preface_schema: ‘1.0’ title: ‘Digital health for allied healthcare students - a course Module 3’ source_type: ‘Consulting Company’ publisher: ‘Longboardfella Consulting Pty Ltd’ publishing_date: ‘1 Nov 2025’ authors: [‘Digital Readiness’] credibility_tier_value: ‘1’ credibility_tier_key: ‘commentary’ credibility_tier_label: ‘commentary’ credibility: ‘Self published report’ keywords: [‘digital’, ‘health’, ‘patients’, ‘care’, ‘clinicians’, ‘healthcare’, ‘tools’, ‘stakeholders’] abstract: ’# Week 3: Stakeholders, Equity, and Digital Readiness Module Welcome: The Human Side of Digital Health Digital health is not just about cutting-edge tools and apps – it’s fundamentally about people. As healthcare undergoes digital transformation, our focus must remain on those at the heart of care: patients, carers, clinicians, administrators, and communities. This week, we explore how digital health impacts diverse stakeholders, identify barriers that prevent equitable access, and develop strategies to ensure no one is left behind in our digital journey. We’ll examine real-world Australian examples and case studies to ground these concepts in practice, and equip you – as an allied health professional – with the knowledge to be a digital health advocate who supports inclusion and readiness in your workplace and community. By the end of this week, you will be able to:‘
Week 3: Stakeholders, Equity, and Digital Readiness
Module Welcome: The Human Side of Digital Health
readiness in your workplace and community. By the end of this week, you will be able to:‘
Week 3: Stakeholders, Equity, and Digital Readiness
Module Welcome: The Human Side of Digital Health
Digital health is not just about cutting-edge tools and apps – it’s fundamentally about people. As healthcare undergoes digital transformation, our focus must remain on those at the heart of care: patients, carers, clinicians, administrators, and communities. This week, we explore how digital health impacts diverse stakeholders, identify barriers that prevent equitable access, and develop strategies to ensure no one is left behind in our digital journey. We’ll examine real-world Australian examples and case studies to ground these concepts in practice, and equip you – as an allied health professional – with the knowledge to be a digital health advocate who supports inclusion and readiness in your workplace and community.
By the end of this week, you will be able to:
Analyze stakeholder impacts: Explain how digital health technologies affect different stakeholder groups (patients, carers, clinicians, healthcare organizations, and system-level actors).
Identify barriers for priority populations: Recognize and evaluate barriers to digital inclusion for groups such as Indigenous Australians, culturally and linguistically diverse (CALD) communities, older adults, and people with disabilities.
Assess digital readiness: Use validated frameworks to assess digital health readiness at individual, organizational, and system levels, understanding factors like infrastructure, skills, and attitudes.
Support diverse users: Develop practical strategies to support clients and colleagues with varying levels of digital literacy and access, including training and alternative solutions for those less digitally engaged.
users: Develop practical strategies to support clients and colleagues with varying levels of digital literacy and access, including training and alternative solutions for those less digitally engaged.
Apply co-design principles: Understand and apply principles of co-design and user-centered design when implementing digital health solutions to ensure they meet user needs and are adopted successfully.
Throughout this module, keep in mind that successful digital health is human-centered. The promise of technology will only be realized if we tailor it to the needs of all users and actively work to close digital divides.
Topic 1: Understanding Digital Health Stakeholders
Digital health is transforming healthcare delivery, but its impact varies widely across different people and roles in the healthcare ecosystem. As an allied health professional, you will interact with multiple stakeholders – each with unique perspectives, needs, and challenges. Understanding these stakeholders is critical: success in digital health isn’t just about technology, but about people. By listening to each group’s concerns and collaborating on solutions, we can ensure that digital tools serve a shared goal: better health for everyone[1][2].
The Digital Health Stakeholder Ecosystem
Think of the healthcare system as an interconnected web of stakeholders. Patients and carers, allied health professionals, doctors, clinic administrators, hospitals, government agencies, insurers, IT developers – all are nodes in this ecosystem, with data and communication flowing between them. Each stakeholder experiences digital health differently:
hospitals, government agencies, insurers, IT developers – all are nodes in this ecosystem, with data and communication flowing between them. Each stakeholder experiences digital health differently:
Patients and Carers: For patients, digital health promises empowerment through 24/7 access to information (for example, Australia’s My Health Record), telehealth consultations from home, and mobile apps to manage health. These tools can enable patients like Mary (a 72-year-old in regional NSW) to receive care without traveling long distances[1]. Telehealth can eliminate the need for long-distance travel for rural patients, cutting down time and cost burdens[1]. Patients can be more involved in their care decisions, which can improve satisfaction and outcomes. Carers and family members also benefit by accessing information and supporting their loved ones remotely. However, digital health can pose challenges for patients: not everyone finds patient portals or health apps intuitive, and navigating new technology can be confusing or frustrating. Digital literacy varies greatly – Mary, for instance, struggles with the smartphone app for her continuous glucose monitor and worries about her personal data security. Privacy and trust are common concerns; patients need to feel confident that their health information is secure. There is also a risk of changing the patient-provider dynamic – some patients might feel overwhelmed by constant data or feel that digital tools are impersonal. Ensuring accessibility and simplicity in patient-facing tools is therefore crucial to avoid alienating those who are less tech-savvy.
helmed by constant data or feel that digital tools are impersonal. Ensuring accessibility and simplicity in patient-facing tools is therefore crucial to avoid alienating those who are less tech-savvy.
Healthcare Professionals (Clinicians): For clinicians, including allied health professionals, digital health offers the potential for streamlined workflows and enhanced care delivery. Electronic health records (EHRs) and clinical decision support systems can reduce duplicate paperwork and provide evidence-based guidance at the point of care. Telehealth allows allied health providers (physiotherapists, speech pathologists, dietitians, etc.) to reach clients beyond geographic boundaries – for example, a physiotherapist can conduct tele-rehab sessions with a patient in a remote area, or a speech pathologist can coach a client via video. Clinicians often appreciate these new capabilities: “Telehealth lets me reach clients I never could before,” says one physiotherapist, “especially those in rural areas or with mobility issues.” Digital tools can improve communication among care teams (secure messaging, shared records) and with patients (patient portals, remote monitoring data). Moreover, automating routine tasks (like appointment reminders or progress tracking) can free up time for direct patient care. Challenges: On the flip side, clinicians face a learning curve and added workload in adopting new systems. Time investment is needed to learn software or update digital records, and many clinicians experience “alert fatigue” or burnout from increased screen time. A speech pathologist notes, “Digital tools enhance my practice, but I spend more time troubleshooting tech issues than I’d like.” There can be workflow disruption if systems are not user-friendly or well-integrated – for instance, juggling multiple logins or devices during a consultation can be distracting. Clinicians may also feel their professional identity shift – the role now includes be
well-integrated – for instance, juggling multiple logins or devices during a consultation can be distracting. Clinicians may also feel their professional identity shift – the role now includes being an IT navigator and data interpreter. Training and support are critical so that healthcare workers feel confident and competent using digital health technologies. Without adequate training, what should be a helpful tool can become a hindrance that slows clinicians down. Additionally, clinicians must adapt to new models of care (e.g. virtual care, asynchronous consultations) and ensure that the quality of care and therapeutic rapport is maintained in digital environments.
Healthcare Organizations (Administrators and Managers): For clinics, hospitals, and health services, digital health innovations promise operational efficiencies and quality improvements. Administrators see benefits in data-driven decision-making – for example, dashboards that show hospital occupancy or patient outcomes can inform management decisions and continuous quality improvement. Electronic records and digital communication can streamline processes (e.g. reducing transcription errors, speeding up referral communications). Adopting telehealth and online services can expand an organization’s reach and offer competitive advantage in a consumer-driven healthcare market. There are also compliance drivers: government mandates like electronic prescribing or My Health Record participation require organizations to upgrade digitally. Opportunities: A clinic owner might achieve improved billing efficiency or better performance on key indicators through a new digital system. Administrators often cite positive return on investment (ROI) in the long term – for instance, reducing paperwork and duplication can save time and costs, while telehealth services can attract new patients. Challenges: Implementing these technologies is complex. There are significant upfront costs (hardware, software licenses,
can save time and costs, while telehealth services can attract new patients. Challenges: Implementing these technologies is complex. There are significant upfront costs (hardware, software licenses, IT support) and ongoing costs for maintenance and cybersecurity. Integration is a major hurdle – new systems must talk to existing ones (interoperability issues are common when merging EHRs, scheduling software, diagnostic systems, etc.). Administrators worry about cybersecurity and data privacy, as breaches can have serious consequences. They also face change management challenges: ensuring the entire workforce is confident and capable with the new tools. Staff training, resistance to change, and workflow redesign all require careful management. It’s not uncommon for an organization to see productivity dip during the transition phase. Leadership and planning are needed to navigate these challenges. Successful organizations often take a phased approach, involve clinicians in planning, and invest in support resources (like an IT helpline, super-user champions) to ease the transition. The payoff can be substantial, but so are the risks if the implementation fails – hence the importance of readiness assessment and stakeholder engagement (discussed further in Topic 3).
transition. The payoff can be substantial, but so are the risks if the implementation fails – hence the importance of readiness assessment and stakeholder engagement (discussed further in Topic 3).
System-Level Stakeholders: Beyond individual organizations, there are larger players shaping the digital health landscape. Government agencies (like the Australian Digital Health Agency, state health departments, Medicare) set policies, fund initiatives, and develop national infrastructure. For example, the Australian government’s investment in telehealth (especially during COVID-19) and the rollout of My Health Record have been major system-level drivers. These stakeholders aim for broad outcomes: improved public health, cost-efficient healthcare delivery, and equity of access. Insurers and funding bodies influence digital health by determining what services are reimbursed (e.g. telehealth eligibility for Medicare rebates) and by incentivizing certain digital practices through funding programs. Technology vendors and developers are also key system stakeholders – their decisions on design and interoperability of software impact how well the healthcare system functions digitally. System-level actors generally see population-level benefits in digital health: better data for policymaking and research, potential cost savings through preventive care and telehealth, and the modernization of health services. Their challenges include ensuring regulations keep up with technology (for example, updating privacy laws for health data, or creating standards for digital therapeutics), and addressing the digital divide so that innovations don’t inadvertently widen health disparities. There is also the challenge of coordinating across a fragmented system – aligning multiple healthcare providers, vendor platforms, and jurisdictions to create a cohesive digital health ecosystem.
