Patient Portal Achieves WCAG 2.1 AA After ADA Demand Letter
A regional hospital network received an ADA Title III demand letter targeting its patient scheduling portal. BuildWithAccess remediated 47 critical barriers in 21 days — the lawsuit was dismissed without settlement.
47
Critical barriers fixed
21 days
Audit-to-remediation timeline
0
Subsequent ADA complaints
18 months
Complaint-free monitoring
The Challenge
What A National Hospital Network Was Facing
A national hospital network with 12 outpatient facilities received a formal ADA Title III demand letter alleging that its patient scheduling portal was inaccessible to users with visual, motor, and cognitive disabilities. The letter cited specific failures: a form-based appointment scheduler that could not be completed by keyboard alone, images lacking alternative text, and error messages not programmatically associated with form fields.
Beyond the legal exposure, patients with disabilities were being directed to phone-based scheduling while all other patients used the digital portal — an equity disparity the organization's leadership recognized needed immediate correction.
Our Approach
How We Solved It
Conducted an expedited 5-day WCAG 2.1 AA audit of the patient scheduling portal using automated scanning (axe-core), keyboard-only navigation testing, and screen reader testing with JAWS and NVDA.
Produced a court-ready compliance report documenting all 47 barriers by WCAG criterion and severity, formatted for the organization's ADA attorney to use in the demand letter response.
Embedded two accessibility engineers in the client's development team for a focused 16-day remediation sprint targeting all critical and major findings.
Rebuilt the custom appointment scheduling form using native HTML elements with explicit aria-labelledby associations, eliminating the keyboard trap and restoring full screen reader operability.
Implemented aria-live regions on dynamic scheduling availability so screen reader users receive real-time slot updates without losing form focus.
Added descriptive alternative text to all clinical imagery and marked decorative images as presentational so assistive technologies skip them.
Integrated axe-core automated tests into the CI/CD pipeline as a deployment gate to prevent regression of fixed issues in future releases.
Provided the legal team with a signed WCAG 2.1 AA conformance statement suitable for submission in the demand letter response.
The Outcome
What We Achieved Together
The remediation was completed in 21 days from audit start. The plaintiff's attorney confirmed receipt of the conformance documentation and the case was dismissed without settlement. The organization subsequently engaged BuildWithAccess for ongoing quarterly audits and automated monitoring.
In the 18 months since remediation, the portal has recorded zero accessibility complaints. An unexpected operational benefit: the accessible scheduling form reduced call volume to the appointments desk by 11%, as patients with disabilities could complete scheduling independently online for the first time.
“We were terrified when the demand letter arrived. BuildWithAccess had our portal fixed and legal documentation ready in three weeks — far faster than we thought possible. The lawsuit was dismissed, and we finally have a portal that works for every patient.”
Services Used
- WCAG Audit
- Remediation
- ADA Consulting
Standards Achieved
- WCAG 2.1 AA
- ADA Title III
- Section 508
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