How do patients describe their disabilities? A coding system for categorizing patients' descriptions

Morris, Megan A.; Inselman, Jonathan; Rogers, Julie M.; Halverson, Colin; Branda, Megan E.; Griffin, Joan M.

doi:10.1016/j.dhjo.2017.10.006

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…For example, Health Center staff reported that some patients interpreted the question about accommodation for a mobility limitation as an inquiry about transportation needs. This confusion concurs with prior health setting research examining how patients respond to questions about disability and how they speak about their health conditions and limitations [ 28 , 40 , 41 ]. Answers to, “do you have a disability?” are different from answers to questions asking about limitations in function [ 41 ].…”

Section: Discussionsupporting

confidence: 79%

“…With the disability question, patients express confusion over whether their diagnosed condition is a disability or whether their limitation is severe enough to qualify as a disability [ 40 ]. If asked in an open-ended fashion about the nature of the disability the answer is sometimes a diagnosis (e.g., Parkinson’s disease) and sometimes a functional statement (e.g., balance problems) [ 28 ]. These differences not only highlight the importance of wording, but also the distinction between health condition or diagnosis and functional limitation.…”

Section: Discussionmentioning

confidence: 99%

“…Among potential problems are concerns that the patient portal software will not be easy to use and accessible, especially for patients with visual or intellectual impairments, and that the EHR architecture might not be able to capture the complexities and interacting factors of health care problems [ 13 , 27 ]. Few studies have actually observed the daily workflow of a medical practice to understand the use of the EHR with patients in general, or with patients with disabilities [ 13 , 18 , 19 , 24 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Can disability accommodation needs stored in electronic health records help providers prepare for patient visits? A qualitative study

Mudrick

Breslin

Nielsen

et al. 2020

BMC Health Serv Res

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Background Embedding patient accommodation need in the electronic health record (EHR) has been proposed as one means to improve health care delivery to patients with disabilities. Accommodation need is not a standard field in commercial EHR software. However, some medical practices ask about accommodation need and store it in the EHR. Little is known about how the information is used, or barriers to its use. This exploratory-descriptive study examines whether and how information about patients’ disability-related accommodation needs stored in patient records is used in a primary health care center to plan for care. Methods Four focus groups (n = 35) were conducted with staff of a Federally Qualified Health Center that asks four accommodation questions at intake for the EHR. Respondents were asked how they learned about patient accommodation need, whether and how they used the information in the EHR, barriers to its use, and recommendations for where accommodation information should reside. A brief semi-structured interview was conducted with patients who had indicated an accommodation need (n = 12) to learn their experience at their most recent appointment. The qualitative data were coded using structural coding and themes extracted. Results Five themes were identified from the focus groups: (1) staff often do not know accommodation needs before the patient’s arrival; (2) electronic patient information systems offer helpful information, but their structure creates challenges and information gaps; (3) accommodations for a patient’s disability occur, but are developed at the time of visit; (4) provider knowledge of a regular patient is often the basis for accommodation preparation; and (5) staff recognize benefits to advance knowledge of accommodation needs and are supportive of methods to enable it. Most patients did not recall indicating accommodation need on the intake form. However, they expected to be accommodated based upon the medical practice’s knowledge of them. Conclusions Patient accommodation information in the EHR can be useful for visit planning. However, the structure must enable transfer of information between scheduling and direct care and be updatable as needs change. Flexibility to record a variety of needs, visibility to differentiate accommodation need from other alerts, and staff education about needs were recommended.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can disability accommodation needs stored in electronic health records help providers prepare for patient visits? A qualitative study

Mudrick

Breslin

Nielsen

et al. 2020

BMC Health Serv Res

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“…Early in my research career, I became interested in determining a manner in which to identify persons with communication disabilities in the electronic health record (EHR), with the goal of tracking the quality of care delivered to the population at an organization level. I quickly realized there was not a straightforward manner to identify patients with communication disabilities in the EHR, and so proceeded to embark on a series of studies aimed at addressing the gap ( Morris & Hasnain-Wynia, 2014 ; Morris & Kho, 2014 ; Morris, Lagu, et al, 2017 ; Morris, Schliep, et al, 2017 ; Morris et al, 2018 , 2019 ). After several years, I began receiving phone calls from individuals working within health care organizations who were interested in documenting patients' disability status in the EHR.…”

Section: Health and Health Care Disparities Experienced By Persons Wi...mentioning

confidence: 99%

Striving Toward Equity in Health Care for People With Communication Disabilities

Morris

2022

J Speech Lang Hear Res

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Purpose: Approximately 10% of the U.S. adult population has a speech, language, and/or voice disability, collectively referred to as communication disabilities. An increasing number of studies demonstrate that persons with communication disabilities have worse health and health care outcomes as compared to those without communication disabilities. Understanding the state of the science, including potential contributing factors is critical to begin to address the disparities. Method: Applying a historical lens and integrating multiple models of disability provide a comprehensive perspective of the health and health care outcomes of persons with communication disabilities. Results: Three phases for addressing health care disparities exist: detecting, understanding, and reducing. Results from a 2012 National Health Interview Survey provide compelling population-level results of the health and health care disparities experienced by persons with communication disabilities. To understand the disparities, factors within the health care system, such as availability of communication aids and services, as well as provider and staff biases, assumptions, and lack of knowledge need to be considered. To date, few interventions exist to address disparities in care for persons with communication disabilities. Consequently, researchers need to engage with stakeholders in innovative study designs and methods to facilitate the rapid development, implementation, and dissemination of interventions that address the disparities. Conclusion: To ensure equity for the large and growing population of persons with communication disabilities, researchers, policy makers, patients, and health care systems need to collaborate in identifying and addressing the factors contributing to health and health care disparities.

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Routine identification of patients with disabilities in primary care: A mixed-methods study

Pinto

Shenfeld

Lattanzio

et al. 2020

Disability and Health Journal

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How do patients describe their disabilities? A coding system for categorizing patients' descriptions

Cited by 3 publications

References 10 publications

Can disability accommodation needs stored in electronic health records help providers prepare for patient visits? A qualitative study

Can disability accommodation needs stored in electronic health records help providers prepare for patient visits? A qualitative study

Striving Toward Equity in Health Care for People With Communication Disabilities

Routine identification of patients with disabilities in primary care: A mixed-methods study

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