As a young blind adult living independently, managing my health and wellness is one of my top priorities. With a global pandemic happening, I’m even more vigilant about keeping myself in good health and staying connected with my doctors and other healthcare specialists. But I can only do that if the healthcare websites and apps are accessible to me.
To access technology, I use NVDA, a type of screen reader software. With NVDA, I can navigate the web using a series of keyboard commands and shortcuts. My screen reader announces the controls and elements on a page that are accessible to me, and I can use keyboard commands to interact further with those elements. Unfortunately, quite a lot of the web is still inaccessible for assistive technology users and I don’t always have a pleasant experience trying to navigate the web. One of the more frustrating accessibility barriers is access to my own healthcare information.
How Apple Gets Healthcare Technology Accessibility Right
I rejoiced when Apple released their line of watches that could track health and fitness. What a gamechanger for me! I work out every day and my Apple Watch and Health app can tell me how high my heart rate is on the treadmill, track how many calories I’ve burned, and measure my energy levels before and after cross training.
Unfortunately, not every healthcare organization has the accessibility of Apple’s products and services. I still struggle to access my healthcare data before and after doctor appointments and often can’t interact with the data and information on my healthcare plans and services with my screen reader.
My Quest: Finding an In-Network Doctor
One of the biggest barriers I faced in recent years was searching for a doctor within my network when I moved to the DC area for graduate school. I have an incredible relationship with my medical team in Boston where I’m from, but I needed to have somebody nearby for emergencies or when I felt like my health was declining.
The healthcare system is complicated, and I’ve heard the UX of insurance websites is terrible even for sighted people. But the inaccessibility of many healthcare portals and insurance websites can completely block access to healthcare for many folks like myself.
What may be an annoying experience for a sighted person can be an impossible one for someone who is blind.
Barrier 1: Login Forms without Field Labels
But I got ahead of myself! Before I can search for a doctor that takes my insurance plan, I need to log in to the insurance website. That in itself can be problematic. More often than not, the login fields are located within a menu that doesn’t expand properly. Sometimes they’re located on a page that a “Log In” link brings me to, but the fields aren’t properly labeled, so I’m forced to make educated guesses about where my username/password/member number go, or hope that a family member answers a FaceTime call and can look at my screen to help me.
Barrier 2: Search Engine with Unlabeled Controls and Other Issues
If I can get past the login barrier, the next issue I run into is the search engine for finding medical professionals in network.
When a site is coded correctly, this is how search controls work:
- I tab to the control,
- I can input a keyword,
- I listen for a dropdown to populate with suggestions, and
- either I use the down arrow to highlight a suggestion or use the search button/enter key to search based on my search term.
Here’s what often happens instead:
- I run into an unlabeled search control,
- Its placeholder text disappears when I bring focus to the control,
- When I begin typing, I either cannot access the drop down, or
- I don’t hear anything from the drop-down being announced at all.
I usually end up typing in a search term, hitting enter, and hoping for the best. If I am lucky, I might get a new page title announced that indicates results have rendered, and if not, I end up waiting a bit to see if I can then find a heading or landmark that indicates a region where I might find some search results based on my search term.
Barrier 3: Reading through the Search Results
Assuming that I have successfully navigated to a search results region, my next issue is reading information about the medical professionals or offices that have come up based on my search. In an ideal world, I would probably like to see some sort of implementation of heading structure for displaying results and be able to navigate to different names or locations in the results by heading. This is similar to how a sighted person can skim down a page reading the headlines or the list of locations for each doctor.
With a screen reader, this hardly ever happens. I am forced to use my virtual cursor and listen to the names and contact information for dozens of medical practitioners. Instead of being able to skim the page, I have to read all of it. This can be tedious, especially after all the inaccessible elements of the site I’ve already navigated through to get to this page.
More often than not, whether you’d call it a “worst case scenario” or “work around”, I end up just calling my general practitioner from home in Boston, waiting on hold for sometimes hours, and then begging them to recommend a friend from medical school in the nearby area that I can google, or ask a secretary in their practice to search for someone in network on my behalf. It’s not really ideal to spend hours of my day on hold with the hospital or practice, but sometimes it’s the only option I have when I need to find a medical professional.
Barrier 4: Misuse of Alt Text
The misuse of alternative text on charts and other graphics is also rampant on healthcare and insurance websites. These graphics are meant to communicate information to a user, so they need alternative text that can be read by a screen reader.
For example, let’s say there is a chart with data about flexible spending dollars used so far in a year. If the alt text says, “Graphic showing how many flexible spending dollars were used in 2020”, that doesn’t give me the full picture. A sighted person can see the data points, so the alt text should provide a screen reader user with those same data points. In this case, it is better to use plain text to communicate the information or present the chart data in an accessible table so people like me can understand the data and not miss out on anything important.
Final Thoughts on Healthcare Accessibility
It’s a struggle to feel like an independent young person when I constantly have to rely on others to assist me when something like a healthcare portal is inaccessible. In my perfect world, I’d like to be able to log into my healthcare portal at any time and find what I need without factoring in hours of FaceTime calls or hunting around for ridiculous accessibility workarounds. At a time when it is crucial for folks to have access to healthcare data, information and services, it is imperative that developers and designers for healthcare providers consider and implement accessibility when it comes to healthcare on the web.
We have an eBook with more information on this topic. Check out 10 Things People with Disabilities Wish Healthcare Organizations Knew.