The integration of digital communication into health care has revolutionised the way healthcare services are delivered, enhancing the accessibility, efficiency and quality of nursing and midwifery care. This chapter aims to contextualise digital communication within health care. We first provide a scope for communication in the digital health context with reference to national digital health strategies. We then provide an overview of digital communication tools used nationally and internationally. The challenges and opportunities brought by such tools are then discussed, particularly for vulnerable and marginalised groups in Australia. Throughout the chapter, you will be guided to relevant readings and websites, and we provide examples to help your understanding of concepts and apply digital communication in practice contexts. This chapter will be a foundation for later chapters to develop deeper knowledge in digital health.

1. Introduction to digital health communication in national and international contexts

Digital health refers to ‘systems, tools and services based on information and communication technology that can be used to treat patients and collect and share a patient’s health information’ (Australian Institute of Health and Welfare, 2025). Digital health is a contemporary development, nationally and internationally. It shows great potential in helping to overcome traditional challenges in health care, such as inequitable accessibility, management of chronic illnesses, duplicated investigations and more. The World Health Organization (WHO, 2021) in its Global strategy on digital health 2020–2025 (PDF) has suggested that digital and information and communication technologies are essential for universal health coverage and better protection from health emergencies. Therefore, digital health is an enabling factor for people to enjoy better health and wellbeing. However, the use of digital and information and communication technologies to improve healthcare delivery and patient outcomes (generally known as digital transformation) can be challenging for institutions, healthcare professionals, healthcare providers and end users (e.g. patients and caregivers).

In the context of digital health, communication has two-way functionality involving data sharing between a sender and a receiver. It can be synchronous or asynchronous for the purpose of delivering or receiving health and medical care. While sharing and exchange of health data is essential for communication in the context of digital health, those health data are also personally identifiable and contain sensitive information. As such, a high safety and security standard is crucial, and this requires strategic commitment and investment. In Australia, the Australian Digital Health Agency is the lead organisation for guiding the operation and development of the national digital health infrastructure that underpins the delivery of digital health.

1.1 National digital health strategy: outcomes, enablers and roadmap priorities

The video above, introduced the National Digital Health Strategy 2023–2028. In this section, you are going to develop a deeper understanding of the National Digital Health Strategy, in terms of its outcomes, enablers and roadmap priorities.

Finally, Table 2 summarises the 12 priorities in the strategy delivery roadmap of the National Digital Health Strategy.

Table 2: Health system outcomes and priorities

The National Digital Health Strategy has driven the development of digital communication initiatives in Australia. These initiatives are now increasingly used by people across the country.

2. Digital communication tools in Australia

Digital communication tools are at the heart of Australia’s journey toward enhancing healthcare service and delivery. Ensuring communication systems are connected and can share information easily is key. In Australia this is supported by the:

• National Digital Health Strategy
• Digital Health Blueprint and Action Plan 2023–2033
• National Healthcare Interoperability Plan.

The National Digital Health Strategy has digitally enabled connection of care as a core priority. This means digital communication tools are required for virtual connection of care episodes. These tools can streamline workflows, promote timely decision-making and support person-centred care across the nursing and midwifery professions.

Australians increasingly expect, as a norm, the use of digital capabilities to support their health and wellbeing. Therefore, it is important that nurses and midwives are informed and understand the evolving expectations and needs related to digital health communication tools. Increasingly, communication can be improved by consumers and healthcare providers using digital devices such as smartphones, applications (apps) and websites, combined with the availability of near real-time data to support and enhance services.

In Australia there has been a shift from paper-based records to digital (electronic) medical records. More efficient communication and collaboration can occur between different health care providers when notes are located on a patient’s electronic medical record. For example, patient medications, investigation results and discharge summaries.

Table 3 shows some digital communication initiatives and examples.

Table 3: Digital communication initiatives and examples

The next sections introduce a range of digital health communication tools and explores their application in real-world Australian healthcare contexts.

2.1 Mobile health

Mobile health (or mHealth) leverages mobile devices and applications (apps) to deliver health services and messages, facilitate patient engagement and improve health outcomes.

For example, parents can digitally manage their child’s health information through the My Child’s eHealth Record. This ensures continuity of care, as clinicians can access past care information, vaccination records, allergy information, medication records and pathology tests at the point of care.

