Felena Chau
All work

Plainly

When you leave the hospital, you get a page of instructions that can be hard to follow. Plainly rewrites them in simple English or Chinese, lets you tap any sentence to see what the doctor originally wrote, and turns your medications into a daily schedule.

Problem
Families read discharge notes written for the chart, often in their second language, and doses get misread.
Our role
We framed the problem, made the product decisions, wrote the check rules and built the prototype.
What we made
A working prototype that rewrites a note, links every sentence to its source and copies doses exactly.
Where it stands
Next is a teach-back test with families.
Animation: the discharge note sentence “Continue furosemide 40 mg by mouth once daily every morning for management of ongoing fluid retention and pulmonary congestion.” is highlighted and rewritten as “Take furosemide 40 mg by mouth once a day every morning. It’s a water pill that clears out the extra fluid.”. A line links the new sentence back to the original, and the dose, 40 mg, is checked as an exact match. The reading grade drops from 16.0 to 4.8.
Plainly is a concept we designed and is not meant to be medical advice. For the purpose of this demo, hospitals and patients are made up.

01

Problem

The person reading the note usually isn’t the patient

When an older parent comes home from the hospital, it’s often their children who reads the discharge sheet and is tasked with translating the complicated medical jargon. The note in this case study scores about grade 12, and a free translation app can easily rewrite a dose.

Caregiving taught me how much rides on that one sheet of paper.

I wanted a family to be able to act on the note without the meaning drifting on the way.

More detail: who reads it

The adult child is bilingual and busy, and often wasn’t in the room when the nurse explained things. They need to get it fast, explain it to their sick parent, and keep family and friends updated.

The parent wants to handle their own care. That means big text in their native language and straightforward, actionable steps.

Behind every patient is a wonderful nurse. Nurses won’t trust unverified text unless it says what the note says, and since they're constantly busy, they only want to look at the parts that need a human.

02

What families get

A sheet for the fridge and a page that stays current

Plenty of parents don't know how to open an app. So the first thing Plainly makes is paper: a folded sheet in both languages, with the warning signs at the top and a week of boxes for the morning weigh-in.

The same plan lives online for the rest of the family. It’s built for a tablet on the kitchen counter, with the original note always one tap away.

The reading view. Tap a plain sentence and the line shows where it came from.

03

Principles

What the rewrite can and can’t touch

  1. Warning signs come from a template a clinician approved in each language. The model never sees them and they’re on every screen.
  2. Tap any plain sentence and you get the original. If there’s no original to show, the sentence gets flagged.
  3. Drug names and doses carry over character for character, in Chinese too.
  4. Plain does not mean childish. I kept the sentences short and the words simple, but it’s still written for adults.

04

How it works

A language model rewrites it, and small checks review the result

Rules can’t write natural plain language, so a language model does that part. Everything that decides what’s safe to show is deliberately boring.

System

From discharge note to family view

How Plainly turns a discharge note into the family view The note gets scanned and split into sentences, and the drug names and doses are pulled out. A language model rewrites it in plain language and translates it. Then simple checks run. Each sentence has to match a sentence in the original, and every dose has to appear exactly as written. Anything that fails goes to a nurse. The emergency warning signs skip the model entirely and come from templates a clinician approved. 01 · Capture 02 · Understand 03 · Rewrite 04 · Verify 05 · Deliver if a check fails bypasses the model entirely reference drug names + doses Discharge note photo or PDF OCR text + layout Sentence split rules Entity extraction drug names and doses Simplify LLM, aiming for grade 8 Translate LLM + medical glossary Faithfulness TF-IDF / embeddings Dose match every dose, letter for letter Readability reading grade score Nurse review only what got flagged Family view plain text and pill schedule Red-flag templates clinician-approved copy Deterministic rule Trained model (non-generative) Generative AI Human-authored or reviewed
More detail: how it could go wrong

A wrong dose

The model turns “25 mg” into “2.5 mg”, or drops the unit.

The dose check blocks the whole page until a nurse looks at it.

A bad translation

A symptom gets translated into a word the family reads differently.

Drug names stay in English. Warning signs use fixed translations a person wrote.

Made-up advice

The model adds something helpful-sounding that isn’t in the note.

Anything without a source gets flagged in the app and sent to the nurse.

Too much trust

Friendly, plain text can feel more official than it is.

Every screen says it’s from your discharge note, with the original one tap away.

05

Prototype

Hover a plain sentence to find its source

The checks run in your browser. Each match gets a score from 0 to 1, and anything under 0.20 counts as having no source. The last sentence is advice the “model” made up, so it gets flagged. Switch off the lexicon (a short list that maps “water pill” to “diuretic”) and you can see some matches fall apart.

Reading level
Language

Simplest version, measured reading grade 3.6.

