dialog Systems

Application Category

• User Modeling, Personalization and Recommendation: Accountability, Transparency, and Ethics for personalization
• Search and Retrieval-Augmented AI: Multilingual and cross-lingual Web search
• Social Networks and Social Media: Generative AI / large language models and their impact on social systems

Abstract

While it is known that North Korean defectors (NKDs) struggle with South Korea's healthcare system, the specific challenges of their patient journey remain underexplored. To investigate this, we conducted interviews with 10 NKDs about an 8-step patient journey and identified the clinical consultation step as a critical barrier for all participants, marked by three key challenges: expressing symptoms, managing social and cultural concerns, and overcoming language differences. In response, we developed Medibridge, a mobile prototype that allows users to rehearse with an AI doctor before a real hospital visit to generate a tangible ``Helper Note'' for their actual consultation. Our evaluation with 15 NKDs showed improvements in perceived communication capability, including greater expression clarity, reduced social and cultural concerns, and enhanced linguistic confidence. Our contributions include an empirical understanding of NKDs' healthcare challenges, a novel AI-powered rehearsal system that prepares users for real-world clinical communication, and design implications for inclusive technologies for displaced populations.

Problem

• North Korean defectors
• healthcare access
• patient journey
• clinical communication
• language barrier

Innovation

• AI-powered rehearsal
• patient journey
• North Korean defectors
• inclusive design
• clinical communication