The rapid expansion of telemedicine across healthcare systems has improved service delivery, yet accessibility needs for elderly users and individuals with disabilities are still insufficiently addressed in interface design. This study examines how universal design principles can be integrated into telehealth systems, with emphasis on accessible video consultations, effective assistive technology support, and reduction of cognitive complexity for aging populations. A mixed-method research approach was adopted, including heuristic assessments of eight widely used telemedicine platforms using WCAG 2.1 AA standards, expert interviews with accessibility specialists, and usability simulations involving participants with diverse sensory, motor, and cognitive limitations. To systematically measure accessibility, this research introduces the Telehealth Accessibility Conformance Score (TACS), which evaluates platforms across five dimensions: perceivability, operability, assistive technology compatibility, cognitive simplicity, and error recovery. Results indicate that current platforms achieved an average TACS of 51.3 out of 100, with the weakest performance observed in assistive technology integration. Common usability gaps include inconsistent screen reader navigation during live consultations and limited adaptive interaction mechanisms for users with mobility constraints. The study proposes the Inclusive Telemedicine Interface Design (ITID) framework, consisting of eighteen structured guidelines spanning perceptual adaptation, flexible interaction methods, cognitive support mechanisms, and compliance considerations. Prototype validation demonstrated a 34.2-point improvement in accessibility performance compared to baseline systems. These outcomes provide actionable guidance for healthcare technology developers, clinical organizations, and policymakers working to enhance inclusive digital health services.
Agarwal et al. (Thu,) studied this question.