2.2 Digital medicines: electronic prescribing and medication charts

Electronic prescribing (ePrescribing) and medication charts can reduce errors and improve patient safety by providing accurate and up-to-date information. ePrescribing is the use of electronic rather than paper prescriptions. An ‘eScript’ can be sent to a person by SMS or email. The benefit of an eScript is that it comes with a QR code (also known as a digital token). The pharmacist then scans this so that they can access the prescription and give the person their medication. eScripts might also benefit those who are travelling or short on time, as the eScript can be forwarded to the pharmacist for pick up. Additionally, eScripts are less likely to be forged. The challenge with handwritten prescriptions is that they can contain errors, be inaccurate and have poor legibility, therefore, be more susceptible to fraud (Sendlhofer et al, 2019)

2.3 Healthcare identifiers

The Healthcare Identifiers Service assigns unique identifiers to individuals, providers and organisations, facilitating seamless data exchange.

Websites

Read more about individual healthcare identifiers on the Services Australia website and about healthcare identifiers generally on the national Department of Health and Aged Care website.

The My Health Record system is a cornerstone of Australia’s National Digital Health Strategy, centralising health information for access by authorised healthcare providers.

2.5 Telehealth

Telehealth refers to the provision of healthcare services, information and education using digital communication technology. This includes virtual consultations, remote monitoring and health education, allowing care to be delivered across geographical barriers. As a tool to enhance nursing care, telehealth supports telenursing, enabling patients to receive remote monitoring, telephone triage, health coaching and help with postoperative recovery or chronic health condition management. Likewise, telemidwifery integrates telehealth technologies into midwifery care. It enables midwives to remotely monitor pregnancies, offer antenatal education and provide postnatal support, such as breastfeeding guidance and postpartum recovery care. This approach is particularly beneficial for individuals in remote or underserved areas, ensuring that they receive consistent and quality maternity care.

Telehealth can provide vital healthcare services to remote and marginalised populations in Australia. What other populations could benefit from telehealth? Review the list below and see if you can think of any others.

• Rural and remote communities: provide access to specialists and healthcare services that may be unavailable locally.
• Elderly populations: reduces the need for travel and supports chronic disease management and routine care.
• People with disabilities: offers convenience and accessibility for individuals facing mobility or transportation challenges and those with high healthcare needs.
• Disadvantaged communities: bridge gaps in healthcare access for those in low-income or resource-poor settings.
• Chronic conditions: facilitates ongoing monitoring and management of conditions like diabetes, hypertension, arthritis and asthma.
• Mental health patients: provides accessible therapy and counselling, particularly in areas with limited mental health services.
• Parents and newborns: supports postnatal care and consultations for babies in remote locations.
• Aboriginal and Torres Strait Islander communities: enhances culturally appropriate healthcare access in remote areas.
• Immunocompromised people: reduces exposure risks by enabling remote consultations.
• Adolescents and young adults: offers accessible sexual and reproductive health services, including education and support.

Overall, telehealth ensures more equitable healthcare delivery by overcoming geographical, financial and physical barriers.

2.6 Wearable devices

Wearable technologies like smartwatches and fitness trackers offer real-time health monitoring and empower patients to take charge of their health.

Reading

Read this paper by Canali et al. (2022): Challenges and recommendations for wearable devices in digital health: Data quality, interoperability, health equity, fairness

The four main functions of wearable devices are monitoring, screening, detection and prediction (Canali et al., 2022). Data from wearable devices can be used for continuous and remote monitoring, the aim being the connection with, for example, remote telehealth for individuals who may be at risk of deterioration and require hospitalisation. The role of a nurse or midwife would be accessing and interpreting crucial physiological data such as heart rate, oxygen saturation and so on. Digital technology enables efficient access to and communication of patient data and supports nurses and midwives’ workflow, routine tasks, and information management (Schlicht et al 2025).

During COVID-19 remote monitoring of mild cases allowed patients to report their vital signs from home to a nurse or other care provider via access to an app or telehealth, reducing the risk of transmission to healthcare providers and other patients by avoiding an in-person assessment (Seshadri et al., 2020).

Wearable devices can also be used for prediction, more so in relation to outbreaks, as uploading of data from those who are infected means primary healthcare nurses can be informed of hotspots and increase education on preventive measures.

What did you think of the paper? Can you think of any other benefits or challenges in the use of wearable devices for collecting health care data?

2.7 Electronic referrals

Electronic referral systems streamline communication between healthcare providers, reducing delays and improving care coordination. Once an electronic referral (eReferral) is made, it can be integrated into the electronic medical record system. This integration, for example, facilitates the automatic sharing of a patient’s referral documentation and information in preparation for an outpatient visit.

Website

Read about how NSW Health is using eReferrals at this NSW eHealth website: Engage outpatients

eReferrals save time, enable secure submission of patient information and improve communication between referrers, patients and outpatient clinics. Standardised forms help to ensure that accurate medical information, including test results, medical history and current medications, is captured correctly at the time of referral. The benefits electronic referrals have meant a move away from paper-based referrals, which are usually sent in the mail. Importantly, eReferrals can provide real-time notifications for patients and carers in languages other than English.

