Bridging the Digital Divide in Primary Care: Exploring the Impact of Digital Exclusion on Patients and Providers

Mi Segerström, Cecilia Fagerström, Evalill Nilsson, Hans Thulesius, Sandra Öberg, Carin Benjaminson

Keywords: Digital divide, digital exclusion, healthcare equity, person-centered care, primary care, Sweden

Background:

The digital transition in primary care aims to improve access but may worsen inequities for those unable or unwilling to use digital pathways. This "digital divide" affects individuals with psychosocial or cognitive disabilities, risking health disparities. Barriers such as neurodevelopmental and cognitive impairments are known, but further research is needed to explore these issues in primary care. This study examines how digital exclusion impacts patients and how primary care providers address their needs.

Research questions:

Why do some patients avoid digital contact pathways in primary care?
How does digital exclusion affect their health, well-being, and access to care?
How do primary care staff address the needs of these patients?

Method:

A qualitative, inductive study using phenomenography to explore individual perceptions.
Data will derive from semi-structured interviews with two groups: patients visiting primary care without appointments and the healthcare staff who work there. Conducted across three primary care units in Sweden, the study will include approximately 30 participants, ensuring diverse socioeconomic and geographic representation. Analysis will focus on identifying patterns and categories of understanding.

Results:

Prior research links digital exclusion to psychosocial and cognitive challenges. This study aims to provide new insights into Swedish primary care, highlighting how digital exclusion shapes healthcare interactions and outcomes. Findings will assist in designing more inclusive systems. The study aims to reveal the experiences of digitally excluded patients and strategies used by primary care staff to support them. The results will inform inclusive, person-centered practices, addressing the digital divide in an increasingly digital healthcare system.

Conclusions:

Primary care in Sweden is becoming increasingly digitized. Digital exclusion leads to difficulties in contacting primary care, but what these difficulties are from the perspective of the patient and healthcare is currently not known. The study is expected to provide new knowledge about this phenomenon.

Points for discussion:

How can healthcare systems address the digital divide without sacrificing person-centered care?

What methods can primary care providers use to better understand and accommodate digitally excluded patients?

What policy changes are needed to ensure equitable access to healthcare in the context of digital transformation?

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