There are several questions you can ask yourself to help identify key journeys and uncover potential barriers:

• Who needs access to your digital content? Employees, patients, lawyers, relatives, other treating physicians, etc. These are all individuals who may need to interact with your website for one reason or another. Work out your key user personas and use their needs to dictate the critical paths.
• When someone lands on your website, what information do they need to access? A patient may need to schedule an appointment; a physician may be looking for contact information for another doctor. Identifying these needs and the steps users will need to take to accomplish each task will help define your key user journeys.
• How would a prospective or current patient convey important information such as insurance info, patient history details, and other legal/health-related information? Forms are the gold standard for submitting information online. When you include forms as part of the user journey, how do you evaluate if all elements are accessible?
• Consider real-life appointment check-ins. Does your organization use kiosks to help with this?
• What about appointment follow-ups? Consider how you provide a patient’s next steps or access to important documents.

Many healthcare systems are digitizing as much of this as possible to reduce the risks of spreading viruses. New tools or systems are being brought online by the day as a result. We recommend creating several use cases to represent all the key scenarios that your customers and employees engage in for your primary care purpose and stepping through those digital experiences and documenting these key user journeys.

A spreadsheet is helpful when documenting your critical flows, as you will want to create multiple rows to track several layers of each critical item. For example, your scheduling software may require 3-4 web pages, forms, email verification, phone number validation, etc. If the software sends reminder emails, make sure to include that as part of your flow, as emails are commonly overlooked.

Start by focusing on public-facing and patient experiences. Is scheduling an appointment through your website a high-frequency, high-value flow that requires all individuals to have equal access? What help is available if someone gets stuck? Some items will be more critical than others; still more may be outliers. Use this information to ensure the greatest impact for your time and effort applied.

If your organization relies on any third-party systems like a CRM, patient portal, CMS, or employee systems, you take on responsibility for their accessibility, full stop. Even if your website is reasonably conformant, you’ll still be held liable if one of these tertiary systems has accessibility barriers. Document and assess these third-party components for accessibility if they are part of a critical user flow.

There are two primary methods for assessing accessibility:

• • Manual Review/Assessment – The most comprehensive and accurate method for evaluation, but also the most time-consuming. An assessment provides a more holistic accessibility assessment that evaluates much more than conformance to guidelines. A good reviewer will also check an individual’s ability to use, consume, or complete items using a screen reader or some other assistive technology.
  • Automated Accessibility Testing – This provides the fastest and most cost-effective method to determine the magnitude of issues or violations against the WCAG standards both on a website as a whole, and for individual user flows. You’ll get great directional insight on a range of accessibility issues that can impact a user’s to utilize the digital content. With TPGi’s automated accessibility testing solution, ARC Monitoring, you’ll also get a WCAG Density Score, a key metric you can use to help assess your legal risk.

Before you gather all this data, however, you need to identify the primary technical “owner” of each system and work out a process for change requests. Document all this information and. house links to relevant items in a centralized management location.

Once you’ve accumulated all this information on accessibility barriers, you need to plan how to resolve these issues. First, prioritize. Are there any low-hanging-fruit opportunities? Are there any glaring show-stoppers you need to fix immediately? This may seem overwhelming, you can get a free website accessibility scan that will highlight such issues and give you a great place to start.

Feed the relevant information to the appropriate technology owners and schedule the implementation work. Ensure the developers have access to accessibility code libraries, resources, and experts who can support them. TPGi’s HelpDesk is a rapid-response support solution where teams can get accessibility help for tough problems, coding techniques, and other methods for creating accessible code solutions. Developers can also benefit from our KnowledgeBase, a repository of accessibility techniques that double as a learning resource. Are you able to integrate directly with CI/CD processes or submit tickets as bugs/ideas in aha, Jira, or other development project management software?

Once your team has completed remediating the accessibility barriers, verify the fixes have resolved the issues. After every section of code has been approved, document it in your tracking log. At this point, it’s beneficial to secure documentation from a third-party consulting company to confirm the fixes were correct. Part of the verification process can include a VPAT that proves that the new code conforms to accessibility requirements. This information will be critical in the event your organization becomes the target of a lawsuit.

As part of your review and verification process, engage individuals who use screen readers to test out your handiwork. If this is not feasible, try a tool like JAWS Inspect, a software solution that turns JAWS audio output into text. You can actually see how a JAWS reader would experience the site without using the screen reader software as a testing agent (which can be difficult to learn).

Consistently document statuses in your records for all your related work and remediation effort. Automated testing software is invaluable for this, as it automatically tracks changes in your website’s accessibility. If the testing shows your accessibility has declined, you’ll be able to quickly see the impact on your site and know where to go to find out what has been done to date. If you are facing litigation, your record-keeping efforts here will be helpful to defend your case (and your job!).

If you start this step at the beginning of a cycle, you will be able to use it as a baseline for measuring success. Alternatively, if you set it up towards the end, know that accessibility does have a cyclical or recurrent nature, so you’ll be able to use the insights you’ve gathered to identify the next set of items to shepherd through these stages.