The digital divide in telepractice service delivery

The digital divide in telepractice service delivery

8 September 2021
Woman working at home with daughter playing in the background

This short article considers the nature of digital exclusion and implications for effective telepractice in the COVID-19 era and beyond.

Australia’s adaptation during COVID-19 has driven major growth in the creation and use of online services. This has required a significant increase in the digital participation of the people who use child, family and community welfare services and of those who deliver them. With more than 2.5 million Australians not using the internet,1 digital exclusion has now become a greater driver of inequality than ever before. This short article outlines what digital inclusion and exclusion are, the evidence on what works to respond to the digital divide, and what this means for service managers and program planners.

What are digital inclusion and exclusion?

We are digitally included when we have the ability and the opportunity to make use of online technologies according to our needs. The Australian Digital Inclusion Index identifies three key features of digital inclusion:

  1. Access: having available, good quality and flexible internet connections, suitable hardware and sufficient data allowances
  2. Affordability: having the resources to cover the cost of access, relative to overall costs of living (or organisational operations for services)
  3. Ability: having the knowledge, skills and attitude to use online technologies in various ways with confidence.1

In Australia, there is a city/country digital divide, as well as digital exclusion following similar patterns to other forms of socio-economic exclusion.1 People who can only access mobile phones (have no fixed internet connection or personal computer) – which includes people on lower incomes and those experiencing homelessness – are also relatively digitally excluded.1 Community-sector organisations are less digitally included than government and for-profit organisations, due to limited access to IT software and systems, and less confidence in using digital technologies.2,3

Since 2020, the physical distancing requirements of COVID-19 restrictions moved many services online, amplifying the existing problems of digital exclusion. The emerging evidence shows that during COVID-19 older Australians’ existing digital exclusion exacerbated their lack of access to services and social isolation, while Indigenous children and children from lower-income households were substantially educationally disadvantaged by lack of digital access and affordability.4,5,6

What works to respond to the digital divide?

Affordable access

Digital inclusion improves when people and services have affordable access to reliable internet connections and hardware.1,7 For services, this may include ensuring clients or families have (or, at least, are assessed for) minimum standards of access to online devices and data allowances to ensure they can access services adequately.

Importance of practising skills

Multi-year research shows strong evidence of a ‘use it or lose it’ effect in digital abilities, with people who are in work or formal education more digitally included than those who are not.1 This suggests that service designs and community activities that support people to regularly use online technologies for a variety of purposes will help their long-term digital inclusion, including their ability to make best use of community services available to them.

Localised support and peer teaching

Recent evaluation of a federal digital inclusion program for senior Australians – a highly digitally excluded group – also shows that localised support and peer coaching by community service organisations and volunteer networks can be significantly effective in building people’s digital access (through local technology hubs) and digital abilities (through local connections and support).4

What does the digital divide mean for organisations and service planners?

Telepractice can provide benefits to clients and service providers, including increased accessibility and perceived lower costs.8 Within a service, the use of telepractice should be determined based on each individual client’s circumstances, especially as some highly digitally excluded groups are also the groups that are often the focus of services. Attention needs to be given to increasing digital participation for clients, while also recognising where digital solutions are not possible or fit for purpose. Effective telehealth delivery must be guided by improved understanding of how people in different life situations use online technologies, as well as providing practical assistance to resource people’s online access and abilities.1,3,4,7

Agencies delivering community services also need to attend to their own digital inclusion, including increasing organisational access to appropriate hardware, software and data usage, and further developing staff abilities to effectively deliver services online. Early documented practice experience from the COVID-19 pandemic shines a light on factors well beyond technology use itself that need to be addressed.9,10 These include: protocols for assessing client safety in remote online interactions; workplace design that supports client confidentiality where agencies are offering blended face-to-face and online services; and developing new evaluation practices to understand how clients access and use online technologies in order to ensure they are getting the most out of telepractice services.

Conclusion

Digital inclusion is a key consideration when delivering an equitable service delivery model using telepractice. Properly supported telepractice is an opportunity to extend the reach of community services and increase their responsiveness to the diverse needs of Australian families. The digital divide needs to be considered when planning programs and services to ensure those that are already excluded do not fall further behind.