Table 1. Benefits and Challenges of Digital Health for Key Stakeholder Groups
ligning multiple healthcare providers, vendor platforms, and jurisdictions to create a cohesive digital health ecosystem.
Table 1. Benefits and Challenges of Digital Health for Key Stakeholder Groups
Each stakeholder has a voice in the digital health conversation. A core message is that inclusive design and collaboration are necessary. For example, a hospital implementing a new electronic record must engage clinicians (to make sure it fits clinical workflows), educate patients about new patient portals, allocate resources for staff training, and comply with government data standards – all while keeping the system secure. When stakeholders work together – tech developers listening to clinician feedback, managers involving end-users in design, policymakers consulting communities – the result is digital health solutions that are more likely to be effective and accepted. Success in digital health isn’t just about the technology; it’s about aligning the technology with the needs of all its users[2][3].
Stakeholder Mapping and Analysis
When planning a digital health project (for instance, introducing a new exercise prescription app in an allied health clinic), it’s helpful to map out stakeholders and analyze their influence and needs. One common tool is a stakeholder impact/influence matrix (also known as a power-interest grid). This matrix plots stakeholders according to how much impact the project will have on them, and how much influence or power they have over the project. The result is typically four categories, with guidance on how to manage each:
rs according to how much impact the project will have on them, and how much influence or power they have over the project. The result is typically four categories, with guidance on how to manage each:
High Impact, High Influence – “Manage Closely”: These stakeholders are heavily affected by the project and also have the authority or power to shape it. Example: The clinic owner/manager and the lead physiotherapist in our exercise app scenario. They will directly benefit from or be disrupted by the new system and have the decision-making power to support or veto it. These stakeholders should be engaged deeply – involved in planning, kept informed of progress, and given roles in implementation (e.g. a lead physio championing the app among colleagues). Ensuring their buy-in is critical for success.
High Impact, Low Influence – “Keep Informed”: Stakeholders who will feel substantial effects from the project but have limited ability to influence it. Example: Patients who will be asked to use the new digital exercise program – say, an older patient with low digital literacy and a younger tech-savvy patient. The success of the project hinges on their adoption, but they are not in positions of authority within the organization. It’s essential to keep these users informed, involved through feedback sessions or co-design if possible, and to support them (training, alternate options) so the solution truly works for them. Even if they don’t have formal power, their acceptance (or rejection) of the technology will determine real-world outcomes.
t them (training, alternate options) so the solution truly works for them. Even if they don’t have formal power, their acceptance (or rejection) of the technology will determine real-world outcomes.
Low Impact, High Influence – “Keep Satisfied”: Stakeholders who are not directly or heavily affected by the project’s day-to-day use, but who hold influence, perhaps externally. Example: An IT support vendor or the Medicare system (if reimbursement is tied to digital record-keeping). These parties might not use the app themselves, but their policies or support can affect it (e.g. Medicare’s reimbursement rules for telehealth exercise consultations, or the IT vendor’s reliability and contract terms). You should manage their expectations and keep them satisfied – for instance, maintain good communication with the IT supplier, and ensure the project complies with any external requirements.
Low Impact, Low Influence – “Monitor (Minimal Effort)”: Stakeholders who are only marginally affected and have little influence. Example: A clinic receptionist who might see a small change in workflow (perhaps scheduling appointments differently with the new app), but isn’t deeply impacted or in a position to shape the project. We should not ignore these stakeholders – sometimes those seemingly peripheral can offer practical insights – but they typically require only monitoring and occasional check-ins rather than intensive management.
gnore these stakeholders – sometimes those seemingly peripheral can offer practical insights – but they typically require only monitoring and occasional check-ins rather than intensive management.
Performing a stakeholder analysis upfront helps identify who should be at the table when designing or choosing a digital health solution. It reminds us to consider all voices – especially those who will use the technology (patients, frontline clinicians) and those who control resources (management, funding bodies). By actively engaging stakeholders according to their needs and influence, we increase the chances of a smooth implementation. For example, involving a few representative patients in co-design can reveal usability issues early, while close collaboration with high-influence leaders can secure the necessary resources and policy support. We will revisit co-design principles in Topic 5, but it’s clear even at the planning stage that a “many voices, one goal” approach is needed to ensure digital health tools are usable and beneficial for all.
Topic 2: Digital Inclusion and Health Equity
While digital health has the potential to improve care and reduce disparities, it also carries the risk of widening existing gaps if not implemented thoughtfully. The term “digital divide” refers to the gap between those who have ready access to digital technologies and the internet, and those who do not. In healthcare, this divide can translate into differences in who can benefit from digital health services. As allied health professionals and health advocates, we must actively work to ensure that digital health reduces rather than reinforces inequities in health outcomes. This involves understanding the digital determinants of health – factors that influence people’s ability to access and use digital health resources – and taking action to promote digital inclusion for priority populations.
Understanding Digital Determinants of Health
t influence people’s ability to access and use digital health resources – and taking action to promote digital inclusion for priority populations.
Understanding Digital Determinants of Health
Just as social determinants (like income, education, and environment) affect health outcomes, digital determinants increasingly influence healthcare access and quality. One useful framework for digital inclusion can be summarized as five A’s: Access, Affordability, Ability, Agency, and Availability.
Access: This is the foundational determinant – the physical availability of infrastructure and devices. It asks, does an individual have access to the internet (broadband, mobile network) and to a suitable device (smartphone, computer, tablet) for digital health services? In Australia, internet access is high in urban areas but lags in some rural and remote regions. For example, only about one-third of Australia’s land area has mobile connectivity (despite regional and remote areas comprising 30% of the population). In some remote Aboriginal communities, 30% of people have no household internet or phone connection – a stark access gap. Access can also be affected by disabilities (e.g. a person with visual impairment may need specific accessible devices or software) and by living environment (unstable housing can make consistent connectivity difficult). Without basic internet and device access, digital health services (telehealth, health apps, online portals) are simply out of reach. Addressing access may involve improving telecommunications infrastructure (like extending the NBN or mobile coverage in remote areas) and providing community access points (such as free internet at libraries or telehealth hubs in rural towns).
ecommunications infrastructure (like extending the NBN or mobile coverage in remote areas) and providing community access points (such as free internet at libraries or telehealth hubs in rural towns).
Affordability: Even if infrastructure exists, can people afford to connect? Affordability covers the costs of devices, data plans, and digital services. For low-income individuals, cost is a major barrier to digital inclusion. For instance, half of low-income households in Australia had difficulty paying for home internet service. Many low-income families rely on mobile-only internet (no fixed broadband), which often comes with data limits and a higher cost per gigabyte. Indeed, one-third of those with mobile-only data connections are low-income households with school-aged children – highlighting a compounded disadvantage for education and health. Using only a mobile phone plan for internet also usually means data is precious; people may avoid video consultations or downloading health apps to conserve data. Some may not upgrade devices regularly due to cost, leaving them with outdated technology that might not run new health apps securely. Strategies to improve affordability include subsidized internet or devices for those on low incomes (for example, programs that provide discounted broadband to concession card holders), zero-rating certain health websites or apps (meaning using those services doesn’t count against data caps), and offering free public Wi-Fi or loaner devices in healthcare facilities. Community organizations and charities also play a role – for example, the Good Things Foundation’s programs help provide devices and digital training to socially disadvantaged groups.
facilities. Community organizations and charities also play a role – for example, the Good Things Foundation’s programs help provide devices and digital training to socially disadvantaged groups.
Ability: Ability refers to the skills and digital literacy needed to use technology effectively. This encompasses basic technical skills (turning on a device, navigating apps or websites), as well as more advanced skills like evaluating online information and protecting one’s privacy online. Digital literacy is increasingly seen as a critical component of health literacy. A person may have internet and a smartphone, but if they don’t know how to install an app, or how to troubleshoot a login issue, those tools might be useless to them. Ability also varies widely among populations: for example, many older adults did not grow up with digital technology and may lack confidence with it; similarly, people with lower education levels might have had less exposure to computers and the internet. According to the Australian Digital Inclusion Index, digital ability scores are lower among Australians with fewer years of education and among those outside the workforce. In practice, low ability can manifest as a patient not understanding how to join a telehealth call, or a client being unable to figure out how to input their daily exercise data into an app without assistance. To address ability gaps, digital skills training is vital. This can range from one-on-one coaching (for instance, a community center hosting “tech help” sessions for seniors) to structured courses. An example is the Health My Way program led by the Good Things Foundation, which trained digital health mentors in community organizations to teach people how to use health apps and websites. Through this program, 71 community organizations across Australia taught digital health literacy skills, training 232 mentors and directly supporting at least 3,000 people to improve their abilities. Participants report
m, 71 community organizations across Australia taught digital health literacy skills, training 232 mentors and directly supporting at least 3,000 people to improve their abilities. Participants reported increased confidence in using tools like My Health Record and finding reliable health information. As an allied health professional, even in daily practice, you can help build ability – for instance, by spending a few minutes to walk a patient through how to download and use a recommended app, or using “teach-back” techniques to ensure they feel comfortable with a new digital process.
Agency: Agency in the digital context refers to a person’s confidence and autonomy in using digital tools. It’s related to ability but more about mindset and empowerment – the belief that one can use technology to achieve one’s goals, and having control over one’s digital interactions. Someone with high digital agency feels they can troubleshoot problems, make informed choices online, and assert preferences (like opting out of data sharing if desired). Those with low agency might be hesitant to try using technology without help, or may feel anxiety about “doing something wrong” online. Building agency often requires supportive experiences that increase confidence. For example, an older adult might initially be very anxious about telehealth – worried they’ll press the wrong button – but after a few successful video appointments (perhaps facilitated by a family member or a community worker initially), they gain the confidence to do it independently. Agency also relates to privacy and security awareness: a person who understands how to protect their information (like recognizing phishing scams or using strong passwords) will feel more in control and less fearful of using online health services. Healthcare providers can support agency by normalizing different comfort levels (“It’s okay if you’re not used to this – we will take it slow together”), by prov
sing online health services. Healthcare providers can support agency by normalizing different comfort levels (“It’s okay if you’re not used to this – we will take it slow together”), by providing clear instructions and reassurances about safety, and by offering alternative routes as backups (so the person knows they won’t be abandoned if digital doesn’t work for them). In short, enhancing agency is about empowering users – making them feel capable, safe, and in control in the digital health space.
