Rising to Meet the Telehealth Accessibility Challenge in the Time of COVID-19

August 11, 2020

For the first time in history, many health care consumers are required to take advantage of virtual health care visits due to COVID-19. They may have consulted with psychologists or specialists or their primary care physician via video or audio conferencing. For some, it may be the only way they’re able to be seen by a doctor or nurse, as many are overwhelmed caring for coronavirus patients.

Since the pandemic, health care providers have had to adjust their care for patients in ways that don’t require face-to-face contact, necessitating the use of telehealth technologies. Federal, state, and local governments have scrambled to remove legal barriers to telehealth and many companies swiftly transformed digital products into HIPAA compliant modalities. However, access for people with disabilities has lagged.

Telemedicine use before the pandemic was minimal, though it was slowly trending upward. Necessity has accelerated demand, but many developers still fail to provide products usable to consumers with disabilities, painting a frightening picture of many people unable to access care.

Telehealth modalities and their impact on patients with disabilities

Telehealth provides remote health care access via digital information and communication technologies, such as computers and mobile devices.

Of the types of telehealth available, synchronous modalities have become ever more crucial and in demand since the pandemic. Synchronous telehealth involves using a smartphone, tablet, or computer, to engage with providers in real-time, typically through video, audio, or telephone conferencing.

Video conferencing, in particular, has become a primary means through which we communicate with loved ones, coworkers, and now health care providers. The unfortunate fact is that many of these platforms lack digital accessibility. The consequences for people with disabilities can be dire. For example, a person who is deaf or hard of hearing may not be able communicate with a doctor when captioning or volume control aren’t available.

Furthermore, functioning of these platforms often isn’t compatible with screen readers or assistive devices like Braille keyboards, creating barriers for people who are blind or visually impaired. Color contrast and screen magnification are also important elements of accessible virtual visits, allowing people to better view images and text on the screen.

For people with speech disabilities, virtual visits can be made accessible using technology like voice synthesizers and text-to-speech generators. If the controls of virtual visit applications are too restrictive in size, users with physical disabilities may have difficulty using the fine motor movements required to operate the platform.

Asynchronous modalities, which often involve storing health information online, have also become essential. Patient portals that store online medical charts, images, and messages allow patients to access their medical history, lab results, and communicate securely with providers. Website accessibility is crucial for patient portals and should follow the Web Content Accessibility Guidelines. Some of the same accessibility solutions helpful for virtual visits can also work for other digital products and services. Color contrast, screen magnification, and screen reader compatibility, for example, can enhance website accessibility.

The solutions listed here are by no means exhaustive. The point, however, is that at a time when all of our options for accessing health care are limited or restricted, inaccessible telehealth can create dangerous barriers for people with disabilities. When digital accessibility is ignored or overlooked in telehealth technologies, it’s a violation of civil rights and the right to equal access to health care. There has never been a greater need or opportunity to rise to the challenge and create inclusive telehealth services for all.

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