For which population groups will strong identification and thus eHealth services use not be possible?

Abstract

Abstract Background Digital services are expected to improve the availability of public social and health care services in many European countries as well as in Finland. eHealth and eWelfare services often require strong electronic identification which may form barriers in the availability of care. This study focuses on recognising population groups who are vulnerable to exclusion either by not having access to web or by lacking a strong electronic identification. Methods The data were gathered from the cross-sectional survey on well-being among people aged 20-64 with foreign background (PFB) (FinMonik), conducted in Finland 2018-19 (N = 12 877; response rate 53%). The data from the National survey of health, well-being and service use (FinSote 2017-18) were used as reference data for the overall population, (N = 26 422, response rate 45%). Surveys asked respondents “Do you have at your disposal internet access at home, your workplace, library or some other place?” and 'Do you have at your disposal online banking codes or a mobile certificate for electronic identification online?”. PFB were defined by background country into seven country-groups. The age-standardized proportions with confidence intervals were examined by socio-demographic background variables. Results Almost all (98%) of the overall population reported access to internet, but the proportion was lower (92%) among PFB (p < 0.001). Proportion of having a strong electronic identification was higher among general population (98%) than among PFB (88%) (p < 0.001). In both populations, younger age increased the likelihood of having a strong electronic identification. PFB students reported lower level of strong electronic identification compared to the employed. Conclusions Although most had access to internet and a strong identification, there were statistically significant differences between country-groups and by employment status. Key messages Designing and developing of eHealth and eWelfare services must ensure that everyone has the opportunity to have a strong electronic identification. Development of digital services requires user guidance, which takes into account the varying needs and operating environments.