Imagine this: you’re at work and your doctor’s office calls about your prescription refill request. You look around at the dozen coworkers who overhear your business phone calls every day. They are great people, but you definitely don’t want them listening to this conversation! So, you ask the caller to wait a moment while you search for someplace more private.
The elevator? Bad signal.
The stairwell? Too loud.
A bathroom? Occupied.
A supply closet? Locked.
With nowhere to hide, the best you can do hope nobody is listening.
“Prozac, yes,” you whisper, hoping the connection is clear so you don’t need to repeat yourself. “No, no, I’m not on the Wellbutrin anymore. Yes, the pharmacy is the same.”
It’s awkward. It’s uncomfortable. And your private details are now public.
Inaccessible technology has the same effect for people with disabilities.
HIPAA’s Privacy Rule “protects all individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral.” (PDF at HHS.gov)
Patients have the right for their personal health information (PHI) to be between them and their doctor. Any time a person with a disability has to rely on someone else to help them complete healthcare tasks via inaccessible technology, their PHI must be shared with that third party.
Some examples of inaccessible technology violating patient privacy
- Online Health Portal: Jim has low vision and must zoom in to 200% in order to read text on his laptop. Unfortunately, when Jim zooms in on his doctor’s portal, it’s nearly impossible to read the results of his most recent blood tests.
- Tablets and kiosks: Monique is blind and frequents the walk-in clinic in her neighborhood for minor medical issues. The clinic recently upgraded their systems and now uses iPads to check in patients and collect information about their reason for visiting. Monique tries to turn on VoiceOver like she does on her personal iPad, but the speakers have been muted. She must fill out this information with the help of one of the medical assistants.
- Insurance websites: Jorge gets migraines triggered by bright light. He uses “dark mode” on his laptop and Android smartphone so the colors are reversed and there isn’t bright white on the screen. Jorge needs to find a urologist. He tries to search his insurance website for one that takes his plan, but in dark mode, the contrast is so poor that he can’t read anything. He doesn’t want to have to call the 800 number and talk to a stranger about his medical needs, but he can’t do it online.
- Appointment scheduling: Eileen uses voice-command software because arthritis makes it too painful to type or use a mouse. Unfortunately, her doctor’s website does not accept her voice commands when she tries to pick a date and time for her next appointment.
- Medical devices: Arjun has sleep apnea which is managed via a CPAP machine. However, the screen on the device is too small for him to read. Since he lives alone, anytime he needs to adjust the humidity level on his machine, he needs to ask his Meals on Wheels delivery person to help.
What can you do to ensure privacy for patients with disabilities?
If you receive funding from HHS or other federal agencies, the law requires you to make your information and communications technology accessible to people with disabilities. If you have not audited your systems for accessibility, that is a great place to start. You will be able to get a clear picture of whether your technology is usable by people who:
- are blind and use screen reader software
- have low vision and use zoom or special color schemes
- are deaf or hard of hearing
- use voice command software
- use only a keyboard to navigate
- use a switch to navigate and type
- have cognitive disabilities or brain injury
Once you have completed an audit, you will be able to prioritize your remediation project. Then your patients with disabilities will have equal access to—and privacy for—their personal health information.
Want a taste of the auditing process?
Scan up to five pages of your website with our free tool at WebAccessibility.com.