Digital Literacy and the Future of Integrated Care within Community Settings: Insights from a Maltese Population Survey

Integrated care relies on digital technologies to ensure its coordination, continuity, patient engagement if Malta is to achieve improved outcomes through community-based care. However, there may be gaps that may limit the equitable adoption of such technologies. A nationally representative cross-sectional survey (n=500) conducted between February–March 2025, measured digital literacy among Maltese adults aged 40 years and above. The survey sought to understand the implications for implementing integrated care within the community by examining device ownership and access to devices, internet use, online engagement, as well as cybersecurity practices.

 

The results show that, although device ownership and digital access is high, there are divides in terms of digital confidence, usability and cybersecurity literacy, which may in turn become barriers to the deployment of integrated care at the community level – where trust and engagement with digital services comes into play. Over 80% indicated daily internet use while smartphone ownership exceeded 80%. On the other hand, close to 40% expressed no interest in online shopping, and 13% faced usability challenges, suggesting low levels of confidence with digital systems. Cybersecurity was identified as a significant weakness; with 40% of respondents writing down their passwords and more than 21% reporting breaches, thus implying that public confidence in digital health platforms may be fragile.

 

This survey helps to understand the importance of digital literacy in determining the acceptability and equity of implementing integrated care in the general Maltese population. The prevalence of high mobile phone ownership coupled with everyday internet use indicate a high potential for the uptake of digital health interventions, however there are also impediments, according to this survey: digital confidence gaps, inadequate navigation skills and poor cybersecurity practices threaten effective patient engagement and trust in digital software tools. In addition, age, education and employment-status-related inequalities suggest that people who might be in societal need of integrated care are jeopardized to be excluded from the gains of integrated care. The success of this digital transformation is predicated on digital literacy— without adequate skills and access, the digital divide risks exacerbating health inequalities.

For Malta, incorporating integrated care into the community necessitates a dual approach of investment in technology infrastructure alongside interventions that promote digital literacies, cyber security awareness and the development for user-friendly health interfaces. In particular, the paper suggests that although Malta is suitably prepared in respect of accessibility and usage of the internet on a daily basis, discrepancies in digital confidence and cybersecurity literacy pose hazards for more balanced participation in integrated care.

 

Lastly, digital literacy needs to be recognised as a major pillar of integrated care. Within the Maltese context, the requirement for focused training, better digital trust creation and ease of use in the interfaces to guarantee inclusive and sustainable integrated care pathways is evident. The results of this survey support the international consensus for digital literacy as a key facilitator for sustainable, person-centred care.