Original discharge noteGrade 12.4
  1. 1The patient was admitted with an acute of secondary to dietary non-adherence and was subsequently stabilized with intravenous .
  2. 2Continue furosemide 40 mg by mouth once daily every morning for management of ongoing fluid retention and pulmonary congestion.
  3. 3Continue metoprolol succinate 25 mg by mouth once daily in the morning for heart rate control.
  4. 4Take lisinopril 5 mg by mouth once daily in the evening; hold if is below 95 or you feel lightheaded.
  5. 5 chloride 20 by mouth once daily with breakfast is indicated to replace losses associated with therapy.
  6. 6Atorvastatin 40 mg by mouth once daily at bedtime.
  7. 7Adhere to a -restricted diet of less than 2 grams per day and restrict total fluid intake, including beverages and soups, to 1.5 litres daily.
  8. 8Weigh yourself every morning after and before breakfast, and record the result.
  9. 9Notify your physician if weight increases by more than 1 kg in one day or 2 kg in one week, or if worsens.
  10. 10 as tolerated, but avoid lifting objects heavier than 4.5 kg for two weeks.
  11. 11Laboratory evaluation of serum and is required in approximately one week to monitor medication tolerance.
  12. 12Arrange a follow-up appointment with the outpatient clinic within 7 days of discharge.
Plain versionGrade 3.6

Call 911 or go to the ER if you have:

  • Chest pain or pressure
  • Trouble breathing while resting
  • Fainting or passing out
  • Coughing up pink, foamy mucus

Call your doctor the same day if you gain weight fast or your legs swell more.

Approved by a clinician. Shown exactly as written.

  1. Your got worse because of too much salt, so fluid built up in your body. In the hospital, medicine in an IV took the extra fluid out.Weak match, worth a look · From sentence 1 · score 0.22
  2. Take furosemide 40 mg by mouth once a day every morning. It is a water pill that takes out the extra fluid in your body.From sentence 2 · score 0.39
  3. Take metoprolol succinate 25 mg by mouth once a day in the morning. It keeps your heart rate slow and steady.From sentence 3 · score 0.64
  4. Take lisinopril 5 mg by mouth once a day in the evening. Skip it if you feel lightheaded or your blood pressure is low.From sentence 4 · score 0.86
  5. Take chloride 20 by mouth once a day with breakfast. The water pill makes you lose .From sentence 5 · score 0.56
  6. Take atorvastatin 40 mg by mouth once a day at bedtime.From sentence 6 · score 0.88
  7. Eat less than 2 grams of salt a day. Drink no more than 1.5 litres of fluid a day, and that includes soup.From sentence 7 · score 0.55
  8. Weigh yourself every morning after you pee and before breakfast. Write it down.From sentence 8 · score 0.63
  9. Call your doctor if your weight goes up more than 1 kg in one day or 2 kg in one week. Call if your legs swell more.From sentence 9 · score 0.49
  10. Walk as much as you feel able to. For two weeks, do not lift anything heavier than 4.5 kg.From sentence 10 · score 0.56
  11. Get a blood test in about one week to check your kidneys and the salts in your blood.Weak match, worth a look · From sentence 11 · score 0.26
  12. See the heart clinic in 7 days.From sentence 12 · score 0.54
  13. Bring this sheet and all your pill bottles to every visit.This isn’t in the original. Check it before you rely on it.

Reading level

origplainsimplest3.6

Scored live from sentence and word length. Plainly aims for grade 8 or under.

Sources found

12/13 plain sentences matched to the original

1 sentence isn’t in the original, so it’s flagged

Against my hand-checked answers: 12 of 12 right for Plain, 12 of 12 for Simplest. Switch the lexicon off and watch the paraphrases miss.

Doses copied exactly

  • 40 mg matches
  • 25 mg matches
  • 5 mg matches
  • 20 mEq matches

No AI here. Every dose in the note has to show up in the output exactly as written.

Words explained

14 medical terms in the note have a tap-to-read definition

Tap any dotted word. Each definition was written by hand.

Today’s medicines

  1. Morning8:00

    Weigh yourself before breakfast

    Furosemide 40 mgWater pill
    Metoprolol succinate 25 mgSteadies heart rate
    Potassium chloride 20 mEqWith breakfast

  2. Noon12:00

    No medicines

  3. Evening18:00

    Lisinopril 5 mgSkip if dizzy

  4. Bedtime22:00

    Atorvastatin 40 mgCholesterol

Sample data.

06

Key decisions

Two calls that shaped it

Showing sources

The source is one tap away

Clinicians like both versions side by side. For a family that doubles the reading, so the original opens only when you tap, or when something’s flagged.

Most people will never check, so the checks can’t depend on them.

Thresholds

Words instead of a score

“0.63” means nothing at a kitchen table. “Check this one” and “this isn’t in your note” do.

The cut-offs (0.30 and 0.20) are my guesses until they’re tuned on real notes.

More detail: translation and the pill schedule

I translate the plain version, not the clinical one. Short, clear English translates better, and the same checks run on what comes out. The downside is that a mistake in the English ends up in every language, so those checks have to be strict.

The schedule comes straight from the note. Drug names and doses get picked out and matched exactly, so it can’t invent a pill. Odd instructions like “every other day” fall back to “ask your nurse”.

07

Testing

How we’d test it

I’d start by interviewing five or six adult children who’ve been through a parent’s discharge, ideally from bilingual families.

Then the teach-back test: people read either the original note or Plainly, explain the plan back, and I count the key actions they get right. Nurses and pharmacists would rate a batch of outputs to help set the safety thresholds.