Healthcare apps are on the rise as technology helps more people with their health-related issues. Yet, for manufacturers, the challenge arises: How to maintain accessibility in healthcare apps? Let’s discuss it.

What is accessibility in healthcare apps?

The European Commission defines accessibility as a precondition to ensure that people with disabilities can fully and equally participate in society. 

When we discuss accessibility in healthcare apps, we should mention web accessibility, which means that “websites, tools, and technologies are designed and developed so that people with disabilities can use them".

Essentially, accessibility is about making your healthcare app usable by all people, no matter their potential disabilities, through maintaining a comprehensive and positive User Experience, fostering empathy towards the end-users.

Accessibility vs inclusivity – what’s the difference?

Keep in mind that accessibility isn’t the same as inclusivity. So what’s the difference?

The inclusive design of your app is about providing a system that can be easily used by people regardless of their cultural background, gender, race, culture, or education. Of course, inclusive design is also about persons with disabilities – but not only. 

Think about the forms in which you need to state your gender or race – sometimes, they are limited in choice. Another issue might be a section for the “last name” – it happens that there is a minimum number of letters one needs to use, e.g., three. So what about people whose surnames consist of two letters? Can’t they use your app?

Inclusivity is a vast topic we recommend every app developer learn about. You can find more about inclusive design on the Nielsen Norman Group website. Now, let’s get back to accessibility in healthcare apps.

Why should you care about accessibility in healthcare apps?

You might wonder – why should you even consider taking care of accessibility in your healthcare app? Well, there are multiple reasons for it.

1. That’s the right thing to do

All people deserve equal opportunities, especially when taking care of their health. Why can't a visually impaired person use an app to plan out a diet, support therapy, or help control the progress of a disease?

Regardless of disability, everyone should be able to use an app independently and comfortably. Therefore, it is extremely important to ensure accessibility and give users equal opportunities.

2. Persons with disabilities are your clients

You should know that persons with disabilities make up 16% of the global population, according to WHO (and this number is growing). If you don’t care about the accessibility of your app, you give up on them as your potential clients whose usage of the app might translate into your financial profit.

In addition, remember that accessibility in healthcare apps is also beneficial to older people. It is estimated that in 2030, 1 in 6 people will be over the age of 60. Thus, when designing healthcare solutions, designers should think about this growing group of people who might have issues with handling an app.

3. Healthcare apps are used by people with health issues

It is worth bearing in mind that health apps are used by people with a variety of health problems, which may cause some difficulties in using them. Consider people with vision impairment or poor manual dexterity.

Therefore, it is worth ensuring their comfort when using the app by ensuring accessibility, e.g., by providing them with descriptions of the graphics or allowing them to use the app with assistive technologies. After all, healthcare should be accessible to all people.

4. Risk of app not working properly

Consider the following scenario: an application sends a notification that the user misses due to a pop-up's poor visibility. In the case of a mobile game, the severity of such an omission may be low. However, in a health app that reminds users to take their medication, a missed notification due to poor accessibility could pose a massive risk to their health and life.

Thus, it would help to consider accessibility a necessary element of your app working correctly.

5. People without disabilities benefit from accessibility

It is worth thinking about accessibility as a broad concept. Focus not only on people with disabilities, but also on those who are temporarily impaired (e.g., those who broke an arm), have reduced dexterity due to ageing, or are in difficult conditions (e.g., they are on an overcrowded bus or the sun prevents them from reading their phone screen).

By maintaining accessibility, you will make using your healthcare app easy and positive for all your clients, no matter their situation.

6. Incoming law regulations

Although accessibility regulations in the European Union do not yet impose such requirements on healthcare app developers, this may change in the coming years. Therefore, it is worthwhile designing the app with accessibility in mind to avoid legal issues in the future.

Who regulates accessibility rules in Europe?

Accessibility regulations vary depending on the region, so when putting your healthcare app on the market, you should find out the expectations regarding accessibility.

For example, in the United States, accessibility requirements are set out in the ADA (Americans with Disabilities Act). But today, we will focus on two standards – the European Accessibility Act and Web Content Accessibility Guidelines.

Meet the European Accessibility Act

The European Accessibility Act aims to “improve the functioning of the internal market for accessible products and services by removing barriers created by divergent rules in Member States” (source: European Commission).

This directive applies to products which will be placed on the European market after 28 June 2025. What’s more, it doesn’t apply to all the products and services available in member countries but only to some of them, such as:

• consumer general purpose computer hardware systems and operating systems,

• self service terminals (e.g., payment terminals, automated teller machines, ticketing machines, and more),

• consumer terminal equipment with interactive computing capability, used for electronic communications services and accessing audiovisual media services,

• e-readers,

• some of the electronic communications services,

• services providing access to audiovisual media services

• some transport services (such as their websites, mobile applications, ticketing services, and more)

• consumer banking services,

• e-books and dedicated software,

• e-commerce services (source: The European Accessibility Act).

As you have probably noticed, there is no information about healthcare apps in the European Accessibility Act. However, if your solution has the elements mentioned above (e.g., e-commerce compounds), it fits into the requirements set out in the European Accessibility Act.

