Smartphone Health Apps and Blind Readers

By Sondra Forsyth

University of Washington researchers who conducted a review of nine mobile health applications found that they were not fully accessible to blind customers.

In a paper published in the Journal on Technology & Persons with Disabilities, the researchers investigated nine common iPhone mobile health (mHealth) applications that upload data from blood pressure and blood sugar monitoring devices.

The shortcomings they found ranged from improperly labeled buttons to confusing layouts that don’t work well with iPhone VoiceOver or Android TalkBack services that “read” information on the phone screen.

“We wanted to see if these health applications would be out-of-the-box accessible, and most really weren’t,” said lead author Lauren Milne, a UW computer science and engineering doctoral student. “They made a lot of amateur mistakes that people make when they build apps.”

According to a news release from the university, the researchers also concluded it would take little effort for developers to make mainstream health sensors fully accessible to blind smartphone users — largely by following accessibility guidelines already established by Apple and the federal government.

“It wouldn’t have been hard to make their apps accessible by making that a priority in the first place. They could have been heroes from the get-go,” said senior author Richard Ladner, a UW computer science professor who leads multiple projects to make technologies more broadly accessible.

The research team — which includes co-author Cynthia Bennett, a UW human-centered design and engineering doctoral student — rated four iPhone glucose monitoring apps (iBGStar, Glooko Logbook, Telcare, iGluco) and five blood pressure monitoring apps (iHealth BP Monitor, Withings, iBP, myVitali, Digifit).

They developed seven criteria for making apps accessible to low-vision users, borrowing from Apple’s guidelines to help app developers take advantage of the phone’s built-in accessibility capabilities and accessibility standards that technologies purchased by the federal government must meet.

Those include buttons that are programmed correctly to tell a user what to do with them, hints that help with navigation and grouping items so they make sense to screen readers that tell blind users what icon their finger is on or describe aloud what’s happening on the screen.

At the time that the mHealth apps were tested in March 2014, one blood glucose monitoring app — the Glooko Logbook — met all of the accessibility criteria except for one. The other apps failed to meet at least half the accessibility guidelines. The study did not examine other accessibility features such as the ability to zoom or the use of large or high-contrast print, and researchers say it’s possible manufacturers have made accessibility upgrades to more recent versions of the apps.