Digital Inclusion in Healthcare

What is Digital Inclusion?

About the author

Dr Chris Archer-Brown has been involved with digital businesses since the mid-1990’s and was co-founder of one of the UK’s first specialist ‘big data’ companies. He led marketing and innovation for Experian plc’s Marketing Services division. He went on to complete his PhD at the University of Bath on influence in social media and continued to research equality and ethics in digital design throughout his academic tenure (latterly as Chair of Design Thinking in Falmouth University, one of the country’s foremost digital creative institutions. Chris now works with companies he’s passionate about.


This paper provides an overview of the key issues in digital inclusion in healthcare and engages with some constructive solutions that can add value to many communities.

One of the features of the COVID-19 global pandemic was that it became a ‘strategy accelerator’ for digital transformation. In Healthcare, even when the vaccine is fully rolled out, the advantages for many of virtual consultations with General Practitioners and even Hospital Specialists will outweigh those of face-to-face healthcare visits.

However, the critical point here lies in those two words ‘for many’. The wealthy, connected, digitally savvy, and able-bodied are able to enjoy the benefits of digital services. For those who don’t fall into that category, the reality is somewhat different. The risk, then, is that as digital transformation strategies continue at a post-COVID speed, we fail to keep focused on equality of access to care.

I have been involved in research in this area for over 10 years as an Academic and as part of various digital businesses since the 1990’s. The purpose of the paper is to explore some of the issues related to digital inclusion and it has two parts: first, a short summary of some of the issues related to digital inclusion; and second to highlight some examples of good work in this area. I should issue a spoiler alert here: Healthwave’s mission is to contribute to solving the problem of people in our communities missing out on vital healthcare as a result of digital exclusion, and the case studies referred to all include the work of passionate members of the Healthwave team.

What is digital inclusion?

The digital divide has been a topic of interest since Dr Mark Prensky first coined the terms ‘digital natives’ and ‘digital immigrants’ [PDF 132KB] in 2001. Yet, surprisingly, the past 20 years of research on the topic have not identified a clear, precise definition; it seems to be something authors and policy-makers believe we intuitively understand.

Dr Ellen Helsper of London School of Economics wrote a very helpful paper in 2012 [PDF 533KB] which draws upon definitions of social exclusion: e.g. “deprivation from goods, services and activities which the majority of the population defines as being the necessities of modern life” (Gordon et al., 2000, p.5) [PDF 352KB]. Helsper developed her own model which identifies ‘fields’ in which exclusion is found (Economic, Social, Cultural and Personal), supplementing them with ‘social mediators’ (access, skills and attitudes) and ‘digital mediators’ (relevance, quality, ownership and sustainability). But even she shies away from proffering a full definition of the term.

The NHS agree that when we talk about digital inclusion, we should consider digital skills, connectivity and accessibility. If, like me, you wonder about the difference between the second two, connectivity refers to the plumbing (WiFi, broadband, mobile) and accessibility relates to the design of the digital services themselves (apps, websites, forms). When they consider the barriers to inclusion, they include attitudes (specifically confidence and motivation) as well as awareness of the digital services available to them. The UK Government Digital Inclusion Strategy (which, naturally, is referenced by the NHS strategy) was written in 2014, drawing on research carried out by the BBC in 2013 [PDF 327KB] also does not specifically provide a definition of the term.

In the absence of anything more formal, let me offer a working definition for the purposes of this paper.

Digital inclusion is the ability for all to have easy, safe access to digital connections and services, complemented by confidence in their own skills (self-efficacy), allowing them to access, utilize and benefit from available digital services to serve their personal needs and protect themselves from any risks that lurk online. It is the antithesis of or the solution to digital exclusion.

My colleagues at Healthwave always refer to digital inclusion – they feel that this is the right, solution-oriented approach. They strive in their work to help local authorities and healthcare providers to focus on being inclusive and to ensure that digital designs consider all needs not just those of the majority.

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