Availability (of relevant services): This determinant considers whether appropriate digital health services exist and are designed in a culturally and linguistically appropriate manner for the person. It’s about the content and services being available and tailored to diverse needs. For instance, are there health apps and information resources in the person’s preferred language? Does a telehealth system provide Auslan (sign language) interpretation for Deaf patients? Is the design of a patient portal considering people with low literacy or those from different cultural backgrounds? Availability also touches on whether the digital service addresses the user’s context – for example, an app for managing chronic disease that assumes a certain level of health literacy or baseline knowledge might not be usable by someone with limited health literacy. Culturally appropriate design is crucial in a multicultural society. A positive example is the NSW Multicultural Health Communication Service (MHCS), which hosts a library of multilingual health resources in over 50 languages. This service ensures that vital health information (now increasingly digital, like PDF fact sheets or online videos) is available in languages like Arabic, Mandarin, Vietnamese, etc., so that CALD communities can access information in their first language. The MHCS also advises on culturally appropriate ways to communicate health messages. Another aspect of availability is having digit
hat CALD communities can access information in their first language. The MHCS also advises on culturally appropriate ways to communicate health messages. Another aspect of availability is having digital health content for different literacy levels or disabilities – e.g. providing easy-read versions of online information for people with intellectual disabilities, or ensuring websites meet accessibility standards (discussed more under disabilities below). As healthcare providers, when adopting any digital tool, we should ask: Is this tool available and usable for my diverse client base? If not, how can we accommodate those who need a different format?
These digital determinants are interrelated. For example, improving access (broadband in a rural area) won’t fully close the gap unless people also develop the ability and agency to use that connectivity for health, and unless relevant services are available in their context. As we move to priority populations, we’ll see how these factors come into play for specific groups. The main point is that digital inclusion requires intentional, sustained effort – just as we address social determinants like transport or housing in care planning, we must address digital determinants to ensure equitable health outcomes.
Priority Populations in Australia
Certain population groups in Australia are at higher risk of digital exclusion and thus may not benefit equally from digital health innovations. Let’s discuss some of these groups, the specific challenges they face, and opportunities to promote inclusion. We will focus on: Indigenous Australians; Culturally and Linguistically Diverse (CALD) communities; Older Adults; People with Disabilities; and People experiencing socioeconomic disadvantage.
Indigenous Australians (Aboriginal and Torres Strait Islander Peoples)
lly Diverse (CALD) communities; Older Adults; People with Disabilities; and People experiencing socioeconomic disadvantage.
Indigenous Australians (Aboriginal and Torres Strait Islander Peoples)
Challenges: Indigenous Australians, especially those living in remote and rural areas, often face significant digital access issues. Remote Aboriginal communities may have limited internet infrastructure – some rely on satellite connections that are slow or expensive, and mobile coverage can be spotty or non-existent outside community centers. As noted, about 30% of people in remote First Nations communities have no internet or phone at home. This lack of connectivity is a major barrier to using telehealth or online resources. There are also economic barriers; many remote Indigenous families have low incomes, making devices and data plans hard to afford. Beyond access and affordability, cultural appropriateness of digital health tools is a concern. A lot of mainstream health content is not tailored to Indigenous languages or cultural contexts. Historical mistrust of government systems can extend to e-health records or data sharing – for instance, concerns about how health data might be used or a general lack of trust if past experiences with healthcare were negative. Additionally, English may not be the first language for some Aboriginal people in remote areas, and literacy levels vary, so text-heavy apps or websites can be unsuitable. Health literacy issues intersect with digital literacy, compounding the challenge. There’s also the question of community acceptance – any health initiative (digital or not) in Aboriginal communities needs to engage with community leaders and respect local practices and knowledge systems.
also the question of community acceptance – any health initiative (digital or not) in Aboriginal communities needs to engage with community leaders and respect local practices and knowledge systems.
Opportunities: Despite the challenges, digital health can be a game-changer for Indigenous health if done right. Telehealth has a clear benefit in reducing the need for travel. For example, consider dialysis treatment for kidney disease (a condition with higher prevalence in many Aboriginal communities). Traditionally, patients had to relocate to cities or large towns for dialysis, uprooting them from their land and support networks. With innovative models like Purple House, this has changed. Purple House (Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation) is an Aboriginal community-controlled health service providing dialysis in 20+ remote communities across NT, WA, and SA, as well as through mobile dialysis trucks. Using a combination of on-site services and technology, Purple House enables people to receive lifesaving dialysis on Country, near their families. Nurses or Aboriginal health workers provide dialysis locally, and a supervising doctor (often hundreds of kilometers away) oversees treatment, which can be facilitated via telehealth communications. This model drastically reduces travel burden and keeps patients connected to their culture and community, which has immense social and mental health benefits. “Being back on Country with family delivers powerful outcomes,” says Purple House CEO Sarah Brown[4][5]. Purple House combines high-tech (e.g., machines and teleconsultation) with culturally safe care – the clinics double as community hubs where patients can cook traditional foods (like kangaroo tail) and make bush medicine while undergoing treatment. This example shows that digital health (telehealth, remote monitoring) can be woven into culturally grounded care. Other opportunities include developing apps or messaging services
dergoing treatment. This example shows that digital health (telehealth, remote monitoring) can be woven into culturally grounded care. Other opportunities include developing apps or messaging services in Indigenous languages – for instance, flu or COVID-19 public health messages recorded in Yolŋu Matha or Pitjantjatjara and sent via community Facebook pages or radio. There are projects where Indigenous communities co-design health apps to ensure they are relevant (like apps for managing diabetes that include Indigenous diet options and use local artwork in the interface). Community-controlled digital health initiatives, where Indigenous organizations lead the design and implementation, tend to have more trust and uptake. Telehealth can also support Indigenous Health Workers by connecting them with specialists for advice without the patient leaving the community. Going forward, it’s crucial that Indigenous communities have a say in digital health strategy – for example, through consultations around the forthcoming National Digital Health Strategy – to ensure technology is used to support Indigenous models of care, not override them. The government and health services can support this by investing in infrastructure (like the new remote dialysis units funded in 2023, delivered in partnership with Purple House[4]) and by funding digital literacy programs in communities, potentially as part of broader community development.
Scenes from Purple House: an Aboriginal-led health service combining technology (dialysis machines, telehealth links) with cultural safety – providing “home away from home” care so patients can stay on Country. Community members engage in social and cultural activities (like bush medicine preparation) alongside clinical care, illustrating the importance of co-designing digital health solutions that align with community needs.
Culturally and Linguistically Diverse (CALD) Communities
eparation) alongside clinical care, illustrating the importance of co-designing digital health solutions that align with community needs.
Culturally and Linguistically Diverse (CALD) Communities
Challenges: Australia’s multicultural population means many patients and families speak a language other than English at home, and come from diverse cultural backgrounds. Digital health can pose several challenges for CALD communities. Language is a big barrier – a patient portal or health app available only in English will be of limited use to someone with low English proficiency. Even when people speak conversational English, understanding medical content in a second language can be hard (imagine navigating a complex consent form or health questionnaire full of jargon in a language you’re less familiar with). Cultural differences in concepts of health, privacy, and communication styles can also affect uptake. Some cultures have different expectations about family involvement in care or may be more hesitant to discuss certain health issues over impersonal channels. Privacy norms vary – for example, refugees from countries with surveillance might distrust electronic record systems. Additionally, digital literacy levels vary across migrant groups. Some new migrants or refugees may have had little exposure to computers if they come from regions with limited technology access, or they may have had interrupted education due to displacement. There’s also the issue of trust and awareness – if health agencies don’t effectively reach CALD communities with information about digital health initiatives (like My Health Record), these communities might remain unaware or skeptical of using them. During the COVID-19 pandemic, for instance, language barriers and lack of translated digital resources hindered some CALD individuals from accessing services like vaccine bookings or telehealth consultations.
he COVID-19 pandemic, for instance, language barriers and lack of translated digital resources hindered some CALD individuals from accessing services like vaccine bookings or telehealth consultations.
Opportunities: Culturally tailored approaches can vastly improve digital inclusion for CALD groups. Australia has some strong initiatives in this area. The NSW Multicultural Health Communication Service (MHCS) we mentioned ensures translated health information is widely available – their online library hosts health publications in over 50 languages, covering topics from chronic disease management to how to use telehealth. This means a physiotherapist could print or email a brochure about, say, using an exercise app that’s written in Arabic or Chinese for the patient. Additionally, the rise of professional video interpreter services has bolstered telehealth for CALD patients – clinicians can now conference in an interpreter during a telehealth session so that language is less of a barrier, similar to how one would use telephone interpreters in person. Many telehealth platforms used in Australia are now equipped to handle three-way calls with interpreters. Another resource: the Australian government’s Translating and Interpreting Service (TIS National) is accessible to healthcare providers to facilitate communication, and they have been utilized in telehealth contexts (patients at home, provider in clinic, interpreter on the line). Designing digital tools with multilingual support is key. For example, some health apps now offer menus in multiple languages or have visual icon-driven interfaces for those with limited literacy. Community organizations also step up – the NSW Multicultural Health Communication Service during COVID worked with multicultural media and community leaders to spread digital messages (via WhatsApp groups, ethnic radio, etc.) ensuring that important health information in digital form reached communities in languages they understand. A conc
mmunity leaders to spread digital messages (via WhatsApp groups, ethnic radio, etc.) ensuring that important health information in digital form reached communities in languages they understand. A concrete example: The NSW Health “Ask Mona” chatbot was launched to answer COVID-19 questions and was trained to respond in multiple languages, which helped non-English speakers get accurate info digitally. Another example is the NSW Multicultural Health Communication Service’s translated resources on their website, which by 2019 hosted more than 450 publications in a wide range of languages. Health providers can leverage these resources by directing CALD clients to them or printing materials for clients who prefer offline. Culturally, involving community figures can help with trust – for instance, training bilingual health workers or community educators to teach digital health skills within their communities (like how to use a Medicare online account or book appointments online) can be effective. In Melbourne, for example, there are programs where tech-savvy youth volunteers from migrant backgrounds hold workshops for older migrants on using smartphones for health and social connection. The key opportunity is co-design with CALD communities – asking them what they need. This could lead to solutions like multilingual telehealth navigator programs, ethnic-specific telehealth lines (some Primary Health Networks have trialed this for mental health support in languages like Vietnamese or Arabic), or simply ensuring representation of diverse names and faces in app user-testing to catch cultural usability issues. In summary, bridging language gaps via translation and interpreter services, and ensuring digital health information is presented in culturally sensitive ways, will support CALD Australians to benefit from digital health on an equal footing.
