Generative Engine Optimization (GEO) is making organizations scramble — our clients have been asking “Are we ready for the new ways LLMs crawl, index, and return content to users? Does our site support evolving GEO best practices? What can we do to boost results and citations?”  

Large language models (LLMs) and the services that power AI summaries don’t “think” like humans but they do perform similar actions. They seek content, split it into memorable chunks, and rank the chunks for trust and accuracy. If pages use semantic HTML, include facts and cite sources, and include structured metadata, AI crawlers and retrieval systems will find, store, and reproduce content accurately. That improves your chance of being cited correctly in AI overviews.

While GEO has disrupted the way people use search engines, the fundamentals of SEO and digital accessibility continue to be strong indicators of content performance in LLM search results. Making content understandable, usable, and memorable for humans also has benefits for LLMs and GEO.

How LLM systems (and AI-driven overviews) get their facts

Understanding how LLMs crawl, process, and retrieve web content helps us understand why semantic structure and accessibility best practices have a positive effect. When an AI system generates an answer that cites the web, several distinct back-end steps usually happen: 

  1. Crawling — Bots visit URLs and download page content. Some crawlers execute javascript like a browser (Googlebot) while others prefer raw HTML and limit their rendering.
  2. Chunking — Large documents are split into small, logical “chunks” of paragraphs, sections, or other units. These chunks are the pieces that are later retrieved for an answer. How a page’s content is structured with headings, paragraphs, and lists determines the likely chunk boundaries for storage.
  3. Vectorization — Each chunk is then converted into a numeric vector that captures its semantic meaning. These embeddings live in a vector database and enable systems to find chunks quickly. The quality of the vector depends on the clarity of the chunk’s text.
  4. Indexing — Systems will store additional metadata (URL, title, headings, metadata) to filter and rank results. Structured data like schema metadata is especially valuable. 
  5. Retrieval — A user asks a question or performs a search and the system retrieves the most semantically similar chunks via a vector search. It re-ranks those chunks using metadata and other signals and then composes its answer while citing sources (sometimes). 

The Case for Human-Accessible Content

There are many more reasons why digital accessibility is simply the right thing to do. It turns out that in addition to boosting SEO, accessibility best practices help LLMs crawl, chunk, store, and retrieve content more accurately.

During retrieval, small errors like missing text, ambiguous links, or poor heading order can fail to expose the best chunks. Let’s dive into how this can happen and what common accessibility pitfalls contribute to the confusion.

For Content Teams — Authors, Writers, Editors

Illustration of the problem with poor alt text on images, comparing one poor example and one good example

Lack of descriptive “alt” text

While some LLMs can employ machine-vision techniques to “see” images as a human would, descriptive alt text verifies what they are seeing and the context in which the image is relevant. The same best practices for describing images for people will help LLMs accurately understand the content. 

Illustration of poor heading structure, where the poor example shows skipped heading levels while the good example shows consecutive heading levels

Out-of-order heading structures

Similar to semantic HTML, headings provide a clear outline of a page. Machines (and screen readers!) use heading structure to understand hierarchy and context. When a heading level skips from an <h2> to an <h4>, an LLM may fail to determine the proper relationship between content chunks. During retrieval, the model’s understanding is dictated by the flawed structure, not the content’s intrinsic importance. (Source: research thesis PDF, “Investigating Large Language Models ability to evaluate heading-related accessibility barriers”) 

Illustration of poor link text context, where the poor example shows Click Here and Read more links and the good example shows more descriptive and unique text samples

Descriptive and unique links

All of the accessibility barriers surrounding poor link practices affect how LLMs evaluate their importance. Link text is a short textual signal that is vectorized to make proper retrieval possible. Vague link text like “Click here” or “Learn More” does not provide valuable signals. In fact, the same “Learn More” text multiple times on a page can dilute the signals for the URLs they point to.

Using the same link text for more than one destination URLs creates a knowledge conflict. Like people, an LLM is subject to “anchoring bias,” which means it is likely to overweight the first link it processes and underweight or ignore the second, since they both have the same text signal. 

Example of the duplicate link problem: <a href=“[URL-A]”>Duplicate Link Text</a>, and then later in the same article, <a href=“[URL-B]”>Duplicate Link Text</a>. Conversely, when the same URL is used more than once on a page, the same link text should be repeated exactly.

Illustration of plain language with a poor example and a more positive example. The poor example is dense and wordy while the good example if succinct and uses a list to break the text into chunks.

