To gather comprehensive insights and users’ requirements for the system, a series of interviews and focus group sessions were conducted with stakeholders. The interview phase involved engaging with a diverse group of participants, including 3 academic advisors, 3 administrative staff working on student affairs related to health and academic performance, 2 physicians/health counselors, 3 health professionals, and 4 teaching faculty members. The participants’ experience ranged from 6 to 13 years. These stakeholders were chosen based on their expertise and previous involvement in activities and cases related to students’ health information. In the methodological design of this study, we considered content saturation to be achieved within the 15-participant sample, as no additional unique insights were observed beyond this point. Consistent with findings from the usability testing literature, studies such as that by Faulkner [14] have shown that increasing the sample size from 5 to 10 participants can capture up to 95% of usability issues, thus providing a robust basis for our sample size decision and ensuring comprehensive data collection for system evaluation.

Additionally, 2 focus groups were conducted with 10 students. All students were undergraduates, and their age ranged from 19 to 24 years. The aim of these focus groups was to understand students’ perspectives and needs.

Before the interviews, participants were given introductory information about the research project. Participation was voluntary, and they were allowed to skip questions, withdraw, or end the interview at any time without any conditions. No compensation was offered for participation. Prior to initiating the interview, participants were briefed on the study’s scope and provided their informed consent. The interviews were unstructured, and probing questions were introduced as needed (Multimedia Appendix 1). The main areas covered during the interviews are described in the following sections.

Following the data collection phase, thematic analysis was conducted to identify patterns, common themes, and user requirements [15]. This analysis informed the design phase, where a conceptual design of the workflow was developed. The design process involved translating the gathered requirements into system functionalities and a workflow. In addition, an artifact analysis was conducted to examine existing forms, templates, and guidelines related to the workflow. This analysis involved systematically reviewing and coding these documents to identify recurring themes, inefficiencies, and opportunities for improvement. The artifacts were evaluated based on criteria such as clarity, efficiency, and alignment with the workflow.

To establish a holistic approach, the design phase was informed by the systems model of Bowman and Marzouk [16] for implementing the ADA in higher education. Their model, based on general systems theory, encompasses a comprehensive structure with input, throughput, and output subsystems. By adopting this systems model, the workflow design addressed core components such as accessibility, learning resources, and quality control.

To enhance the design methodology, insights were incorporated from previous studies to provide a broader understanding of user requirements and system functionalities. Fichten et al [8] contributed valuable information on variables related to how well the ICT needs of students with different disabilities are being met at institutions of higher education, at home, and in e-learning contexts. Their work also explored the disciplines and programs pursued by students with varying disabilities and the specialized ICTs used. Stein et al [10] provided a knowledge-based system design to assist university administrators in meeting the requirements of disability-related legislation. This ensured that the proposed system was comprehensive and aligned with compliance standards. Finally, Sharby and Roush [9] delivered an analytical decision-making model for addressing the specific needs of allied health students with disabilities, offering accommodations that are both practical and inclusive.

Once the conceptual design was drafted, participants were presented with the proposed design and concept. Their feedback and suggestions were collected to ensure their perspectives were considered in the development process. An iterative and agile approach was adopted to incorporate the feedback received from participants.

The study was approved by the ethical review committee at Jazan University (REC-45/11/1100). Participation for both staff and students was entirely voluntary, and no compensation was provided to participants. Participants were allowed to withdraw at any time without any conditions. Informed consent was obtained and all data collected were anonymized to ensure the privacy and confidentiality of participant information.

Based on our analysis, we have identified several systemic challenges and shortcomings in the existing system, which are summarized in the following sections.

Our results identified several requirements that need to be taken into consideration for integrating health-related information into the student information system. We categorized these needs into the following 4 categories: privacy and confidentiality, timely communication, workload and automation, and disability resources.

Based on the interviews, it is evident that the design of student information systems needs to consider various aspects of students’ health. In this study, we categorized the types of information required into 3 categories, which we describe in the following sections.

