Christabel Pankhurst Institute

Developing Accessible Digital Health Software

Research team: Digital Health Software Team, University of Manchester

As a digital health software team, our aim is to build software to support health research across multiple disease areas and conditions. A key focus for us is co-designing websites and mobile apps with our target population to ensure the digital platforms that we build will be usable, useful and engaging. To do this, we work intensively with our end users to understand their accessibility needs and to create software that responds to their requirements.

We currently work across a digital health portfolio of 20+ research projects, many of which are funded by the National Institute of Health Research (NIHR) or the Medical Research Council (MRC) in the UK. Most of these projects are focused on building software to support under-served populations.

Across our projects, ‘under-served populations’ are defined in different ways but within our current portfolio ‘under-served’ includes: people living with serious mental illness, people from economically-deprived areas and people living with multiple chronic conditions.

 Stages and methods of end users involvement

When we develop software, we typically co-design it with a sample of our end user population. For many of our projects, the end users are people living with a long term health condition. We involve end users at every step of our software development life cycle.

A key part of the User Research journey is to identify the accessibility needs of the target population. This could be, for example, identifying that we need to ensure the software is accessible on assistive technologies and/or that we need to increase the default font size of the text because people in our target population have visual impairments. We design and test for accessibility throughout the User Research journey.

There are four key phases in the User Research journey that we follow: Discovery, Alpha, Beta, Live. At each phase we consider how we need to address digital health inequities by maximising the accessibility of the tools that we build.

User Research Activities

Across each stage of the User Research journey, we use different methods to ensure the needs of under-served populations are represented in the design and implementation of the software. Some of the methods we use to do this are described in the table below.

Methods Toolbox

Benefits of involving end users

• Users are consulted about their specific needs for engaging with digital tools.
• We explore how people engage with technology by asking them to engage with prototypes of the software as it is being developed.
• We develop the software iteratively and in partnership with our end users so that we can assess if the tools we have built are responding to the accessibility needs identified.
• We ask people what their accessibility needs are rather than make assumptions about their needs. For that, we work closely with researchers to explore software accessibility needs, as well as how the software would enable accessibility to healthcare services.
• We involve people throughout the software development life cycle so that we can respond to shifts and changes in needs or correct misinterpretations along the way.

Other things our team (could) do to promote digital health equity

• Develop an expert diverse accessibility advisory group to help guide our accessibility reviews, policies and activities.
• Keep up to date with emerging digital health equity research.
• Explore how digital innovations can better support accessible software design.