2.8 Access to trusted data

Access to trusted, evidence-based data is essential for safe and effective nursing and midwifery practice. Sources like the Australian Institute of Health and Welfare (AIHW) and the Joanna Briggs Institute (JBI) offer reliable, evidence-based resources that support clinical decision-making and policy development.

3. Challenges and opportunities for digital communication in health care

Digital communication in health care has transformed the way information is shared, stored and accessed, enabling more streamlined and person-centred care. However, the rapid evolution of technology presents challenges and opportunities that must be addressed to maximise its potential while ensuring equitable and ethical practices.

3.1 Challenges

Equity of access

Digital communication relies heavily on technology, which is not equally accessible to all populations. Disparities in access to devices, reliable internet connections and digital skills can make existing health inequities worse, particularly for those in rural or remote areas, for individuals with low socioeconomic status and for older populations. Addressing these barriers is critical to ensuring that healthcare communication is inclusive and equitable for all.

Interoperability and data standards

Healthcare systems often use diverse technologies that lack interoperability, leading to challenges in sharing and accessing patient information across platforms. Without universal data standards, important details may be fragmented or lost, hindering continuity of care and potentially compromising patient safety.

Data literacy and data citizenship

Healthcare providers and people accessing health care need adequate data literacy to understand and effectively use digital health tools. Data citizenship – an individual’s ability to engage responsibly with digital data – becomes increasingly important in fostering trust and collaboration in the digital healthcare landscape. Lack of knowledge in this area can limit the effective adoption of technology.

Security and privacy

As health care becomes more digital, the risk of data breaches and cyberattacks grows. Patient data is highly sensitive, and any breach can have devastating consequences for individuals and institutions. Striking a balance between accessibility and robust security measures is essential for maintaining patient trust and compliance with legal and ethical standards.

3.2 Opportunities

Timely communication

Digital platforms enable real-time communication between healthcare providers and the people they care for, facilitating faster decision-making and improving outcomes. Tools such as telehealth, patient portals and instant messaging allow for immediate access to care and support, even across large distances.

Improving health literacy

Digital communication opens up opportunities to improve health literacy by providing people with easy access to accurate, evidence-based information. Interactive tools, videos and infographics can enhance understanding, enabling individuals to make informed decisions about their health.

Accessibility and inclusivity

Well-designed digital tools can enhance accessibility for diverse populations, including those with disabilities or language barriers. Features such as screen readers, translation services and simplified interfaces make health care more inclusive, empowering people to engage more actively in their care.

3.3 Making positive change in digital communication

Digital communication is reshaping the healthcare landscape, offering immense potential to improve accessibility, consumer engagement and outcomes. However, these opportunities can only be realised by addressing challenges such as inequities in access, technological fragmentation and the need for robust security and privacy measures. Recognising and tackling these issues ensures that digital communication serves as a tool for positive change, fostering a more equitable and efficient healthcare system.

Ethical and legal principles

Health professionals must maintain confidentiality, professionalism and legal compliance when using digital tools. Ethical communication requires safeguarding patient privacy, avoiding misinformation and adhering to privacy laws and professional codes of conduct.

Social media policies for health professionals

Social media offers opportunities for education and networking but must be used responsibly. The Australian Nursing and Midwifery Federation advises avoiding patient-identifiable information and maintaining professional boundaries (ANMF, 2022). The Australian Health Practitioner Regulation Agency emphasises confidentiality, accurate information and adherence to advertising rules to avoid disciplinary action (Ahpra, 2022). These will be explored further in the next chapter (1.3).

4. Conclusion

This chapter has described digital health, digital communication and various digital tools used nationally and internationally. It introduced communication strategies used in the context of digital health and outlined how the WHO global strategy on digital health has served as a foundation for communication.

Importantly, this chapter introduced some of the key stakeholders in digital communications within an Australian healthcare context. It outlined digital information and communication tools used in the Australian healthcare system and introduced some of the evolving digital communication initiatives, with examples of use ranging from mobile health and applications to record keeping, wearable devices and electronic health records. This provides important foundational knowledge and gives those new to health an insight into the complexity of digital communication tools in use in an Australian healthcare context.

The chapter also introduced how nurses and midwives can use digital health communication tools to support person-centred care in the Australian healthcare system, along with challenges, opportunities and ethical considerations. This included examples of how digital communication can enhance accessibility and inclusivity and increase health literacy for vulnerable and marginalised populations. Ranging from the use of digital communication tools for those in rural or remote locations to those in marginalised populations, the chapter explored challenges for security and privacy, equity of access, data literacy and citizenship, and interoperability and standards. In addition, opportunities for timely communication, increased accessibility and inclusivity and improved health outcomes were also introduced. Many of these will be explored in more depth in later chapters.

