PDF Accessibility in Healthcare
Patient information, information sheets, forms, discharge letter templates and quality reports: Accessful automatically audits and remediates your PDF documents according to PDF/UA-2 and WCAG 2.2 - in the cloud or completely on-premises, so that health data does not leave your premises.
The challenge
Hardly any information is as momentous as that about your own health. Information sheets, consent forms and patient information only fulfill their purpose if all patients can read them independently - even with visual impairments, with a screen reader or with limited reading ability. A non-accessible PDF excludes the very people who are particularly dependent on understandable health information.
At the same time, large quantities of PDF documents are constantly being created in clinics, practices and health insurance companies - from form templates to quality reports to letters from the hospital information system. Manual post-processing does not scale here: it ties up specialists per document, and passing it on to external service providers often fails due to data protection, because health data is one of the particularly protected data according to Art. 9 GDPR.
The legal framework in the healthcare system is divided into two parts: public bodies such as university clinics, municipal hospitals and statutory health insurance companies are obliged to ensure accessibility via BITV 2.0. Private institutions can fall under the BFSG if they offer services to consumers electronically - for example via patient portals or online appointment booking. Accessful automates auditing and remediation for both cases - if desired, completely in your own infrastructure.
Typical documents
- Patient information and educational brochures
- Information sheets and consent forms
- Medical history, admission and application forms
- Templates for discharge and doctor's letters
- Quality reports and QM documents
- Invoices and letters regarding the assumption of costs
What Accessful does for healthcare
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On-premises for patient data
Operation entirely in your own infrastructure, air-gapped if desired and with your own AI models - health data remains within your organisation.
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Layout and content remain unchanged
Accessful only complements the structural layer: tags, reading order and alt text. Information sheets and declarations of consent in particular remain exactly as they were released.
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Over 110 languages
Patient information is often available in multiple languages. Accessful audits and remediates documents in over 110 languages - foreign language materials are processed in the same way as German ones.
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Correct stocks in the batch
Batch processing for thousands of documents in one go - from the inventory of forms to the archive of patient information, with live status in the web app. Results are typically available in seconds.
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audit-ready report
Each document receives an audit-ready report - as proof for quality management, data protection officers and sponsors.
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Remediation guarantee
If a document remediated by Accessful is not recognized as accessible during an accessibility audit, we will remediate it free of charge - quickly, easily and at no additional cost.
Legal framework
- BFSG / European Accessibility Act for private institutions
- The German Accessibility Strengthening Act implements the European Accessibility Act (EAA) into German law and has been in force since June 28, 2025. It is relevant for private healthcare institutions if they offer services electronically to consumers - such as patient portals, online appointment booking or the electronic dispatch of documents. PDF documents that are part of such a service must be made accessible.
- BITV 2.0 and EU Directive 2016/2102 for public bodies
- Public bodies - including university clinics, municipal hospitals, health authorities and statutory health insurance companies as social insurance providers - are obliged to offer accessible file formats such as PDF via BITV 2.0 based on EU Directive 2016/2102. This obligation exists independently of the BFSG.
- EN 301 549, WCAG 2.2 and PDF/UA-2
- The technical benchmark is the European standard EN 301 549, WCAG 2.2 and the PDF standard PDF/UA-2. Accessful audits and remediates documents against exactly these standards and documents the result in an audit-ready report for each document.
- GDPR: Health data according to Art. 9
- Health data are special categories of personal data according to Art. 9 GDPR. For the correction this means: Processing takes place in ISO/IEC-27001-certified data centers in Germany; If the requirements are stricter, you operate Accessful completely on-premises in your own infrastructure.
Note: This content provides information about legal requirements, but does not replace legal advice.
Frequently asked questions about healthcare
How is patient data protected during processing?
Processing takes place in ISO/IEC-27001-certified data centers in Germany. For institutions whose specifications exclude external processing, Accessful runs entirely in their own infrastructure - air-gapped if desired and with their own AI models, so that health data remains within the organisation. Details can be found at On-Premises.
Do information sheets and consent forms remain unchanged after correction?
Yes, in terms of content and appearance. Accessful only complements the structural level - tags, reading order and alt text; Layout and content remain unchanged. For digitally signed documents, it is best to plan the correction before signing, as the document must be re-signed after any subsequent changes.
Does the BFSG apply to hospitals and doctor’s practices?
The BFSG does not apply across the board to all institutions. This includes services that are offered to consumers electronically - in the healthcare sector, for example patient portals or online appointment booking including the documents provided there. Regardless of this, public bodies such as university hospitals or statutory health insurance companies are obliged to comply with BITV 2.0. You can find a classification under BFSG and accessible PDFs; it does not replace legal advice.
How do we make multilingual patient information accessible?
Accessful audits and remediates documents in over 110 languages. You can process foreign-language patient information and educational materials in the same way as German ones - individually via a web app with drag-and-drop or in batches for entire stocks. The conditions for larger quantities can be found at Pricing.
Can we connect Accessful to our hospital information system?
Yes. The hospital information system or your forms server passes generated letters and forms via the REST API; Once the correction has been completed, a webhook informs your system, which automatically retrieves the accessible PDF. Nothing changes in terms of templates and processes. Details can be found at API & Integration.
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