The work, start to finish
A Compliance Package takes a practice website from wherever it stands to WCAG 2.1 Level AA, deals with its documents and forms, and leaves a written record of what was done. This page sets out the work in the order it happens.
What gets tested
Software finds some barriers in seconds. Others can only be found by a person using the site the way a patient with a disability does. We do both, on every job.
Every page, by software
Each page of the site is run through axe-core, a widely used open-source rule engine. It catches missing image descriptions, unlabeled form fields, low contrast, broken headings and dozens of other coded failures, the same way every time.
Every task, by keyboard
A person works through each page template and each thing a patient comes to do: find a provider, request an appointment, complete a form, pay a bill. Only the keyboard is used. Every control has to be reachable, in a sensible order, with a focus mark you can see.
With screen readers
The same tasks are repeated with NVDA on Windows and VoiceOver on Apple devices, listening to what a patient who cannot see the screen would hear. This is where a link that says only “link” or a form that cannot be submitted shows up.
Enlarged and on a small screen
Pages are viewed at 200% and 400% zoom and at phone width. Text has to grow and the page has to rearrange itself, with nothing cut off and no scrolling sideways to read a line.
Color and contrast
Each text and background pair is measured against the required ratio. We also check that nothing depends on color alone, such as a required field marked only in red.
Forms
Every field needs a label a screen reader can announce, instructions before the field and error messages written in words. We complete each form from first field to confirmation.
Video and audio
Video with speech needs captions. We list every video on the site and record which have them.
Documents
Every PDF and Office file the site links to is logged and checked: whether it has tags, whether its text can be read, whether its reading order makes sense and whether its form fields are named.
A Small package, day by day
21 calendar days from signed scope to handoff. A Standard package follows the same steps over 35 days. The clock starts when we have access to the site.
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Day 0
Kickoff
The scope is signed. You name one contact person and give us access to the site.
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Days 1 to 2
Scan and inventory
Every page is scanned. Every posted document is logged with its type, its page count, whether it has tags and which pages link to it.
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Days 3 to 5
Testing by hand
Each page template and each patient task is tested by keyboard, with screen readers and at high zoom. Every failure is written up with the page, the element and the fix.
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Day 5
Triage call, 30 minutes
We arrive with every document already sorted: repair, convert, archive, exempt or remove. You approve the sort or change it. You leave with a short memo your attorney can review.
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Days 6 to 14
Repair
The site is repaired, or rebuilt when that is faster. Documents are repaired. Forms patients still use are rebuilt as web forms. An archive area is set up for old material.
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Days 15 to 17
Retest
A full rescan of every page, then a second pass by hand over everything that changed.
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Days 18 to 19
Statement and training
The accessibility statement and the request procedure go live. The staff training is recorded and delivered.
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Days 20 to 21
Handoff
You receive the conformance report, the exception register, the owner summary and the vendor file. If you chose a Care plan, it begins.
Repair or rebuild
Either one is covered by the package price. Which we do depends on what your site is built on.
| Your site | What we do |
|---|---|
| Runs on WordPress or another platform we can edit | We repair it in place. Your pages, design and address stay as they are. |
| Runs on a vendor platform whose templates we cannot edit | We fix all of the content, send the vendor a written list of the defects in its templates and offer a rebuild if the vendor will not act. |
| Is small, out of date or no longer maintained | We rebuild it as a hand-coded site with the same content. For a small site that is faster than repair and leaves less to go wrong later. |
Documents and forms
Most practices have more PDFs online than they remember. The rule does not require all of them to be repaired. Every file gets one of five outcomes, and you approve the list.
Repair
The file stays a PDF and gains tags, a reading order, text descriptions for its images and a title. Used for documents patients still read.
Convert
A form patients still complete becomes an accessible web form that works on a phone and by keyboard. This is usually the better answer for intake and consent forms.
Archive
Old material kept only for reference moves to a clearly labeled archive area and is not edited again. The rule has an exception for content kept this way.
Exempt
A file posted before your deadline that patients do not need in order to receive care can stay as it is. We record which exception applies.
Remove
Out-of-date files nobody needs come down. Fewer files means less to maintain.
On request
Whatever the sort, a patient who asks for a document in a form they can use still has to be given one. We set up that request procedure with you.
The exceptions are set out in the rule itself. Read the five exceptions in plain terms.
Your portal and other vendor tools
The rule covers what a practice provides directly and what it provides through a vendor. A patient portal, an online scheduler or a bill-pay page run by another company still counts as yours.
Nobody but the vendor can change those products, so we do the part that can be done. We test the path from your site into each tool. We write to each vendor asking for its Accessibility Conformance Report, the standard document in which a vendor states how its product measures up. We file what comes back and tell you plainly where the gaps are and what to ask for next.
Of the 116 Ohio practice sites we scanned, 86 send patients to an outside portal, scheduling or forms tool.
What you receive
Six things, in writing. Together they are your record of what was done and why.
Conformance report
A dated record of what was tested, how it was tested, the result against each WCAG 2.1 Level AA requirement and anything still open.
Exception register
Every document and item left as it is, with the rule exception relied on for each. This is what you show if someone asks why a file was not repaired.
Owner summary
One page in plain language for the physicians or the board: what was done, what remains and what to watch.
Vendor file
Our written requests to your portal, scheduling and forms vendors, and each conformance report they send back.
Statement and request procedure
An accessibility statement for your site, and a simple way for a patient to report a problem or ask for a document in another form.
Staff training
A recorded 60-minute session for the people who post to the site: writing link text, describing images and posting a document without creating a new barrier.
What we need from you
- One contact person who can answer questions and approve decisions
- Access to the site: a login to the content system, or to the hosting account
- Thirty minutes for the triage call on day 5
- A decision on the document sort within a few days of that call
- The names of your portal, scheduling and forms vendors
What a package does not cover
- Changes inside a vendor's portal or scheduling product, which only the vendor can make
- Captions or transcripts for video, which we quote separately
- Mobile apps, which we quote separately
- A redesign or new content beyond what the repair requires
- Legal advice. We work alongside your attorney, not in place of one.
After handoff
A site drifts as staff post and vendors change things. The Care plan is the monthly work that keeps it at the standard.