Accessible eHealth: opportunities and challenges in Italy

Journal title SALUTE E SOCIETÀ
Author/s Eliseo Sciarretta, Emilio Greco, Giorgia Elisa Cafiero
Publishing Year 2025 Issue 2025/2 Suppl.
Language English Pages 10 P. 99-107 File size 351 KB
DOI 10.3280/SES2025-19153
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Digital accessibility is essential to provide inclusive services, and should always be respected in a sector such as digital health, where the target is extremely varied. This manuscript aims to inspect the state of accessibility of eHealth services in the Italian market. Through an assessment of 3 different services, the authors want to highlight their main strengths and weaknesses, in order to understand the opportunities still to be exploited and the challenges to be overcome, also depending on the Italian and European regulations that establish rigid constraints, but do not consider, at the moment, the digital health sector. The results indicate that the level of accessibility is not satisfactory yet, with some good peaks, but many aspects to be improved, in particular on how information is structured and presented.

Keywords: eHealth; accessibility; inclusive health; universal design; guidelines; digital inclusion.

  1. Acosta-Vargas P., Acosta T., Luján-Mora S. (2018). Framework for Accessibility Evaluation of Hospital Websites. International Conference on eDemocracy & eGovernment (ICEDEG), Ambato, Ecuador. 9-15. DOI: 10.1109/ICEDEG.2018.837236
  2. AGID (2024). Piano Triennale per l’Informatica nella Pubblica Amministrazione 20242026. Retrieved from: https://www.agid.gov.it/sites/default/files/repository_files/piano_triennale_per_linfor matica_nella_pa_2024-2026.pdf (last accessed on 17/12/2024).
  3. ETSI (2021). EN 301 549 “Accessibility requirements for ICT products and services”. Version 3.2.1, retrieved from: https://www.etsi.org/deliver/etsi_en/301500_301599/301549/03.02.01_60/en_301549 v030201p.pdf (last accessed on 17/12/2024).
  4. European Commission (2018). Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on Enabling the Digital Transformation of Health and Care in the Digital Single Market; Empowering Citizens and Building a Healthier Society (COM/2018/233). Retrieved from: https://eur-lex.europa.eu/legalcontent/EN/TXT/?uri=CELEX:52018DC0233 (last accessed on 19/02/2025).
  5. European Disability Forum (2019). EDF analysis of the European Accessibility Act. Retrieved from: https://www.edffeph.org/content/uploads/2021/02/edf_analysis_of_the_european_accessibility_act_-_june_2019_2_0.doc (last accessed on 17/12/2024).
  6. European Parliament and Council of the European Union (2019). Directive (EU) 2019/882 of the European Parliament and of the Council of 17 April 2019 on the accessibility requirements for products and services. In OJ L 151, 7.6.2019, p. 70–115. Retrieved from: https://eur-lex.europa.eu/eli/dir/2019/882/oj (last accessed on 17/12/2024).
  7. Goddard M., Smith P. (2001). Equity of access to health care services: Theory and evidence from the UK. Social science & medicine, 53(9), 1149-1162.
  8. Henni S.H., Maurud S., Fuglerud K.S., Moen A. (2022). The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review. BMC Public Health. 22(1):35.
  9. Jokinen A., Stolt M., Suhonen R. (2021). Ethical issues related to eHealth: An integrative review. Nursing Ethics, 28(2): 253-271. DOI: 10.1177/096973302094576
  10. Jonsson M., Johansson S., Hussain D., Gulliksen J., Gustavsson C. (2023). Development and Evaluation of eHealth Services Regarding Accessibility: Scoping Literature Review. J Med Internet Res, 25: e45118. DOI: 10.2196/4511
  11. Pettersson L., Johansson S., Demmelmaier I., Gustavsson C. (2023). Disability digital divide: survey of accessibility of eHealth services as perceived by people with and without impairment. BMC Public Health 23, 181.
  12. Savolainen K., Kujala S. (2024). Testing Two Online Symptom Checkers With Vulnerable Groups: Usability Study to Improve Cognitive Accessibility of eHealth Services. JMIR Hum Factors, 11: e45275. DOI: 10.2196/4527
  13. Schiavone F., Tagliaferri S., Cafiero G., De Rosa M., De Angelis R. (2021). Health 4.0 for the elderly: new challenges and opportunities for a smart system. The Digital Transformation of Healthcare, 90-102.
  14. Vainieri M., Vandelli A., Benvenuti S.C., Bertarelli G. (2023). Tracking the digital health gap in elderly: a study in Italian remote areas. Health policy, 133, 104842.
  15. Valokivi H., Carlo S., Kvist E., Outila M. (2023). Digital ageing in Europe: A comparative analysis of Italian, Finnish and Swedish national policies on eHealth. Ageing & Society, 43(4): 835-856. DOI: 10.1017/S0144686X2100094
  16. W3C Web Accessibility Initiative (2005). Website Accessibility Conformance Evaluation Methodology (WCAG-EM). Retrieved from: https://www.w3.org/WAI/test- evaluate/conformance/wcag-em/ (last accessed on 17/12/2024).
  17. W3C Web Accessibility Initiative (2023). Web Content Accessibility Guidelines (WCAG) 2.2. Retrieved from: https://www.w3.org/TR/WCAG22/ (last accessed on 17/12/2024).
  18. W3C Web Accessibility Initiative (2024). Introduction to Web Accessibility. Retrieved from https://www.w3.org/WAI/fundamentals/accessibility-intro/ (last accessed on 17/12/2024).

Eliseo Sciarretta, Emilio Greco, Giorgia Elisa Cafiero, Accessible eHealth: opportunities and challenges in Italy in "SALUTE E SOCIETÀ" 2 Suppl./2025, pp 99-107, DOI: 10.3280/SES2025-19153