Patient Access

Accessible Care for All

July 23, 2019

Accessible Care for All

A key element of our company’s mission is to provide intuitive access to virtual care. This year, we’ve expanded this commitment to include web accessibility to patients with disabilities.

It all started when Cottage Health let us know they had prioritized digital accessibility for all their services, and that they expected our software to be fully compliant with the WCAG 2.1 level AA standard. Kudos to them doing so! They are leading by example in making healthcare accessible to more patients. It’s the right thing to do: the 20% of Americans living with disabilities deserve access to virtual care.

Where to start?

Until recently, it’s safe to say that most people on our team (myself included) were unaware of what “intuitive access” meant to patients with disabilities—or what we could do to help.

We knew attaining full compliance would be no small task. To make sure we got it right (engineering is all about getting it right!) we hired Accessible360, a Minneapolis-based accessibility auditor with the expertise to help us understand the full scope of the effort up front, and to give us ongoing technical guidance.

The audit revealed critical issues. If you tried using our software using only a keyboard and no mouse, which many users must, you were unable to proceed past one of the very first signup screens. Some of the required input fields and buttons were completely keyboard-inaccessible and required a mouse to operate successfully. Epic fail.

When Allan demoed the Fabric platform before we started to do any work on this, using the same tools that the visually impaired use, it was a complete and utter failure. But, because here at Fabric we’re also bold and enthusiastic we rolled up our sleeves and got to work.

Jon Pearce


It’s unfortunate that we never noticed these issues until the audit. Perhaps some users did notice them, but didn’t call our support line to report them. Why would they bother to tell us? Imagine yourself as the user: if you can’t even get through the signup page, why would you expect the rest of the software to be any good?

Fast Forward a Few Months

Now, a few months later, we’ve gone through the remediation process. And people are noticing the improvements. These are not “invisible” features! Web accessibility improves the experience for all users—sometimes in subtle ways, but those little positive experiences add up. For example, by updating our select menus to use standard HTML, iPhone and Android users now see menus that look and feel just like all their other apps.

From a technical retrospective, the biggest reason we had accessibility problems was failure to write proper HTML. This is not a new thing. The HTML 4.01 standard was published in 1999 and has been the basis of the entire World Wide Web ever since. That’s 20 years now. (Wow, does that make anyone else feel old?) The surprise is that there’s more to HTML than it may seem at first. Our team had quite a bit to learn about it. Coming out of this project, I’m confident we will do better on all future projects.

If you are a web developer not sure where to start with accessibility improvements, I recommend learning everything you can about Semantic HTML and ARIA in HTML. Also, learn to use your computer’s screen reader and try using the software without looking. Don’t cheat; get an audience. It really raised the bar for me (and forced me to fix a bunch of issues) when I had my company watch me stumble through a live demo, blindfolded.

If you are a patient who relies on a keyboard (and even a screen reader), what you should find now is that any online health care service that is powered by Fabric should be accessible to you. We hope that means you can get the care you need online, without necessarily needing to find your way to an in-person clinic.

If you are considering implementing virtual care for your health system, and have any concerns about the ADA or accessibility in general: Fabric will not only improve your clinical efficiency; it will help you welcome all patients.

If you want to see an accessibility demo, please don’t hesitate to contact us!

Enjoy Allan’s blog post? Check out Jon’s vlog on Fabric’s journey to truly accessible virtual care here!


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