In healthcare, just as in life, great digitization comes with great responsibility. With more technologies getting involved in delivering and accessing healthcare, the questions of digital accessibility and digital equality become vital. This is especially relevant in the world that’s still suffering from the pandemic, which requires patients to stay home and avoid medical facilities unless they really need them.
In this article, we’ll go through what digital accessibility and digital inequality in healthcare mean and how they can be improved.
What is digital accessibility?
Digital accessibility refers to making healthcare websites and mHealth apps easily usable for people with disabilities. Websites, mHealth apps, and documents must be programmed in a way that removes every possible barrier that might interfere with the user experience of a person with a disability.
Why is this important?
Currently, around 15% of the world’s population lives with a disability.
Studies reveal that they are less likely to receive preventative medical services and are less satisfied with medical care. A lot of this has to do with people’s inability to use digital services as a result of their specific health issues. This includes but is not limited to problems such as blindness and low vision, hearing and speech impairments, motor and mobility disabilities, and learning and cognitive disabilities. Often, digital services are also not accessible for people with temporary disabilities, such as a broken arm or cataract surgery. These people make up an even bigger percentage of the population and they need regular health care just like anyone else.
For hospitals, the lack of digital services for people with disabilities may result in a number of problems, such as lawsuits from legal firms and advocacy groups, penalties for ADA (Americans with Disabilities Act) violations, loss of government funding, as well as damage to the hospital’s reputation and decrease in patient’s flow.
How can healthcare providers make services more accessible?
It’s one thing to state a broad problem ― and a rather obvious one at that. It’s another to take it apart and see what can be fixed. Here is how websites can ensure digital accessibility.
Keep in mind governmental standards
Healthcare website providers often ignore even the basic rules, such as being compliant with standards (e.g., Affordable Care Act and the Americans with Disabilities Act). Remember that your websites should include people with disabilities, even if you don’t believe they are using your website (this is usually a mistake).
Keep in mind people with disabilities before and during website development
Look for barriers that might play a role for people with disabilities. Use large fonts, have a possibility for the user to zoom in up to 300% with text staying visible on the screen and images scaling without resolution loss, introduce speech recognition, include night and day display modes, and a color-blind mode option. Ensure all links stand out. The website navigation design should ensure a seamless experience for anyone. All writing should also be simple to understand. For example, the digital requirements of the UK’s National Health Service ask for website text to aim for a reading age of a 12-year-old.
Integrate assistive technology
Assistive technology helps people with disabilities and the elderly population to perform tasks such as typing, moving a mouse, reading a screen, or using a touch-screen smartphone, all of which they might be experiencing problems with. If your website allows integration with assistive technology, they can book appointments, see which services your medical facility offers, and access tests.
Integrate AAC devices
Augmentative and alternative communication (AAC) devices allow people with speech deficiencies to navigate their online content. Just like with assistive technology, AAC makes it possible for them to do basic tasks, such as booking appointments and researching medical services.
Offer different content formats
Your website content should be accessible in multiple ways. Images should have text alternatives, texts should have images; videos should have transcripts and closed captions, and audio descriptions should be created for video files.
Ask persons with disabilities to help with testing
The biggest mistakes healthcare companies make when tailoring for digital accessibility is assuming they can do the job without the help of an actual user. Instead, involve people with various disabilities to test your website, app, and mobile version. They should do manual and functional testing, and report on problems that will inevitably arise.
Which tools ensure digital accessibility?
This is a toolkit for healthcare providers that includes assistive technology, website, and mobile evaluations, PDF remediation, automated and manual testing, multi-media accessibility, ongoing monitoring, and training.
AccessiBe recently received a $28 million funding and grew by more than 350% during 2020. The platform provides the full accessibility suite, from making the website compliant to solving any specific accessibility problem you might have on your website or mobile.
Silktide takes it upon itself to identify, show you, and tell you what are the best ways to fix all the accessibility problems that exist on your website and your mobile version of the site. The platform has been used by the UK’s National Health Service among other clients.
What is digital inequality?
Now that we understand the issue with digital accessibility, it’s time to talk about digital inequality. The latter means something different, but no less vital. Digital inequality refers to the digital divide that exists between those who have access to technologies and those who don’t, as well as those who are digitally literate and those who are not. With more and more health services becoming digital, those two factors exacerbate the divide between those who get healthcare and those who don’t. The reasons for this divide are usually socio-economic and geographical. Age difference also plays an important role: it’s often much harder to make it clear to your granny that her doctor is now on screen than it is to someone who grew up surrounded by digital devices.
How does digital inequality manifest itself?
One of the markers of the digital divide was the surge of telehealth usage in 2020. While being a growing trend for the past decade, telehealth became instantly very popular with the spread of COVID-19. Many healthcare facilities chose telehealth as a better option of providing services when it was dangerous and even impossible for people to physically enter hospitals. It became an essential tool for the elderly, people with disabilities, and people with chronic diseases.
However, the adoption was not equal across different populations. There was a strong racial disparity: a study in the Journal of the American Medical Informatics Association found that Black patients were four times less likely than White patients to use telehealth instead of the emergency department at the start of the pandemic. Telehealth was harder to access for non-English speaking patients and patients who live in rural areas, due to the poor broadband connection of the latter. Overcoming language barriers is one of the main goals for telehealth providers today. A broadband connection is an even bigger health factor: in 2017, the American Medical Informatics Association (AMIA) asserted broadband is a key social determinant of health, due to its role in exacerbating digital inequality. The other key determinant of health is digital literacy.
What is digital health literacy and how can we address it?
As defined by WHO, digital health literacy is the ability to search, assess, and make use of health information via electronic media. Digital health literacy correlates with health inequality.
Addressing digital health illiteracy requires providing consistent support and education for those struggling with technology. It’s important to battle the fear of technology that older and lower tech-literacy people usually have, starting with outlining the benefits of digital health technology. Benefits can be especially relevant for older people and people living in further geographical areas. The promise of no transportation, lower contagion risk, and on-demand medical advice can motivate a lot of people to start learning. Providing digital literacy support can be as simple as sending step-by-step instructions by SMS or providing patients with paper instruction at the medical facility on their first visit. Often, digital services have unclear and complicated designs. These issues can be solved by testing the service on future users.
Over time, all digital accessibility problems and inequalities related to health will become more apparent and more influential. For companies, this means that unless they make their services accessible to everyone, they’ll lose more and more clients over time. In a world that’s inclusive and socially conscious, digital accessibility and equality are a must. For governments, this means that it’s time to financially support projects that extend digitization so that it can reach rural and underdeveloped areas, work more closely and reach the ones who need them the most.