Digital Accessibility: How to Achieve Compliance and Create a Better User Experience

August 1, 2019

// By Marlene Kurban //

Marlene KurbanThe Americans with Disabilities Act (ADA), signed into law 29 years ago, covers much more than ramps and rails. Today, accessibility includes the internet and the digital accommodations required for people with vision, hearing, speech, cognitive, or mobility impairments.

More than 56 million Americans live with a disability. Ensuring that your website is easily navigated and understood by people with a range of cognitive and physical limitations is not just an ethical business practice. It’s a legal requirement if your organization receives federal funding or assistance.

The Department of Justice (DOJ) has long considered websites to be covered under the ADA. There is no specific legislation related to web accessibility, but Assistant Attorney General Stephen E. Boyd stated in a September 2018 letter to Congress that “the absence of a specific regulation does not serve as a basis for noncompliance with a statute’s requirements.”

WCAG, short for Web Content Accessibility Guidelines, is a global standard that covers a wide range of recommendations for making website content more accessible. Compliance is voluntary, and Boyd’s letter notes that “noncompliance with a voluntary technical standard for website accessibility does not necessarily indicate noncompliance with the ADA.”

In the absence of regulatory standards, courts are setting precedent and often ruling in plaintiffs’ favor. ADA-related digital accessibility lawsuits are on the rise and have been recorded in every state, with the largest number of lawsuits filed in Florida and New York.

John Mulvey, founder, Digital Echo

Given that digital technologies, content, and services are constantly evolving, how can healthcare organizations achieve compliance without costly, time-consuming redesigns? John Mulvey, founder of digital accessibility solution provider Digital Echo, weighed in during a recent Strategic Health Care Marketing webinar, “Digital Accessibility: How to Achieve Compliance and Create a Better User Experience,” with co-presenter April Morgan, accessibility training manager at AudioEye.

“Digital accessibility used to require a lot of work and compliance was viewed as complicated, labor-intensive, time-consuming, and expensive,” says Mulvey. “This resulted in a user experience that was more difficult or even discriminatory for people with disabilities.”

April Morgan, accessibility training manager, AudioEye

A new solution offers a more automated way to manage digital accessibility. Digital Echo, in partnership with AudioEye, a technology-based managed service that identifies and fixes accessibility issues, provides full WCAG 2.0/2.1 compliance through Ally Managed Service.

“Ally Managed Service is an alternative to the traditional approach to achieve compliance, which often involves extensive redesign, no continued oversight of content editors, and ongoing audits,” states April Morgan, accessibility training manager for AudioEye. “Ally Managed Service combines proprietary technology, engineering subject matter experts, and accessibility testers to identify and fix compliance issues. The service also continually monitors compliance without changing the look and feel of the website or accessing source code.”

Achieving WCAG Compliance

The first step, activation, begins with implementation of JavaScript, which is the only programming change to the organization’s website. Monitoring then illuminates the most pertinent and pressing issues impacting users. “Most importantly, we can fix the most common errors on day one,” Morgan says. “We also post an initial certification notice on our customer’s site to show how we are achieving compliance. This essentially says to the world that the organization is taking steps to remediate the site and lessens their legal risk while we’re in the process. Organizations achieve substantial WCAG 2.0/2.1 AA conformance within 90 to 180 days.”

Testing, Optimization, and Ongoing Monitoring

Step two is automated and manual testing to detect access barriers and identify accessibility issues. An “always on” monitoring service provides ongoing site evaluation based on site edits and AudioEye’s analytics. Accessibility testing is conducted by assistive technology (AT) testers, including individuals with disabilities.

The end result of step three — remediation, validation, and optimization — is an optimal user experience for users of all abilities, including those with disabilities. Once a website is certified as meeting the standards, customers receive continued issue tracking, compliance monitoring, and scheduled manual testing so any new or edited content on the website is checked for accessibility. One process provides oversight of multiple domains and multiple content editors. Daily tracking, weekly remediation, monthly/quarterly reporting, and ongoing support and training are included in a monthly or annual subscription service.

Ally Toolbar for Consumers

The Ally Toolbar is a suite of free assistive web personalization utilities that allows site visitors to customize their experience with features such as simplified navigation and screen display options.

For example, users can choose to listen to the content of a web page read aloud, command the browser using their voice, and get support from a help desk staffed with accessibility experts. “The Ally Toolbar goes beyond accessibility to make a website usable and inclusive for the largest audience possible,” states Morgan. “It addresses the needs of people including those with low vision, dyslexia, color blindness, and a range of vision, auditory, mobility, and cognitive disabilities.”

Factors to Consider

While the traditional approach to digital accessibility is labor-intensive, it also affords an organization the opportunity to rethink usability for all of its design and user experience. Digital Echo helps healthcare providers make the determination as to whether a traditional approach or a managed service such as Ally will meet their needs best.

“The best solution takes into consideration your people, your processes, and technology,” says Mulvey. Some of the questions to consider include:

  • What is the size of your team?
  • Do you have the expertise on staff to achieve and maintain compliance, with continual audits and monitoring of content editors?
  • Do you favor a continuous improvement model or a big periodic redesign?
  • How many web properties do you maintain and how complex are they?
  • Which CMS are you on?
  • Is the infrastructure dated?

Since hospital systems and larger healthcare providers are typically the ones targeted with ADA-related web accessibility lawsuits, achieving compliance quickly is a plus. In addition, daily monitoring from accessibility experts removes the ongoing burden of audit and review.

Smaller organizations that lack the expertise also find value in the Ally Managed Service. Accessibility can be very resource-intensive. “How many times have you trained someone in an important subject only to see them move on, so you have to train someone else?” Mulvey points out. “Or, how many times have you seen your budgets swell due to needing more billable hours because of poor scoping and execution? Smaller organizations may prefer a known fixed cost for compliance which allows them to allocate their marketing budgets for other digital marketing initiatives.”

Whatever approach is best for your organization, incorporating digital accessibility best practices is not just a “nice to have,” it’s a “must have.” Efficient, effective technological solutions exist that take into account your resources, timelines, and budget, allowing you to offer a website that is usable and valuable for all of your visitors.

Marlene Kurban is a business development consultant and freelance writer with more than 20 years of experience in the behavioral healthcare field.