5. Further reading

Plans, strategies, and websites

Australian Digital Health Agency: National Digital Health Strategy

Australian Digital Health Agency: National Healthcare Interoperability Plan

Australian Government Department of Health and Aged Care: The Digital Health Blueprint and Action Plan 2023–2033

Australian Health Practitioner Regulation Agency. (2022). Social media guidance. https://www.ahpra.gov.au/Resources/Social-media-guidance.aspx

Australian Nursing and Midwifery Federation. (2022). Guidance note: Social media and online networking. https://anmf.org.au/media/ntfjgv00/anmf-guidance-note-social-media-and-online-networking.pdf

eHealth NSW: Engage outpatients – Outpatient referral management

Healthcare IT News: Inpatient care experience gets a boost from telenursing and AI A story about the provision of care with minimal disturbance to the patient.

Journal articles

Cresswell, N. R., Walker, S. T., Harrison, C., & Kent, F. (2024). Teaching digital interprofessional collaboration. The Clinical Teacher, 21(6), e13651. https://doi.org/10.1111/tct.13651

Hants, L., Bail, K., & Paterson, C. (2023). Clinical decision-making and the nursing process in digital health systems: An integrated systematic review. Journal of Clinical Nursing, 32(19–20), 7010–7035. https://doi.org/10.1111/jocn.16823

This paper identifies how nursing processes of assessment, planning, intervention and outcome evaluations have been incorporated into digital health systems.

6. References

Australian Health Practitioner Regulation Agency. (2022). Social media guidance. https://www.ahpra.gov.au/Resources/Social-media-guidance.aspx

Australian Nursing and Midwifery Federation. (2022). Guidance note: Social media and online networking. https://anmf.org.au/media/ntfjgv00/anmf-guidance-note-social-media-and-online-networking.pdf

Australian Institute of Health and Welfare. (2025). Digital health. https://www.aihw.gov.au/reports/australias-health/digital-health

Canali, S., Schiaffonati, V., & Aliverti, A. (2022). Challenges and recommendations for wearable devices in digital health: Data quality, interoperability, health equity, fairness. PLOS digital health, 1(10), e0000104. https://doi.org/10.1371/journal.pdig.0000104

NSW Department of Health. (2025). Engage outpatients – Outpatient referral management. NSW Government. https://www.ehealth.nsw.gov.au/solutions/patient-experience/electronic-referral/engage-outpatients

Paola, S. (2020). Pharmacies ‘often targeted on weekends and after hours’. AJP.com.au. https://ajp.com.au/news/pharmacies-often-targeted-on-weekends-and-after-hours/

Schlicht, L., Wendsche, J., Melzer, M., Tschetsche, L., & Rösler, U. (2025). Digital technologies in nursing: An umbrella review. International Journal of Nursing Studies, 161, 104950. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2024.104950

Sendlhofer, G., Pregartner, G., Gombotz, V., Leitgeb, K., Tiefenbacher, P., Jantscher, L., Richter, C., Hoffmann, M., Kamolz, L. P., & Brunner, G. (2019). A new approach of assessing patient safety aspects in routine practice using the example of “doctors handwritten prescriptions”. Journal of Clinical Nursing, 28(7-8), 1242-1250. https://doi.org/https://doi.org/10.1111/jocn.14736

Seshadri, D. R., Davies, E. V., Harlow, E. R., Hsu, J. J., Knighton, S. C., Walker, T. A., Voos, J. E., & Drummond, C. K. (2020). Wearable sensors for COVID-19: A call to action to harness our digital infrastructure for remote patient monitoring and virtual assessments. Frontiers in Digital Health, 2, 8. https://doi.org/10.3389/fdgth.2020.00008

Shen, Y., Guo, D., Long, F., Mateos, L. A., Ding, H., Xiu, Z., Hellman, R. B., King, A., Chen, S., Zhang, C., & Tan, H. (2020). Robots under COVID-19 pandemic: A comprehensive survey. IEEE Access: Practical Innovations, Open Solutions, 9, 1590–1615. https://doi.org/10.1109/ACCESS.2020.3045792

World Health Organization. (2021). Global strategy on digital health 2020–2025. https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf

Wu, M., Du, X., Gu, R., & Wei, J. (2021). Artificial intelligence for clinical decision support in sepsis. Frontiers in Medicine, 8, 665464. https://doi.org/10.3389/fmed.2021.665464

Yadav, P., Chaudhari, K., Dave, A., & Sindhu, A. (2024). Exploring the evolution of robotic surgery in obstetrics and gynecology: Past, present, and future perspectives. Cureus, 16(3), e57155.