Rowe Joanne, Devine Alexandra, Merrick Nicole, Huska Marie, Morris Kristen, Feely Kath, Segal Ahuva, Mogg Louise, Medland Jenni, Jamwal Rebecca, Smith Alison, Gleich Maricar, Munakabayo Jeremiah, Imms Christine
The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, Australia.
BMC Health Serv Res. 2025 Jul 1;25(1):833. doi: 10.1186/s12913-025-12974-5.
A third of the 5.5 million Australians with a disability require adjustments to access healthcare effectively. Ensuring clinicians have timely information about a patient’s disability and care needs can support more responsive care. Disability Identifiers—brief question sets—offer a practical way to capture this information. However, their use in healthcare remains limited. To address this, a group of clinicians, consumers and researchers from five tertiary and quaternary health services in Victoria, Australia, co-designed and implemented a patient self-report Disability Identifier within Electronic Medical Record systems. This paper presents an evaluation of the acceptability of this intervention among patients, carers, and clinicians.
The Disability Identifier questions were integrated into Electronic Medical Record systems across the five health services in March 2023, with the evaluation period spanning the first nine months of implementation (1st March–30th November 2023). Using a mixed methods convergent parallel design and guided by the Theoretical Framework of Acceptability, we conducted online surveys, interviews, and focus groups with patients, carers, and clinicians. Data analysis explored perspectives and experiences across eight constructs: general acceptability, affective attitude, burden, ethicality, intervention coherence, opportunity costs, self-efficacy, and perceived effectiveness.
Survey results indicated strong acceptability of the Disability Identifier questions. Interviews with patients and carers reflected generally positive perceptions of the intervention, with many noting that it signalled a commitment by health services to improve care for people with disability. Clinicians emphasised that, with adequate training and resources, this intervention could raise awareness about disability and contribute towards disability-responsive care.
Integrating patient self-reported Disability Identifiers into EMR systems marks a critical step toward improving disability-responsive healthcare. Building trust in Disability Identifiers requires clear communication about their purpose, benefits, and role in improving care while also addressing disability awareness and discrimination in healthcare settings. While continuous evaluation of their use and impact on patient experiences and outcomes is recommended, this research lays the foundation for other jurisdictions to adopt a standardized approach to integrating Disability Identifiers into health data systems. Ultimately, effective use of patient self-report Disability Identifiers has the potential to promote more equitable health outcomes for people with disability.
The online version contains supplementary material available at 10.1186/s12913-025-12974-5.
在550万澳大利亚残疾人中，三分之一的人需要进行调整以便有效地获得医疗保健服务。确保临床医生及时了解患者的残疾情况和护理需求有助于提供更具响应性的护理。残疾标识符——简短的问题集——提供了一种获取此类信息的实用方法。然而，它们在医疗保健中的应用仍然有限。为解决这一问题，来自澳大利亚维多利亚州五家三级和四级医疗服务机构的一组临床医生、消费者和研究人员共同设计并在电子病历系统中实施了患者自我报告的残疾标识符。本文对该干预措施在患者、护理人员和临床医生中的可接受性进行了评估。
残疾标识符问题于2023年3月整合到五家医疗服务机构的电子病历系统中，评估期涵盖实施的前九个月（2023年3月1日至11月30日）。采用混合方法收敛平行设计，并以可接受性理论框架为指导，我们对患者、护理人员和临床医生进行了在线调查、访谈和焦点小组讨论。数据分析探讨了八个方面的观点和经验：总体可接受性、情感态度、负担、道德性、干预连贯性、机会成本、自我效能感和感知有效性。
调查结果表明残疾标识符问题具有很高的可接受性。对患者和护理人员的访谈反映出对该干预措施总体上持积极看法，许多人指出这表明医疗服务机构致力于改善对残疾人的护理。临床医生强调，通过充分的培训和资源，该干预措施可以提高对残疾的认识，并有助于提供适应残疾情况的护理。
将患者自我报告的残疾标识符整合到电子病历系统中是朝着改善适应残疾情况的医疗保健迈出的关键一步。要建立对残疾标识符的信任，需要明确传达其目的、益处以及在改善护理方面的作用，同时还要解决医疗保健环境中的残疾意识和歧视问题。虽然建议持续评估其使用情况及其对患者体验和结果的影响，但本研究为其他司法管辖区采用标准化方法将残疾标识符整合到健康数据系统奠定了基础。最终，有效使用患者自我报告的残疾标识符有可能为残疾人促进更公平的健康结果。
在线版本包含可在10.1186/s12913-025-12974-5获取的补充材料。
