Randomized trial evaluates an AI framework for accessibility in healthcare web applications, indicating significant improvements over traditional tools.
Healthcare web applications such as patient portals, telehealth systems, and medication management platforms increasingly rely on continuous deployment practices, yet accessibility validation remains largely dependent on rule-based testing tools with limited detection capability. This paper presents HEALTHA11Y, an AI-driven accessibility validation framework designed for continuous integration and continuous deployment (CI/CD) environments in healthcare software systems. The framework combines a fine-tuned DistilBERT semantic analyzer, a convolutional neural network for visual contrast inspection, and a graph neural network for DOM structure evaluation to identify WCAG 2.1 accessibility violations in healthcare web interfaces. To support evaluation, a domain-specific dataset containing 3,420 annotated healthcare web pages was constructed across patient portals, telehealth interfaces, and pharmacy systems. Experimental results demonstrate that HEALTHA11Y achieves a macro-averaged F1-score of 0.863 and ROC-AUC of 0.924, significantly outperforming traditional rule-based accessibility testing tools. The framework maintains an average CI/CD validation latency of 4.3 seconds per page, enabling practical deployment as an automated accessibility gate within modern healthcare software pipelines. The proposed approach provides a scalable mechanism for continuous accessibility governance, improving the reliability of accessibility compliance verification in regulated digital healthcare environments.
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Butra et al. (2023) studied this question.
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