To design the workflow, we separated the process into two different processes: (1) a health and disability system and (2) quality of life (QoL) and wellness measures (Table 1).

Information related to disability and special needs are entered by students for health center review and approval (Figure 2). The university health center approves and enters the students’ health-related information. Based on the type of disability selected, the system suggests a classroom or laboratory based on the availability of necessary accommodations that the student may need, including academic, technological, or administrative needs. The advising unit receives notification of registrations that have a mismatch between disabilities and resources for further attention. If needed, the student advising unit identifies the necessary accommodation that a student may need and sends messages to communicate with the registration office, administration, and teaching faculties.

The university administration selects the health measures they are interested in and specifies the frequency of measurement (Figure 3). Students receive the invitation and complete their responses. The university administration uses the dashboard to view the results, including summary information and a data overview. Responses with low scores that needs attention are identified by the system, triggering a notification that is sent to the advising unit for attention. The advising unit reviews the triggered student response and takes the necessary action.

In this study, we investigated the current status of integrating health and disability information within university systems, identified the existing gaps, and provided design considerations. Using a user-centered design approach, we assessed the impact of these design considerations on students’ success and inclusion. Our findings revealed several challenges. These challenges include privacy concerns, underidentification of stress, anxiety, and depression, and reluctance among students with hidden disabilities to disclose their conditions due to fear of stigma and discrimination. Our user-centered design approach addressed these issues by emphasizing the role of advising units in maintaining privacy and facilitating support. Additionally, the design focused on resource allocation to meet the diverse needs of students with various disabilities, ensuring accessibility and adaptive learning support. By incorporating health and disability information into university systems, the proposed design aims to enhance inclusivity, improve resource allocation, and promote better academic outcomes for all students. In the subsequent sections we discuss these findings and provide recommendations for future work.

Incorporating health and disability information is crucial for promoting students’ academic success. However, effectively integrating this information into existing systems remains challenging. To address this challenge, there is a need to incorporate the use of health and disability information into the academic process and daily activities. The appropriate inclusion and use of health and disability information within university information systems offers a promising approach to integrate these data into daily tasks and processes, leading to enhanced effectiveness and improved outcomes. In our study, we adopted a user-centered approach to design the integration of health and disability information into university information systems. This approach prioritizes the needs and perspectives of users, ensuring that the system is tailored to their requirements and preferences. By considering the user experience and incorporating user feedback throughout the design process, we designed a system process that effectively incorporates health and disability information, ultimately enhancing its usability and impact on student success.

Our study uncovered many challenges in the existing system. Among these challenges was the privacy and confidentiality of students’ health information. While obtaining knowledge about students’ health events is essential for providing adequate support and accommodation, some students were reluctant to share their health information due to concerns about privacy breaches, stigma, or fear of discrimination.

Another significant challenge was the underidentification and underdisclosure of psychological conditions such as stress, anxiety, and depression among students. Many students perceive stress and anxiety as a normal part of the academic journey and may not seek professional help to differentiate between healthy stress and unhealthy stress. The systematic collection of stress, anxiety, and depression data via validated measures offers great potential for timely interventions and support. Furthermore, students with hidden disabilities often encounter barriers that hinder their university experiences [18]. Due to a desire to avoid the label of “disability,” many students with invisible disabilities choose not to access the supports they are entitled to, which can hinder their academic success [18,19].

To address these challenges, the proposed design emphasizes the role of student advising units in facilitating support while maintaining students’ privacy. Advising units can play a crucial role in creating a safe and supportive environment where students feel comfortable sharing their health information and accessing the necessary support services [20,21]. By establishing trust and providing guidance, advising units can help students navigate the system while respecting their privacy needs.

