The digitalisation of public services has a significant impact on refugees’ inclusion in healthcare. A large proportion of refugees are women, children and older people. Medical needs are considerable among these groups. The healthcare resources of the sending countries are often weakened, and the refugee experience itself contributes to the exacerbation of chronic diseases and mental disorders.
The wave of refugees from Ukraine since February 2022 has become one of the largest in European history. For the first time, a Temporary Protection Directive was applied on 4 March 2022. The consequentially applied digitalisation of work with refugees has allowed the status granting procedure to be optimised, but it has simultaneously created new challenges for the refugees in adapting to the environments of their receiving countries. One of these challenges is the inclusion of the refugees in the digitalising of national healthcare systems.
Digitalisation of healthcare at the national and transnational levels requires digital literacy from patients. This means that patients must be skilled in using digital tools to find information, schedule appointments and use electronic translators. Besides these issues, the digitalisation process is closely intertwined with the local environment and patterns of daily routines. Digital algorithms are commonly derived from recurring activities of daily life. For example, information about payment procedures for consultations or the building numbering system on a large hospital campus might be missing from the online appointment form, as these aspects are common knowledge for local residents. However, refugees require extra effort to understand these details.
Finland’s healthcare system is among the most digitally advanced in Europe. For refugees arriving from different cultural, bureaucratic, social and linguistic environments, mastering the use of digital tools for interactions can become significant barriers to accessing healthcare. This can result in patients forgoing care, a lack of information regarding diagnosis and therapy, treatment timelines and outcomes, self-medication or attempts to seek care from healthcare practitioners who treated them before they became refugees.
The healthcare needs of refugees in the context of increasing digitalisation has not received enough scholarly attention. At the macro level, questions arise regarding the rights of refugees to access welfare resources in the countries in which they arrive. National and supranational agencies are transforming sets of rules and instructions for working with refugees into digital algorithms. It is essential to investigate whether these algorithms add to existing inequalities, creating new forms of exclusion and hindering refugees’ equitable access to essential services.
At the micro level, there is a need for reviews of best practices in digitalising refugee healthcare. This requires further in-depth studies of refugees’ interactions with the healthcare system, healthcare practitioners, treatment and rehabilitation, considering the cultural contexts of both the origin and the host countries. This also includes assessing the impact of grassroots relational support – from civil society, volunteers, and local communities – in making digitalised healthcare resources more accessible to refugees.