Self Service ADA for Healthcare

Nice post/blog on TPGi updated 9/8/2023

The Importance of Accessibility and Usability in Healthcare Self-Service Kiosks

Updated 9/8/2023

More than ever, healthcare kiosks are an essential tool for serving patients. Self-service devices have become standard in the patient journey. They can streamline appointment check-ins, update patient information, collect outstanding balances, provide wayfinding in healthcare facilities, measure blood pressure and perform other diagnostic testing, enable telehealth services, and more.

Self-service technology has become increasingly prevalent across various industries, and healthcare is far from the exception. According to Industry, ARC’s Self-Service Kiosk Forecast, the self-service kiosk market is estimated to surpass the $35.8 billion mark by 2026, with an expected growth rate of 6.4% from 2021 to 2026.

The rampant growth of self-service devices in healthcare is likely, in part, a result of the COVID-19 pandemic. A Market Report by Grand View Research estimates that the medical kiosk market grew 10.4% from 2020 to 2021. In 2021, the global medical kiosk market size was valued at 1.1 billion USD, and that number is expected to expand at a compounded annual growth rate of 14.8% from 2022 to 2030.

Innovations in the self-service medical space are not new: this 2013 article in Forbes shows diagnostic kiosks placed in pharmacies and grocery stores. And in 2030, the revenue forecast for the medical kiosk market is 3.8 billion USD. Self-service functionality in the healthcare space is here to stay.

Healthcare kiosks have several use cases that can improve patient care. However, without a thorough understanding of how and why accessible features must be implemented and reviewed, patient care is at risk of being compromised for a substantial portion of the population.

Patient Care and Disabilities: Why Accessibility is Vital

Making a healthcare kiosk accessible is required by the Americans with Disabilities Act (ADA). The ADA prohibits discrimination against individuals with disabilities regarding public accommodations, and the court has defined public accommodations to include service establishments, including healthcare facilities, under Title III.

The ADA provides protections for people with a wide range of disabilities that cause physical, cognitive, or sensory impairments. To be accessible for patients who are blind or have low vision, self-service devices need to have screen reader software, such as JAWS® for Kiosk, to turn text into speech.

There are 7.2 million visually impaired adults in the United States, according to the National Federation of the Blind. The World Health Organization (WHO) reports that, globally, blindness and low vision impacts over 282 million people and is expected to increase by 72% over the next 11 years.

When considering the widespread need for accessibility in healthcare self-service devices, it is important to note that patient demographics skew older, and so does the percentage of people with disabilities. 80% of those who are blind are over 50 years old, according to WHO. The Census Bureau estimates that about 46% of Americans ages 75 and older and 24% of those ages 65 to 74 report having a disability, compared with 12% of adults ages 35 to 64 and 8% of adults under 35.

According to The Institute of Medicine’s Committee on the Future Health Care Workforce for Older Americans, older adults use far more healthcare services than younger groups. A large majority of older adults (approximately 82 percent) have at least one chronic disease that requires ongoing care and management. And over the coming decades, the total number of Americans ages 65 and older will increase sharply. As a result, an increasing number of older Americans will be living with illness and disability, and more care providers and resources will be required to meet their needs for healthcare services.

An ADA-compliant and usable self-service kiosk empowers equal access to healthcare kiosks for all patients, regardless of ability.

The Benefits of Accessible Kiosks in Healthcare

There are many advantages to using kiosks in healthcare, like shorter wait times and streamlined check-in processes. Consistency is another benefit: Kiosks provide patients with the same experience each time, which improves efficiency. Kiosks can be used to schedule follow-up appointments, pay bills, collect insurance information, and request contact or demographic details. Kiosks serve a wide range of purposes and help alleviate healthcare attendants’ demands.

Kiosks can also save time and resources, allowing healthcare providers to obtain more patient information while reducing employee demands. They can also serve patients across language and literacy barriers.

During the COVID-19 pandemic, kiosks helped mitigate the risk of exposure through the use of temperature sensing and exposure questionnaires. Healthcare kiosks can be used to gather patient information without exposing providers to the immediate risk that occurs when interacting with patients directly. Using kiosks to collect patient information allows for distancing and proper triage processes, minimizing the number of potential contagious interactions during a doctor’s office visit.

Making kiosks accessible is critical to preserving the quality of patient care for all patients.

Kiosk Accessibility Settlements and Agreements

Kiosk accessibility has been at the root of numerous public settlements.

In a July 2016 settlement, Massachusetts Attorney General, Maura Healy, with the National Federation of the Blind, announced a settlement with Pursuant Health. In the agreement, Pursuant Health agreed to make their self-service healthcare kiosks accessible to blind consumers.

The services available on the kiosks included vision assessments, blood pressure screening, weight assessments, BMI evaluations, and advice on pain management. Pursuant also agreed to pay $95,000 in the settlement, in addition to the cost of retrofitting their kiosks for accessibility.

