Digital health promises to bring patients closer to care. But in all the talk of innovation, haven't we forgotten one essential thing: access?
An inaccessible health service is not progress, it's a new form of exclusion. In a field where every detail counts, this invisible exclusion is becoming a real public health problem. Digital technology should be repairing inequalities in access, but it is sometimes creating new ones.

Over the last ten years, the number of healthcare platforms has increased: appointment booking, pathology monitoring, teleconsultations, prevention applications, connected hospital pathways.
Everything seems smoother, faster and more “patient-centric”. Laboratory portals display elegant graphics, monitoring tools promise intelligent alerts, and institutional sites vie for technical efficiency. But behind this showcase of modernity, one disturbing question remains: who really benefits from these tools?

In 2025, a visually impaired person will still have to struggle to consult the results of a laboratory test, an elderly patient will have to struggle to validate a simple form, and a mother, with a baby in her arms, will have to give up navigating with one hand. Meanwhile, Doctolib, Europe's leading e-health company and a French unicorn, has still not published an accessibility statement for November 2025. A real symbol, more than an oversight.

Digital healthcare is aimed at everyone, but it is not designed for everyone. Could this dissonance between intention and reality reveal a systemic weakness: has digital health put technology at the centre and people at the periphery?

Accessibility, the missing link in digital care

The word “care” evokes benevolence, caring and attention to others. It implies a relationship based on listening and understanding. However, in the reality of e-health projects, this human dimension often stops where the RGAA begins. We talk about security, interoperability, AI, compliance with the RGPD - but rarely about keyboard navigation, text alternatives or screen reader compatibility. Accessibility is still seen as a corrective measure, not as a design principle. Yet integrating accessibility means designing differently: thinking of each piece of content as an open door, not an obstacle. It means anticipating the diversity of uses, abilities and contexts. It also means avoiding the paradox of “digital care” that forgets those who need it most.

A silent fracture

The groups affected by the lack of accessibility are not marginal. They are numerous, discreet and sometimes invisible:

• Around 28 % of French people live with a lasting functional limitation (DREES - Le handicap en chiffres 2024)
• 43 % of the over 65s have difficulty using digital services. (IFOP)

These figures remind us of a simple fact: digital health cannot be limited to a logic of efficiency. It must remain an area of equity. Yet complex interfaces, low contrast and forms that are not compatible with technical aids create a silent barrier. The result: a usage divide on top of the medical divide. An intolerable paradox for an area that is supposed to embody solidarity, and a major brake on the promise of a universal healthcare system.

From “patient user” to “digital citizen”

Making a healthcare platform accessible is more than just correcting the code. It means recognising that the healthcare experience begins with the first digital interaction, even before the waiting room, before the consultation. It's about accepting that accessibility is not an extra, but a condition of dignity.

When a public or hospital service does not comply with the RGAA, it is not just excluding users: it is undermining the promise of digital care. It undermines trust, widens gaps and turns innovation into a constraint. Conversely, accessible design becomes an act of care in itself, a concrete extension of the public service mission.

4 levers to reconcile digital health and accessibility

• Integrate accessibility from the outset. Not at the end of the project. When you define the target, the pathways and the prototypes. You can't make up for accessibility: it has to be built in.
• Test with the users concerned. Audit tools are not enough. There is no substitute for listening to patients in real-life situations. User testing must become a structuring stage in e-health projects.
• Training product and design teams. The RGAA is not just a checklist: it's a universal design culture. Training means passing on a different way of thinking about the experience, one that is more inclusive and more sustainable.
• Measuring digital maturity differently. A truly modern healthcare service is not just the one that is the fastest, but the one that everyone can use. Accessibility thus becomes a quality indicator, in the same way as security or performance.

Digital health has no shortage of innovations. What it lacks is an ethic of access. As long as accessibility remains a compliance tab rather than a design pillar, digital care will remain incomplete. Because we can't use technology to provide better care if it excludes those who need it most. Real progress does not lie in multiplying applications, but in ensuring that every citizen can use them. And what if, in the future, the digital maturity of healthcare establishments were measured by their ability to include, listen to and make every journey smooth and human?