Achieving Equal Access in Health Care Information

As per a report published by the Equal Rights Center in 2011, blind and visually impaired individuals routinely face barriers in receiving information regarding their health care including documents such as test results, prescriptions, etc., benefits information such as Explanation of Benefits, eligibility and termination information and e-delivered communications such as billing statements, summary of benefits and more in accessible formats.

This includes information received by visually impaired Americans being covered by Medicare and Medicaid. These individuals are often presented with work-around solutions, such as relying on friends, family or healthcare practitioners to read their private medical information to them. Not only is this a breach of the individual’s privacy, but also leads to outcomes that could result in poor health and loss of benefits.

The Centers for Medicare and Medicaid (CMS), an agency of the US Department of Health and Human Services, is the largest single payer for health care in the United States. As per data from the CMS:

  • 90 Million Americans receive healthcare coverage through Medicare, Medicaid and the State Children’s Health Insurance Program.
  • Approximately 4.3 million individuals over the age of 65 report some form of visual impairment.
  • There are also approximately 700,000 Medicare beneficiaries between the ages of 21 and 64 who have some form of visual impairment.

Private healthcare insurers have been contracted by the Centers for Medicare and Medicaid Services to offer Medicare and Medicaid programs, and these insurance providers must meet federal regulation i.e. Section 508, requiring that they ensure access to and use of their websites and digital documentation to people with disabilities, including the blind or visually impaired individuals. Non-compliance could lead to penalties and the loss of lucrative contracts for insurers. It is therefore no surprise that document (e.g. PDF) accessibility is a hot-button issue for government and even private healthcare insurers contracted by the CMS.


As “public accommodations” under the Americans with Disabilities Act (ADA), healthcare insurers are generally well aware of their legal responsibility to customers with disabilities such as visual impairment, and are quite used to complying with these regulations. But now that accessibility requirements are expanding into cyberspace, healthcare insurers need to find appropriate technology solutions for this new challenge.

Until a couple of years ago, it simply had not been possible for healthcare insurers to create high-volume, communications and documents in accessible PDF format. The sheer scale of production, with documents numbering in the thousands or millions, precludes manual remediation because of several limiting factors:

  1. Costs of manually remediating documents
  2. Delivery time due to the laborious nature of manual remediation
  3. Stringent accessibility tagging requirements

OpenText has created an automated, software-based solution to address these very limitations. The OpenText Automated Output Accessibility solution can generate accessible PDFs from any high-volume, system-generated input print stream or other formats quickly and efficiently, while keeping storage size at bay. The solution was designed using thousands of man-hours worth of very specific experience and expertise in the system-generated document accessibility space, and our industry-leading transformation engine enables generating accessible output in the milliseconds. In fact, the output generated from this solution has been reviewed by the National Federation of the Blind and other prominent organizations for the visually impaired.

Meha Varier

Meha Varier is Product Marketing Director for OpenText’s Customer Experience Management division that offers a set of applications focused on delivering personalized content and engaging interactions along a continuous customer journey. With over 12 years of experience in product marketing and digital marketing at various enterprise software and digital companies, Meha brings extensive knowledge on how digital transformation drives customer experience and engagement.

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