WCAG Aligned Framework for Inclusive Online Patient Intake

Presenter Information

Asal Hamidi, Hasan Mollaee, College of Osteopathic Medicine,Β Duquesne UniversityΒ 

Abstract

Purpose: The digital intake forms are rapidly dominating the collection of high-value clinical and administrative information and informed consent, but frequent inaccessibility failures in semantics, keyboard/focus behavior, and error recovery may contribute to heightened abandonment and disparities. This paper plans and assesses an implementation action logic that aids in assembling the accessibility needs into reusable modules and verifiable interaction and content guidelines, and quantifies the normative compliance as well as the operational inclusivity under non-homogeneous user conditions. Methods: Using a design-science approach, we operationalized a requirements-to-component mapping and a rule set spanning the POUR principles, and compared two interfaces with identical clinical content and workflow: a conventional baseline intake (𝐡0) and a framework-aligned intake (𝐹1). WCAG conformance was scored over a tailored criterion set (n=21; Σ𝑀 = 51.0) using weighted graded criterion values. Operational inclusivity was evaluated via scenario-driven Monte Carlo simulation across 10 simulated user scenarios (S1–S10) parameterized by assistive technology, functional capabilities, and contextual constraints. Outcomes included task success, completion time, error burden, and recovery penalty; composite indices 𝑆!"#$, 𝑆%&", and a joint index were computed under both uniform and equity-weighted scenario prevalence. Results: 𝐹1 substantially reduced accessibility debt and improved completion performance. Overall conformance increased from 𝑆!"#$ = 0.686 (𝐡0) to 0.968 (𝐹1) (+41.2%), with Pass/Partial/Fail shifting from 1/4/16 to 19/2/0 and the severity-weighted gap shrinking from 16.025 to 1.625. Gains were consistent across POUR, with the largest relative improvement for Understandable. Across scenarios, completion time decreased by 14.7%–22.3% and error burden decreased by 37.0%–40.1%, with an overall task-success gain of +1.89 percentage points and the largest uplift in the cognitive impairment scenario (+12.57 pp). Module-level outcomes reached Εͺ=1.000 in all modules under F1 and reduced recovery time by 50.0%–62.5%. Composite scoring confirmed robustness: 𝑆%&" improved from 0.700 to 0.930 (uniform) and 0.686 to 0.920 (equity), while distance-to-ideal in the 𝑆!"#$, 𝑆%&" plane decreased by 82.2% (uniform) and 80.7% (equity). 𝐹1 remained superior across policy-relevant Ξ± values. Significance: The results suggest that converting WCAG requirements into enforceable component behavioral and interaction/content rules can provide near-Pareto improvements, both in formal accessibility conformance and in saving time/error overhead in the completion process. The suggested framework and scenario-based assessment offer a reliable decision-making process for designing and verifying inclusive, safety-relevant patient intake systems.

School

Nasuti College of Osteopathic Medicine

Submission Type

Paper

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Asal Hamidi-permission form.pdf (184 kB)

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