Web Content Accessibility Guidelines

Web Content Accessibility Guideline for View, Download and Transmit

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Web Content Accessibility Guideline

In this post we will focus on the web content accessibility guideline functional standards required to pass View, Download and Transmit meaningful use certification criteria. Though VDT is a comprehensive meaningful use measure for certification but here we will only discuss the web content accessibility guideline functional standard required to complete this measure for Medicaid and Medicare incentive program.

According to Test guide, A Health IT Module must demonstrate compliance with the Web Content Accessibility Guideline (WCAG) 2.0 Level A at minimum, and may alternatively demonstrate compliance in accordance with the standard specified in Level AA protocols. This information will be listed with the product as part of its Certified Health IT Product List (CHPL) listing. A Health IT Module does not need to support both WCAG 2.0 Levels.

In the light of above statement below are the details about the both (WCAG) 2.0 Level A and (WCAG) 2.0 Level AA standards.

Web Content Accessibility Guideline 2.0 checklist Level A (Beginner)

Guideline Summary
1.1.1 – Non-text Content Provide text alternatives for non-text content
1.2.1 – Audio-only and Video-only (Pre-recorded)
1.2.2 – Captions (Pre-recorded) Provide captions for videos with audio
1.2.3 – Audio Description or Media Alternative (Pre-recorded) Video with audio has a second alternative
1.3.1 – Info and Relationships Logical structure
1.3.2 – Meaningful Sequence Present content in a meaningful order
1.3.3 – Sensory Characteristics Use more than one sense for instructions
1.4.1 – Use of Colour Don’t use presentation that relies solely on colour
1.4.2 – Audio Control Don’t play audio automatically
2.1.1 – Keyboard Accessible by keyboard only
2.1.2 – No Keyboard Trap Don’t trap keyboard users
2.2.1 – Timing Adjustable Time limits have user controls
2.2.2 – Pause, Stop, Hide Provide user controls for moving content
2.3.1 – Three Flashes or Below No content flashes more than three times per second
2.4.1 – Bypass Blocks Provide a ‘Skip to Content’ link
2.4.2 – Page Titled Use helpful and clear page titles
2.4.3 – Focus Order Logical order
2.4.4 – Link Purpose (In Context) Every link’s purpose is clear from its context
3.1.1 – Language of Page Page has a language assigned
3.2.1 – On Focus Elements do not change when they receive focus
3.2.2 – On Input Elements do not change when they receive input
3.3.1 – Error Identification Clearly identify input errors
3.3.2 – Labels or Instructions Label elements and give instructions
4.1.1 – Parsing No major code errors
4.1.2 – Name, Role, Value Build all elements for accessibility

Web Content Accessibility Guideline 2.0 checklist Level AA (Intermediate)

Guideline Summary
1.2.4 – Captions (Live) Live videos have captions
1.2.5 – Audio Description (Pre-recorded) Users have access to audio description for video content
1.4.3 – Contrast (Minimum) Contrast ratio between text and background is at least 4.5:1
1.4.4 – Resize Text Text can be resized to 200% without loss of content or function
1.4.5 – Images of Text Don’t use images of text
2.4.5 – Multiple Ways Offer several ways to find pages
2.4.6 – Headings and Labels Use clear headings and labels
2.4.7 – Focus Visible Ensure keyboard focus is visible and clear
3.1.2 – Language of Parts Tell users when the language on a page changes
3.2.3 – Consistent Navigation Use menus consistently
3.2.4 – Consistent Identification Use icons and buttons consistently
3.3.3 – Error Suggestion Suggest fixes when users make errors
3.3.4- Error Prevention (Legal, Financial, Data) Reduce the risk of input errors for sensitive data

Though above functional standards are for VDT implementation but here i would like to add advance level of Web Content Accessibility Guideline 2.0 Level AAA for Health IT developers as per future expectation for certification.

WCA 2.0 checklist Level AAA (Advanced)

Guideline Summary
1.2.6 – Sign Language (Pre-recorded) Provide sign language translations for videos
1.2.7 – Extended Audio description (Pre-recorded) Provide extended audio description for videos
1.2.8 – Media Alternative (Pre-recorded) Provide a text alternative to videos
1.2.9 – Audio Only (Live) Provide alternatives for live audio
1.4.6 – Contrast (Enhanced) Contrast ratio between text and background is at least 7:1
1.4.7 – Low or No Background Audio Audio is clear for listeners to hear
1.4.8 – Visual Presentation Offer users a range of presentation options
1.4.9 – Images of Text (No Exception) Don’t use images of text
2.1.3 – Keyboard (No Exception) Accessible by keyboard only, without exception
2.2.3 – No Timing No time limits
2.2.4 – Interruptions Don’t interrupt users
2.2.5 – Re-authenticating Save user data when re-authenticating
2.3.2 – Three Flashes No content flashes more than three times per second
2.4.8 – Location Let users know where they are
2.4.9 – Link Purpose (Link Only) Every link’s purpose is clear from its text
2.4.10 – Section Headings Break up content with headings
3.1.3 – Unusual words Explain any strange words
3.1.4 – Abbreviations Explain any abbreviations
3.1.5 – Reading Level Users with nine years of school can read your content
3.1.6 – Pronunciation Explain any words that are hard to pronounce
3.2.5 – Change on Request Don’t change elements on your website until users ask
3.3.5 – Help Provide detailed help and instructions
3.3.6 – Error Prevention (All) Reduce the risk of all input errors

Besides the implementation of actual standards, Health IT developers must focus on the following general design guide lines as well for healthcare web application.