Older Adults
preter services, and ensuring digital health information is presented in culturally sensitive ways, will support CALD Australians to benefit from digital health on an equal footing.
Older Adults
Challenges: Older adults (generally considered 65+ years) are often highlighted in discussions of the digital divide. Many current seniors did not use computers or the internet during their working lives, so the rapid digitization of services poses a steep learning curve. Physical and cognitive changes can also make technology use harder – declining vision, tremors or arthritis affecting use of touchscreens or keyboards, hearing loss making telephone navigation difficult, or mild cognitive impairment affecting memory of steps/passwords. A significant portion of older Australians remain offline or minimally online. As of a few years ago, only about 55% of Australians over 65 even used the internet at home, compared to around 86.5% national average – meaning nearly half of seniors might not be accessing any online services. Furthermore, only 1 in 5 people over 65 (20%) were using the internet to access health services (such as booking appointments or looking up health information), about half the rate of the general population. This indicates both access and confidence issues. Even those who have basic internet access may not feel comfortable with newer digital health tools. A 2021 research found 80% of Australians over 65 feel it’s difficult to keep up with technological changes. Common sentiments among older patients include fear of “breaking something” on the device, concerns about privacy scams, or simply a preference for face-to-face interaction out of habit and comfort. Social isolation can exacerbate the issue – older people living alone may have no one to ask for help with tech issues. Economic factors: retirees on fixed incomes might be reluctant to invest in expensive devices or upgrades. Some older adults also experience low health literacy, and w
o ask for help with tech issues. Economic factors: retirees on fixed incomes might be reluctant to invest in expensive devices or upgrades. Some older adults also experience low health literacy, and when combined with low digital literacy, navigating telehealth or health websites becomes doubly challenging. For example, an older patient might struggle to log into a patient portal, then also have trouble interpreting the test results once in. Finally, design factors play a role – many apps have small font sizes, or websites require navigating complex menus, which may not be senior-friendly unless adjusted for accessibility.
Opportunities: There are many strategies to support older adults in the digital health space, often focusing on education, simplification, and support. On the technology design front, age-friendly design can make a big difference: simplified interfaces with clear, large text options, high-contrast visuals, and straightforward navigation benefit those with visual or cognitive difficulties. Voice-activated technologies are promising – smart speakers or voice assistants allow an older person to, say, “ask” for their medication schedule or have health information read aloud, bypassing the need to type or read. The Australian Digital Health Agency has recognized the need to build digital health literacy among seniors, partnering with libraries and community centers in initiatives like “Health My Way” as mentioned, and also leveraging the existing Be Connected network (a government-funded program that provides digital skills training to seniors through community organizations). Through these programs, thousands of older Australians have been trained to use the internet and essential online services. For instance, seniors are taught how to navigate My Health Record, how to use telehealth (from checking email for a video link to adjusting the volume on their device). The Good Things Foundation reported that after training, many seniors signif
ate My Health Record, how to use telehealth (from checking email for a video link to adjusting the volume on their device). The Good Things Foundation reported that after training, many seniors significantly improved their confidence – e.g. a participant named Val, age 74, learned to send her first email and said, “I want to continue being independent and having full control of my life and health”. Such personal triumphs illustrate the empowerment that can come from targeted support. Intergenerational support is another asset: programs that pair tech-savvy younger volunteers (even high school students) with older residents have shown success, as the communication can be patient and tailored. Health providers should also normalize alternative pathways for older people who really cannot or do not want to engage digitally. For example, while an online booking system is great, always also offer a phone booking option. While electronic pharmacy orders are convenient, ensure there’s a way for an older patient to do it in person or by phone if needed. In a clinical setting, an allied health professional could print online information for an older patient rather than assume they will scan a QR code. Co-designing digital health with older adults is crucial – involving them in usability testing highlights pain points. For example, some telehealth systems introduced a one-click link (no login required) because testing with seniors showed that remembering usernames/passwords was a big hurdle; instead, they receive a secure link by SMS or email that directly launches the session. Assistive technologies can also help: hearing aids that stream audio from telehealth calls, or screen-reader software for those with poor eyesight, can make digital health more accessible. Lastly, many older Australians trust and frequently visit their GP or local pharmacy – these can be points to introduce digital health gently (e.g. a GP practice nurse might spend a few minutes showing an
many older Australians trust and frequently visit their GP or local pharmacy – these can be points to introduce digital health gently (e.g. a GP practice nurse might spend a few minutes showing an interested senior how to download the government’s myGov or My Health Record app on their phone during a consult). Overall, the approach should be respectful and empowering, avoiding stereotypes that older people “can’t learn” – evidence shows many can and do learn when given the chance, but we also must keep non-digital options available so that increased digitization of health doesn’t inadvertently shut out our elders.
People with Disabilities
Challenges: People with disabilities are a diverse group, including those with physical, sensory, intellectual, and psychosocial disabilities. Digital health can offer great benefits (like independence via assistive tech), but if not designed with accessibility in mind, it can erect new barriers. Inaccessible design is a primary issue – for example, a telehealth platform that lacks closed captioning will be problematic for someone who is Deaf or hard-of-hearing. A health kiosk that relies on touch screens might not be usable by someone with limited hand dexterity or someone who is blind (if there are no tactile or audio alternatives). Websites or apps that aren’t coded for screen reader compatibility effectively exclude users with vision impairment. Unfortunately, many mainstream digital health tools have not fully implemented universal design principles. Another challenge is lack of integration with assistive technologies that people already use. For instance, a person with motor impairments might use voice control software or alternative input devices – if a health app can’t interface with those, it’s not usable for that person. People with cognitive disabilities or lower literacy may find typical health websites overwhelming in complexity; they benefit from easy-read content or more visual interfa
not usable for that person. People with cognitive disabilities or lower literacy may find typical health websites overwhelming in complexity; they benefit from easy-read content or more visual interfaces, which are not always provided. A related issue is bias in new tech like AI: if machine learning algorithms (e.g., symptom checker apps or appointment triage systems) are not trained on data including people with disabilities, they might give inappropriate recommendations (for example, misinterpreting someone’s atypical speech pattern). There is also an attitudinal barrier: providers might assume someone with a disability can’t or won’t use tech, and thus not even offer digital options, even when the person could use them with adaptations. For example, assuming an older person with a disability can’t do video calls, when maybe they can if given a chance and some setup. Additionally, some people with disabilities have understandable privacy concerns: e.g., data about one’s disability might be sensitive, and if an app is not clearly secure, they might avoid it. People with disabilities often face socioeconomic disadvantage too (higher unemployment rates), so affording devices or internet can be an extra hurdle (there’s overlap with the affordability issues mentioned earlier). Lastly, note the legal context: in Australia, anti-discrimination law (Disability Discrimination Act 1992) requires that services (including digital services) be provided without discriminating against people with disabilities. In practice, this means if a hospital only provides appointment info via an inaccessible app, they could be running afoul of the DDA. All public-facing digital health services should comply with accessibility standards like WCAG (Web Content Accessibility Guidelines) to meet these obligations. Yet compliance is inconsistent.
he DDA. All public-facing digital health services should comply with accessibility standards like WCAG (Web Content Accessibility Guidelines) to meet these obligations. Yet compliance is inconsistent.
Opportunities: Embracing universal design benefits not only people with disabilities but often all users (e.g., captions help a hard-of-hearing person and also someone in a noisy environment). To include people with disabilities in digital health, multiple strategies can be used. First, ensure that accessibility standards are followed in any digital health product or content your organization uses or develops. This includes providing text alternatives for images (so screen readers can describe them), ensuring keyboard-only navigation (for those who can’t use a mouse), having sufficient color contrast, offering transcripts or captions for audio/video, and testing with screen reader software. The Australian government and many health agencies now have policies stating that digital services must be accessible under the DDA – for example, all Federal government websites need to meet WCAG 2.1 AA standards. Healthcare providers can advocate with vendors: if your clinic’s new telemedicine software isn’t accessible, raise it with the vendor or choose a different product. Assistive technologies integration: Digital health should work hand-in-hand with assistive devices. Some EHRs are now ensuring their patient kiosks or portals can be used with refreshable Braille displays or allow voice input. Smartphones themselves have many built-in accessibility features (voiceover, magnification, etc.); as a provider, you might familiarize yourself with a couple so you can help a patient enable them. For instance, if a low-vision patient wants to use a medication reminder app, showing them how to enlarge text or use the phone’s screen reader can be empowering. Another approach is specialized apps: there are apps specifically for certain disabilities, like medication management a
them how to enlarge text or use the phone’s screen reader can be empowering. Another approach is specialized apps: there are apps specifically for certain disabilities, like medication management apps designed for people with intellectual disabilities using simple icons, or mental health apps tailored for neurodiverse users – connecting patients with these can improve their engagement. Moreover, co-design with the disability community is essential. When new digital health programs are rolled out, including people with disabilities in focus groups or testing will catch problems and generate creative solutions. A success story: some Australian hospitals developed an accessible telehealth guide in PDF with step-by-step pictures and plain language, after feedback that standard instructions were too confusing for patients with cognitive disabilities. Another example: the National Disability Insurance Scheme (NDIS) online portals have undergone iterative improvements after consulting users to simplify the process. On a person-to-person level, allied health practitioners can support clients with disabilities by being flexible – for instance, if a client with severe anxiety finds video calls stressful, allow text-based consults or more frequent secure messaging check-ins as an alternative. Or if a client has difficulty typing due to a physical disability, perhaps assist them to set up auto-refill of scripts online to reduce the need for manual entry each time. The principle is to adapt the tech to the person, not force the person to fit the tech. Finally, ensuring equal access means always having a reasonable adjustment. If a particular digital solution just cannot be made accessible for someone, have a parallel process (like a direct phone line to accomplish the same task that an app would). Many health services now state upfront, “If you have any difficulty using our online service, please call or visit us – we will accommodate your needs.” This kind of proac
sk that an app would). Many health services now state upfront, “If you have any difficulty using our online service, please call or visit us – we will accommodate your needs.” This kind of proactive accommodation fosters trust that digital health is there to help, not exclude.