What’s more, if your app or website is developed for and offered to users by the public sector, it should meet the requirements stated in the EU Directive 2016/2102 – “Accessibility of public sector websites and mobile apps”. In such a case, your app should be perceivable, operable, understandable, and robust. You will find more information regarding the designer's obligations in the directive.

Also, if you are interested in the requirements regarding accessibility stated by the European Union, they are set out in Annex 1 of the European Accessibility Act. They are divided into three categories:

• requirements on the provision of information

• user interface and functionality design

• support services.

We encourage you to read and include them when working on your healthcare app, even though they are not yet legally demanded. Bear in mind that despite them not being required by the European Accessibility Act or the Medical Device Regulation (MDR), this situation might change in the future as people speak more about the need for accessible services.

Create a healthcare app in compliance with WCAG

WCAG 2.2 (Web Content Accessibility Guidelines) is a set of recommendations for making Web content more accessible. It is regulated by the W3C (World Wide Web Consortium), which aims to help build “a web based on the principles of accessibility, internationalisation, privacy and security”.

WCAG 2.2 – accessibility design guidelines

In the WCAG 2.2 you will find four principles which “provide the foundation for Web accessibility”. They are:

• Perceivable,

• Operable,

• Understandable,

• Robust.

You should know that those four principles consist of a set of guidelines that are categorised by success criteria. There are three levels of conformance:

• A – minimum level of conformance,

• AA – medium level of conformance,

• AAA – high level of conformance.

In this article, we won’t discuss the success criteria of particular guidelines but will briefly introduce you to the main principles.

1.WCAG 2.2 – Perceivable

This principle sets the guidelines for information and user interface components so they can be presented to the users “in ways they can perceive”. What does it mean? There are four main rules you should follow:

• use text alternatives for any non-text content (such as photos, symbols),

• provide alternatives for time-based media, such as audio-only and video-only media, by offering captions, audio description, or sign language,

• create content that can be presented in different ways without losing information or structure,

• make it easier for users to see and hear content, such as the possibility to resize text, providing contrast ratio, and more.

2.WCAG 2.2 – Operable

Basically, “operable” means that components and navigation must be operable with ease and – if necessary – with the use of assistive technology. There are four main guidelines:

• the website should be easily navigated with the usage of the keyboard,

• users should have enough time to read and use content,

• developer should create an app which does not cause seizures or physical reactions,

• users can navigate and find content easily, for example, through headings, labels, etc.

3. WCAG 2.2 – Understandable

Understandable is all about making your content easy to read and understand in the natural language. What’s more, it means that:

• the language of the page can be programmatically determined,

• the website should operate predictably, e.g., through consistent navigation,

• there should be input assistance so users can avoid and correct mistakes.

4. WCAG 2.2 – Robust

This rule is crucial for people who rely on assistive technology. It can be achieved through taking care of “compatibility with current and future user agents, including assistive technologies”.

Of course, our description isn’t complex, as every principle can be described in a separate article. If you want to learn more, you can find complex descriptions of all the guidelines with their success criteria and examples of sufficient techniques here.

How to maintain accessibility in healthcare apps?

Although we would like to say that meeting all the guidelines set in WCAG 2.2 is enough to maintain accessibility in healthcare apps, much more work must be done. How can you ensure that your app provides all users a positive experience?

Empathise with your users

Empathy with the end-users is crucial to creating a positive User Experience. Think about the doctors, nurses, care providers, and patients who might use your app. What unpredictable life situations might they face?

Think about health deterioration resulting from ageing, accidents causing temporary disability (e.g., breaking an arm), or change of marital status (e.g., getting married or losing a spouse). During our lives, we encounter many different situations that might result in temporary or permanent disability. Thus, when developing an app, we should always try to empathise with our users’ life situations.

Cooperate with persons with disabilities

To provide accessibility in your healthcare app, you should include persons with disabilities when researching target users. You will benefit from asking about their opinions, issues, and needs. You and your team might not come up with some potential problems on your own; however, persons with disabilities might point out some aspects which should be addressed.

Thanks to this, you will gather knowledge and experience, which will help you develop an app with a high level of accessibility.

Test your healthcare app

Also, remember to include people with disabilities when testing your mockup. Their feedback is crucial when developing a solution and might allow you to fix potential problems within the app.

What’s more, after you launch your solution on the market, we recommend you conduct complex usability research with people with disabilities, as some apps' issues cannot be pointed out during the testing process.

To sum up, we propose you look into the WCAG guidelines and include people with disabilities in the development process. It might seem tiresome and demanding; however, if you develop your healthcare app with accessibility in mind from the beginning, it will be much easier. We highly recommend that you consider persons with disabilities from the design stage.

Do you want to maintain accessibility in your healthcare app?

At Revolve Healthcare, we ensure that your medical or healthcare app is developed with the highest quality and with your users in mind. How do we achieve this? Our design process includes complex research and workshop processes, which allow us to get to know your potential users and your ideas.

We would be happy to talk about your idea. If you want to discuss the design of your app, schedule a free consultation with our experts!