COAT Affiliates Push for Accessible Health Information Technology

On March 26, 2010, COAT steering committee members Jenifer Simpson of AAPD and Mark Richert of AFB, attended NIDRR's "Stakeholder Forum on Requirements for Accessible Health Information Technology (HIT) for People with Disabilities."  The forum's intent was to bring together experts to identify criteria for the future development of HIT disability accessibility measures for HHS's Healthy People 2020 initiative. With broadband technology expanding, HIT will surely expand due to federal financial incentives. There has been also little federal commitment to accessibility within health IT to date.

This all-day meeting looked at how accessibility standards such as for websites (e.g., WCAG) for electronic & information technology (e.g., Section 508) and for phone services and equipment (e.g., Section 255) could be part of the vision for disability accessible HIT going forward. The meeting ended with a proposal to have the federal Interagency Committee on Disabililty Research (ICDR) as the vehicle through which to continue discussions about implementation of HIT accessibility & usability. Some highlights from the discussion are below.

Mark Richert of AFB noted that HIT accessibility is a priority for people who are blind "due to the privacy and dependency issues raised by inaccessibility." He also noted that user interfaces should be the focus of  requirements. Jenifer Simpson of AAPD saw the forum bringing together digital literacy, health information literacy & disability accessibility concerns, all within the Healthy People 2020 context, a large feat for the forum to accomplish at one meeting.

Judy Brewer of WC3 said "putting accessibility into newer dynamic websites is like outrunning a speeding train" and added that 'wrapping accessibility into usability as a new Healthy People 2020 objective would not work well' as they are two separate topics.  Prof. Parmanto Bambang added that "usability professionals perceive 'accessibility' as something needed by only 2% of the population," despite its critical nature so the Healthy People 2020 revised objective must mention accessibility, not just usability.

Prof. Tom Horan of Claremont saw two applications ("apps") developing in HIT: one is health management, such as in the Personal Health Record process and another is to expedite disability determinations by the Social Security Administration. On the other hand, Prof. Greg Vanderheiden of Trace Center believes that "health apps are being developed everywhere by millions but website accessibility is going to be more important."

June Kailes of Western University raised critical concerns about quality of care measures in terms of accessible health care service delivery that could be addressed, asking if "[HIT] is cool tools or more barriers for people with disabilities?"

NIDRR's Margaret Campbell emphasized the need for evidence-based health research information and knowledge to be translated, or re-purposed for consumers as HIT develops and within the context of the social determinants of health inquities to meet Healthy People 2020 goals. Miguel Gomez of Aids.gov echoed this purpose by saying health information must respond to what consumers look for and how they use it, such as via electronic social networks.

David Hunt from the Office of the National Coordinator within HHS said that "Without government, [HIT] development will stay haphazard, like Babel" and promised to confirm how accessibility would be incorporated in their actions.

Other discussants included Pam Gregory of the FCC who spoke about the National Broadband Plan, Prof. Andrew Sears of the Univ. of MD, and David Baquis of US Access Board who emphasized that within accessibility is the concept of non-discrimination & this should be taken up in the revised Healthy People 2020 objectives.

Another meeting focused on this subject will likely occur in May.