Just as physical accessibility to stores, offices and public buildings is now commonplace, so should access to information in documents and on websites. However, experts say that’s the last thing on many web developer’s minds.
“It is disappointing to me that we have seen lots of mainstream technology get easier and more attractive, but the tools for accessibility have not kept pace,” says Bruce Bailey, Accessibility IT Specialist at the U.S. Access Board. “It also seems that commercial professional web developers who are new to accessibility underestimate the level of effort required, and overestimate their ability to get up to speed on accessibility. Many still do not pay attention to accessibility unless the customer brings accessibility up as a requirement at the beginning of a project.”
In today’s world of the information superhighway being used for everything from shopping to job hunting to researching and more, picture not being able to use it effectively–or at all. And what if the information you are seeking is vital to your health?
“Independent access to health information can have extraordinarily serious consequences if it can not be accessed or if it is presented incorrectly,” says Brad Hodges, access technology consultant. “Access to the complex financial considerations presented by insurers can also bring critically important consequences if not well understood by an individual.”
And it doesn’t end there. Imagine not being able to read the services covered under your health plan because the downloadable document is not accessible. The right to accessibility extends to electronic documents in formats, such as PDF, that work with assistive technologies. PDF documents that have been tagged correctly can been easily read by screen reading software, as this article explains.
Generally, three groupings of disabilities should be considered: sensory disabilities (blindness, low vision and hearing loss); motor disabilities that impair physical interaction with a computer; and cognitive disability (dyslexia, for example).
“I believe it is safe to say that based on the metric of importance and given future health policy in the U.S., increased scrutiny of health insurer sites is a given,” says Hodges. “If these sites are found to be inaccessible than increased regulation is equally likely.”
However, rather than designing or redesigning a website to meet the needs of users with specific disabilities, a better approach is to follow accessibility standards. In the United States, Section 508 of the Rehabilitation Act of 1973, as amended by the Workforce Investment Act of 1998, requires that when Federal agencies procure, develop, maintain, or use electronic information technology, they ensure that employees and members of the public with disabilities “have access to and use of information and data that is comparable to the access to and use of information and data that is available to individuals without disabilities.” (CMS Policy for Section 508 Compliance)
In keeping with that policy, the Centers for Medicare & Medicaid Services (CMS) has committed to making its websites and all of its electronic and information technology accessible to the widest possible audience, including individuals with disabilities.
It may sound daunting, but accessibility need not be expensive. Adding captions to video and ALT text to informative images can help and takes only moments. Only slightly more costly is adding transcription for any video offered.
“If a website has not been designed with best practices in mind, accessibility will not happen by accident,” says Bailey. “If a person is blind and alternative text is missing from an image that conveys information, it does not matter what software they have nor how skilled they are.”
Inexpensive or free testing tools can uncover pervasive issues, for example, a recurring unlabeled “Submit” button. Hodges recommends testing with a screen reader and screen magnification. Free screen readers include System Access 2 Go and NVDA for Windows and VoiceOver for OSX (press Command F5 on any OSX machine).
Accessible information also benefits those without disabilities; a fully sighted person using a website under poor lighting conditions or on a compromised display will value the availability of appropriate contrast and sizes of design elements.
And you don’t have to tackle your existing website all at once.
Experts recommend, if an organization is just coming up to speed with accessibility, taking a triaged approach by prioritizing and remediating the parts of your website that are the most popular and that typical customers find the most important. To avoid compounding your problems, set a date by which all new material will be fully accessible. You can then make a plan to fix or remove old content.
“If new content is not important enough to make accessible, it is not important enough to warrant posting,” says Hodges. “If new content is important enough to post, it is important enough to find the resources to make it accessible. This may mean posting less, but it means that what does get posted is of high quality.”
So-called “features” that are particularly problematic for users with disabilities include inaccessible controls that cannot be identified by a screen reader and activated by the enter key; a CAPTCHA with no audio option is also a potential barrier for those using screen readers.
Bailey says he often hears: “None of our customers have disabilities.” Website owners appear to believe this is automatically the case if they haven’t heard otherwise. However, it is perfectly reasonable to assume that customers of the healthcare industry have disabilities that are in proportion to or even exceed the general population.
“Such an attitude almost always tends to be a myth, and those of us in the field like to draw a parallel to the Americans with Disabilities Act and the requirement for curbcuts and ramps,” says the U.S. Access Board’s Bailey. “Businesses complained, ‘But none of our customers use wheelchairs!’ Before curbcuts and ramps, how could they? Accessibility, on the web or on the street, is a civil rights issue!”
By Shawna McAlearney
“Procedure: Determining Section 508 Compliance” [PDF file on Centers for Medicare & Medicaid Services website]
“CMS EIT Accessibility Policy Statement” [PDF file on Centers for Medicare & Medicaid Services website]
How the disabled use the web: http://www.w3.org/WAI/intro/people-use-web/stories.html
WCAG 2.0: http://www.w3.org/TR/WCAG20/
WCAG 2.0 bullet points: http://www.w3.org/WAI/WCAG20/glance/
WCAG 2.0 for “Accessible Digital Office Document (ADOD) Project”: http://adod.idrc.ocad.ca/
Help creating Section 508-compliant documents: http://www.appligent.com/services/pdf-accessibility-services/