Accessible digital healthcare: From WCAG compliance to comprehensible content

Why accessibility is crucial in healthcare

The numbers don't lie: in the Netherlands, 2.5 million adults have difficulty with reading and writing. Of these, 1.3 million cannot read functionally - in other words, they don't understand medical letters, patient information leaflets, or websites. At the same time, healthcare is becoming increasingly digital, from making appointments online to looking up medication information.

2.5 million Dutch people have difficulty with reading and writing
34% of over-65s have limited digital skills
18% of the Dutch population has a migration background

For healthcare institutions, this represents an enormous responsibility. Your information can literally be life-saving - but only if people understand it. A misunderstood medication instruction or a missed appointment can have dramatic consequences.

Moreover, it also has practical benefits. The better your digital healthcare provision is accessible, the less time your care staff spend answering questions whose answers are already on the website. Win-win.

The limits of WCAG compliance

WCAG (Web Content Accessibility Guidelines) are important and necessary. They ensure websites are technically accessible for people with visual, auditory, or motor impairments. Think of good contrast ratios, alternative texts for images, and keyboard navigation.

But WCAG doesn't solve all problems. The guidelines state that your website must be technically accessible, but not how to make content comprehensible for people with different backgrounds and skills.

What WCAG doesn't solve

An 85-year-old patient can, thanks to WCAG compliance, technically operate your website with a large mouse and enjoy a better reading experience thanks to the high-contrast screen setting. But do they also understand what "systemic side effects" means? Or what to do if they forget to take a heart medication once?

Example: WCAG-compliant but not comprehensible

WCAG text: "In mild to severe hepatic insufficiency, the dosage should be adjusted according to the product information."
Comprehensible text: "Do you have liver problems? Your doctor may choose to prescribe a lower dose."

WCAG guarantees technical accessibility - but true inclusion also requires cognitive accessibility, cultural accessibility, and linguistic accessibility.

From universal to personalised

The traditional approach is to make content as universal as possible: one version that works for everyone. But in the healthcare sector, it proves time and again that this doesn't suffice. What's perfectly clear for one patient is incomprehensibly complex for another.

The solution lies in modular content that adapts to the user. Not everyone needs to receive the same level of detail. Not everyone needs to speak the same language.

Modularity in practice

Imagine: a diabetic patient visits your website to find information about blood sugar measurements. Depending on their profile, they see different content:

Newly diagnosed: "Diabetes means your blood sugar is too high. We'll explain step by step how you can measure this."

Experienced patient: "New guidelines for HbA1c target values and continuous glucose monitoring."

Non-native speaker: Automatic translation to native language, with visual support.

Low literacy: Mainly images and videos, with simple text in short sentences.

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AI for automatic complexity adjustment

Modern AI can automatically adjust texts to the desired language level. From academic language use to B1 level, from medical jargon to ordinary people's language, from long sentences to short, punchy messages.

At iO, we're experimenting with AI tools that can "translate" medical content to different complexity levels without losing medical accuracy. This enables healthcare institutions to generate multiple versions for different target groups from one source text.

How technology enables personalisation

The technology to realise this already exists. It involves smart combinations of headless content management, AI-driven personalisation, and progressive usability improvements.

Headless CMS: flexible content delivery

With a headless CMS like Drupal, you create content once and then serve it in different ways. The same basic information about medication can appear as:

An extensive product page for medical professionals
A simple FAQ for patients
A visual infographic for people with reading difficulties
An audio version for people with visual impairments
A simplified version in multiple languages

Automatic translations and accessibility tools

AI-driven translation tools are getting better, especially for standardised medical terminology. Combined with text-to-speech, adapted fonts, and simplified navigation, you can quickly create multiple accessible versions of your content.

Tools and techniques you can deploy:
AI content rewriting: Automatically adjust language level
Progressive web apps (PWAs): Websites that behave like apps and users can interact with via the browser
Voice interface: Voice-controlled navigation
Visual assistance: Pictograms and symbols alongside text
Smart forms: Forms that adapt to user skills

Example: Progressive complexity

A smart approach is progressive disclosure: start simple and give users the option to go deeper if they want to.

Level 1: "Blood thinners ensure your blood clots less quickly."
Level 2: "Blood thinners like [medicine name] reduce your clotting risk with heart rhythm disorders."
Level 3: "Anticoagulants inhibit the coagulation cascade via factor Xa inhibition..."

The user determines how deep they want to go, without being overwhelmed by information they can't (yet) use.

The benefits for patients and organisation

True accessibility has benefits for all involved. Patients receive better comprehensible information and feel taken more seriously. Healthcare institutions see concrete results in their daily operations.

Lower burden on call centres

The more comprehensible your online information, the fewer people call with questions. The Thuisarts.nl case demonstrates this: by making reliable, comprehensible medical information available online, the number of contacts with GP practices fell by 12%.

Better therapeutic compliance

Patients who understand why they need to take medicines and how to do so adhere better to treatment protocols. This leads to better outcomes and fewer complications.

Greater inclusivity and higher satisfaction

When people feel heard and understood by your organisation, this leads to higher patient satisfaction and loyalty. You build a reputation as an organisation that's truly there for everyone.

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Step-by-step plan towards inclusive digital healthcare

Building true accessibility doesn't happen overnight. It's a process you can tackle step by step.

Step 1: Audit current content

Begin with a thorough analysis of your current digital setup. Not just technical WCAG compliance, but also:

Language level of your content (measure this with tools like Tekstanalyse.be)
User experience for different target groups
Places where people get stuck or drop out
Frequently asked questions that are actually already answered on your website

Step 2: Develop Personas and Scenarios

Develop concrete user profiles that go beyond demographic data. Think about:

Persona example: Maria (67 years)
Maria has diabetes and mild heart problems. She can read and write, but isn't very handy with computers. She'd rather trust a phone call than a website. Her Dutch is good, but she often doesn't understand medical terms. She mainly wants to know if something's serious and what she should do - details about why interest her less.

Step 3: Build content modularly and test

Build your content in reusable modules that you can combine differently for different users. Test this continuously with real patients from your various target groups.

For example, a medication module:
• Basic module: what does this medicine do?
• Practicalities module: how and when to take?
• Warning module: side effects to be aware of
• Science module: how the medicine works biochemically
• Experience module: stories from other patients

Step 4: Implement technology incrementally

Start small with one component or one patient group. Learn from what works and expand slowly. Better a small accessible part than a large incomprehensible website.

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Accessibility as Person-Centred Care Mission

True accessibility goes beyond compliance. It's about your mission as a care provider: being there for everyone who needs your help, regardless of their background, language, or skills.

The patients who have the most difficulty with complex medical information are often also those who need care the most. Elderly people, people with chronic conditions, people in vulnerable situations. By making your digital channels truly accessible, you ensure these groups don't fall between the cracks.

Technology doesn't have to be exclusive. With the right approach, it becomes inclusive - and helps people receive better care and make better choices about their health.

That's perhaps the most beautiful aspect of our work: using technology to make care more human, not less personal. To remove barriers instead of creating new ones. And to ensure that everyone - truly everyone - has access to comprehensible, reliable healthcare information.

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