“Digital is nice, but only to smart people”: a qualitative analysis of barriers to digital healthcare for migrants in high-income countries

Background The use of digital technologies in healthcare has been expanding rapidly. While these tools have improved service delivery by increasing efficiency and convenience, they have also introduced barriers for certain groups, including migrants. As a result, digitalisation may deepen existing social inequalities, particularly for vulnerable populations. Despite these concerns, there is limited understanding of how migrants engage with digital healthcare in their everyday lives. This study addresses this gap by examining the challenges and consequences of digital healthcare use among Nepali, a minority migrant community in Finland. Results The data comprise semi-structured interviews with 27 Nepali migrants. The study identified four key challenges: limited digital skills, language barriers, reliance on proxy users, and a strong preference for in-person care. Although most participants had access to smartphones and digital platforms, many lacked the confidence or ability to use them independently for healthcare-related tasks. This, combined with language barriers, often led to a reliance on proxy users, with healthcare tasks frequently assisted by family members, including underage children. While these practices sometimes reflected cultural norms of collective care, they also raised significant concerns about privacy, autonomy, and the overall accessibility of digital healthcare systems for migrants. Conclusions Access to digital tools alone does not guarantee meaningful engagement with healthcare. Reliance on proxy users and complex digital interfaces can reinforce inequality, particularly under the ‘digital by default’ model of high-income countries. To support inclusive access, the study recommends multilingual interfaces, user-friendly design, tailored digital literacy training, and the continued availability of in-person services. Further research is needed to inform policies that reflect the needs of diverse populations.