Section 508 of The Rehabilitation Act compels federal government agencies to make all of its electronic information and technology fully usable by people with various disabilities. This means that websites, software, webinars and PDF user guides, to name a few examples, have to meet specific accessibility requirements to comply with the law. The revised Section 508, which came into full force on January 18, refers to the Web Content Accessibility Guidelines (WCAG) 2.0, Level AA.)
Does a healthcare provider need to know – or care – about Section 508? After all, hospitals, clinics and most other healthcare institutions are not considered government departments – unless you’re talking about, say, federal health agencies like the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health.
But that doesn’t let healthcare off the hook. Although Section 508 as it’s written does not apply to the private sector, nor does it apply to recipients of federal funds, some funding agreements have nevertheless incorporated the requirements of Section 508 as a condition of receiving funds.
For example, Medicare and Medicaid rules state that healthcare institutions receiving reimbursements through these programs must make program information “readily accessible” to the public. In the most recent update, readily accessible information is defined as “electronic information and services which comply with modern accessibility standards such as section 508 guidelines, section 504 of the Rehabilitation Act, and W3C’s Web Content Accessibility Guidelines (WCAG) 2.0 AA and successor versions.” 1
Other Accessibility Laws That Affect Healthcare
There are at least two more reasons healthcare institutions should care about their digital accessibility: They’re known as Section 1557 and the ADA. Just like Section 508, these are both laws meant to protect people from discrimination.
Section 1557 of the Affordable Care Act obliges health agencies to ensure that whenever information technology is used to deliver services, programs or activities, that technology is accessible to people who have disabilities.
Title III of the Americans with Disabilities Act (ADA) states that public accommodations (such as healthcare providers) must not discriminate against people with disabilities when communicating with them or otherwise serving them.
Members of the public with disabilities – whether they’re your patients, prospective patients, family members or friends of patients, or professionals such as advocates or medical personnel who happen to have disabilities themselves – must have fair and equal access to your website and other digital services, just like everyone else.
The Real Reasons – There are Millions of Them
Those are compelling reasons from a legal standpoint – because, of course, no health provider wants to risk financial penalties, loss of government funding, or a class-action lawsuit.
Digital accessibility also makes sense from a business perspective, since leaving barriers in place can mean losing patients to a more accommodating practice. There are about 62 million Americans of all ages who have disabilities. On average, they tend to use more healthcare services than the rest of the population. In fact, people with disabilities represent more than a quarter (26.7%) of all health care spending in the U.S. even though they’re one-fifth of the population.2 Currently, that amounts to more than $881 billion!3
Perhaps what’s most compelling, however, are the needs of the patients themselves. As we’ve mentioned above, people with disabilities usually have higher healthcare needs than the average person. Not only do they require the usual medical check-ups, vaccinations and screening tests, they might also require specialist care to help manage their condition, or treatment for disability-related complications. And yet having a disability actually lowers your likelihood that all your healthcare needs are met.
There are a few reasons for this. A CDC survey, for instance, found that working-age people with disabilities were much less likely than those without disabilities to seek health care when they need it. Among uninsured adults, this was linked – as you might expect – to the cost of medical care. What may surprise you is that even among insured Americans, there was a striking difference. If these individuals had a disability, they were about 2.5 times more likely to put off health care – or skip it altogether.4 Although cost in these cases would not have been an issue, there were still multiple barriers obstructing their access to the health care they needed.
Healthcare Barriers Are Often Online
What do people typically do when they’re looking for information about a healthcare provider or a health service in their area? They go online. A health organization’s website is often its first chance to make a positive impression on new and prospective patients. But if that website is not accessible, it’s like having a front reception desk that’s kept empty. There’s no welcoming smile. It’s impossible for a visitor to get any information or book an appointment. There isn’t even anyone there to watch the visitor turn around and leave.
People who are blind, for example, often use screen readers to go online. A screen reader is a type of assistive technology that reads aloud any text it finds on a web page; thus, it enables someone who can’t see to know what’s written on the page. If your website includes a large graphic with the words “Click Here to Book Your First Visit” – but is missing a text equivalent to this graphic, because the website hasn’t been made accessible – then the screen reader will not identify it as text. The person checking out your website won’t have a means of arranging that first appointment online. In fact, they may not even realize there’s an appointment portal on the page.
Consider the other resources you offer on your website. Do you have an online symptom checker? If this tool requires people to click a body part with a mouse, without a way to accomplish the same thing with a keyboard, then someone with an urgent medical question who doesn’t have the hand dexterity to click a mouse will be prevented from using this tool and getting health information.
Do you have other features in development to increase your range of services? Will you provide a doctor-on-demand app, or video-based doctor’s visits? Do you have a mobile-friendly site? All of these digital properties should follow the accessibility requirements outlined in WCAG 2.0. If they don’t, people with disabilities will be shut out yet again.
You may be starting to understand why people with disabilities often have many more hurdles than other people just to obtain basic healthcare. And why they’re four times more likely to rate their own health as “fair” or “poor” compared to those who don’t have disabilities, according to the National Center for Health Statistics.5
How are the Biggest Healthcare Providers Doing?
Not long ago, we used an automated testing tool to check the accessibility of 10 major healthcare websites. We selected the top five for-profit and top five non-profit healthcare providers in the nation. These organizations operate hundreds of institutions across the U.S. and, in 2015, collectively pulled in more than 161 billion dollars in net-patient revenue.
These are organizations with big, big budgets – and yet the accessibility of their respective websites was a big, big disappointment.
In our analysis, we found that every one of these 10 websites failed to comply with WCAG 2.0, Level AA (which is the level that is usually referenced by legislation, including, as we noted above, the revised Section 508). On average, there were 28 problems meeting Level AA success criteria and 13 problems at Level A.
This means that all 10 of these healthcare institutions are failing to comply with the law, and failing patients with disabilities.
Would Your Website Pass The Test?
Perhaps you’re now wondering how your own digital properties would perform if tested for accessibility. An expert consulting firm not only can answer this question, it can provide you with a wide-ranging solution that will enhance the accessibility of your digital services, increase your engagement with people with disabilities, and apply regular monitoring to ensure that you always stay in compliance with your legal obligations.
Best of all, you’ll know that you are making a direct difference to the health and well-being of a population in need – which, of course, is the primary mandate of all healthcare providers, no matter who they are.
An Innovative Solution
eSSENTIAL ACCESSIBILITY has developed a comprehensive accessibility solution to help organizations follow the Web Content Accessibility Guidelines (WCAG) and achieve and maintain compliance with standards and regulations. This includes integrating web compliance evaluation and remediation services with assistive technology to deliver a transformative experience for people with disabilities. Learn more about eSSENTIAL ACCESSIBILITY’s innovative solution.
- Federal Register Department of Health and Human Services, 2016
- Healthcare Data Costs CDC, 2017
- National Health Expenditure Data CMS.GOV, 2018
- Morbidity and Mortality Weekly Report CDC, 2010
- Persons with Disabilities as an Unrecognized Health Disparity Population American Journal of Pubic Health, 2015