Accessibility barriers at M.D. Anderson

OK, now I’m pissed. I went to the “MyMDAnderson” Web site to check my schedule for the next couple of weeks. It’s a good idea—a secure site where you can check appointments, request schedule changes, send secure messages to members of your care team, even look at your billing information.

But there are a few annoying accessibility barriers. For example, none of the pages on the MyMDAnderson site (or the rest of the MD Anderson site) uses HTML heading markup. Yet there are clearly places where such markup is called for—specifically, pictures of text that identify the beginning of the primary content on the page. These pictures of text have alt text (as required for any image) that contains the same text as what
Is shown in the image. So what’s the problem? The problem is that I can’t use the tools built into my screen reader that would allow me to navigate directly to those headings (that’s what I’d be able to do if they were marked up correctly). So I can’t get a good overview of what’s on the page and how it’s organized.

Also, there is no mechanism for bypassing the large blocks of repeated content that appears on every page—such as navigation links that may run across the top and down the left side of the page. So I have to listen to them all, right down to the links at the bottom that are required for all state organizations. Only then do I get to hear what I came for.

Both of these issues are easy to fix. In fact, marking headings correctly would also fix the second problem, since screen reader users could then jump directly to the appropriate heading. This would save at least 40 seconds per page!

When I finally did get to my appointment list, I discovered one that I’d sort of like to change. So I selected the handy “Reschedule” link. This took me to a form where I could send a message to Dr. Andersson’s scheduler. In theory, that is. Only problem was that the field for the actual message wasn’t labeled—other parts of the forms were labeled (or at least JAWS was able to guess). But I couldn’t find the place where I was supposed to type in my comment.

Enough already. I found a link called “Feedback” and figured I’d send a comment to the Webmaster. This time I was able to find the comment field, so I was happy, or at least happier. I wrote a careful comment, describing the problems discussed above and providing a link to the Accessibility Institute’s How-tos and Demos page, where techniques for addressing these problems are documented. I was just about to write that I would be willing to discuss the issues with the Web team, when—poof!! Up popped a message that said “timeouts expired,” and the damn thing logged me off! (“Timeouts expired” is jargon for “you’ve been here too long and we’re kicking you out.”)

Here’s the message I got:

Monday, July 24, 2006

Time Out/Page Expired Notification

You have been logged out of myMDAnderson because you haven't requested a new page in the last 20 minutes or have already logged out and are trying to view a page in your browser's history. To access your personal information, please login again using the menu option on the left.


I don’t remember seeing/hearing anything anywhere on MyMDAnderson about time limits. This is an important accessibility issue—not just for me and other patients or caregivers who are blind, but for any cancer patient who  may have peripheral neuropathy in the hands, anyone who may be unable to type quickly, anyone who has cognitive limitations that may make it difficult to complete online transactions quickly. We spent a lot of time on such issues in Web Content Accessibility Guidelines 2.0 (see especially Guidelines 2.2, which is about timing; and Guideline 2.5, which is about minimizing chances of error and making it easier to correct errors that do occur).

So I’m pissed. The MyMDAnderson site is supposed to provide a convenience for patients, a way to track important things without having to play phone tag with the extremely helpful but extremely busy humans who are juggling many other people’s needs in addition to mine. But instead of being a convenience, it became a time-sink and got me all riled up on a day that started out just fine! I got a decent night’s sleep, I felt good and strong when I woke up, I took my time showering and getting dressed and feeding and walking and grooming Dillon and eating the lovely breakfast that Anna had prepared for me, and then I sat down at the computer to do something that should have taken 10 minutes, tops, and instead God only knows how long I’ve been here.

MD Anderson is a state agency. It’s also part of the University of Texas System. On both counts, it should comply with published accessibility standards. Interestingly, there doesn’t seem to be a link to an accessibility policy (at least not on the “Timeouts expred” page), and the term “accessibility” doesn’t show up on the “Legal statements” page.

I wonder what percentage of the thousands of patients who move through the corridors and clinics of MD Anderson each day would qualify as at least temporarily disabled? Certainly a great many are very weak, and would have a hard time walking up a flight of stairs or walking a city block without having to stop and rest; some may be experiencing cognitive impairments as the result of chemo or radiation treatment or the cancer itself; some may be experiencing changes in visual perception for the same reasons; some may have neuropathy that makes it difficult to type quickly or accurately.

I was OK till the timeout expired. That was the last damn straw. Insult to injury, yatta yatta yatta.