Can We Start Talking about Digital Ableism in Healthcare?
This nurse sees a trend.
I have been a nurse for 15 years. Over that time, I have watched technology shift in mind-boggling ways. From sleep testing that you can wear at home using your phone app, to nurses being asked to use AI technology to generate responses to patient MyChart messages to sound more “professional,” things have gotten… different.
As the use of technology in healthcare has ascended, and darn near become a more important element of care than the nurse! (that’ll be a different article) The patient who either can’t or doesn’t want to use technology like smart phones or email are being ‘inconvenienced’ out of care access. They still have access to telephone calls, letters and other forms of communication, but as large Electronic Medical Record (EMR) systems like EPIC are more and more integrated into every facet of the care we provide, the pull for patients to use their apps to navigate their own healthcare is becoming more compelling. App access is profoundly convenient and quick if you have wealth and ability to use the digital communication systems that MyChart offers. However, monitoring the inaccessibility of online forms and the complexity many of our patients struggle against is often blamed on their “digital illiteracy” more so than the unnavigable build of a website. Ableism starts with this assumption.
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I also cannot fail to mention agesim plays a role in this issue. Many times in the clinic hallway have heard “Well, they will just have to get with the times,” or “Can’t their kid help them?” The shame and gratitude I witness as I sit, not only with elder clients, but with anyone who is pushed to use technology that they are not comfortable is painful. We have started to regard technology changing as though it were an organic process, like aging or the weather, but it is not. It is manufactured, planned and often operates around obselescence to self-perpetuate demand. Part of it, at least, is a financial stratagy.
Thinking that this is inevitable creates pressure for us not to stop and think about how we want it to go, or what would be a way for us to include everyone because of an ethical (and legal) duty to remain accessible. The sheer cultural minimization of the mental load we place on our patients as we force them to keep up with technological “progress” just for access to care shows me that this is a problem we do not want to see. When we blame the very people we are trying to help and minimize their struggle by saying “that’s just the way it is” we forget that they often have no other option for care. That us sweeping their struggle under the rug means that the illness they are coming to see us for is the least of their problems. At least they have someone to talk to about that.
Not all Doom:
There is hope on the horizon for some web design relief. 2027 is the deadline for the new Rule on the Accessibility of Web Content and Mobile apps. This rule will apply to web content provided by state and local governments. I would assume organizations that accept Medicare and Medicaid insurance will be in that compliance number as well.
Reflection:
Why are things this way? Maybe it’s because healthcare is big business here in the US. Maybe they are trying to fit into the tech-business model to maximize outcomes or whatever jargon the CEO spouts into our outlook email every Tuesday. I do know that it has caused us to quit thinking and quit questioning the barriers that we are creating for our patients.
After all, it’s so much easier to blame the victim; it’s convenient not to disrupt the momentum of the powerful. But it’s often what we nurses are called to do.
