Advancing Accessibility in Medical Technology

with Clark Rachfal of the American Council of the Blind

According to the CDC, approximately 12 million American adults ages 40 and over live with some form of limited vision, from mild impairment to blindness. Visual impairment can present unique challenges, including when using in-home medical devices like select glucose monitors.

Clark Rachfal of the American Council of the Blind discusses advocacy efforts to ensure medical devices are designed to be both inclusive and accessible.

Posted on:

Oct 07, 2019

Hosted by: Sheila Hyland
Produced by: National Newsmakers Team

Hyland: Diabetes is the leading cause of blindness for American adults. And while advances in technology afford patients the ability to monitor their health at home, not all medical devices are accessible for blind users. Hello, and welcome to "Comcast Newsmakers." I'm Sheila Hyland. For the next few minutes, we'll discuss efforts to increase accessibility of durable medical equipment for blind and visually impaired users. Joining me to talk about this is Clark Rachfal. He is the Director of Advocacy and Governmental Affairs for the American Council of the Blind. And, Clark, thank you so much for being our guest.

Rachfal: Absolutely. Thank you so much, Sheila.

Hyland: So, we mentioned diabetes, but let's start off by exploring the number of reasons why there are an increasing number of Americans who are blind, starting off with diabetes but then ending with the aging population, as well.
Rachfal: Absolutely, so diabetes is the leading cause of blindness for working-age adults. The Centers for Disease Control project this number to triple by 2050. But also, the U.S. population is aging. And as people age, they are more susceptible to conditions such as macular degeneration that causes vision loss.

Hyland: And there is an inaccessibility of what we call durable medical equipment for those with vision loss and diabetes. What do we mean when we say "durable medical equipment," and what is the challenge here?

Rachfal: Sure, so durable medical equipment, specifically to diabetes, we're talking about that equipment that's used to monitor and test and ultimately manage somebody's diabetic care. So that could be a continuous glucose monitor, as well as an insulin pump. And these are products that, in the case of Medicare, provided to seniors and people with low income at a subsidized rate. However, these products either have a screen that is inaccessible. It can't be read by somebody with low vision. Ironically, it could be a product that is given to somebody that has lost their vision due to diabetes, and now the equipment that they're supposed to use to manage and care for themselves is inaccessible to them.

Hyland: And yet we live in this technologically advanced world, and some people don't have access to equipment that they need for their own healthcare.

Rachfal: That's right. Some of these products do interface with smartphones and applications. However, that's not a silver bullet. The smartphone apps do increase the accessibility to an extent. Not all features are accessible. And it also requires a population that could have a higher unemployment rate, as well as, traditionally, lower income, that they have to now own, operate, and afford a smartphone, in addition to the medical equipment that they need to manage for this condition.

Hyland: So this can come to a great expense for them, as well. And this can also lead to a host of other potential health problems if they don't have access to durable medical equipment. Explain how that might be the case.

Rachfal: Absolutely. So a lot of times, diabetes is referred to as a gateway illness. If diabetes is not properly managed or cared for, it can lead to a whole host of other conditions, whether that's heart conditions, pulmonary conditions. And it really impacts somebody's ability to manage and treat their conditions independently at home, where they're more comfortable, where it's more cost-effective, versus going into an assisted-living facility, heaven forbid, the E.R., or something worse.

Hyland: How is your organization not just advocating for people who are blind, but lobbying to make this durable medical equipment accessible to everyone who needs it at a fair cost?

Rachfal: Sure, so the American Council of the Blind has a nationwide membership. And unfortunately, we get too many calls from Americans that are experiencing vision loss due to diabetes and coming to the realization that the equipment is inaccessible. We're sharing these stories with members of Congress both in the House and Senate. We are pushing for legislation that would require accessibility be a consideration for durable medical equipment for the management and treatment of diabetes, as well as other conditions. We're also working with the Department of Health and Human Services, Centers for Medicare and Medicaid Services, and the Food and Drug Administration to make sure that the equipment that they authorize for use] meets the needs of the people who need it.

Hyland: Clark, where can people go for more information about these issues we discussed or about your organization?

Rachfal: Absolutely. The best way to find out more about these issues and the American Council of the Blind is our website at And everyone can always reach out to the Advocacy and Governmental Affairs team by e-mailing And, of course, social media, as well. Everything's on the Internet these days.

Hyland: Yes, it is. All right. Clark Rachfal from the American Council of the Blind. Thank you for being our guest today.

Rachfal: Thank you.

Hyland: And thank you for joining us, as well. For more great conversations with leaders in your community and across the nation, visit I'm Sheila Hyland.

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