Patient Portal Adoption has Surged, but Accessibility Failures are Locking out the Patients who Need Digital Access the Most
The digital transformation of healthcare has made it easier than ever for patients to manage their own care. For the one in four Americans living with a disability, that promise often falls apart at the first click.
A patient checks her lab results at 10 p.m. She logs into her health system’s patient portal, pulls up the results page, and sees what her doctor ordered. Five minutes, start to finish.
Same portal, different patient. This one is blind. The login form has no labels, so her screen reader can’t tell which field is for her username and which is for her password. She guesses. Gets it wrong. The error message that pops up? Invisible to her assistive technology. She never gets past the front door.
That second scenario is not uncommon. According to the ONC’s 2024 Health Information National Trends Survey, over 75% of individuals now have online access to their medical records. But for the one in four American adults living with a disability, the digital front door to healthcare might as well be bolted shut. These aren’t people opting out of digital health. They’re being shut out by the very tools meant to bring them in.
Where Patient-Facing Digital Tools Break Down
The failures in patient portals aren’t random. AudioEye’s 2025 Digital Accessibility Index analyzed more than 420,000 web pages across 15,000 websites and found that the average healthcare page had 272 accessibility issues. They cluster in the exact workflows patients use most.
- Keyboard Navigation Failures: Patients with motor disabilities often can’t use a mouse, so they navigate entirely by keyboard; healthcare sites averaged 6.1 keyboard-related violations per page – that’s enough to make logging in or filling out a form a dead end
- Low Contrast Text: If the color contrast between text and background is too low, people with low vision can’t read it; healthcare pages averaged 69.1 contrast violations per page; lab results, medication instructions, appointment details: all potentially unreadable
- Broken Links and Forms: Screen readers need properly labeled links and form fields to guide someone through a page; without them, it’s guesswork; healthcare sites averaged 5.4 inaccessible links and 4.0 broken form elements per page
All of this is happening on live patient portals, at organizations that would absolutely describe themselves as patient-centered.
The Regulatory Pressure is Real and Immediate
The updated Section 504 rule from HHS, finalized in May 2024, requires organizations receiving federal financial assistance to meet WCAG 2.1 Level AA across their digital properties (45 CFR Part 84).
59% of business leaders said their organizations would face legal risk if audited today, according to AudioEye’s 2026 Accessibility Advantage Report. Yet only 47% describe their accessibility programs as proactive. The rest are operating reactively or meeting bare minimums. If you’re in health IT, that gap should worry you.
A Practical Fix Roadmap for Stretched Teams
Most patient portal accessibility failures are configuration and content issues. Fixable, if you prioritize the highest-impact areas.
Start with the critical path. Map the five to ten workflows patients use most. Audit those specifically against WCAG 2.1 AA using both automated scanning and manual testing with assistive technology. Automated tools catch roughly two-thirds of issues. The rest — screen reader behavior, keyboard flow logic, cognitive accessibility — requires human evaluation.
Fix login and authentication first. A patient who can’t get past the front door can’t use anything else. Then test and fix form labels, link descriptions, and alt text on high-traffic pages.
Someone has to own it. Nearly half of organizations manage accessibility entirely in-house, but 64% of those teams admit they lack the specialized skills. If nobody owns accessibility as an ongoing practice, it won’t survive the next site update.
Build testing into every release cycle. Every portal update, new feature, and vendor patch can introduce new barriers. The organizations that stay compliant test at every release, not once a year before an audit.
The Real Impact is Patients, Not Compliance
Yes, the Section 504 deadline matters. But fines aren’t the real cost here.
If the disability rate in your community mirrors the national average, approximately 25% of your patients have a disability. Even if only a fraction of those people can’t complete basic portal tasks, you’re talking thousands of patients a year who are functionally locked out. They give up on the portal. Call the front desk instead. Skip the follow-up because the phone line was busy. And slowly drift away from their own care.
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