General Design Considerations
General Design Considerations Proper web application interface design comes from an understanding of what makes web applications distinct from standard web sites and traditional client-applications. Effective solutions to web application interface issues arise from the criteria, goals, constraints and trade-offs inherent in the nature of web applications. Web applications are distinct from standard web sites in many ways.

They are not only more interactive, requiring constant user action and reaction, but often times they consist of more complex interactions than those found in traditional web sites. In addition, these interactions are often unique. Even web applications for similar activities exhibit striking differences in design and workflow. For example, one corporation’s online trading system may be drastically different from a competitor’s. On the other hand, following hyperlinks and searching for content on the two corporations’ web sites is likely to be very similar.

Also, it is often the case that web applications are more likely to be used more intensively and perhaps more frequently than traditional web pages. Users want the services that web applications have to offer. Therefore, they are willing to invest more time in learning the functionality of a web application for the payoff of increased productivity.

This is very much unlike the rapid surfing of web pages for information, in which case users will promptly move on if they cannot quickly understand the site. It is this rapid surfing and informational retrieval that web usability guidelines aim to optimize. The assumption in web usability guidelines is that attention is a serious limiting factor for effective interactions. As just pointed out, this is not the case in web applications and hence, it is a source of substantial discrepancies between web usability guidelines and web application guidelines.

Client application GUI guidelines are more applicable to web applications, since they are application-orientated and not constrained by the requirements of the browsing model. However, the constraints of the WWW are still very real and need to be taken into account when designing an application to run in the browser environment instead of the desktop environment. Because a web application is accessed over the Internet, users will perceive its use as similar to that of a web page, and transfer both applicable and inapplicable knowledge to the web application.

In addition, web applications are subject to be treated in the informal manner common to web page use. For these reasons, the conventions of web users need to be taken into careful consideration. The current limitations of the WWW also constitute an important set of considerations for web applications. Interacting with data over the Internet poses unique problems for users. Delays in download time and connection errors need special accommodations. During delays, users may multitask and need to be reminded of their status within a web application upon their return. Also, the presentation and development environment of the web is much more limiting than that of the desktop environment.

As a result, many interface elements need to be adjusted to work within this new environment. An advantage that results from this common environment is that users can assume the availability of shared commands native to the browser. This unification by domain is important to keep in mind during the design process.

Web applications most often do not occur independent of a web presence. In order to achieve a unified user experience, a sense of “place” needs to be maintained within a web site. Therefore, the design and visual presentation of a web application that belongs in that “place” needs to be seamlessly integrated with the remainder of a web presence. This is a constraint not often encountered in client application guidelines.

