Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

2.4.1 Current Marketplace Dynamics

The Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973 already require that covered medical care providers ensure the provision of medical care and services to persons with disabilities in a nondiscriminatory manner. These federal laws also require that persons with disabilities have an equal opportunity to participate in and benefit from the providers’ medical services, including having access to health care facilities and to the medical equipment used to provide services. Accessible medical equipment is required in order to meet this nondiscrimination obligation and eliminate the barriers that inaccessible equipment can create for persons with disabilities. As is discussed below, the regulations implementing these federal laws do not currently include specific technical requirements for the accessibility of non-fixed medical equipment, although steps are underway by the Department of Justice to propose specific ADA technical standards for medical equipment.

Even without specific technical requirements for non-fixed medical equipment, the examination table marketplace is developing and selling more equipment intended to meet accessibility needs. As noted above, historically, fixed-height examination tables set at 32” for the convenience of clinicians have dominated the health care delivery system. Increasingly, these so-called “box tables” are being replaced by examination tables that are height adjustable, such as that shown in Figure 2.4.1(a). Typically, height adjustable tables today lower to about 19” from the floor.^I Sales figures from examination table manufacturers indicate that in 2012, about 25% of examination tables sold are height-adjustable (Figure 2.4.1(b)).

Other MDE manufacturers have also begun addressing accessibility issues, primarily within certain specialized populations. For example, manufacturers of diagnostic imaging equipment have produced equipment specifically to serve pediatric populations and persons with extreme obesity (so-called “bariatric” equipment).^J Diagnostic imaging equipment manufacturers are also designing equipment for specific health care delivery settings, including facilities with lower financial resources (e.g., institutions in rural regions, developing countries) and hospital emergency departments. As part of designing for broader patient populations and delivery settings, new equipment designs incorporate patient and clinician usability considerations, such as adjustable table heights and table minimum heights.

Figure 2.4.1(a)

Height Adjustable and Fixed-Height “Box” Examination Tables

(SOURCE: Midmark Corporation) Fixed height table on right, adjustable height table on left.

Figure 2.4.1(b)

Types of Examination Tables Sold: 2005-2012

(SOURCE: Global Healthcare Exchange (GHX)) The y axis indicates the percent of tables sold that are adjustable height (blue) and fixed height (red). The x axis indicates the quarter and year of the data (e.g., first quarter in 2005, extreme left).

Notes

^I The methods for measuring “low heights” for current height adjustable products vary among manufacturers and product designs. No official measurement method currently exists. Sections 4.1.2 and 5.1.4 describe the new standardized measurement method proposed by the Advisory Committee. Heights referenced in this report utilize this proposed new measurement method.

^J As noted in Sections 1 and 8, this report does not address accessibility standards for children or for individuals with extreme obesity.