Introduction: This project implemented an integrated patient self-reported screening tool in a patient portal and assessed clinical workflow and user experience in primary care practices.Methods: An electronic health risk assessment based on the CMS Annual Wellness Visit (AWV) was developed to integrate self-reported health information into the patient’s electronic health record (EHR). Patients enrolled in care coordination tested the implementation. The evaluation plan included quantitative and qualitative measures of patient adoption, provider adoption, workflow impact, financial impact, and technology impact.Findings: Seventy-two patients completed the sample AWV, and 80% of the questionnaires had clinical findings that required provider follow-up. Patients expressed satisfaction with the portal, as it enabled them to view their health record and enter information. Implementation did not reduce office staff time. Providers and office staff agreed that an electronic system for adding information to their record would increase patient satisfaction, but they expressed concern with the need to promptly review the information and the time involved to accomplish this prior to an office visit.Discussion: Despite satisfaction among patients, portal adoption is still low, due totechnological limitations and to the lack of adaptability to primary care practice workflow. Notwithstanding those barriers, the use of the portal for completion of repetitive tasks, such as screening tools, should be encouraged.Conclusions: Patients can effectively use portals to complete the patient reported section of the CMS AWV. However, if the information is not completed during the same day of the office visit, the time required to address health findings outside of a regular office visit is uncompensated, and diminished the enthusiasm for this process among primary care practice staff.

Graphical representations are ubiquitous in the learning and teaching of science, technology, engineering, and mathematics (STEM). However, these materials are often not accessible to the over 547,000 students in the United States with blindness and significant visual impairment, creating barriers to pursuing STEM educational and career pathways. Furthermore, even when such materials are made available to visually impaired students, access is likely through literalized modes (e.g., braille, verbal description), which is problematic as these approaches (1) do not directly convey spatial information and (2) are different from the graphic-based materials used by students without visual impairment. The purpose of this study was to design and evaluate a universally accessible system for communicating graphical representations in STEM classes. By combining a multisensory vibro-audio interface and an app running on consumer mobile hardware, the system is meant to work equally well for all students, irrespective of their visual status. We report the design of the experimental system and the results of an experiment where we compared learning performance with the system to traditional (visual or tactile) diagrams for sighted participants (n = 20) and visually impaired participants (n = 9) respectively. While the experimental multimodal diagrammatic system (MDS) did result in significant learning gains for both groups of participants, the results also revealed no statistically significant differences in the capacity for learning from graphical information across both comparison groups. Likewise, there were no statistically significant differences in the capacity for learning from graphical information between the stimuli presented through the experimental system and the traditional (visual or tactile) diagram control conditions, across either participant group. These findings suggest that both groups were able to learn graphical information from the experimental system as well as traditional diagram presentation materials. This learning modality was supported without the need for conversion of the diagrams to make them accessible for participants who required tactile materials. The system also provided additional multisensory information for sighted participants to interpret and answer questions about the diagrams. Findings are interpreted in terms of new universal design principles for producing multisensory graphical representations that would be accessible to all learners.

The lack of accessible information conveyed by descriptions of art images presents significant barriers for people with blindness and low vision (BLV) to engage with visual artwork. Most museums are not able to easily provide accessible image descriptions for BLV visitors to build a mental representation of artwork due to vastness of collections, limitations of curator training, and current measures for what constitutes effective automated captions. This paper reports on the results of two studies investigating the types of information that should be included to provide high-quality accessible artwork descriptions based on input from BLV description evaluators. We report on: (1) a qualitative study asking BLV participants for their preferences for layered description characteristics; and (2) an evaluation of several current models for image captioning as applied to an artwork image dataset. We then provide recommendations for researchers working on accessible image captioning and museum engagement applications through a focus on spatial information access strategies.