By Tammy Coutts (MEDITECH), Chair of the EHR Association Social Determinants of Health & Health Equity Task Force

Ability and disability exist on a spectrum, one that nearly everyone will find themselves on at some point in time. Ways in which limitations show up vary dramatically and can be permanent, temporary or sporadic in duration. That is why, when it comes to inclusive design, health IT software developers should focus more on empowering everyone to succeed and less narrowly on addressing specific disability challenges.

As 2025 National Disability Employment Awareness Month (NDEAM) draws to a close, it is the perfect time to revisit the EHR Association Accessibility Checklist, designed to help software developers do exactly that: provide guidance for EHR developers in creating software that meets the needs of individuals with disabilities. Featuring scenarios rooted in healthcare settings and modeled after the W3C Web Accessibility Initiative’s Easy Checks—A First Review of Web Accessibility, the checklist emphasizes the importance of considering the human aspect of accessibility when designing EHR products. 

While the checklist can be utilized at any stage of the development lifecycle, it is most effective when incorporated during the design phase, ensuring that accessibility is a foundational element rather than an afterthought.

While the checklist can be utilized at any stage of the development lifecycle, it is most effective when incorporated during the design phase, ensuring that accessibility is a foundational element rather than an afterthought. By reviewing these scenarios, developers can empathize, identify potential barriers to access, and create health IT solutions that offer equitable experiences for users across a broad spectrum of disabilities. Our goal is to ensure every user is successful.

Based on real-life experience

The EHR Association developed the scenarios addressed in the Checklist based on real-life experiences of people whose disabilities—permanent and temporary—impacted their job performance. By applying guidelines to physical and digital workspaces to eliminate accessibility barriers, everyone across the employment spectrum can do their jobs without hindrance. 

Ironically, technology, which has been the solution to so many daily challenges, is often one of the biggest culprits when it comes to insufficient accessibility. Software usually comes with features that, while user-friendly for most, can block healthcare professionals with disabilities from fully performing their core responsibilities — obstacles that are not obvious to someone who has not walked in the shoes of users with limited abilities.

• Drop-down menus and drag-and-drop design elements make it difficult for someone with severe rheumatoid arthritis, a hand injury, or other conditions that make gripping or maneuvering a mouse difficult.
• Color enhancements, such as red for critical alerts and blue or green for notifications, are not helpful for someone with a color vision deficiency. 
• Patients with diminished vision struggle to log in to patient portals or message their providers unless there is an option to zoom in on text.

Sometimes, design misfires are the problem. A clinician with low vision, who was a guest speaker at an EHR Association User Experience Workgroup, shared a story about being stopped in her tracks during a patient exam when the screen reader she used to document in the EHR glitched due to an unlabeled button on the screen. Instead of alerting her to the required input command, the reader could only repeat “button” until a colleague stepped in to help. HIPAA implications aside, the clinician was obviously frustrated at both the disruption to her care process and the need to rely on a colleague to successfully perform such a basic task because of a missing label. 

Design and development teams should consider accessibility guidelines when building software solutions and other technology tools designed for healthcare workplaces and by patients. Approaching design through the lens of the disability spectrum will help avoid features that disrupt, rather than support, workflows. 

Design and development teams should consider accessibility guidelines when building software solutions and other technology tools designed for healthcare workplaces and by patients. Approaching design through the lens of the disability spectrum will help avoid features that disrupt, rather than support, workflows. 

Accessibility for Every Employee

While the industry still has work to do before technology can be deemed fully inclusive, we hope that tools like our Accessibility Checklist will get us closer, faster.

If you’re interested in learning more about inclusive design, along with our checklist, we encourage you to read our blog series:

• Inclusive EHR Design Starts with Understanding the Disability Spectrum
• Disability Inclusion Part One: What is Accessibility and Why It’s Important for EHRs
• Disability Inclusion Part Two: Introducing Accessibility into Health IT Personas
• Digital Health Equity: Harnessing Design Systems to Advance EHR Accessibility