Healthcare digital accessibility compliance

The current landscape: From nice-to-have to mandated accessibility

The regulatory ground shifted in March 2024, but most healthcare providers are still operating like it’s 2019.

Here’s what changed: Section 504 of the Rehabilitation Act now explicitly covers digital properties. Your website, patient portals, and appointment booking systems all fall under the same civil rights protections as your physical facilities. WCAG compliance isn’t a suggestion anymore. It’s the baseline, and the Department of Health and Human Services can investigate you for failing to meet it.

This isn’t happening in a vacuum. Healthcare providers continue to be targets of ADA compliance lawsuits. Plaintiff firms have industrialized the process of finding violations. They’re not targeting small clinics. They’re pursuing health systems with deep pockets and sprawling digital footprints.

Meanwhile, patient expectations have completely changed. Seventy-eight percent of patients now expect accessible digital healthcare services as standard care, not as a requested accommodation. When your portal’s form labels break screen readers or your appointment scheduler fails keyboard navigation, patients don’t think “accessibility issue.” They think “this hospital doesn’t care about me.”

Regulators and advocacy groups are watching. The plaintiff bar is watching. More importantly, your patients are watching.

The gap between “we did an audit in 2023” and “we’re operationally accessible right now” is where the risk lives. You can’t audit your way out of this, not when you’re shipping new content, microsites, and portal updates every week while your last accessibility check happened nine months ago. Equal access to digital health care isn’t optional anymore.

Process gaps: Audits and reactions aren’t a governance model

Most healthcare systems handle accessibility the same way they handle facility inspections: schedule it annually, fix what gets flagged, file the report, and move on.

I’ve watched this play out dozens of times. A hospital hires a third-party firm to audit their main website. The report comes back with 300 issues. IT and marketing spend six weeks fixing the critical ones. Everyone breathes a sigh of relief. Then the content team publishes 40 new pages over the next three months, landing pages for new services, physician bios, health resources, and event microsites. Nobody checks any of them for web accessibility until the next audit rolls around. Or until someone files a complaint.

This approach has three structural problems:

Violations pile up in gaps between audits

You audit once a year, maybe twice if you’re diligent. But your teams constantly publish. Every new campaign, every portal update, every redesigned form is a fresh opportunity to introduce accessibility barriers. The math doesn’t work. Annual checks can’t govern weekly publishing. By the time your next audit comes around, you could have hundreds of new pages that nobody’s tested.

No integration means creators are flying blind

Content authors and marketers have no real-time feedback on whether the page they’re building will pass accessibility standards. They’re guessing. Maybe they remember some training from two years ago. Maybe they don’t. By the time someone flags an issue, that content has been live for months, patients have already hit barriers, and fixing it means rework nobody budgeted time for.

One practical way to close this gap is to integrate accessibility feedback into the authoring workflow, so issues like missing alt text, heading order, or vague link text are flagged while pages are being drafted. Some teams use tools, such as Siteimprove.ai, which surface checks in-editor and route fixes through clear workflows rather than ad hoc tickets.

Brand and accessibility live in separate universes

Your brand team enforces terminology, disclaimers, and visual standards through one set of tools and processes. Your accessibility checks happen somewhere else entirely, often by different people using different systems. So, you end up with pages that are perfectly on-brand but completely inaccessible or accessible but wildly off-brand. Neither builds patient trust.

The result? A patchwork of fixes with no consistent baseline. No single source of truth for “what’s the accessibility status of our digital properties right now?” No way to answer when leadership asks whether you’re compliant or Legal asks about risk exposure. Just a stack of old audit reports and a hope that nothing’s gotten worse since you last checked.

The cost of reactive accessibility: Risk, inequity, and wasted effort

When accessibility is something you handle after someone complains, the bill comes in three currencies: money, trust, and time. None of them are cheap.

Start with the legal math. Digital accessibility lawsuits targeting healthcare continue unabated. One lawsuit turns into a settlement, which turns into a consent decree, which turns into three years of court-monitored remediation.

