Researchers: Shira Ramot¹, Angela Chetrit ¹, Sivan Ben- Avraham¹, Galia Barkai²

Background: Telemedicine benefits patients and healthcare systems, but access varies. The Ultra-Orthodox (UO) community faces challenges due to their unique cultural characteristics, often avoiding the internet for religious reasons, which limits their use of online services.

Objectives: Evaluating: (a) the rate of telemedicine use in the Ultra-Orthodox community in Israel (b) socio-demographic, medical and digital factors associated with telemedicine use (virtual medical visit / administrative actions), (c) attitudes, barriers and ways to expand the use among the UO sector (d) readiness for remote home hospitalization.

Method: The participants in the study (n=1,460), constituting a representative sample of the adult UO population in Israel, underwent a phone interview, including questions regarding socio-demographic characteristics, use of health services, internet and digital devices, attitudes and barriers. Multiple logistic regression models were used to assess factors associated with the use of telemedicine services (virtual medical visit via phone/video call/e-mail) and administrative actions (appointment scheduling, accessing personal medical information, sending administrative requests and ordering medications).

Findings: The UO use telemedicine but less than the general population. 39% use virtual visits and 42% use administrative actions, with phone consultations being the most common. Most of the respondents have a simple kosher phone and only half have a laptop. Women, young people (age group 30-44), those with high income, those who visit a family doctor more, and those who use the internet- use telemedicine more. The main barrier to the use of telemedicine is a religious-ideological reason and about third of the respondents stated that they do not have a smart phone or internet. About a third suggest a dedicated kosher device for telemedicine as a solution. Over half-expressed consent to remote home hospitalization for relatives.

Conclusions: Telemedicine is being used within the UO community, although the rates were lower than the general population in Israel. The current results demonstrate that there are barriers in using telemedicine in this population, both ideological-religious and technological.

Recommendations: The study's findings can help policy makers and health services in expanding the provision of telemedicine to the UO society and can aid in developing strategies tailored to this population.

Research end date: 12/2024