Specific Design Guide Lines
These guidelines are derived from research cited above as well as from experience working on the design and development of numerous Web-based applications. This works encompasses academic as well as corporate applications reviewed by focus groups and informally administered user analysis. Due to a current lack of empirical data to support these recommendations, it is important to point out the goal of this presentation. The objective of these recommendations is to address the issues associated with web application interface design and to present an overall method for thinking about them. An understanding of how and why to adopt this approach to web application interface problems is more important than a strict adherence to all the points outlined below. The recommendations should not be interpreted as established guidelines. Rather, their use or disuse in a web application interface should be supplemented with user testing. Because most web applications are unique, their particular interface solutions are often unique as well.
1. Open the browser window in which web application interaction occurs to full screen size. Full screen maximizes the information communication capabilities of the display, allows the web application to be the focus of users’ attention, and hides the navigation tools of the web browser window in the infrastructure. The elimination of the web browser tools, borders, and menus makes the browser less confusing when reoriented toward delivering a real application, allowing users to utilize the interaction models of the web application instead of the browser. Caveats: Inexperienced users may not expect such actions from a browser. Users may also be confused about how to access other applications necessary to complement their interaction with the web application. It is possible that use of animation could help to clarify the browser’s actions.
2. Minimize the use of windows. A minimum number of windows reduces the mental load of managing multiple windows, reduces the possibility for browser windows getting lost behind others, and the confusability of multiple windows. Caveat: Advantages of multi-window systems, such as working on several tasks at once no longer apply. Multiple windows could, however, be contained within a single browser window using Dynamic HTML technologies.
3. Make the windows’ content visually dominate window borders. Emphasizing the content of the window over its appearance makes windows less obtrusive. Caveat: Unfamiliar representations of windows may not be perceived as windows, but rather as HTML tables or other visual elements. As a result it may not be obvious to a user that they may be manipulated.
4. Use constant values for fonts, tables, and other visual elements. A consistent layout across browsers and platforms will enhance usability within applications by maintaining a stable interface that users can rely on. Caveat: Separate layouts or accommodating scripts may be needed for the variety of displays and resolutions utilized by web users.
5. Use rollovers. Rollovers are commonly used on the web and users are familiar with them. They also reduce screen clutter by revealing alternate choices or presenting additional information as it is needed and avoid user confusion by not presenting too many options at once. Caveats: Too many rollovers may result in a flickering effect by constantly having visual items appear and disappear. Some choices and functions will also be unknown to a user until they mouse over.
6. Use ALT-overs when the immediacy of a rollover is not needed. ALT-overs can clarify the use or function of interface elements without necessitating excessive explanatory labels. ALT-overs are present within many client applications and therefore already familiar to users. Caveat: ALT-overs should not be counted on as the sole clarifier for interface elements.
7. Avoid double clicks. Web users are accustomed to a single click when interacting with web sites. Eliminating double clicks therefore caters to the established conventions of the WWW. Also, double-clicking is problematic for users. The use of a double click requires users to remember which class of interfaced elements responds to a double click and then also what the outcome of the double click will be as opposed to a single click. Caveat: Interface elements within a web application may visually resemble elements within client applications that require a double-click to activate.
8. Use the conventions of link selection in web. Web users are used to exploration and will move their mouse until a clickable area appears. The users’ willingness to explore can facilitate unique forms of interaction. Caveat: This notion should not be stretched too far. Developers should not imbed important functions within hard to find or irrelevant elements.
9. Use inherent functionality of visual elements. Text can initiate actions and images can correspond to various actions as well. Web users have come to expect this from their interfaces. Caveat: Do not imbed important functions within hard to find or irrelevant elements.
10. Use both saturated and unsaturated link colors. A natural mapping exists between executed actions and those not yet executed when saturated and unsaturated versions of a color are used in their visual representation. Caveat: The differences between the saturated and unsaturated versions of a link should not be too subtle.
11. Use underlined fonts as hot-spots. Actions can be embedded within text-based explanations and executed as part of a natural sequence, allowing the information to be adjacent in space to where its use is required. Caveat: Do not imbed important functions within hard to find or irrelevant text elements.
12. Use pull-down menus, radio buttons, and checkboxes as utilized online. Web users are familiar with the functionality of these elements, they are easy to implement, and help to conserve screen space by allowing many possible options to reside in a small area. Caveat: Avoid non-standard implementation and do not rely on them solely, especially if they are not the proper solution.
13. Use plug-ins and frames as tools for web application design. Plug-ins increase functionality and alleviate shortcomings of web browsers in the areas of three-dimensional, animated, and sound-based elements while allowing for richer forms of interaction or information display. Caveats: Users are subject to lengthy download times and may not wish to install or utilize a plug-in. The developer must also rely on the plug-in provider for installation and availability of the plug-in.
14. Use motion cues and animation as a feedback mechanism. Animation can be effectively utilized to show continuity and dimensionality in transitions, illustrate change over time, multiplex the display, enrich graphical representations, visualize three-dimensional structures, and attract attention. Caveats: Poorly implemented animation may distract users. The interface should not depend solely on motion cues for understanding.
15. Use common functionality between a web application and web browsers. Utilizing interactions common to web browsers allows transfer of knowledge between web applications. Caveat: The interactions available in browsers might not be a good solution for the task at hand.
16. Exploit the similarities in the basic functionality of all web applications. Standardization allows for transfer of knowledge between web applications and eliminates problems associated with implementing non-standard interactions. Caveat: Widespread use of poorly designed interfaces can encourage bad practices among users.
17. Utilize the resource potential of the web in the design of a web application. Web application content may be generated by users and documentation can be easily and continually updated in one place and not to be distributed to all users. Caveats: Web may not be the best design platform for an application and a client application might yield a more successful product. Monitoring the users’ additions to determine appropriate content is necessary.
18. Manage time and workflow within a web application. The resulting product will be more task-oriented, guide users through the actions necessary for task completion, and distinguish web applications from content-based web sites. Caveat: Web site developers may lack the skills necessary to develop effective workflow scenarios.
19. Consider the aesthetic integrity of the interface. Aesthetic presentation can give a web application a personality, provide users enjoyment or familiarity, and a sense of trust and professionalism. Consistent aesthetics unite various sections of a web application and give it a coherent look and feel. Caveat: Placing too much emphasis on aesthetics can cause usability to suffer. It is important to not allow visual treatments to overwhelm interaction elements.
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