Presentation given by Prof Jonathan Hassell on the UK Faculty of Health Informatics Programme of Health Informatics Congress 2012. Covers: why disabled and elderly audiences are potentially the main users of online healthcare information; how to design for their particular needs; examples of how online healthcare can learn lessons from web accessibility. More information on BS 8878 can be found at: http://www.hassellinclusion.com/bs8878/

1. Improving accessibility for online healthcare
service users - inclusive design and BS 8878
Prof Jonathan Hassell (@jonhassell)
Director, Hassell Inclusion ltd.
Chair, BSI IST/45
Panel: applying Usability & Human-Centred Design principles in health & social care information systems
Health Informatics Congress, UK Faculty of Health Informatics Programme
2nd May 2012
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2. 1
Human-centred Design
starts with knowing
who your audiences are
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3. What groups of people are likely to be using healthcare the most?
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4. Older, disabled and long-term sick are the most likely patients
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5. And the number of older people is growing rapidly
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6. 2
How should that influence
the design of
information systems?
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7. What do elderly & disabled people need from online information?
- a few examples
Blind people: want sites which they can ready easily with
screenreaders (good reading order of content and heading use)
Older people: want sites with a text size that‟s big enough
for them to read
People with hearing impairments: need subtitles on video
People with Aspergers: want sites that are easy to process, in the
colours they want, without images or video distractions
People with learning difficulties: need pages to just include the
important information, preferably in images/video, with no clutter
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8. 3
Is healthcare unique
or can lessons learnt
on the web be applied?
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9. Inclusion Issues:
• Will people with literacy difficulties
understand all this text, and be
able to take apart their password
letter by letter to get through
secondary authentication?
• Do the terms of use include the
ability for people with learning
difficulties to nominate
intermediaries (carers) to access
records on their behalf?
Challenge 1: security vs ease of access
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10. Inclusion Solutions:
• Advice on how to secure access
without preventing accessibility…
Lessons can be learnt from accessibility to online banks
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11. Inclusion Issues:
• Information communicated solely in
text (will people with literacy or
learning difficulties get access?)
• Information uses specialist terms,
aimed at health professionals, not
patients (will patients understand?)
Challenge 2: data vs information
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12. Inclusion Solutions:
• Browsealoud provides text to
speech facilities
• Word Bank provides explanations
of difficult words:
• These are underlined with a
dashed hyperlink.
• When you click on these words,
a pop-up box opens to show a
clear text definition of the word
and short animation
• [But why not for „Cancer‟ or
„Drugs‟?]
Lessons can be learnt from elsewhere in healthcare
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13. Inclusion Issues:
• Information communicated solely in
text (Can older people get it in a text
size they can read? Can people with
Aspergers or Dyslexia get it in the
colours they need?)
Challenge 3: I need it my way
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14. Ana Menendez
146. At 08:24am on 14 Jul 2010, thrifty wrote: (anamenendez@yahoo.com) says:
* The secondary menu bar is a bright red - glares Your website claims to be
"danger" in western psychology. Perhaps you could accessible, but it is not, at least not
use a darker shade of the burgendy instead. 100% AA compliant. It fails the
criteria: 1.4.3 Contrast (Minimum):
• design it background colour is strain &to white - high
* The forced
for everyone headaches.
contrast contributes to eye
The visual presentation of text and
images of text has a contrast ratio of
• tweak it soa disabled help here?
Perhaps light grey would
people at least 4.5:1(Level AA)-
http://www.w3.org/TR/WCAG20/
can use Assistive Technologies
or OS/browser settings to make
115. At 08:05am on 14 Jul 2010, chris b wrote:
it work for them …
Awful 'UK News/World New' panel - … Terrible
contrast too between the text and dark
background.
The rest of the web has the same challenges…
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15. Before… during…
After…
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16. Inclusion Solutions:
• DNPR Standards already created
for „recording additional needs,
including issues of accessibility‟
• If additional accessibility needs
are stored in patient records,
patient information systems
should automatically personalise
themselves to present information
according to the patients recorded
needs
Healthcare professionals are looking at how to capture these
preferences and use them to improve patient experiences
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17. 4
So how should you
approach accessibility?
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18. Thinking of Accessibility as Compliance with Standards…
… gets rid of some of your legal and reputational risks
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19. But it’s better to listen to your diverse audiences’ needs…
this identifies challenges…
but innovation often follows a challenge
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20. What accessibility really should be…
• all about disabled & elderly people
• aim shouldn‟t be accessibility… or even usability…
but a great user experience for disabled & elderly people
• whether they can get the right value out of what you create
• exactly what you aim for, for every other audience
• you don‟t want to exclude 10m+ people from using your products…
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21. Integrating accessibility in human-centred design processes
• relating web accessibility to wider • and bringing in concepts of
human-centred and inclusive design user-personalised
practices approaches…
From:
ISO/FDIS 9241-210
Human-centred design for
interactive systems
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22. BS 8878 does that and more
– presents the business-case for accessibility and digital inclusion
– gives advice for how to embed accessibility strategically within an organisation
– recommends a human-centred process which identifies the key decisions
which are taken in a web product’s lifecycle which impact accessibility
– recommends an informed way of making these decisions…
– and a way of documenting all of this to ensure best practice
Organizational Web Web
Web Product Product
Accessibility Accessibility Accessibility
Policy Policy Statement
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23. “BS 8878 is an integral part
of our web accessibility
strategy.
It has given us the
framework to help reduce
costs and improve the
quality when delivering
accessible web products for
our customers.”
Rob Wemyss
Head of Accessibility
Royal Mail Group

24. 5
Find out more…
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25. Get slides on all 16 BS 8878 steps
www.hassellinclusion.com/bs8878/
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26. Get latest news, tools, blogs, training:
www.hassellinclusion.com/bs8878/
Join the community:
www.meetup.com/bs8878-web-accessibility/
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27. 6
An international issue…
We could set the Standard
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28. Many countries are facing the same challenges…
but the UK should lead…
"Digital technology has changed the way we do so
much and has opened up a world of new
possibilities. Accessing essential services have
become so much easier thanks to the Internet. Some
of those who could benefit most from the digital
revolution are currently being excluded. We must
ensure technology is accessible to as many people
as possible.”
“The UK and US are the countries which are furthest
ahead in this agenda – and we must build on this…”
Ed Vaizey,
Communications Minister
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29. If you need support & training – I’m happy to help...
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30. Training & Innovation
support for
BS8878
Standards
Strategy &
research
www.hassellinclusion.com
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31. e: jonathan@hassellinclusion.com
t: @jonhassell
w: www.hassellinclusion.com
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