People Experiencing Socioeconomic Disadvantage
Challenges: Socioeconomic disadvantage (low income, unemployment, low education levels, unstable housing) is a strong predictor of lower digital health engagement. Many barriers we discussed – cost, lower literacy, lack of devices – often coincide in this group. Data from the Australian Digital Inclusion Index show that Australians with lower income, education, and employment have significantly lower digital inclusion scores. For example, in 2016-17, 1.25 million Australian households (about 14%) had no internet access at home, and these are disproportionately households with lower incomes. The cost of technology is a big hurdle – not just the monthly internet bill, but also the upfront cost of devices. If forced to choose, families might prioritize a single smartphone for the household, which then might be shared and not always available for each person’s health needs. And as noted, relying on mobile data can be more expensive in the long run, creating a paradox where those who can least afford it pay more per unit of data (the concept of “data poverty”). Unstable housing or homelessness adds another layer: someone without a secure home might not have any internet at all (no fixed connection, possibly no phone), and charging devices or maintaining an account becomes difficult. These individuals also have many pressing needs, so digital health might seem a distant priority unless integrated with support for those immediate needs. Lower educational attainment often correlates with lower health literacy and digital literacy, meaning these individuals might struggle more with complex health information or technical instructio
ds. Lower educational attainment often correlates with lower health literacy and digital literacy, meaning these individuals might struggle more with complex health information or technical instructions. There’s also a trust factor: some people facing disadvantage have had negative experiences with institutions and may be wary of sharing personal info online or via apps, fearing it could affect things like Centrelink benefits or just not understanding how it’s used. Finally, disadvantaged communities may have less exposure to success stories of digital health – if your social circle doesn’t use these tools, you lack informal learning opportunities (unlike higher-income groups where everyone might be wearing a fitness tracker and encourages each other).
Opportunities: Combating these challenges involves community-based initiatives, affordable access programs, and supportive design. On a broad scale, governments and NGOs are addressing affordability: NBN Co (the National Broadband Network company) has in recent years introduced cheaper broadband plans for low-income households (often in partnership with ISPs) – for instance, offering a concessional rate for families with a pensioner or for disadvantaged students. Some mobile providers have likewise trialed “zero-rated” health content – during the pandemic, certain health websites (like government COVID information) were made free to access without using data. Expanding these policies (like zero-rating major health portals or telehealth usage) could help ensure people aren’t choosing between buying data and accessing care. Community access points remain crucial. Libraries, community centers, and telecentres provide free internet and often free device use; many people who can’t afford home internet will use these to fill out online forms or attend telehealth appointments. For example, a patient without a computer might go to a library to do a video consult with their specialist – libraries in some
use these to fill out online forms or attend telehealth appointments. For example, a patient without a computer might go to a library to do a video consult with their specialist – libraries in some areas have set up private rooms or booths for exactly this purpose, sometimes called “telehealth pods.” Allied health clinics themselves can assist: a social worker or admin might set up a tablet in the clinic for clients to use to check their My Health Record or fill in an e-form with assistance, if they can’t do it from home. Digital literacy training targeted at disadvantaged groups is another key strategy. The Good Things Foundation’s “Health My Way” (discussed) and broader “Be Connected” program focus heavily on working through community organizations that disadvantaged people trust – like neighborhood houses, Aboriginal health services, refugee support agencies. One successful example is the Good Things Foundation’s Health My Way program, which established local support in 75 locations and saw 80% of participants increase their digital health literacy and confidence. Those kinds of programs often include one-on-one mentoring, recognizing that people facing complex life challenges may need personalized help at their own pace. Healthcare providers can refer patients to these programs or even host digital help sessions at their clinics (some GP practices have run “digital drop-in” days with volunteer tutors to help patients set up their My Health Record or Medicare online accounts). Also, consider integrating digital inclusion into routine care: for example, a dietitian working in a low-income area might routinely ask, “Do you have access to the internet or a smartphone? Would you like resources online or do you prefer paper?” – if the client says they lack access, the provider could then adjust their approach (provide printed materials, or sign them up for an SMS reminder service instead of expecting app usage). In some cases, healthca
nt says they lack access, the provider could then adjust their approach (provide printed materials, or sign them up for an SMS reminder service instead of expecting app usage). In some cases, healthcare services can provision loan devices or kiosks. Hospitals have begun lending internet-enabled tablets to inpatients who don’t have devices, so they can communicate with family or look at educational materials. Community health centers might have a lending library of tablets or BP monitors that patients can use at home with cellular data included, bridging the gap for those who can’t afford remote monitoring tech. Partnerships with philanthropic organizations and charities (like Infoxchange or local rotary clubs) have facilitated donating refurbished devices to people in need. Lastly, design for simplicity helps everyone, but especially those with less education or higher stress. For instance, using plain language in patient communications, minimizing data entry (auto-filling forms with known info), and offering content in multiple formats (videos, diagrams, not just dense text) can ensure that even if someone has limited literacy or is time-poor, they can still grasp and use digital health tools. In essence, a multi-faceted approach – combining affordable access, skill-building, supportive community infrastructure, and user-friendly design – is needed to bring the benefits of digital health to socioeconomically disadvantaged Australians. When done right, digital health can actually alleviate some disparities (for example, telehealth saving someone the cost of a long trip to a specialist), but we must consciously design and implement it with equity in mind to achieve that outcome.
Video Spotlight: Breaking Down Digital Barriers
(This section refers to a hypothetical documentary-style video “Breaking Down Digital Barriers,” which we will summarize in text.)
at outcome.
Video Spotlight: Breaking Down Digital Barriers
(This section refers to a hypothetical documentary-style video “Breaking Down Digital Barriers,” which we will summarize in text.)
In the video, we meet three Australians who illustrate digital inclusion challenges and solutions:
Jamal, an older gentleman in a small regional town, shares his frustration: “The doctor said, ‘Just book online.’ But our internet is so slow, and the website is confusing. I feel left behind.” Jamal’s story highlights the access and ability issues many face – slow or unreliable internet and user-unfriendly design. He felt excluded when an online-only booking system replaced the friendly receptionist he was used to. For Jamal, the solution came when a community center ran weekly tech help sessions. A volunteer helped him navigate the booking site and also showed him how to increase the text size on his tablet. Now, Jamal can book his appointments online (when the internet cooperates), though he still prefers to call if he can. The lesson: we can’t assume that just because a service is available online, everyone can use it – we have to support people like Jamal through that transition.
he still prefers to call if he can. The lesson: we can’t assume that just because a service is available online, everyone can use it – we have to support people like Jamal through that transition.
An allied health professional in a community health center appears next, emphasizing a comprehensive approach: “We can’t just give someone an app and expect it to work,” she says while in a workshop setting with community members. “We have to ask: Do they have a smartphone? Can they afford the data? Do they know how to use it safely? We have to co-design solutions with them.” Her perspective encapsulates the INCLUDE framework (Identify, Normalize, Co-design, Link, Use plain language, Develop alternatives, Evaluate) introduced later. In the video, we see her facilitating a co-design session where clients are giving feedback on a physiotherapy exercise app – one client notes they need voice instructions because reading is hard while exercising, another suggests integrating with an affordable prepaid data plan. By listening, this AHP and her clinic adapt their digital implementation (they ended up providing a DVD of exercise videos for one group of clients without internet, and simplified the app interface for others). This segment reinforces the idea that inclusion requires listening and iterating based on users’ real-world challenges.
oup of clients without internet, and simplified the app interface for others). This segment reinforces the idea that inclusion requires listening and iterating based on users’ real-world challenges.
We also meet a young woman, Priya, who uses a wheelchair and has a visual impairment. Initially, she found a new medication management app from her pharmacy totally unusable because it wasn’t screen-reader compatible. She recounts calling the pharmacy in frustration and being told no alternative was available. Rather than give up, Priya connected with a disability advocacy group, which reached out to the app’s developers. The video shows a follow-up where Priya is testing an updated version of the app that now works with her phone’s accessibility features. “It’s night and day – I can finally manage my meds without asking my mum for help,” Priya says with a smile. Her story shows the power of advocacy and inclusive design – once the issue was flagged, the developers (perhaps nudged by the specter of discrimination law) made changes that not only helped Priya but improved the app for all visually impaired users.
The video concludes with a powerful message on screen: “Digital inclusion requires intentional, sustained effort from all healthcare providers.” The montage shows Jamal confidently on a video call with his physiotherapist, the community workshop celebrating a successful app rollout, and Priya efficiently ordering a prescription refill through the now-accessible app. The narrator emphasizes that whether it’s through policy, community programs, or everyday patient interactions, breaking down digital barriers is an ongoing process – one that’s essential for achieving health equity in the digital age.
Practical Strategies: The INCLUDE Framework
y patient interactions, breaking down digital barriers is an ongoing process – one that’s essential for achieving health equity in the digital age.
Practical Strategies: The INCLUDE Framework
To equip allied health professionals with a systematic approach to digital inclusion, we introduce the INCLUDE framework. This mnemonic encompasses key steps to ensure we are considering and supporting the needs of all clients in digital health initiatives:
I – Identify digital barriers early: In your initial interactions or assessments with clients, proactively identify any digital access or literacy barriers. For example, include a few questions in the intake form or first consultation: “Do you use the internet or any health apps currently?” “Do you have access to a device and reliable internet?” “How comfortable are you with technology, like using a smartphone or computer?” Identifying these factors up front prevents assumptions. If a client has no email or struggles with tech, you can immediately adjust your approach (perhaps opting for paper handouts or more face-to-face follow-up). Identifying barriers is also about recognizing which barrier – is it access (no device or data), ability (needs training), or something else (fear, privacy concerns)? Each requires a different solution.
tifying barriers is also about recognizing which barrier – is it access (no device or data), ability (needs training), or something else (fear, privacy concerns)? Each requires a different solution.
N – Normalize different comfort levels with technology: It’s important clients (and colleagues) don’t feel judged or “behind” if they have low digital literacy. Normalize it by saying things like, “A lot of people find this app confusing at first,” or “It’s completely okay if you prefer in-person – many of my clients do, and we’ll work with what you’re comfortable with.” By normalizing, you reduce stigma and anxiety. For colleagues, some may be very tech-forward while others hesitant – normalize that range too in staff training, encouraging a culture where asking for help with the new system is welcomed. When people feel that it’s normal not to know something, they are more likely to ask questions and learn. You can share brief anecdotes (without breaching confidentiality) of success: “I had a client in his 80s who learned step-by-step to use the patient portal – it’s definitely doable if it’s something you want to try.” This conveys that struggling with tech isn’t a personal failure, it’s common and can be overcome with support.
e patient portal – it’s definitely doable if it’s something you want to try.” This conveys that struggling with tech isn’t a personal failure, it’s common and can be overcome with support.
