Telehealth has many benefits including reduced, or eliminated travel and wait times; decreased exposure to communicative diseases; easier access to healthcare professionals and therapeutic interventions; and greater flexibility. However, for many individuals with disabilities, Telehealth and its associated benefits may be out of reach due to web inaccessibility. Benefits can become barriers because of websites’ inconsistent compatibility with screen readers, closed captions, magnifiers, speech to text software (used by individuals with limited dexterity), easy to understand instructions and hyperlinks (for individuals with cognitive disabilities), and alternative text formats.
Although Telehealth companies provide guidance on ensuring accessibility by conforming to guidelines laid out in Section 508 of the 1973 Rehabilitation Act, it is only voluntary because the Act only applies to federal agencies and not private companies. So, while an individual with a disability will be met with a relatively accessible federally funded Telehealth website, that same individual may be greeted by an inaccessible private Telehealth website. But wait! What about the Americans with Disabilities Act (ADA)?! Surely it requires public accommodations like Telehealth websites to be accessible?!
While the ADA does require brick-and-mortar private businesses that are labeled as public accommodations to be accessible, there is no such mandate for websites. Because of this, federal courts are split by jurisdiction on how to apply the ADA to websites: some jurisdictions say the ADA applies to all websites; some say it is inapplicable to all websites; and others conclude it applies only if the website has a connection, or "nexus," to the physical, brick-and-mortar place it represents. This lack of consistency can leave a disabled Telehealth user without an accessible Telehealth website simply because they live in a jurisdiction that does not ensure accessibility to websites. What can be done to help solve this problem?
Perhaps the most comprehensive solution would be for the Department of Justice (DOJ), the federal Department tasked with enforcing the ADA, to finally answer the repeated calls by private business owners, courts, and other federal agencies for guidance by issuing a concrete rule requiring website accessibility under the ADA. However, because the Department proposed such a rule in 2010 and then withdrew from its proposal in 2017, it appears that those calls for guidance will go unanswered, save for a few amicus briefs and unofficial statements. Another, and perhaps more viable, solution is to lobby state senators to implement legislation requiring accessible Telehealth. It appears the ball has already started rolling because just this year, the New Jersey legislature has proposed a new bill that requires Telehealth to “ include accessible communication to facilitate the use of… Telehealth by individuals with a disability….”
Access to accessible Telehealth should not be based on the coincidence of location, but on the coincidence of being human. Since we are all human, we all deserve accessible Telehealth — it is a right. This right will not be realized unless, and until, we stand up and demand mandated accessible websites.