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Abstract
The United States federal government is in the midst of an e- government revolution characterized by a shift from paper-based citizen-government interactions to electronic-based interactions. Driven by the demands of citizens and supported by the President and Congress, federal departments are redesigning the look and feel of their Internet presences, moving away from traditional bureaucracy- centred presentation of information to more usable citizen-centred presentations. The Department of Health and Human Services (HHS), the USA's principal federal agency tasked with protecting the health of all Americans and providing essential human services, has undertaken a massive reorganization of its e-health enterprise. The most publicly visible component of this reorganization is the hhs.gov portal website. This desperately needed portal - usability testing indicated that more than 60 per cent of visitors to the Department's original website failed to find the information they sought - provides easy access to the wealth of HHS information and links its diverse operating agencies. The new HHS portal simplifies citizen access to the Department by: decompartmentalizing information by removing content from bureaucratic silos2 and rearranging it in a natural navigation scheme; tuning content and navigation features to ensure that all users have access to information tailored for them; presenting content in appropriate and citizen-preferred formats; and complying with federal accessibility regulations for blind and vision-impaired users. This paper presents a series of lessons learned during the development of the HHS portal, and results of usability testing to determine what common design features present accessibility problems particular to the blind and vision-impaired communities. These discussions of practical avenues to improving the accessibility and usability of e-health websites through appropriate and effective information designs are followed by our thoughts on the future of Internet architectures and the limitations of 'layering' technologies when striving for universal accessibility.