Post settlement, Mark A. Riccobono, President of the NFB stated “Health information has the potential to be more accessible than ever to the blind with twenty-first-century technology, but only if the manufacturers of technology keep accessibility in mind.”

Creating an Accessible Healthcare Kiosk

To comply with the ADA and ensure usability, healthcare kiosks must be physically accessible.

Wheelchair users need to be able to access the kiosk. This is a requirement of the ADA, which outlines specific compliance guidelines for the height of operable parts, the viewing angle, and the approach area for accessing the kiosk. The approach area requires a clear path without stairs, uneven flooring, or objects to obstruct access.

Once physical accessibility has been established, turn your attention to an equally vital component: software. The kiosk application must be accessible to someone who is blind or has low vision. The kiosk needs to have a screen reader, such as JAWS® for Kiosk, to turn text into speech.

Touchscreens may be difficult for people with disabilities, so an external input/navigation device is also useful to allow users to engage with a kiosk without using a touchscreen. The kiosk application must be developed to ensure it can be easily navigated and understood when read through a screen reader. and website guidelines for accessibility must also be incorporated. The kiosk application must be developed to ensure conformance and usability according to accessibility best practices and the latest WCAG 2.1 AA standards.

See An Accessible Patient Check-In Kiosk in Action

During the 2023 HIMSS Global Health Conference, Storm Interface US Operations Manager Nicky Shaw used the patient check-in experience to demonstrate common barriers for vision-impaired patients.

Planning Your Accessible Healthcare Kiosk: Keep These Questions in Mind

• What application will you be using? Is it already accessible? If yes, can you improve usability for kiosk users?
• Is the kiosk hardware ADA-compliant for height and reach specifications?
• Does the kiosk include an input device with an audio jack? Using an input device that includes an audio jack allows JAWS® to turn off and on based on the presence of the headphones. Learn more about selecting the right input device for your accessible kiosk.
• Are you providing information in a way that is accessible to all users, including those who are deaf or hard of hearing, and those who are blind or who have low vision? That includes any PDFs being read on the screen, videos needing captioning, and document signing for HIPAA compliance.
• Are you protecting user privacy at every turn?

Ensuring Privacy with an Accessible Kiosk

In any healthcare setting, kiosks must provide an accessible and private user experience for all patients. This means including accessibility features to allow a blind or low-vision user to use the kiosk without assistance and not broadcasting personal information out to the entire room. In order to protect patient privacy, all patients with disabilities should be able to use kiosks without the need for third-party assistance.

You can protect patient privacy with kiosks by providing a privacy screen that shields others from viewing the screen. Additionally, proximity switches that reset the kiosk when a user is finished should be implemented, and kiosk software must clear user data between each session.

Protecting Patients with Clean Kiosks

The need to protect patients and healthcare workers from exposure and relieve healthcare workers from unnecessary tasks was of utmost importance during the COVID-19 healthcare crisis, but the question of kiosk cleanliness is always relevant in a healthcare setting.

Anti-microbial touchscreen films and surfaces are available through some kiosk manufacturers.

Kiosks can be easily overlooked on cleaning schedules and are only cleaned if they are considered a priority by janitors and staff. Therefore, it is also important to discuss cleaning procedures and appropriate cleaning supplies for washing kiosks and kiosk accessories such as input devices.

Here are some resources about cleaning kiosks and peripheral devices:

• Cleaning Storm Interface Devices.
• Antibacterial Touch Screen Wipes for Kiosks.
• How to Clean Touch Screens.

Patients should take the same precautions when using a kiosk as when they handle a shopping cart. If facilities provide appropriate cleaning supplies for patients to use prior to utilizing the kiosk or upon completion of usage (like at a gym), then the kiosks will preserve both user safety and that of healthcare staff.

What’s Next for Healthcare Facilities with Kiosks

Retrofitting accessibility software and physical guidelines is an option for kiosks that are already deployed in a healthcare setting. Kiosk input devices and screen reader software can be added, and applications can be updated, to provide an accessible experience.

If new kiosks are still being deployed, it is more cost-effective to consider an accessible design earlier in the production phase, or before new kiosks are manufactured. The costs to build an accessible kiosk are marginally higher than those of an inaccessible one.

For more info

Implementing usable and accessible self-service kiosks requires careful consideration and expertise. This is where accessibility experts, like the team at TPGi, can provide valuable guidance. Experienced consultants can help develop and implement inclusive healthcare kiosks, which maximize inclusion for patients and optimize efficiency for healthcare operations. Schedule a call to speak about your kiosk project today.

More Posts

• Four Important Rules for Healthcare Stations and Kiosks(Opens in a new browser tab)
• ADA Kiosk Legal Actions(Opens in a new browser tab)
• Kiosk Accessibility Patient Kiosks(Opens in a new browser tab)
• Patient Kiosk FAQ – Essential in Hospitals and Clinics(Opens in a new browser tab)
• Visit our dedicated website for Patient Kiosks at patientkiosk.io