Accessibility Guidance for Virtual Visits

Accessibility in the virtual care space can be described as the inclusive practice of ensuring there are no barriers that prevent people with disabilities from interacting with, or accessing, virtual care solutions. These solutions may include, but are not limited to, secure messaging, video calls, and remote care management.

This guide is for health service providers who offer virtual visits for patients. Find out what you need to know and look for to make sure your virtual visit solution is accessible for everyone.

On this page:

Accessible Virtual Care Solutions – Why You Need Them

Accessible solutions better serve people with disabilities

More than two million people in Ontario (one in seven) are living with disability. These are often the people who are impacted most by inaccessible virtual care solutions and who would benefit most from the use of virtual care solutions. Most of us experience temporary or situational disabilities from time to time. Learn about different types of disabilities to consider in a virtual care space.

Accessible solutions are easier to use for everyone

You don’t need to have a disability to benefit from an accessible virtual care solution. The more accessible a solution is, the easier it is for everyone to use.

Patients want more accessible options

Based on our user research, the following are some features people with disabilities have requested in their virtual care solutions:

  • Font resizer allows individuals to increase or decrease the size of the text on the page.

  • Keyboard accessibility enables individuals to access and interact with all information on the website without needing a mouse. People should be able to use the tab key to navigate through the page in a logical order; see where they are on the page at all times; and access all content, elements and functionality with the keyboard.

  • Dark or high-contrast modes allows a person to change the colour scheme of the website to increase the contrast of foreground and background colours, making it easier to read.

  • Multi-spotlight allows the presenter to make particular participants the primary active speakers for all participants.

  • Multi-pinning enables an individual to enlarge another participant’s video (other than the speaker) so they can see them more clearly. Example: an interpreter.

  • Closed captions (auto generated, manual, or third-party) allows a person to see on-screen text of the audio, making video accessible to people who are deaf or hard of hearing.

  • Screen reader support an assistive technology that allows people who are blind or have low vision to hear, access and interact with content via audio or touch.

  • Caller ID enables an individual to hear the name and number of the person calling.

  • Online booking functionality provides people with the ability to book a service through a website or application.

  • Use of features (other than colour) to convey meaning allows people who are blind or have low vision to access information that may have otherwise only been represented through colour. For example, a person who cannot see will not know which to choose when instructed to “advance to next screen using the red arrow”. All colour-coded information will also need to be conveyed in a text format.

Accessible solutions are the law

In Ontario, all publicly available websites (including virtual care solutions) are required to meet certain accessibility requirements.

Ontario’s Accessibility Requirements

About the legislation

The Accessibility for Ontarians with Disabilities Act, 2005 (AODA) is Ontario’s accessibility legislation. It requires that all publicly facing websites (including virtual care solutions) conform with a specific set of globally recognized guidelines, the Web Content Accessibility Guidelines (version 2.0, Level AA).

Penalties for non-compliance

Failure to comply with AODA can result in fines of up to $50,000 per day for individuals and unincorporated organizations, and up to $100,000 per day for corporations.

About the Web Content Accessibility Guidelines (WCAG)

The Web Content Accessibility Guidelines are an international technical standard that explains how to make web content more accessible to people with disabilities. WCAG contains 12 guidelines organized under four principles: perceivable, operable, understandable and robust. Each guideline is supported by a set of success criteria that help determine whether or not a solution conforms with WCAG. These success criteria are categorised into three levels of conformance: Level A, Level AA and Level AAA.

Learn more about the Web Content Accessibility Guidelines.

Exclusions and Exceptions

The AODA specifically excludes the following WCAG criteria from the requirements. During video calls, virtual care solutions do not require:

An exception means that it is not technically feasible for the Solution Provider to comply with the guidelines or criteria. There is only one exception that is deemed acceptable grounds for non-compliance:

  1. Where modifications to the solution are not feasible. In determining feasibility, consideration is given to the availability of commercial software and/or tools. If solutions cannot be modified, or software and/or tools are not available, each guideline that cannot be met must be documented as an exception in the solution’s accessibility report. The timeline for expected resolution must also be included.

How to Know if a Solution is Accessible

To comply with AODA, virtual care solutions must conform with WCAG 2.0 to at least Level AA, even though the Virtual Visits Solution Requirements standard indicates that accessibility of solutions is only “recommended.”

Review the accessibility report for the solution

Solution providers that advertise accessibility compliant solutions should provide either of the following reports:

  • VPAT® – Voluntary Product Accessibility Template, a document that explains how information and communication technology products such as software, hardware, electronic content, and support documentation conform to the 508 Standards for accessibility. While this is a US standard, it closely aligns with both WCAG and AODA.
  • ACR – Accessibility Compliance Report, a document that formally summarises the extent to which an information and communications technology, product or service conforms to an agreed set of international accessibility guidelines and standards.

Ontario Health publishes the solution’s VPAT and/or ACR if it is available. To view an accessibility report, select a vendor from the Verified Solutions List.

Ask the solution provider these questions

  • To what extent was the solution evaluated by people with different disabilities?
  • On which devices were accessibility tests performed?
  • How frequently do you update your accessibility compliance reports?
  • What ongoing user research do you perform?
  • How is user feedback used to prioritize new features or feature enhancements?
  • What plans do you have to meet newer accessibility guidelines such as WCAG 2.1 and 2.2?
  • What training do you provide for health service providers?
  • What patient support materials can you offer?

Accessibility Resources

Last Updated: September 26, 2024