Web Accessibility Critical for Health Information Access

New AHIMA Foundation Issue Brief Finds Top U.S. Hospitals Need Improvement

Figure 1. WCAG 2.1 compliance status of top hospitals' home pages, by hospital type (accessScan, August 2022)

This is a bar chart showing the proportion of hospitals that are WCAG 2.1 compliant, semi-compliant, and non-compliant. Depending on hospital type between 4.3 and 12.2 percent of hospitals are compliant; 73.2 to 79.0 are semi-compliant, and 10.5 to 19.6 are non-compliant with WCAG 2.1. 

Source: Krupa, A., J.B. Roark, and K.B. Barrett. “The Critical Role of Web Accessibility in Health Information Access, Understanding, and Use" (Issue brief). Chicago, IL: AHIMA Foundation, 2022.
This is a bar chart showing the proportion of hospitals that are WCAG 2.1 compliant, semi-compliant, and non-compliant. Depending on hospital type between 4.3 and 12.2 percent of hospitals are compliant; 73.2 to 79.0 are semi-compliant, and 10.5 to 19.6 are non-compliant with WCAG 2.1. Source: Krupa, A., J.B. Roark, and K.B. Barrett. “The Critical Role of Web Accessibility in Health Information Access, Understanding, and Use" (Issue brief). Chicago, IL: AHIMA Foundation, 2022.

Chicago, IL, Sept. 27, 2022 (GLOBE NEWSWIRE) -- Currently, the U.S. healthcare system is failing its older adults and patients with disabilities on the digital front. Web accessibility–or digital accessibility more broadly–involves designing web page content to be inclusive of people who have visual, motor, auditory, speech, or cognitive disabilities. More than 61 million people in the United States (nearly 1 in 4) and over 1 billion people worldwide have one of these disabilities, including 46% of people aged 60 years and older.

In recognition of Digital Inclusion Week (Oct. 3-7) and October's Health Literacy Month, the American Health Information Management Association (AHIMA) Foundation, the charitable affiliate of AHIMA, published an issue brief entitled, “The Critical Role of Web Accessibility in Health Information Access, Understanding, and Use,” with key insights from an audit of over 100 top U.S. hospital website home pages and a survey of older adults and patients with disabilities.

“Web inaccessibility prevents those that often need life-changing, life-saving healthcare from accessing it online wherever they live,” said Angela Thi Bennett, Director of Digital Equity, National Telecommunications and Information Administration, U.S. Department of Commerce. “The Digital Equity Act programs will empower Americans with disabilities to independently navigate digital healthcare systems and utilize websites that are designed to respond to their needs.”

Key findings of the AHIMA Foundation brief include:

  • Hospitals and health care systems in the U.S. need continuing education on the role of web accessibility in ADA compliance given the significance of newly issued federal guidance.

  • The home pages of most top U.S. hospitals have many accessibility errors and are not compliant with WCAG 2.1 criteria.

  • Older adults and patients with disabilities face barriers to accessing their health information electronically; many have struggled to use a hospital website or patient portal.

  • Multisectoral collaboration, including user-based testing with patients with disabilities and older adults, is needed to improve digital accessibility in the healthcare ecosystem.

AHIMA Foundation’s research findings included in this brief bring visibility to the newly issued Guidance on Web Accessibility and the ADA by the U.S. Department of Justice’s Civil Rights Division and the newly issued Guidance on Nondiscrimination in Telehealth by the U.S. Department of Health and Human Services’ Office of Civil Rights. As hospitals and healthcare systems across the United States prioritize initiatives centered on diversity, equity, and inclusion (DEI) and environmental, social, and corporate governance (ESG), this research provides institutions with a starting place to improve their digital experience in a way that is compliant, accessible, and patient and data-informed.

“There isn’t a healthcare facility in the country that would leave its main entrance without an accessible physical entrance, yet we found more work needs to be done to ensure equitable entry through the facility’s digital front door,” commented Amanda Krupa, MSc, AHIMA Foundation Director and lead author of the issue brief. “Everyone appreciates a good user experience, but it’s critical from a health access perspective as the population in this country ages and increasingly relies on technology to get both health information and care.”

The number of Americans 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, and one of the objectives of HealthyPeople 2030 is to “increase the proportion of people who can view, download, and send their electronic health information.”

"Outside of a public health emergency, digital accessibility is something we should care about or take ownership for as health information professionals," remarked Aurae Beidler, MHA, RHIA, CHC, CHPS, Director-elect to the AHIMA Board of Directors, Former Compliance and Privacy Officer at Linn County Department of Health Services in Albany, Oregon.

To educate and inform health information professionals about this issue:

AHIMA Foundation is sponsoring the session, “WCAG... W3C... WAI... Wait, What? Web Accessibility Compliance Explained,” at the AHIMA Global Conference in Columbus, Ohio on October 11 and virtually on November 10, 2022.

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About AHIMA Foundation:

AHIMA Foundation is a 501(c)(3) nonprofit organization and philanthropic arm of the American Health Information Management Association (AHIMA) dedicated to empowering people with health information literacy to achieve better health outcomes. Founded in 1962, AHIMA Foundation programs, research, and projects help families make informed health decisions, guide evidence-based healthcare system policies and practices, and educate and train aspiring and current health information professionals. Recognizing that health information is human information, AHIMA Foundation works extensively to convene interdisciplinary stakeholders to identify unmet public health and education needs. Learn more at AHIMAFoundation.org and follow on Facebook, Twitter, LinkedIn, YouTube.

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