From comments: web accessibility trips up a state medical board

Thanks to reader Hugo Cunningham for spotting this in a new Boston Globe report on the failure of the Massachusetts state medical board to post physicians’ disciplinary problems and other performance issues online:

Another major omission has resulted from a Catch-22-like requirement in state law. Russell Aims, the … chief of staff
[of the Massachusetts Board of Registration in Medicine], said the board used to post digital copies of its disciplinary orders [for medical malpractice]. But an online accessibility law requires that documents be available in a text-to-speech format for the visually impaired.

Because the PDF format of the disciplinary records is not compatible with text-to-speech software, Aims said, the law dictates that such records cannot appear in the database. If the visually impaired cannot access the information, then no one can.


  • Not just america but in teh UK as well.

    Went to visit a technology company in Wells, Somerset and after signing in at security, asked to visit their toilets.

    I was refused for the following reason. If they allowed me to use the toilet, the toilets might have to be be designated ‘public’ toilets, and if they were public toilets, they have to meet certain disability requirements, and since they do not meet these requirements and it was not possible to convert them, I was banned from using them.

    The fact that I was an invited visitor to the site and not a member of the public wandering in off the streets apparently was beside the point. I think some twonk on that site has a great career in Elf and Safty.

  • While I think this is asinine yet typical, PDFs can quite easily be converted to text files.

  • PS: it depends on what the PDF was generated from whether it can be easily converted to text.

  • Computer generated PDFs are easily converted to text. PDFs that are just scanned documents aren’t, especially if the documents were hand written.

  • I’m all in favor of disclosure. Is mandating this in this case a bad idea? I would think that if we can easily make things more accessible for handicapped, don’t we do that? I mean, this is a pretty easy requirement.

    The problem many of you have is that you think that burdens on government and business don’t meet a cost benefit test. Here, any 16 year old with a computer could get this job done. So then, why is this rule asinine?

  • Ron
    “I would think that if we can easily make things more accessible for handicapped, don’t we do that? I mean, this is a pretty easy requirement. ”

    Well, the key here is “easily”. As noted in the comment by Greg’s 2nd comment, HOW the PDF was created is key. If you have a document of some sort and it’s scanned into a PDF, it’s more or less a picture. This could easily be the case with hand written notes for example, or say a document that was presented as evidence at the hearing where you don’t have the original computer file. Unless the hand written notes (or paper copy of the typed document) are transcribed in a word processing program, then that file converted to a PDF, there isn’t a way to text search the resulting file. (Says he who’s company is currently scanning thousands upon thousands of pages of hand written engineering records that often date to the 50’s, with the resulting PDF’s being totally unsearchable except by the old fashioned “Mark 1 eyeball” method instead of CTRL+F).

  • “why is this rule asinine”

    Read the post again. Its not the rule that is asinine, it is the Boards response to the rule by shutting down all access which is asinine.

  • No Name Guy, maybe so. I’m more echoing the commenters who said it was not a very difficult thing to convert it.

  • Ron,
    You really think the goverment does cost/benefits tests?
    And then they do it accurately, and then they abandon projects which fail the test?
    Here, exactly how many blind people in MA are trying to view medical discipline records on their laptop? (that number could be zero).
    And this cant be done by a 16 year ago, probably have to hire at least one full time IT professional, with salary + full benefits.
    This is just for silly law # 1…..there are many many more……

  • reminds of me of the case of the Amazon Kindle. Amazon designed it with the ability to convert text-to-speech specifically because of the vision impaired issue.

    Book publishers sued because they said this was a Copyright violation because the Text-to-Speech made it a public performance. Amazon eventually backed down instead of taking it to court. On a book-by-book basis, the Publishers now have the right to enable or disable text to speech on Kindles.

    Presumably, Adobe, or any of their competitors, could design similar functions into their PDF reader products. But I am sure that one glance at what Amazon went through and their lawyers would kill the project.

  • The rule is asinine because it creates the perverse incentives that resulted in this information not being accessible. It punishes limited accessibility more heavily than it punishes inaccessibility, and that is totally asinine.

  • Don: you can read pdf for without using adobe software, so even if adobe would have and killed pdf-to-speach, anyone else can create another one.

  • There is a text-to-speech function in Adobe Reader. It’s under the View menu, called Read Out Loud (bottom of the view menu). You activate Read Out Loud (Shift-Ctrl-Y)* then choose Read This Page Only (Shift-Ctrl-V)* or Read to End of Document (Shift-Ctrl-B)*

    As was noted about the Kindle above, this may not work on every document, but the functionality does exist.

    *Keyboard shortcuts probably different for Mac

  • Interesting that this function is included in Adobe.

    I tried it on a half dozen different documents. Even created a Word document, specifically to test it. Couldn’t get it to read one word to me.

  • Ron

    Nothing “maybe so” about it. The facts are if one does not have the original electronic file, then it’s extremely difficult to make it text search-able from a scanned copy (you have to transcribe / retype the document most likely.) IF, a big IF you have the original electronic file of the document in question (from a word processing program) it’s a trivial matter to turn that into a PDF with full text search capability.

    Now, perhaps some smart guy trial lawyers can develop the technology to have an accurate, reliable, easy to use, inexpensive piece of software that can read text from a scanned document. They’ll actually be useful to humanity in doing that, rather than doing whet they’ve done – hindering humanity by shutting down access to this information for everyone.

  • Some PDFs that are present to the viewer as a scanned document also include the text of the document. I would say in this case the process just needs to be updated so that some OCR software is used to included the document as text and show the scanned document for the sighted.