C – Co-design solutions with clients: Whenever possible, involve the end-users (patients or carers) in designing or selecting digital health interventions. Co-design can be as simple as asking for the client’s input: “How do you think this tool could fit into your daily routine?” or “What would make it easier for you to use?” It can also be more formal, like including consumer representatives when developing a new digital service or running pilot tests where clients give feedback before a full rollout. The principle is that users are experts in their own lives – they will often suggest modifications or identify issues professionals might not see. For example, a client might say, “I keep forgetting my password, so I stop using the app.” A co-designed solution could be setting up a fingerprint login for them or simplifying authentication. Or a group of clients with chronic pain might co-create a digital pain diary template that uses smiley-face scales instead of text entry if typing is hard when in pain. By co-designing, you ensure the solution is user-centered and more likely to be effective. It also increases clients’ sense of ownership and buy-in – they’re not having a technology imposed on them; they helped shape it.
e the solution is user-centered and more likely to be effective. It also increases clients’ sense of ownership and buy-in – they’re not having a technology imposed on them; they helped shape it.
L – Link to appropriate support resources: As a practitioner, you don’t have to solve every digital issue alone. Build a toolkit of referral resources. For instance, know the local digital literacy classes (libraries often run them), or national helplines like the Be Connected help line for seniors. If you identify a barrier you can’t address on the spot – say a client who really needs one-on-one help learning to use a tablet – you might link them to a community center that offers that support. Similarly, link clients to technical support for the tools you recommend: if you suggest a particular app or device, provide the tech support contact or user guide so they have somewhere to turn for troubleshooting beyond you. For CALD clients, link to multilingual resources (like the MHCS website or Health Translations directory) so they can get information in their language. For those who can’t afford tech, link to charities or government programs that might assist (e.g., the National Broadband Network’s affordability initiatives, or nonprofit device refurbishers). Internally, link colleagues to training opportunities – if a new system is introduced, share info on any webinars or modules they can use to upskill. The “link” step is about knowing the ecosystem of support that exists and guiding people to it.
es – if a new system is introduced, share info on any webinars or modules they can use to upskill. The “link” step is about knowing the ecosystem of support that exists and guiding people to it.
U – Use plain language and teach-back methods: When introducing digital tools or instructions, use plain language – avoid technical jargon. Instead of “install the application and authenticate with your credentials,” say “download the app and log in with your username and password – the same ones you use for your email, if that’s what we set.” Break instructions into step-by-step chunks and, crucially, use the teach-back method: after you explain or demonstrate, ask the client to show you or repeat back what they’ll do. For example, after showing how to book an appointment online, you might ask, “Can you walk me through how you’d book your next appointment on the website, just so I know it makes sense?” This allows them to process the steps and reveals any misunderstandings so you can correct them. Teach-back isn’t a “quiz” of the patient; it’s a way to confirm clarity and reinforce learning. Using analogies can help too (e.g., “Think of the My Health Record as a digital filing cabinet for your health info that you and your doctors can open from anywhere – you control who has the key.”). Visual aids like screenshots with circles or arrows can be useful for clients who are visual learners or have literacy difficulties. Plain language benefits everyone – in fact, many guidelines suggest aiming health materials at about a Year 6-8 reading level. By ensuring your communication about digital tools is clear, you greatly increase the likelihood of correct use and continued engagement.
est aiming health materials at about a Year 6-8 reading level. By ensuring your communication about digital tools is clear, you greatly increase the likelihood of correct use and continued engagement.
D – Develop alternative pathways for non-digital users: Despite our best inclusion efforts, some people either cannot or will not use certain digital tools. It’s essential to have alternative, non-digital options so that these individuals aren’t cut off from care. This might mean continuing to offer paper forms, phone call reminders, or face-to-face visits for those who need them. For instance, if your clinic moves to an online-only appointment system, maintain a phone line for booking as well – and advertise that both are available. If you roll out an SMS exercise reminder program but a client doesn’t use a mobile, perhaps give them a printed calendar with exercises instead. Alternative pathways also cover emergency backup: if a telehealth appointment fails due to tech issues, have a plan to revert to a phone consult. As allied health professionals, being flexible is key – meet the client where they are. Document in their care plan or notes if they have a preference (e.g., “prefers phone contact over email” or “mail a hard copy of home exercise program”). Developing alternatives ensures that the march of digital progress doesn’t inadvertently marginalize people. It’s about offering choice. Some clients may even switch modalities depending on circumstances (maybe they’ll do telehealth when their daughter is around to help, but prefer clinic visits otherwise). By keeping multiple doors open, you uphold equity and person-centered care.
on circumstances (maybe they’ll do telehealth when their daughter is around to help, but prefer clinic visits otherwise). By keeping multiple doors open, you uphold equity and person-centered care.
E – Evaluate and iterate your approach: Digital inclusion isn’t a one-and-done task; it requires ongoing evaluation. Regularly evaluate how your strategies are working. Are clients using the tools as intended? Are certain groups not engaging? For example, if you introduced a new education app and notice your older clients aren’t using it, dig deeper – perhaps a focus group or informal check-in could reveal why (did they not understand it, did they encounter barriers?). Collect feedback through surveys or casual conversation: “How are you finding the text reminders? Do they help or are they annoying?” Use these insights to iterate – make changes to improve usability or support. On an organizational level, evaluation might include tracking metrics (like percentage of patients accessing the portal by age group, or no-show rates before and after introducing online booking). If disparities are seen, adjustments can be made (maybe specific targeted training for the group that’s lagging, or tweaking the tool’s features). Also, keep abreast of new inclusion solutions – the field evolves (e.g., new assistive tech or translation AI might emerge). As part of evaluation, ensure you’re addressing the right problem – sometimes what we think is a digital literacy issue might turn out to be a design flaw. For instance, a clinic might think patients aren’t signing into the kiosk due to tech phobia, but evaluation finds it was because the kiosk was poorly located and people didn’t see it. In sum, treat digital inclusion efforts as a cycle: implement, get feedback, refine.
sk due to tech phobia, but evaluation finds it was because the kiosk was poorly located and people didn’t see it. In sum, treat digital inclusion efforts as a cycle: implement, get feedback, refine.
By following the INCLUDE steps, allied health professionals can systematically approach digital inclusion in their daily practice. This not only benefits patients (leading to better access, understanding, and health outcomes), but also enhances workflow (engaged patients are more likely to comply and less likely to miss appointments) and fulfills our professional and ethical commitment to equitable care. Digital health technologies hold tremendous promise – by ensuring stakeholders of all backgrounds can use them, we move closer to the goal of “better health for all” in the digital age.
Topic 3: Digital Health Readiness Assessment
Innovative digital health solutions can only achieve their potential if the people and organizations adopting them are ready for the change. Before implementing any new digital tool or system, it’s crucial to assess readiness at multiple levels – individual, organizational, and system. Doing so can highlight gaps that need addressing (training, infrastructure, engagement) and reduce the risk of failure. Research has shown that e-health implementations often fail when adequate readiness is lacking. In fact, historically up to 70% of e-health projects have been reported as failures or not fully meeting objectives, frequently due to factors like poor user readiness, insufficient infrastructure, or lack of change management. By conducting readiness assessments, we aim to “look before we leap” – identifying what needs to be in place to support a sustainable digital health innovation and thus increasing the chances of success while minimizing disruption.
Let’s break down readiness assessment into Individual, Organizational, and System-level readiness.
Individual Digital Health Readiness
asing the chances of success while minimizing disruption.
Let’s break down readiness assessment into Individual, Organizational, and System-level readiness.
Individual Digital Health Readiness
At the individual level (whether that individual is a patient, client, or a healthcare provider themselves), digital health readiness refers to how prepared and equipped a person is to engage with digital health tools. It includes several components:
Digital Access: Does the person have the necessary devices (smartphone, tablet, computer) and connectivity (internet or mobile data) to use the digital health intervention? Access is a prerequisite; without it, other readiness factors become moot. If a telehealth program assumes patients will join video calls, an individual without a webcam or with very limited data is not ready in terms of access. In a readiness assessment, you might ask directly about device ownership and internet reliability. For example, a physiotherapist surveying clients before starting a tele-rehab program might find that 15% have no suitable device or a poor internet connection at home – those clients would need solutions (like loaner iPads or sessions from a community center) or alternative modes of care. Access also includes whether the person can use the required device independently (if not, do they have a family member to assist?).
or sessions from a community center) or alternative modes of care. Access also includes whether the person can use the required device independently (if not, do they have a family member to assist?).
Digital Skills: Once access is established, what is the person’s skill level in using digital technologies? Basic operation (turning devices on, installing an app, navigating a website), as well as specific skills like using email, video calling platforms, or wearables, fall under this. It’s helpful to gauge confidence – e.g., “How comfortable are you downloading a new app on your phone?”. Perhaps use a scale or multiple-choice: Very comfortable, somewhat, not at all. This can stratify individuals into those who can adopt fairly independently versus those who will need guided support or training. An occupational therapist might do a simple skills screening with an older patient before introducing a tablet-based memory aid, to see if they know how to tap icons, adjust volume, etc. If not, part of the intervention might first be digital skill-building. Tools like the Australian Digital Health Literacy Questionnaire or others can quantify e-health literacy, which overlaps with skills. Remember to consider health literacy combined with digital skills – someone might be good at using Facebook but not know medical terms, making it hard to use a health app. So skills assessment might involve a scenario, e.g., “If you had to find reputable information online about your condition, would you know where to start?” The goal is to identify who needs extra help in becoming ready.
ght involve a scenario, e.g., “If you had to find reputable information online about your condition, would you know where to start?” The goal is to identify who needs extra help in becoming ready.