Logical order and readable content

Simple, direct sentences (one fact per sentence) produce cleaner embeddings for LLM retrieval. Human accessibility best practices of plain language and clear structure are the same practices that improve chunking and indexing for LLMs

For Technical Teams — IT, Developers, Engineers

An illustration of poor semantic structure, where the left shows a potential structure made only of HTML div elements, while the good example shows semantic elements used correctly.

Poorly structured semantic HTML

Semantic elements (<article>, <nav>, <main>, <h1>, etc.) add context and suggest relative ranking weight. They make content boundaries explicit, which helps retrieval systems isolate your content from less important elements like ad slots or lists of related articles. 

Illustration of data in written form as one way to parse information, but contrasted with schema markup which can make it easier for robots to collect correct information about a subject.

Lack of schema

This is technical and under the hood of your human-readable content. Machines love additional context and structured schema data is how facts are declared in code — product names, prices, event dates, authors, etc. Search engines have used schema for rich results and LLMs are no different. Right now, server-rendered schema data will guarantee the widest visibility, as not all crawlers execute client-side Javascript completely. 

How to make accessibility even more actionable

The work of digital accessibility is often pushed to the bottom of the priority list. But once again, there are additional ways to frame this work as high value. While this work is beneficial for SEO, our recent research uncovers that it continues to be impactful in the new and evolving world of GEO.

If you need to frame an argument to those that control the investments of time and money, some talking points are: 

Staying steady in the storm

Let’s be clear — this summer was a “generative AI search freak out.” Content teams have scrambled to get smart about LLM-powered search quickly while search providers rolled out new tools and updates weekly. It’s been a tough ride in a rough sea of constant change.

To counter all that, know that the fundamentals are still strong. If your team has been using accessibility as a measure for content effectiveness and SEO discoverability, don’t stop now. If you haven’t yet started, this is one more reason to apply these principles tomorrow. 

If you continue to have questions within this rapidly evolving landscape, talk to us about your questions around SEO, GEO, content strategy, and accessibility conformance. Ask about our training and documentation available for content teams.

Additional Reading

Digital accessibility can be difficult to stay ahead of. The laws have been evolving and now the European Union (EU) has entered the arena with their own version of the Americans with Disabilities Act (ADA).

If your business sells products, services, and/or software to European consumers, this law will apply to you.

The good news: 

The bad news:

Keep reading for a breakdown of how the Act works and what your business needs to prepare.

What is the European Accessibility Act? 

In 2019, the EU formally adopted the European Accessibility Act (EAA). The primary goal is to create a common set of accessibility guidelines for EU member states and unify the diverging accessibility requirements in member countries. The EU member states had two years to translate the act into their national laws and four years to apply them. The deadline of June 28, 2025 is now looming.

The EAA covers a wide array of products and services, but for those that own and maintain digital platforms, the most applicable items are:

Who Needs to Comply?

The EAA requires that all products and services sold within the EU be accessible to people with disabilities. The EAA applies directly to public sector bodies, ensuring that government services are accessible. But it goes further as well. In short, private organizations that regularly conduct business with or provide services to public-facing government sites should also comply.

Examples of American-based businesses that would need to comply:

There are limited exemptions. Micro-enterprises are exempt, and they are defined as small service providers with fewer than 10 employees and/or less than €2 million in annual turnover or annual balance sheet total.

What is required?

Information about the service

Service providers are required to explain how a service meets digital accessibility requirements. We recommend providing an accessibility statement that outlines the organization’s ongoing commitment to accessibility. It should include:

Compatibility and assistive technologies 

Service providers must ensure compatibility with various assistive technologies that individuals with disabilities might use. This includes screen readers, alternative input devices, keyboard-only navigation, and other tools. This is no different than ADA compliance in the United States.

Accessibility of digital platforms

Websites, online applications, and mobile device-based services must be accessible. These platforms should be designed and developed in a way that makes them perceivable, operable, understandable, and robust (POUR) for users with disabilities. Again, this is no different than ADA compliance in the United States.

Accessible support services

Communication channels for support services related to the provided services must also be accessible. This includes help desks, customer support, training materials, self-serve complaint and problem reporting, user journey flows, and other resources. Individuals with disabilities should be able to seek accessible assistance and information.

What are the metrics for compliance?

The EAA is a directive, not a standard, which means it does not promote a specific accessibility standard. Each member country can define its regulations for standards and conformance and define their penalties for non-compliance. Each country in which your service is determined to be non-compliant can apply a fine, which means that one infraction could accumulate fines from multiple countries. 

Just like the Americans with Disabilities Act, most EU member states are implementing Web Content Accessibility Guidelines 2.1 AA as their standard, which is great news for organizations that already invest in accessibility conformance.