One of the key use cases found during interviews was the allocation of resources to meet the diverse requirements of students with disabilities. It was evident that different types of disabilities present unique needs and challenges. For instance, students with hearing or vision impairments may require special technological resources to facilitate their learning experience [22,23]. On the other hand, students with physical disabilities require accessibility measures, such as wheelchair access, that should be available in various locations across the campus.

Furthermore, the interviewees emphasized the importance of addressing the adaptive learning needs of students. This includes considering students with conditions such as cognitive disabilities and other health conditions that may impact their attendance [21]. While the specific needs may vary in each case, being aware of these needs is crucial for effective preparation and support.

By incorporating health and disability information into the university information system, administrators and faculty members can gain a comprehensive understanding of the diverse requirements of students. This knowledge enables them to allocate resources more effectively and provide appropriate support, ultimately promoting inclusive education and enhancing student success [20,21].

In order to ensure comprehensive inclusion and accessibility, it is crucial for accreditation bodies and policy frameworks to address the needs of individuals with disabilities. While physical accommodations such as wheelchair access, left-handed writing tables, and disability-friendly bathrooms are typically addressed in these standards, there appears to be a significant gap in incorporating disability-related information into IT standards and guidelines. Despite the growing reliance on IT in various domains, there is a lack of explicit guidance on how to handle disability-related information and promote its integration into IT systems. This oversight is concerning given the potential of IT to enhance accessibility and empower individuals with disabilities. By failing to address the inclusion of disability-related information, accreditation bodies and policy frameworks miss an opportunity to ensure equal access and participation for all.

While the current academic accreditation includes requirements related to students’ disabilities in the physical environment, such as wheelchair access, it does not address requirements related to student information systems [24]. To address this gap, it is essential for accreditation bodies and policy guidelines to recognize the importance of incorporating disability-related information into IT standards. This could involve establishing guidelines for designing accessible user interfaces, ensuring compatibility with assistive technologies, and promoting the provision of alternative formats for individuals with sensory impairments. Additionally, the safe handling and protection of disability-related data should be emphasized to safeguard the privacy and confidentiality of individuals with disabilities.

By actively addressing the inclusion of disability-related information within IT standards, accreditation bodies and policy frameworks can contribute to a more inclusive and accessible society. This proactive approach will enhance the usability and effectiveness of IT systems, promoting equal opportunities and empowering individuals with disabilities to fully participate in various aspects of life.

The proposed design offers potential solutions to address the issue of late discovery of health-related cases through systematic data collection and communication with student health clinics. However, challenges persist due to students’ reluctance to disclose their health information out of concerns related to privacy breaches, stigma, and fear of discrimination.

The potential side effects of health information disclosure are a crucial area that requires careful attention. The threat of privacy breaches, stigma, and discrimination needs to be carefully assessed, and risk management strategies should be established to ensure the protection of students’ privacy and prevent any negative consequences.

Although the design process described here incorporated user input, our study was limited to a relatively small sample size. For future work, we recommend prototype usability testing and evaluation of the redesigned model with a larger and more diverse group of users. This would provide a broader range of perspectives, facilitating further evaluation and improvements to the design. In addition, interpretation of our findings should be approached with caution, as the homogeneity of the participant pool, all drawn from a single institution, may limit the generalizability of our results

Future studies should also explore strategies to address privacy concerns, enhance security measures, and develop clear communication strategies to alleviate students’ fears regarding the disclosure of their health information. Additionally, assessing the impact of the proposed design on student outcomes, such as academic performance and well-being, would provide valuable insights into its effectiveness and usefulness.

In conclusion, our study has identified several shortcomings in the current process of handling health and disability data. Based on our findings, we recommend implementing a new, redesigned process that addresses these issues. Effective coordination among stakeholders is crucial for the success of this process, and redesigning the university information system is essential for organizing and streamlining the workflow.

While implementing these changes will require significant resources and commitment, we strongly advocate for increased standardization and regulation to support information system requirements related to health and disability. By adopting standardized practices and regulations, we can ensure that the necessary information system is in place to effectively support these needs.