But here’s what the legal costs don’t capture: the patients who tried to book an appointment through your portal and couldn’t because your form labels break screen readers. The person using keyboard navigation who got trapped on your login page because someone forgot focus indicators exist. These aren’t hypothetical accessibility personas from a training deck. These are real people trying to access care who your digital experience actively blocked, creating an accessibility barrier for patients who rely on assistive technology.

Every health equity commitment statement you publish gets quietly contradicted by inaccessible patient journeys.

Plus, there’s operational drain. Your marketing team launches a new service line campaign with a microsite. Three months later, someone flags accessibility issues. Now you’re pulling developers off other work to fix things that should’ve been caught across your healthcare websites and digital platforms before launch. IT scrambles to remediate. Legal gets involved. Your content team rewrites copy. Everyone’s day is ruined by something that could’ve been prevented with pre-publish checks.

Rework isn’t free. Emergency fixes cost more than getting it right the first time, both in budget and in the opportunity cost of what your teams could be doing instead of firefighting.

What good looks like: Proactive digital accessibility governance

Mature healthcare accessibility governance looks less like an audit schedule and more like how your organization handles infection control: continuous monitoring, clear protocols, everyone knows their role, and leadership can see the data that proves it’s working.

The hospitals that get this right stop treating accessibility as a project with a start and end date. They treat it like security. You don’t finish security and move on. You build systems that continuously validate, catch problems early, and give teams the tools to maintain standards without constant oversight. Accessibility works the same way.

The outcome isn’t perfect; it’s predictable. Patients get consistently accessible experiences across every touchpoint. Regulators see a system of control, not reactive patches. And your teams shift from panic mode to steady progress, because accessibility is built into how work gets done instead of being bolted on afterwards.

How Siteimprove.ai operationalizes accessibility and brand-aligned governance

You can’t fix accessibility with good intentions and an annual audit. You need tooling that makes compliance the default path, not the heroic effort.

Programs, like Siteimprove.ai, turn accessibility from “the thing we check sometimes” into “the thing that happens automatically while teams work.” Below are the four ways this shows up in practice.

Your entire digital footprint gets scanned continuously, not annually

Every healthcare website, microsite, patient portal, and mobile app gets crawled and tested against WCAG 2.1 AA plus whatever custom brand standards you’ve set. You see issues by severity, page type, and patient impact in one central view. High-risk gaps show up immediately.

The blind spots between audits? Gone. Your compliance status isn’t a report from last spring. It’s today.

Content creators see problems before publishing, not after

Direct CMS integration means your content authors get real-time feedback while drafting. Missing alt text? Headings out of order? Form labels that screen readers can’t parse? Link text that just says, “Click here?” All flagged in the authoring interface where fixing it takes seconds instead of filing a ticket and waiting for IT.

Issues get assigned, tracked, and closed through structured workflows instead of the usual chaos of emails and Slack messages with the hope that someone remembers to follow up. Your team can self-correct without becoming accessibility experts first.

Rules get enforced automatically, not manually

Encode your accessibility and brand standards once, then let the policy engine apply them everywhere. Off-brand terminology gets caught. Contrast violations surface. Pages missing required disclaimers get flagged. New content conforms to the standard without someone from Brand or Legal manually reviewing every piece. (Because nobody has time for that, and even if they did, they’d miss things.)

Leadership sees risk exposure and progress in logical dashboards

Executives get high-level views: total issues trending down over time, critical problems by property, and how fast teams are remediating. Legal and Compliance get the evidence they need for audits or investigations: proof of proactive management, not just “we’re working on it.”

The shift is subtle but powerful. Accessibility stops being something you inspect and becomes something built into how content gets made. Teams move faster because they catch issues early. Patients get better experiences because problems don’t make it to production. Leadership sleeps better because the risk profile is visible and trending in the right direction.

