The “virtual front door”–websites and digital information–is often the first interaction point that patients have with healthcare systems. However, people who are blind or have low vision face barriers in accessing healthcare information and the appointment-making processes when website information is inaccessible. The American Health Information Management Association (AHIMA) Foundation reported that in 2022, only 5% of hospitals were compliant with Website Content Accessibility Guidelines (WCAG 2.1) and legal requirements. Principles of universal design could let people who are blind, have low vision, or other disabilities readily establish care. Universal design improves program uptake and effectiveness, but rare in healthcare. We have developed the RAMP (Removing Barriers to the Management of Patient care) score to evaluate healthcare system websites and processes for allowing people to establish necessary specialty care. This project will improve the “virtual front door” to specialty care for people who are blind or have low vision. Using a that centers people with relevant lived experience, we propose the following: In Aim 1, we will refine our RAMP score to more robustly capture the barriers that the diversity of people with low vision and blindness experience in making healthcare appointments. In Aim 2, we will scale RAMP scoring and develop a publicly available and accessible data dashboard to allow comparisons of these scores across academic medical centers. And in Aim 3, we will use implementation science approaches to develop a toolbox of tailorable interventions that outline specific actions which academic medical centers can take to improve RAMP scores. We propose to change academic medical centers to reduce the negative impacts of structural ableism that block access to specialty care, by helping them implement the universal design. These 3 Aims are well-aligned with RFA-HD-24-007 “Understanding and Mitigating Health Disparities experienced by People with Disabilities caused by Ableism” and the National Eye Institute (NEI) focused interest in funding research to “understand and/or mitigate the health impacts of ableism on people who are blind or have low vision”. In the face of growing service delivery, public health, policy, equity, liability, and legal pressures, academic medical centers will have a choice. They can respond to these pressures to improve digital access as compliance checkboxes, minimizing real change while creating the facade of meeting minimal standards. Or, if we build the tools proposed here, academic medical centers can use these pressures to improve their ability to provide care to people who are blind or have low vision, and the full 27% of Americans who have disabilities.