Health Literacy: While not purely digital, health literacy (the ability to understand and use health information) is integral to digital readiness, because using digital health tools often requires understanding the health context. For instance, an app might require understanding of medication schedules or symptom tracking. If an individual has low health literacy, a complex digital tool may overwhelm them or be misused. As part of readiness, assess if the person understands the basic health content that the digital tool will present. This can be done through conversation (ask them to explain in their own words how they manage their condition, to gauge comprehension) or through recognized tests (like the Newest Vital Sign or others) if needed. Health literacy also includes knowing how to navigate healthcare systems – e.g., an individual might not realize a specialist’s telehealth consult still needs a GP referral, etc. If gaps are found, you might need to tailor the digital intervention (perhaps simplifying the content or providing additional education alongside it).
elehealth consult still needs a GP referral, etc. If gaps are found, you might need to tailor the digital intervention (perhaps simplifying the content or providing additional education alongside it).
Motivation and Attitudes: Does the individual see a benefit in using digital health tools? Are they willing to try, or do they have reservations? Readiness is not just about capability, but also willingness. Some common attitudes: concern about privacy (not trusting that their data is safe), fear of making mistakes, skepticism about whether the tool will actually help, or simply a preference for traditional methods (“I’d rather talk to a person than a computer”). During readiness assessment, you might explore these perceptions: “When you think about using health apps or websites, what are your biggest concerns or feelings?” (Options might include privacy, confusing technology, not seeing the value, etc.) Suppose a client responds that privacy is a major worry – then part of increasing their readiness will be explaining the security measures, showing them how their data is protected, and perhaps choosing tools with strong privacy credentials. If a person lacks motivation because they don’t see the benefit, readiness might involve motivational interviewing to highlight how the digital tool could meet their goals (e.g., “You mentioned it’s hard to drive to the clinic – telehealth could save you that effort”). Self-efficacy (belief in one’s ability to succeed with the tool) is key: someone with low confidence might need extra support initially (like a trial run of the telehealth platform with a nurse on the phone to guide them). Social support is another factor – if they have family to assist, they might be more ready by proxy, whereas someone isolated might need more professional support. Summarizing attitudes includes asking if they want digital options or prefer non-digital; respecting their preference is part of patient-centered care, but if
ed might need more professional support. Summarizing attitudes includes asking if they want digital options or prefer non-digital; respecting their preference is part of patient-centered care, but if digital is inevitable (say the hospital is phasing out paper), then working on gradually addressing negative attitudes is necessary (through reassurance, demonstration, peer testimonials, etc.).
Interactive Tool Example: (In the course content, they mentioned an H5P branching scenario for assessing a client’s digital readiness. In narrative form, we can describe how a typical conversation might go incorporating these elements.)
Imagine you’re an allied health clinician meeting a new client, John, and you want to assess his digital health readiness to decide whether to use a new mobile app for part of his therapy:
You start by asking permission: “To help you get the most out of your care, I’d like to ask a few questions about how you use technology. Is that okay?” – This sets a collaborative tone.
Access: “Do you have internet access at home, like Wi-Fi or a good mobile data connection?” If John says, “No, not really, I sometimes use my neighbor’s Wi-Fi but it’s spotty,” that flags an access issue. You’d follow up: “How about mobile data on your phone? Is that something you use or is it limited?” John might reveal he has a basic phone or limited prepaid plan. If access is lacking, you might decide right there that expecting him to use a data-heavy app is unrealistic – you’ll either find an offline solution or work with him on strategies like using a local library’s internet for certain tasks. If he said, “Yes, I have NBN at home,” great – one hurdle down.
you’ll either find an offline solution or work with him on strategies like using a local library’s internet for certain tasks. If he said, “Yes, I have NBN at home,” great – one hurdle down.
Devices: “Do you use a smartphone, tablet, or computer regularly?” The answer helps you know what platform to target. If he only has an older Android phone, you ensure any tool you use is Android-compatible and not too resource-intensive. If he’s not using any devices, that’s a huge indicator he’s currently not digitally engaged – perhaps you’ll lean more on non-digital methods unless he’s keen to start learning from scratch (which would be a longer journey).
Skills: “How comfortable are you with downloading a new app on your phone?” You might give multiple choice: Very comfortable (I do it often), Somewhat (I might need a bit of help), Not at all (I’ve never done that). John might say, “A little unsure.” You respond supportively: “That’s very common. If we decide to use an app, I can go through it together with you the first time.” If he said “not comfortable at all,” you might either offer to set it up for him (with permission) or choose a different approach. You might also ask, “Do you use email or any websites?” to gauge basic internet navigation skills. If he doesn’t, then expecting him to navigate an online portal might be too much initially.
ch. You might also ask, “Do you use email or any websites?” to gauge basic internet navigation skills. If he doesn’t, then expecting him to navigate an online portal might be too much initially.
Attitudes/Concerns: “When you think about using health websites or apps, is there anything that worries you or that you find difficult?” Maybe John says, “I’m worried about privacy – I don’t want my health information floating around online,” or “I just find them too complicated and I get frustrated.” Depending on his response, you address it: for privacy, explain the safeguards (e.g. “We only use secure, government-endorsed apps; your data is encrypted[1] and protected by law, and you can control who sees it.”). If complexity is the issue, promise simplicity: “We can start with something very simple, or if it’s too much, we won’t force it – we’ll do what works for you.” If the person expresses no major concerns and seems enthusiastic (“I use fitness apps all the time, I love trying new tech”), then you know you have a “Digital Ready” individual.
Motivation: You might not ask this outright, but glean it from conversation. Perhaps John says at some point, “I want to learn this because my daughter lives far away and we could do video chats,” indicating personal motivation beyond health. Or conversely, “I’ve gotten by fine without these gadgets so far,” indicating low internal motivation – you might then discuss potential benefits relevant to him.
nal motivation beyond health. Or conversely, “I’ve gotten by fine without these gadgets so far,” indicating low internal motivation – you might then discuss potential benefits relevant to him.
At the end of such an assessment conversation, you summarize: “Okay John, from what we discussed, you have a smartphone and Wi-Fi which is great (Access), you’re a bit unsure with apps (Skills) – we can handle that by installing it together – and your main concern is privacy (Attitude), which we will keep in mind and I’ll show you how we protect your info. It sounds like you’re open to trying this because you want to be independent in managing your health. Based on that, I think we can go ahead and set up this digital tool for you, and I’ll be here to support you as you get used to it. If it doesn’t work out, we have other options too.” This kind of summary reassures and makes sure you and the client are on the same page.
Professionals can use scoring rubrics to categorize individuals’ readiness. For example, you might rate John’s readiness as “Developing” – meaning he’ll need significant support – whereas someone else might be “Ready” and need minimal assistance. One rubric might be:
Digital Ready (e.g. score 80–100%) – Has access, demonstrates necessary skills, is confident and motivated. Can engage with digital tools largely independently. Strategy: Provide tool with standard instructions, minimal follow-up needed beyond normal care.
Digital Capable (60–79%) – Has access and some skills, maybe minor anxieties or gaps. Can use digital tools with minimal support. Strategy: Maybe a brief one-time training or tip sheet is enough, check in occasionally.
79%) – Has access and some skills, maybe minor anxieties or gaps. Can use digital tools with minimal support. Strategy: Maybe a brief one-time training or tip sheet is enough, check in occasionally.
Digital Developing (40–59%) – Partial access (or reliant on shared resources), limited skills, or significant concerns. Needs significant support and training. Strategy: Provide hands-on training, maybe break the digital introduction into small steps over a few visits, involve a caregiver if possible, and have parallel non-digital backups during transition.
Digital Foundations (0–39%) – Lacks access or any experience, or firmly unwilling. Strategy: Likely stick with non-digital approaches for now, or invest in longer-term capacity building if appropriate (only if the person is interested). Ensure they receive equivalent care through traditional means so they’re not disadvantaged.
Such categorization can help a clinician tailor their approach and also help an organization allocate resources (e.g., knowing 30% of their client base is in the developing category might justify hiring a digital navigator or setting up a helpdesk).
Organizational and System-Level Readiness
Beyond individuals, we must assess whether organizations (like your clinic, hospital, or department) and the broader health system (policies, networks, payers) are ready to implement a digital health initiative.
Organizational Readiness: This looks at the preparedness of a healthcare organization’s people, processes, and technology for the change. Key domains often include:
ent a digital health initiative.
Organizational Readiness: This looks at the preparedness of a healthcare organization’s people, processes, and technology for the change. Key domains often include:
Infrastructure: Does the organization have the IT infrastructure (hardware, software, network capacity) to support the digital tool? For example, a clinic wanting to implement telehealth needs sufficient internet bandwidth, webcams or tablets in consult rooms, a private space for clinicians to conduct calls, etc. If the infrastructure is lacking, that must be addressed first (upgrading Wi-Fi, acquiring needed equipment). It’s also about interoperability – will the new tool integrate with existing systems or create silos? If a new app can’t import/export data to the main EHR, workflows may break.
Workforce Capability: Are the staff digitally literate and trained? Assess the overall tech proficiency of the team and their attitude toward change. Perhaps use surveys or workshops to gauge comfort levels. If many staff are not confident, a robust training program and maybe a phased rollout is needed. Workforce readiness also includes having technical support available – do you have IT staff or a vendor support line that can promptly fix issues? Staff need to trust that if something goes wrong, help is at hand. The Australian Digital Health Agency’s Workforce Capability Framework outlines the competencies needed; an organization can self-assess against those standards. Engaging clinical leaders (champions) is another aspect – do you have respected clinicians on board who will advocate and troubleshoot among peers?
anization can self-assess against those standards. Engaging clinical leaders (champions) is another aspect – do you have respected clinicians on board who will advocate and troubleshoot among peers?
Leadership and Governance: Organizational readiness improves when leadership is committed and clear governance is established. Does the organization have a vision for digital health and include it in strategy? Is there a steering committee or point person responsible for the project? If digital adoption is just dumped on staff without visible managerial support, it often falters. Also, policy readiness: are there updated policies and protocols for using the new tool (e.g., a policy on using WhatsApp with patients – yes or no? guidelines on emailing patients)? Ensuring legal and ethical frameworks (consent procedures for telehealth, data privacy compliance) are in place is critical. Many organizations use readiness checklists – e.g., a hospital might use a checklist before launching a new electronic record: checking off infrastructure, data migration plan, user training completed, contingency plans, etc., as measures of readiness.