Operational playbook: Move from reactive fixes to embedded accessibility

Shifting from “we’ll fix it when someone complains” to “we prevent problems before they ship” isn’t a moment of inspiration. It’s a deliberate transformation that takes most healthcare organizations three to six months to fully operationalize.

The teams that pull this off follow a pretty consistent pattern. Not because there’s one perfect way to do it, but because skipping steps or doing them out of order tends to create new problems while solving old ones.

Audit your current digital footprint and map the risk

Inventory everything patient-facing: main sites, microsites, campaign landing pages, and logged-in portal experiences. Use Siteimprove.ai to baseline where you stand against WCAG 2.1 AA and get an honest look at issue density across properties. Then map where accessibility problems intersect with high-traffic, high-stakes patient journeys. (Spoiler: appointment booking and portal login almost always top the list.)

Define policies and clarify who owns what

Establish WCAG 2.1 AA as your minimum standard and add any organization-specific rules on top. Then get specific about ownership: who sets policy (usually Compliance and Legal), who enforces it (Digital and IT), who remediates (content authors, dev teams). Decide which issues are hard blockers that prevent publishing versus soft warnings teams can override with documented exceptions. Without this clarity, every issue becomes a negotiation.

Integrate Siteimprove.ai into CMS workflows and train people to use it

Turn on pre-publish checks so content authors and editors get real-time guidance. Configure issue routing and priority queues: critical problems on high-traffic patient pathways escalate first; lower-severity concerns can wait. Train authors on using in-editor feedback to fix issues themselves instead of filing tickets and waiting. Most accessibility problems at the content level take under 30 seconds to resolve if you catch them during drafting.

Align accessibility with brand and UX standards in one governance layer

Use Siteimprove.ai to enforce accessibility and brand rules, such as approved language, required disclaimers, and design patterns. Make sure your design system components and templates are accessible by default so teams aren’t fighting to be both on-brand and compliant. When brand and accessibility live in the same system, you stop creating tension between them.

Track metrics, report progress, and expand to new properties

Monitor what matters: number of issues over time, remediation speed, accessibility scores, and coverage of high-risk pages. Share progress with Legal, Compliance, and executives to demonstrate active control and measurable improvement. Then extend governance to new properties as they come online on campaign sites, acquisition integrations, and new portal features. Once the system works, scaling it is straightforward.

Most organizations see meaningful progress within 60 days and can point to measurable risk reduction within a quarter. The transformation isn’t instant, but it’s faster than staying stuck in reactive mode.

Organizational impact and ROI: What changes when accessibility is embedded?

Proactive accessibility governance pays off in ways your CFO cares about and ways that don’t fit neatly into budget spreadsheets.

The shift from reactive to proactive doesn’t solely reduce settlements. It frees up capacity, builds credibility with patients and partners, and turns compliance from a risk you’re managing into a capability that sets you apart from other healthcare providers.

Stop audits; start implementation

If accessibility is something you check occasionally, you’re out of alignment with federal regulation and patient expectations. Section 504’s March 2024 update was straightforward: Inaccessible digital properties are civil rights violations.

The only sustainable way to meet Section 504, reduce ADA risk, and build patient trust is to embed accessibility into daily digital operations through continuous monitoring, policy-driven enforcement, and real-time authoring guidance that catches problems before they go live.

Your starting checklist:

• Inventory your digital properties and get a baseline risk profile
• Adopt WCAG 2.1 AA as your minimum standard
• Implement continuous scanning and dashboards for leadership visibility
• Integrate accessibility checks into CMS workflows so teams self-correct before publishing
• Align accessibility with brand standards under one governance model
• Track incident reduction and share results internally

Pick one area where you’re the weakest (such as inconsistent standards, late-caught issues, or unclear risk exposure) and fix it systematically. Measure what changed. Move to the next problem. That beats comprehensive roadmaps that sit in slide decks for six months.

Ready to see how embedded accessibility governance works? Request a demo to see how Siteimprove helps healthcare teams make accessibility automatic.