Accessible Healthcare PDFs: Ensuring an Inclusive, Compliant Experience

Patient looking at a screen with her doctor who is showing her accessible healthcare PDFs.

Healthcare organizations pride themselves on providing the best possible care and health resources to every patient. But what if the helpful or necessary resources provided to your patients aren’t available to 25% of them? Digital resources and content are only helpful if everyone, including people with disabilities, can access them. 

The ADA requires that doctors, hospitals, and other healthcare entities remove communication barriers under the ADA and the Affordable Care Act.  Noncompliance can lead to alienation of your disabled patients and potentially costly litigation. In addition to complying with the ADA and avoiding litigation, making sure your website is accessible also allows your entire client base to find information about their healthcare and your organization.


Which legal standards apply?

Section 508 of the Rehabilitation Act

Section 508 requires that all Federal electronic content be accessible to people with disabilities, many of whom use assistive technology to access websites and other digital resources. Compliance with Section 508 means that all digital content must adhere to Web Content Accessibility Guidelines (WCAG) 2.0. Section 508 requirements extend beyond web pages to include PDFs such as invoices, billing statements, directories, informational brochures, and more.

Section 1557 of the Affordable Care Act

Section 1557 prohibits discrimination against protected classes by any healthcare providers that receive financial assistance from the Department of Health and Human Services, the Health Insurance Marketplaces, and the health programs administered by the Department of Health and Human Services. That includes hospitals, doctors, and any other healthcare provider that accepts Medicare or Medicaid payments. Under Section 1557, covered healthcare entities must ensure that any communication with people with disabilities is as effective as communication with other patients. All programs and services available digitally must be accessible to all patients, including those with disabilities. Like Section 508, Section 1557 also applies to any PDFs available to your patients and website visitors.


ADA compliance enforcement

With the dramatic increase in ADA lawsuits filed in the past two years, it’s becoming obvious that people are taking notice when sites aren’t accessible. The Health and Human Services Office of Civil Rights (OCR) has also started conducting and publishing compliance reviews of Section 1557 of the ACA, making note of facilities who do not address their digital accessibility shortfalls. 

No complaints doesn’t mean no problems

Just because an organization hasn’t received a complaint doesn’t necessarily mean that there aren’t any issues. Assistive technology users may have just gotten frustrated and left the site, taking their business elsewhere, or they may not have been able to even find an email or phone number to which they could send a complaint. They may even decide to go directly to a lawyer for this problem instead of letting you know first. 


Providing an equal experience for every patient

Providing accessibility, not custodians

Many healthcare organizations assume that they don’t need to offer alternative, digitally accessible formats for forms that need to be filled out by a patient as long as they offer a sighted individual, such as a receptionist or assistant, to read the form aloud to the patient and fill out the answers for them. While this is one way to get the form filled out, it’s also a glaring HIPAA violation, because the blind or low vision patient has no choice but to share their very personal medical information with someone they don’t know, and often within earshot of the rest of the patients in the waiting room, or else the other office staff.  Forms and other documents should be offered online as accessible, fillable forms for patients to complete and submit privately. That way, their information stays confidential, and they save time, frustration, and intrusion from having to fill out forms in the office. 

Documents should be both digital and accessible

Many forms and other documents are provided to patients as PDFs, which are not inherently accessible to assistive technology without adding digital tags. These tags identify information for the assistive technology to relay to the end user. Equidox Software uses AI-powered tools to help users quickly and easily apply tags to the elements of their PDFs to make them “readable” by assistive technology. Users simply adjust automated detector tools to ensure each PDF element is correctly identified as a “zone.” Then the software applies tags to the document upon export.

What about High-Volume Documents?

If you have a large number of PDF documents that need to be remediated, Equidox offers a completely hands-off, automated solution to tag every document for you. Equidox AI is trained to to uniquely identify the elements within a specific batch of documents. Equidox developers and PDF accessibility experts work together to train and refine the AI model to ensure every single document in the batch is perfectly remediated every time, with no manual remediation required. This technology is ideal for templated, repetitive documents such as invoices, statements, medical records, and other system-generated PDFs.


Empower Your Patients with Accessible Care Communications

While healthcare facilities focus so much on the health and wellbeing of all of their patients when they are in the office, they may forget that the information offered on their websites needs to be available to all of their patients as well. Healthcare organizations must ensure information is reaching everyone by providing accessible digital resources that help patients take control of their own health. Avoid costly litigation and provide a better user experience by making all content, including PDFs, accessible to every patient.


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Nina Overdorff

Nina comes to Equidox with years of sales and marketing experience from a variety of industries and holds a BS in Language Arts Education. Nina has a passion for words, storytelling, and information, which she believes everyone should have access to regardless of ability. After spending time as a teacher with a blind student, she became much more aware of the limitations and abilities of web accessibility, and how essential it is to those experiencing disabilities. “Being able to access information equally ensures that everyone has an equal opportunity for education, employment, and success in life.”

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