How will you use the evidence or information in this short article in your work? We would love to hear from you in the Comments field below.

Further reading and related resources

  • Australian Digital Inclusion Alliance
    The ADIA is an initiative to accelerate action on digital inclusion and provides a platform to share knowledge on digital inclusion.
  • Australian Digital Inclusion Index website
    This website provides resources and reports on the Digital Inclusion Index and the digital divide.
  • Infoxchange: Technology for social justice
    The annual report, by Infoxchange, Connecting Up and TechSoup New Zealand Digital Technology in the Not-for-Profit Sector, provides an overview on how not-for-profit organisations are using technology, what the areas of growth are and where there could be improvement.
  • Household use of information technology
    This website, by the Australian Bureau of Statistics, reports on findings until 2016–17 on the use of the internet and devices by Australian families.

References

1. Thomas, J., Barraket, J., Wilson, C. K., Holcombe-James, I., Kennedy, J., Rennie, E. et al. (2020). Measuring Australia’s digital divide: The Australian Digital Inclusion Index 2020. Melbourne: RMIT and Swinburne University of Technology, for Telstra. Retrieved from digitalinclusionindex.org.au/wp-content/uploads/2020/10/TLS_ADII_Report-2020_WebU.pdf

2. Infoxchange. (2020). Digital technology in the not-for-profit sector: October 2020 report. Melbourne: Infoxchange. Retrieved from www.infoxchange.org/sites/default/files/digital_technology_in_the_not-for-profit_sector_2020.pdf

3. Crittall, M., McDonald, K., McGregor-Lowndes, M., Scaife, W., Barraket, J., Sloper, R. et al. (2017). Giving and volunteering: The nonprofit perspective (Giving Australia 2016 report series, Department of Social Services). Brisbane: The Australian Centre for Philanthropy and Nonprofit Studies, Queensland University of Technology, Centre for Social Impact Swinburne University of Technology, and the Centre for Corporate Public Affairs.

4. McCosker, A., Tucker, J., Critchley, C., Hiruy, K., Walshe, J., Suchowerska, R. et al. (2020). Improving the digital inclusion of older Australians: The social impact of Be Connected. Melbourne: Swinburne University of Technology. Retrieved from www.dss.gov.au/evaluation-of-be-connected

5. Temple, C. (2020). The digital divide: Lessons COVID-19 taught us about the digital exclusion of students from low socio-economic backgrounds. Canberra: United Nations Association of Australia. Retrieved from www.unaa.org.au/2020/11/15/the-digital-divide-lessons-covid-19-taught-us-about-the-digital-exclusion-of-students-from-low-socio-economic-backgrounds

6. Winch, S. (2020). Connecting on country: Closing the digital divide for First Nations students in the age of COVID-19. Burwood East, Vic.: The Australian Literacy and Numeracy Foundation and World Vision. Retrieved from www.worldvision.com.au/docs/default-source/publications/government-submissions/connecting-on-country.pdf

7. Small Business Digital Taskforce. (2018). Small Business Digital Taskforce: Report to government March 2018. Canberra: Small Business Digital Taskforce. Retrieved from www.industry.gov.au/sites/default/files/small_business_digital_taskforce_-_report_to_government.pdf

8. Joshi, A., Paterson, N., Hinkley, T., & Joss, N. (2021). The use of telepractice in the family and relationship services sector (CFCA Paper No. 57). Melbourne: Child Family Community Australia, Australian Institute of Family Studies.

9. Barr Taylor, C., Fitzsimmons-Craft, E. E., & Graham, A. K. (2020). Digital technology can revolutionize mental health services delivery: The COVID‐19 crisis as a catalyst for change. International Journal of Eating Disorders, 53(7), 1155–1157. doi: 10.1002/eat.23300

10. Pfitzner, N., Fitz-Gibbon, K., McGowan, J., & True, J. (2020). When home becomes the workplace: Family violence, practitioner wellbeing and remote service delivery during COVID-19 restrictions. Melbourne: Monash Gender and Family Violence Prevention Centre, Monash University.


Featured image: GettyImages/andreswd

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Authors

Jo Barraket

Distinguished Professor Jo Barraket is the Director of the Centre for Social Impact at Swinburne University.

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