# The digital transformation of healthcare: a national cross-sectional study on usage, patterns, attitudes, and barriers across social groups in Israel

## TL;DR

This study explores how people in Israel use online health services, their attitudes, and barriers, finding that digital healthcare is widely accepted but needs better literacy and personalized approaches for older adults.

## Contribution

The study introduces a predictive model for online health service consumption and identifies key sociodemographic predictors of high-level OHS usage.

## Key findings

- Participants reported no significant technological or emotional barriers to using online health services.
- Predictors of high-level OHS use included being male, Arab, insured by Clalit HMO, and having high health literacy.
- Online and face-to-face services are seen as complementary, with distinct roles for low- and high-level OHS.

## Abstract

Online health services (OHS) have emerged as a response to healthcare challenges, offering a way to enhance system efficiency. Despite their numerous advantages, studies reveal varying efficacies among populations with differing sociodemographic characteristics. In this study, we describe OHS usage and its characteristics, examine knowledge, attitudes, barriers, and usage patterns in different groups in Israel, and present a predictive model for OHS consumption.

Using a random representative sample stratified by sex, ethnicity, age, and religious affiliation, a cross-sectional study was conducted in Jewish and Arab populations in Israel. Sampling was further stratified by ethnicity and geographical region. Data were collected via an online questionnaire administered through iPanel records.

The sample comprised 2001 participants with an average age of 47 years; about half were women. The research differentiated between low- and high-level technologies. Participants reported an absence of technological or emotional barriers and were more familiar with low-level technology and used it more frequently. The perceived efficacy of OHS was high, but some participants preferred face-to-face treatment. Predictors of familiarity with and use of high-level OHS included being male, Arab, insured by the Clalit HMO, and having high perceived health literacy, efficacy and safety.

Online and face-to-face healthcare services are complementary, while high-level and low-level OHS are distinct categories providing services for different healthcare needs. Because technological barriers are almost absent, access to OHS can expand more easily. Policymakers should focus on improving digital health literacy, particularly in the use of high-level technologies, and map the needs of the older population to provide them with personalized services.