ACCESSIBILITY UPGRADE

An accessibility upgrade for Tickit Health's mobile medical survey app helps score a government contract

• Employer: Tickit Health (startup: 12-15 employees)

• Product: Tickit SaaS medical survey app (for mobile devices)

• Role: Product Design, including user research, palette redesign, and applying accessibility guidelines.

• Activity: Improve product accessibility; raise team awareness of the importance of responsible design for health products.

OVERVIEW

Tickit is a patient survey platform developed by Tickit Health that makes collecting and analyzing patient data fast and easy.

When I joined Tickit Health, I noticed text in some of the surveys was hard to read. It appeared to be a colour contrast problem, but I felt I should do some research to be certain before raising the issue with the team.

I used a colour contrast analyzer tool to sample fore and background colour combinations on sample pages from several different surveys. A whopping 60 percent of the screens failed to pass the WCAG 2.0 accessibility guidelines for colour contrast.

Over 60% of sample survey pages I tested failed minimum colour contrast guidelines for accessibility.

Fail vs. Pass: The difference seems minor, unless you have vision problems - as many patients do.

ACCESSIBILITY & RESPONSIBILITY

I alerted the team. I explained that Tickit did not meet minimum Web accessibility guidelines for colour contrast, and that this meant some of our users would be unable to read survey text, especially when it appeared in a small size. I expected immediate suggestions for ways we might fix the problem, but to my surprise I got push-back instead.

• Summer intern: "But I can read the surveys just fine."

• Lead developer: "If we change the palette, then all the surveys will get updated, even the ones we've already published; ones that clients are already using."

• CEO: "Hang on! We can't make any platform changes without notifying clients 30 days in advance. That's in our contract. This will make us look bad."

Patients are an inherently vulnerable user group. As the senior designer on the team, I felt that issues of accessibility for patients should be a priority for a health/medical app like Tickit. Despite the lack of initial support, I knew this wasn't an issue the team could ignore.

CONVINCING THE TEAM

How would I convince the team it was worth it to upgrade the product's accessibility?

I now knew the product had issues - mainly text colour contrast, but also some issues with reading level. From the surveys I'd reviewed, I could see that some included unnecessarily complicated medical jargon that could interfere with user comprehension.

As a new hire, I needed to earn the team's trust. How could I do that if I kept pushing for change that nobody wanted? And then...

Saved!

Just by chance, the CEO's father-in-law suffered from age-related macular degeneration (AMD), an eye disease that can blur the sharp, central vision you need for activities like reading and driving. Thinking about my request to upgrade the palette, the CEO took her laptop home and showed her father-in-law blocks of sample text I had created to illustrate "safe" and "unsafe" colour combinations.

When the CEO came in to work the next morning, she reported that yes, her father had struggled to read the unsafe text. And...she was now fully on board with the palette accessibility upgrade!

The Amsler grid, left, shows vision distortions common to macular degeneration. According to the Word Health Organization (WHO), more than a quarter of the world's population suffer from some form of vision impairment (2019).

The powerful close-to-home experience that convinced the CEO to upgrade the palette saved me from needing to do all the convincing myself - because once the CEO was on board, everyone else fell into line.

To help address the problem of informing existing clients that the platform was changing, I reached out to Marketing to help craft an email that celebrated the upcoming palette changes as a product enhancement. For our clients, all surveys would now meet accessibility standards for colour contrast, an important feature for patients with vision challenges.

REDESIGNING THE NEW PALETTE

The work of redesigning the palette began with identifying non-compliant "unsafe" colours, and finding close matches that met minimum guidelines.

Once the base palette was established, lighter and darker versions of each main colour were created by adding percentages of black or white

The final palette extends the original 20 colours to 72, by adding colours in harmonious lighter and darker steps.

The final palette is vibrant and harmonious. I introduced several new base colours to extend "safe" colour choices even further. And, I created a one-page style guide so all members of the team would feel confident applying colour. (Colour was most often applied by the developers, but all team members were able to create surveys.)

IMPACT

On the business

The day after the new palette was implemented Tickit Health beat out a competitor to win a bid for a government contract, owing to Tickit's "accessibility considerations."

On the team

Accessibility has become an important part of Tickit Health's marketing strategy. Now, not only does Tickit meet WCAG 2.0 guidelines for colour contrast, clients are also encouraged to use the CDC's "Everyday Words for Public Health Communication" guide when they are creating survey copy. This has reduced medical jargon in Tickit surveys, resulting in improved comprehension across all user groups.