Financial and Resource Readiness: Has the organization allocated sufficient budget and resources for not just the purchase, but ongoing costs of the digital health tool? Sometimes projects fail because ongoing costs (license renewals, hiring data analysts) were not planned for. Also, readiness includes having a realistic timeline and staff allocation (giving staff time to attend training, maybe reducing patient load during go-live). If, say, a small clinic is trying to adopt a complex digital system without hiring any additional admin or IT help, that might be a red flag in readiness – they could be overstretching existing staff. Financial incentives or support from the system (like grants or reimbursements) also factor into readiness.
help, that might be a red flag in readiness – they could be overstretching existing staff. Financial incentives or support from the system (like grants or reimbursements) also factor into readiness.
Organizational Culture: Is the culture one that embraces innovation and learning, or is there high resistance to change? Readiness assessment might involve focus groups or anonymous surveys to feel out staff sentiment: do they believe this change is needed and beneficial? Past experiences matter – if the last IT rollout was a disaster, people may be jaded. The organization may need to invest time in change management activities: communicating the why, involving end-users in planning (which overlaps with co-design), and celebrating early wins to build buy-in. Communication plans are a subset – ensuring everyone knows what is happening and when, which improves readiness by reducing uncertainty.
There are validated frameworks to assess organizational readiness for eHealth. For example, one framework (eHRAF – eHealth Readiness Assessment Framework) defines several types of readiness: technological, organizational (culture/support), governance readiness, staff readiness, etc., and provides guidance questions for each. Using such a framework, one might score an organization’s readiness and identify weak areas to strengthen before implementation. For instance, an eHRAF might reveal that technologically the site is ready (good IT systems), but staff engagement readiness is low (staff not yet convinced or trained) – thus focusing efforts on staff training and engagement before going live could save a failure.
System-Level Readiness: This zooms out to the larger healthcare system or community context. Factors include:
focusing efforts on staff training and engagement before going live could save a failure.
System-Level Readiness: This zooms out to the larger healthcare system or community context. Factors include:
Policy and Regulatory Environment: At a system level, are there supportive policies for this digital health initiative? For example, if you want to start telehealth services, are there Medicare item numbers to reimburse them? If not, the business model might fail unless alternate funding is found. Are there clear regulations on privacy and data sharing that the project must comply with (like Australia’s Privacy Act, or state health records acts)? If implementing a solution that crosses borders (e.g., telehealth across states), are there licensing or jurisdictional issues? A system ready for digital health will have, or be in process of developing, the necessary legal frameworks (for instance, the Australian government’s acceptance of electronic prescriptions, or allowance of digital signatures for consent – if those weren’t in place, some digital workflows would hit roadblocks). In recent years, agencies like the ADHA releasing the National Digital Health Strategy and frameworks shows increasing system readiness by setting national directions.
Interoperability and Standards: System readiness involves having agreed standards that allow different healthcare players to connect digitally. For example, are there standard messaging formats (like FHIR APIs) that your tool can use to send data to GPs or hospitals? If you launch a new digital referral system, will other parts of the system accept those referrals? A digitally ready system strives for interoperability – e.g., Australia’s push for a unique health identifier and standardized terminologies is part of making the system ready to share data. If standards are lacking, projects can become siloed pilots.
�� e.g., Australia’s push for a unique health identifier and standardized terminologies is part of making the system ready to share data. If standards are lacking, projects can become siloed pilots.
External Stakeholder Readiness: If your digital health project involves other organizations (pathology labs, pharmacies, aged care facilities), are they ready or willing to play ball? For example, if you develop an e-referral system for allied health, do the GPs in your area have the capacity or interest to use it? This might involve outreach and alignment with external stakeholders. The ecosystem readiness matters – sometimes a great in-house solution fails because partners (insurers, other care providers) weren’t ready or included. Engaging professional bodies and getting their endorsement can be part of readiness at the system level, smoothing adoption by practitioners broadly.
Funding and Incentives: System readiness is also about whether there are incentives aligned with the digital change. For instance, the government providing bulk-billing incentives for telehealth (as it did during COVID) massively boosted uptake – the system was primed with a financial push. If your initiative depends on patient uptake, consider if there are external motivators (like private health insurance rebates for digital programs, etc.). In absence of that, adoption might lag. So readiness might include advocating at a system level for supportive incentives, or at least being aware of how the initiative fits into current funding models.
absence of that, adoption might lag. So readiness might include advocating at a system level for supportive incentives, or at least being aware of how the initiative fits into current funding models.
Public Readiness and Equity Considerations: On a system scale, evaluate if the broader population is ready. For example, rolling out an app nationally – is broadband widely available enough? Are vulnerable communities consulted? This overlaps with digital inclusion in Topic 2. System readiness would mean addressing digital determinants as a public infrastructure issue (e.g., government investments in rural broadband, digital literacy campaigns nationwide). If you operate in an area where a large segment of the population is not digitally ready, the system (i.e., community capacity) is a limiting factor.
In summary, an organization or health system that is “digitally ready” will have the necessary infrastructure, a skilled and receptive workforce, supportive leadership, appropriate policies, and alignment with partners and users. Checking these boxes through a readiness assessment allows targeted risk mitigation: If infrastructure is the gap, fix that first; if staff skills are low, do training first; if policy is unclear (e.g., concerning telehealth consent), establish protocols first. Skipping these steps can lead to scenarios we want to avoid – like a new system going live and crashing networks, or clinicians abandoning it because they weren’t comfortable, or patients not using it because they weren’t considered in design.
t to avoid – like a new system going live and crashing networks, or clinicians abandoning it because they weren’t comfortable, or patients not using it because they weren’t considered in design.
By systematically assessing readiness at all levels, we essentially perform due diligence for digital transformation. The outcome is a tailored change management plan that addresses identified gaps. As a result, implementations proceed more smoothly, with higher adoption and fewer unintended consequences. In a field littered with pilot projects that never scaled, doing the homework on readiness is what separates sustainable digital health innovations from those that fizzle out. As one study succinctly put it, “an e-health readiness assessment represents a significant step to analyzing the existing setting and providing appropriate approaches to successful e-health transformation”. With solid readiness, digital health solutions can truly integrate into routine care – benefiting stakeholders across the board and moving us towards a more connected, efficient, and equitable healthcare system.
[1] [2] [3] Revolutionizing Healthcare: How Telemedicine Is Improving Patient Outcomes and Expanding Access to Care - PMC
https://pmc.ncbi.nlm.nih.gov/articles/PMC11298029/
[4] [5] New renal dialysis units for remote First Nations patients | Health, Disability and Ageing Ministers | Australian Government Department of Health, Disability and Ageing
nisters | Australian Government Department of Health, Disability and Ageing
Table 1:
| Stakeholder Group | Benefits & Opportunities | Challenges & Concerns |
|---|---|---|
| Patients & Carers | – Convenient access to care (telehealth reduces travel time and cost[1]) – Empowerment through information (e.g. health records, online education) – Tools for self-management of conditions (apps, wearables) – Family/carer involvement via sharing data and teleconsultations | – Varied digital literacy and confidence levels (learning new apps can be daunting) – Access barriers (no device or internet, especially in remote or low-income households) – Privacy and security concerns about health data – Potential for reduced personal interaction or misunderstanding if technology is a barrier |
| Clinicians (AHPs, doctors, nurses) | – Streamlined documentation and information access (EHRs, clinical decision support) – Expanded reach (telehealth to rural/remote patients, continuity of care) – Enhanced patient monitoring and follow-up (remote vital signs, patient-reported outcomes) – Improved interdisciplinary communication (shared records, messaging) | – Time and training needed to learn new systems – “Alert fatigue” and screen overload, contributing to burnout – Workflow disruptions if systems are poorly integrated (multiple logins, duplicate data entry) – Concerns about maintaining quality of care and therapeutic rapport via digital mediums – Need for reliable tech support to troubleshoot issues during care |
| Healthcare Organizations | – Operational efficiency (less paperwork, optimized scheduling, automation of routine tasks) – Data-driven decisions (analytics for quality improvement, [[concepts/population-health | population health]] management) – Ability to deli |
efficiency (less paperwork, optimized scheduling, automation of routine tasks)
– Data-driven decisions (analytics for quality improvement, population health management)
– Ability to deliver new models of care (virtual clinics, remote monitoring programs)
– Compliance with digital health standards and incentives (meeting government or accreditation requirements) | – High initial costs (software, hardware, IT infrastructure) and ongoing maintenance expenses
– Integration challenges with legacy systems (interoperability issues)
– Cybersecurity risks and need for robust data protection measures
– Change management: ensuring staff buy-in and competency, avoiding resistance
– Downtime or technical failures potentially disrupting clinical services |
| System-Level (Government, Insurers, Vendors) | – Improved health outcomes at population level through wider access and preventive care (telehealth, health information portals)
– Cost savings by reducing unnecessary hospital visits (e.g. via telemedicine and remote management)
– Better data collection for public health surveillance and research
– Standardization of care and equity (e.g. national e-health standards, accessible services for all) | – Risk of digital divide exacerbating disparities if vulnerable groups lack access
– Regulatory challenges: keeping policies updated for rapidly evolving tech (privacy, safety, accreditation of digital tools)
– Interoperability across different regions and providers (avoiding silos)
– Ensuring provider reimbursement models adapt to digital services (e.g. paying for telehealth, remote consultations)
– Vendor influence and competition can lead to fragmented systems if not coordinated |
Related Concepts
- Digital Health — Wikipedia
- Equity — Wikipedia
- Digital Readiness — Wikipedia
- Healthcare Digital Transformation — Wikipedia
- Stakeholder Analysis — Wikipedia
- Digital Equity — Wikipedia
- Digital Inclusion — Wikipedia
- Digital Readiness Assessment — Wikipedia
- Healthcare Accessibility — Wikipedia
- Digital Literacy — Wikipedia
- Co-design Principles — Wikipedia
- User-Centered Design — Wikipedia
- Healthcare Systems Infrastructure — Wikipedia
- Culturally and Linguistically Diverse Care — Wikipedia
- Indigenous Health Equity — Wikipedia
- Geriatric Digital Access — Wikipedia
- Disability-Inclusive Design — Wikipedia
- Allied Health Advocacy — Wikipedia
Related Entities
- Longboardfella Consulting Pty Ltd — Wikipedia
- Digital Readiness — Wikipedia
- Indigenous Australians — Wikipedia
- CALD Communities — Wikipedia
- Australian Healthcare System — Wikipedia
- Patients — Wikipedia
- Carers — Wikipedia
- Clinicians — Wikipedia
- Healthcare Administrators — Wikipedia
- Allied Health Professionals — Wikipedia
- Communities — Wikipedia