If a member country chooses to use the stricter EN 301 549, which still uses WCAG as its baseline, there are additional standards for PDF documents, the use of biometrics, and technology like kiosks and payment terminals. These standards go beyond the current guidelines for business in the United States.

Accessibility overlays (3rd Party Widgets)

It should be noted that the EAA specifically recommends against accessibility overlay products and services — a third-party service that promises to make a website accessible without any additional work. Oomph has said for a long time that plug-ins will not fix your accessibility problem, and the EAA agrees, stating:

“Claims that a website can be made fully compliant without manual intervention are not realistic, since no automated tool can cover all the WCAG 2.1 level A and AA criteria. It is even less realistic to expect to detect automatically the additional EN 301549 criteria.”

The goals for your business

North American organizations that implemented processes to address accessibility conformance are well-positioned to comply with the EAA by June 28, 2025. In most cases, those organizations will have to do very little to comply. 

If your organization has waited to take accessibility seriously, the EAA is yet another reason to pursue conformance. The deadline is real, the fines could be significant, and the clock is ticking.

Need a consultation?

Oomph advises clients on accessibility conformance and best practices from health and wellness to higher education and government. If you have questions about how your business should prepare to comply, please reach out to our team of experts.

Additional Reading

Deque is a fantastic resource for well-researched and plain English articles about accessibility: European Accessibility Act (EAA): Top 20 Key Questions Answered. We suggest starting with that article and then exploring related articles for more.


THE CHALLENGE

The Challenge

Oncology nurses play a critical role in patient care, but navigating scattered, disconnected digital resources, research, and education made it harder for them to access the right information at the right time in the right place.

The Oncology Nursing Society (ONS), a professional organization with 200 chapters and over 35,000 members, maintained three separate websites for a variety of functions including clinical tools, research data, educational materials, and membership. The fragmented system made it difficult for:

  • Nurses to quickly find information in fast-paced clinical settings.
  • Healthcare institutions to manage memberships and resources for their staff.
  • ONS administrators to maintain and update content efficiently.

ONS partnered with Oomph to unify these platforms into a single, intuitive digital hub, making essential oncology resources easier to find, use, and manage.


OUR APPROACH

Leveraging our deep expertise in healthcare content strategy and digital engineering, Oomph worked closely with ONS to streamline content, improve search functionality, and enhance the overall user experience.

Creating a Flexible, Scalable Content System

ONS had a vast library of interconnected clinical, educational, and research materials but lacked an effective way to organize them. We:

  • Consolidated over 40 content types into just 23, ensuring a more structured, maintainable system.
  • Built a flexible content model in Drupal that allows the ONS team to easily update and customize pages.
  • Designed an intuitive content architecture that prioritizes clinical tools, continuing education, and membership resources.

Optimizing Interactive Oncology Tools

Two core resources—the Biomarker Database and Symptom Interventions tool—are essential to oncology nurses’ daily workflows. Oomph redesigned these tools to:

  • Enhance filtering capabilities, enabling nurses to quickly access relevant biomarker and treatment information.
  • Improve navigation and searchability, making evidence-based recommendations easier to find.
  • Ensure mobile responsiveness, so nurses can access resources from any device, wherever they are.

Implementing Smarter Search for Faster Access

Nurses often rely on quick search queries to find patient care guidance. To enhance search accuracy and speed, Oomph replaced ONS’ legacy Solr search with Algolia’s instant search technology, delivering:

  • Four custom search experiences, each tailored to different content types.
  • Real-time, intent-based search results to match the needs of busy clinicians.
  • Faster load times and improved accessibility across all search-enabled pages.

Aligning Design With the ONS Brand Evolution

ONS had recently completed a rebrand, but its digital presence hadn’t fully evolved to match. Oomph helped translate the new brand identity into a cohesive web experience by:

  • Refining UI components to align with ONS’ refreshed visual identity.
  • Experimenting with modern layout structures to create a clean, professional look.
  • Ensuring accessibility compliance.

THE RESULTS

A Unified, High-Impact Digital Resource

The new ons.org is a centralized, efficient, and scalable platform that makes it easier for oncology nurses, institutions, and administrators to access and manage critical healthcare resources.

  • One streamlined platform for nurses, institutions, and administrators.
  • Optimized content structure that simplifies navigation and enhances usability.
  • Advanced search functionality that delivers real-time, high-accuracy results.
  • Scalable and flexible design that supports future content growth and evolving member needs.

For oncology nurses, this platform is more than just a website—it’s a trusted clinical resource that supports better patient care, continuing education, and professional growth.

Empowering Healthcare Organizations With Digital Solutions That Work

In healthcare, access to information can directly impact patient outcomes. If your digital platform is fragmented, slow, or difficult to maintain, let’s discuss.