Les services numériques de santé se sont fortement développés ces dernières années : prise de rendez-vous, suivi patient, téléconsultation. Pourtant, une question reste largement sous-estimée : ces dispositifs sont-ils réellement accessibles à tous ?
Pour une partie des utilisateurs, l’accès aux soins devient un parcours d’obstacles numériques. Cette situation dépasse la simple question technique : elle interroge directement la qualité, la sécurité et l’équité des parcours de santé.
Pourquoi l’accès aux soins devient un parcours d’obstacles numériques
Marie, aged 67, gave up after twenty minutes trying to validate an appointment form. Thomas, who is visually impaired, uses a screen reader to check his test results. Except that the laboratory's website only displays graphics that are illegible for his software. Léa, in a wheelchair, navigates her tablet with one hand. It's impossible to fill in certain fields that require multiple interactions.
These three people represent 28 % of French people living with a lasting functional limitation. And yet, in 2025, la plupart des plateformes de santé les ignorent encore y compris certains acteurs majeurs du secteur. Ces situations ne relèvent pas de cas isolés. Elles traduisent une incapacité du dispositif numérique à répondre à la diversité réelle des usages.
Digital health promises to bring patients closer to care, but in all the talk of innovation, haven't we forgotten one essential thing: access for all? The groups affected by the lack of’digital accessibility are not marginal.
Almost a third of the French population could regularly come up against interfaces that have not been designed with them in mind. Contrasts too low, forms incompatible with screen readers, buttons impossible to reach with a keyboard. The result? A digital 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.
THE FIGURES
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- 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)
Even today, accessibility declarations on hospital sites are not systematic, and compliance with 100% is unfortunately the exception rather than the rule. See also Monitoring compliance with digital accessibility obligations - Public hospitals sector
Un dispositif inaccessible ne dégrade pas uniquement l’expérience utilisateur. Il peut compromettre l’accès à l’information médicale, retarder une prise en charge ou générer des erreurs dans le parcours de soins. Au-delà des obligations réglementaires (RGAA), l’accessibilité constitue un enjeu de responsabilité pour les établissements de santé.
Comment intégrer l’accessibilité dans les projets de santé numérique
The good news is that reconciliation is not only possible, but is already underway for some players. Every day, public institutions, start-ups and product teams are demonstrating that digital accessibility and innovation are not opposites in healthcare - they feed off each other.
Intégrer l’accessibilité dès la conception
Accessibility can always be implemented on an existing digital product, but this is often laborious and costly. The solution? Integrate accessibility from the outset.
Some hospitals are now naming an accessibility consultant from the outset of a digital project. Its role? To challenge design choices to take account of all uses.
- Including personas with disabilities in design workshops
- Include accessible user stories in each development sprint
- Allocate a specific budget for accessibility, not a «reserve if we have time».»
Confronter les dispositifs aux usages réels
Automatic audit tools are not very reliable: they detect 30 to 40% accessibility problems. The remaining 60%? They only emerge in real-life situations, with real users. Some healthcare platforms are already working with patient associations to co-construct their interfaces.
- Set up a panel of testers with disabilities (visually impaired, motor impairment, cognitive impairment, etc.)
- Organise user test sessions at each key stage of the project
- Paying testers fairly for their expertise
- Document and prioritise their feedback in the same way as critical bugs
Structurer une culture d’accessibilité
Preparing healthcare establishments for digital accessibility also means offering, through training, a new way of looking at the design of content made available to patients. Training means enabling all teams to think beyond their personal situation and open up to a more universal way of thinking.
- Offering accessibility training for all professions
- Organise immersions: browse for an hour with a screen reader, use the site using only the keyboard
- Share internal case studies: «here's what didn't work and why».»
- Creating specific accessibility guidelines for the healthcare sector
Digital accessibility should not only be considered at the level of the establishment's website. It also concerns PDF documents, forms and all the digital procedures that are part of the patient journey.
Gradually, accessibility through training will become a design reflex rather than a regulatory constraint or a postponed adjustment.
La performance d’un dispositif de santé numérique ne peut pas être dissociée de son accessibilité. Un service qui exclut une partie de ses utilisateurs ne peut être considéré comme pleinement fonctionnel. L’enjeu dépasse la conformité réglementaire : il concerne la qualité des parcours, la sécurité des usages et la capacité des établissements à remplir leur mission de service.