Practice Management Alert

Remember: Doctors’ offices are considered public accommodations under Title III of the ADA.

If you haven’t thought about how people interact with your website, now is a good time to start. The U.S. Department of Justice (DOJ) has been cracking down on organizations whose websites are not accessible under the Americans with Disabilities Act (ADA), including a major healthcare-adjacent entity whose COVID-19 vaccine registration portal was not fully accessible.

“Equal access to healthcare is one of the most important rights guaranteed by the Americans with Disabilities Act,” said Kristen Clarke, assistant attorney general for the Justice Department’s Civil Rights Division, in a release about the settlement.

Understand Why Website Accessibility Matters

Websites are crucial tools for businesses and other entities to provide crucial information. Medical practices use websites to convey information about location and hours, schedule appointments, provide patient access to records via a portal or other secure interaction tool, or even help entice new patients to seek services.

“The ways that websites are designed and set up can create unnecessary barriers that make it difficult or impossible for people with disabilities to use websites, just as physical barriers like steps can prevent some people with disabilities from entering a building,” the DOJ says on the Civil Rights Division portion of its website.

For example, a website feature as seemingly innocuous as a popup can be difficult for some people to manage: People who rely on keyboard navigation instead of a mouse may not have a way to exit the popup and reach the actual website. Website images that don’t include text alternatives may be inaccessible for visually impaired people. Videos with sound that don’t have captions mean that people who have hearing disabilities may not be able to understand the content.

Accordingly, the DOJ is focusing on web accessibility and going after entities that don’t comply, and they’re bringing enforcement actions in the process. The DOJ is looking at state and local government websites, which fall under Title II of the ADA, and businesses that are open to the public, which fall under Title III. Hospitals and medical offices are considered Title III.

“We have heard the calls from the public on the need for more guidance on web accessibility, particularly as our economy and society become increasingly digitized. This guidance will assist the public in understanding how to ensure that websites are accessible to people with disabilities. People with disabilities deserve to have an equal opportunity to access the services, goods and programs provided by government and businesses, including when offered or communicated through websites,” Clarke said.

Focus on These Accessibility Measures

So you have a website, and you’re not sure whether it’s accessible. Where can you find out some specific dos and don’ts?

If you haven’t heard of Website Content Accessibility Guidelines (WCAG), make some time to get familiar with it. WCAG categorizes content in two ways: natural information, which includes text, images, and sound; and code or markup that forms the structure and presentation.

If you can remember Yahoo!’s GeoCities sites, you can appreciate how much design and function allow a user to access the information they need. Bright colors, low contrast between text and background, and songs or other sounds are all barriers to website accessibility. Other aspects of design affect function as well, like making sure any maps you have of your office location are clickable, rather than static images.

Asking patients for information before they arrive can streamline your front desk interactions, but forms are another facet of website interaction that can be particularly complicated for people with disabilities. WCAG offers a tutorial specific to creating forms, and suggests that entities focus on labeling, grouping, and custom controls to isolate each field of the form, making the form fields easier to see and navigate.

For example, you can make sure a patient can directly fill out each individual field, like first name, last name, date of birth, instead of the form presenting as a static image that needs to be printed before being filled out. Making smart design and style choices can help, too, like choosing visually uncomplicated fonts and breaking multiple-page forms into shorter, logical steps or stages and showing users how they’re progressing through the forms.

A major and easy accessibility “feature” to add to your forms is instructions! Tell people how you want the form filled and give them the information they need to fill it out. If you only want typed responses, say so, and make sure your form function makes it easy for people to type their responses. In that vein, validate inputs and also enable corrective functions, so people can move to previous fields and correct misinformation or typos. And don’t forget to confirm form submissions so people know they’re done.

The technical coding aspects can be complicated, but you can find a list of specific, simple principles to prioritize in box below.

Use Rite Aid’s ‘Whoops’ to Avoid Your Own

The switch to digitization seemed especially abrupt and thorough during the beginning of the COVID-19 pandemic. Once COVID-19 vaccines were available, many of the entities that offered them encouraged people to book appointments online instead of over the phone, and Rite Aid, a private pharmacy, as well as several other businesses providing COVID-19 vaccinations, got into trouble with the DOJ because their websites had accessibility issues. The DOJ announced that they reached a settlement with Rite Aid and three other businesses.

Specifically, the DOJ found that the Rite Aid website’s vaccine registration and scheduler presented barriers to people who use screen readers or the tab key of the keyboard. The website didn’t show any available appointment times to people with screen readers and people who don’t use a mouse were not able to select a choice on a consent form.

“As technology increases, the internet is where people gain access to information about COVID-19 vaccines and schedule a vaccination appointment,” said Acting U.S. Attorney Bruce D. Brandler for the Middle District of Pennsylvania. “Individuals with disabilities, including those with visual impairments and those who cannot use a mouse, must be given the same access to that information and the ease of scheduling appointments online. Since the beginning of the fight against the COVID-19 pandemic, private companies have partnered with the United States. Today, with the help of Rite Aid, we make great strides in that continuing partnership by ensuring individuals with disabilities have the ability to schedule a COVID-19 vaccination independently and privately.”