Last week  HealthTech Build examined digital accessibility in healthcare.  The event was generously hosted by ASICS Digital.

To start the event, Geoff Freed from Perkins Access presented about digital accessibility for healthcare apps and services. Perkins Access, the consulting division of Perkins School for the Blind, provides professional services to organizations around the world who wish to make their digital products and services more accessible.

For those addressing digital accessibility, it’s important to keep in mind not just people with vision impairments, but also people with mobility, cognitive, and hearing disorders.  In fact, accessibility for mobility and cognitive conditions covers a  much larger proportion of the population.  Sometimes disabilities can be temporary such as a broken arm, a new parent with baby in an arm, or cataract surgery. Similarly the population of blindness includes many gradations of visual impairment.  Only a very small percentage are completely blind.  For example, many people have enough vision that they would not use screen readers except to get validation that they are seeing the screen correctly.

An inclusive design process involves people with disabilities from the earliest stage of napkin drawings and wireframes.  

‘You can use an eraser on the drafting table or a sledge hammer on the construction site.’ – Frank Lloyd Wright via Geoff Freed of Perkins Accessibility.

Inclusive Design may incorporate different types of people who can lend perspectives to the design, build, and test phases of a project.  For example, one user could be blind from birth and an expert at using assistive technology such as screen readers.  The system for this person should have content ordered logically for easy machine reading.  Another user might be an older person with macular degeneration who is frustrated by small text and buttons.  The system for this person should have a clear visual layout with large targets for clicking and resizable text.

An important tip is that most visually impaired people are easily overwhelmed by screens with motion.  This problem with motion on the screen also impacts many people with normal vision.  It’s worth considering whether the recent trend of integrating video into web page backgrounds is causing more harm than benefit.

Data entry forms are a common obstacle with people with disabilities.  For example, many offices are using tablets in the waiting room for patients to fill out an intake form.  Even the tablet is an accessible device, it may not be configured for the way each person is accustomed.  The system will be more accessible if the patient can fill out the form from their own device.

Another aspect to accessibility is standards, primarily the Web Content Accessibility Guidelines (WCAG 2.1) which were established in 1999 and last updated in 2018.  These are guidelines that carry no legal weight directly, but they inform law and policy.  Many laws are measured by compliance with these guidelines.

Some key things to keep in mind for mobile design:
* Orientation
* Pointer geastures
* Text space
* Color and contrast – also applies to normal vision in cases of screen glare
* Images – need text to describe the image, especially important for buttons
* Forms – use visible labels since placeholder text disappears when you start typing

Barbara Vanaki spoke about her experience as an iOS developer interested in braille, machine learning, and other aspects of accessibility.

Sixty-one million Americans live with a disability of which eleven percent are visual or audio (more than the state population of MA).  That’s a lot of people to miss when you’re building an app or service.

Surveys indicate that more than 70% of patients are interested in telehealth yet many telehealth websites are not ADA or WCAG compliant.

A good model for many aspects of accessibility can be found in the video game industry.  In MarioKart, characters say their own name  and use distinctive sounds and haptics.  Fortnite allows for the customizability of screen displays for different types of color blindness.

Along with the iPhone, Microsoft has also been a leader in accessibility.  Powerpoint can display voice captions.  XBox created a control for peope with motor impairments that can be customized with hand control or foot pedal and move controls from left to right side.  The packaging is elegant and can be opened more easily by someone with a motor impairment.

Anyone who has spent time in the hospital has experienced the volume of sound from alerts and alarms.  It’s often hard to tell what those sounds indicate.  Some of the larger machines make sounds that are scary.  There are experts who specialize in making medical machines less scary and disruptive.  An interesting experiment in this area is Care Tunes (link to Youtube:

Another use case is wheelchairs with remote controls.  A person might not have the dexterity for a standard control but could use a control that’s customizable.

This HealthTech Build event was hosted by ASICS Digital.