Ensuring people have equal access to digital health information
The internet’s democratisation of health information has played a huge role in the rise of the expert patient. But does everyone have equal access to the digital information they need to manage their health? And are the very people digital health is seeking to empower the ones who are getting left behind?
Empowering people to take control of their health is a central plank of our new patient-centred landscape.
It’s a path lined by freely available educational resources, online peer support and digital patient support programmes. In short, it has happened thanks to the internet.
The benefits of digital health in improving adherence to aiding shared decision making are well documented. But when we are sitting down to design the latest all singing, all dancing platform, it can be easy to put style over substance when it comes to digital accessibility.
Disability as a barrier to digital health
At least 11 million people in the UK, more than 15 per cent of the population have some form of disability. Across the EU, one in seven people has some level of activity restriction.
Many problems, such as cognitive and visual impairment, are linked to long-term conditions – and the people living with these conditions are the intended end users of many digital health interventions.
But according to a 2015 report from Citizens Online, at least 80 per cent of websites failed to meet minimum requirements for accessibility.
Digital Accessibility: A brief landscaping also cited a UN audit which found just three of 100 sites in a global sample met even basic accessibility requirements.
This inaccessibility is, not unsurprisingly, making the internet a no-go zone for many. In the UK, 82 per cent of blind or partially sighted people who do not go online mention their sight loss as the reason.
Organisations working in this space, including pharma, have a lot to benefit from thinking about how to stop people falling through the cracks. Many do not know where to start, however.
Developing sites for everyone
The Web Content Accessibility Guidelines (WCAG) offer practical help for developers wanting to ensure accessibility. The global guidelines, which were updated in June this year, were developed by the Accessibility Guidelines Working Group, part of the World Wide Web consortium.
“Each individual is unique. People have diverse abilities, skills, tools, preferences and expectations that can impact how they use the web,” says the guidance.
“Some people have health conditions that may affect their stamina, dexterity, or concentration. For instance, some may experience fatigue, pain, or other symptoms that could have an impact on their physical use of a computer or limit the duration or extent of their use of the web.”
Overcoming these common barriers is not difficult, it says, it just takes someone to realise it needs to be done.
“The internet is an increasingly important resource in many aspects of life, including healthcare, so it is essential that it’s accessible to provide equal access and equal opportunity,” say the guidelines.
“The web offers the possibility of unprecedented access to information and interaction for many people with disabilities. That is, the accessibility barriers to print, audio, and visual media can be much more easily overcome through web technologies.”
The guidelines outline simple design principles that could help people with neurological and physical disabilities, speech and visual impairment, but takes care to note that accessibility is good for everyone.
No one likes long passages of text, flashing content or complex navigation, so imagine if you have cognitive impairment, are using a screen reader or have a tremor.
“Websites and web tools designed for people with a broad range of abilities benefit everyone, including people without disabilities,” say the guidelines.
“It is, therefore, important to consider the broad diversity of functional needs rather than to categorize people according to medical classifications.”
From theory to practice
Such guidelines are only as good as the sites that follow them though, said the Citizens Online report.
“Accessibility criteria such as WCAG provide useful minimum standards but are not sufficient in themselves to ensure that web sites and online resources are fully accessible.”
“Thorough user experience research and engagement with disabled users is required to ensure the usability of sites,” it said.
It points out that while websites in the UK and the EU are legally required to be accessible to people with disabilities, they rarely are.
Leading by example
All the evidence shows that this is a problem that spans industries. But arguably, digital accessibility matters more in healthcare, which could be setting a gold standard example.
The sector’s understanding of these problems is as unparalleled as it is priceless.
What’s more, it matters because the true potential of digital health, including boosting adherence and driving good outcomes, will never be unlocked without equal access.
About the author:
Amanda Barrell is a health and medical education journalist, editor and copywriter. She has worked on projects for pharma, charities and agencies, and has written extensively for patients, healthcare professionals and the general public.