Patients and providers in rural Canada have generally demonstrated positive attitudes toward home-based digital health technologies, although their reported attitudes are often highly context-dependent. In a study of a micropractice model, Burton et al. reported that patients felt empowered, less stressed, and more engaged in their care, while providers expressed pride in offering accessible, patient-centered services (16). Similarly, Fitzsimon et al. (2023) found that physicians appreciated the ability to reach underserved patients and described a sense of personal fulfillment, though some patients, particularly older adults, struggled with digital literacy (17). High patient satisfaction was also observed by Kornelsen et al., with 84 percent of patients recommending virtual surgical consults, though in-person visits remained preferred for emotionally significant care like surgery (18). In a culturally grounded remote monitoring initiative, Petrie et al. found universal patient satisfaction, with many reporting greater confidence in managing their health, and providers overwhelmingly supporting the program (21).

Provider perspectives were consistently supportive but tempered by concerns around system limitations. Providers also noted challenges in maintaining work-life boundaries when providing virtual care (16). Rouleau et al. described how nurses valued video visits to deliver compassionate care, though some felt digital formats constrained relational depth (19). Giroux et al. echoed this sentiment, with providers acknowledging the benefits of virtual care but expressing reservations about its adequacy as a full replacement for in-person services, especially when infrastructure and training were lacking (20). Hebert et al. found that nurses became more enthusiastic post-training, despite initial anxiety, indicating that onboarding and capacity-building are critical to long-term engagement (29). Meanwhile, Goodridge and Marciniuk documented provider worries about increased workload, disrupted workflows, and legal complexities, highlighting the importance of organizational support and clear role definitions (28). Some examples of the legal concerns mentioned include challenges related to patient privacy, securing informed consent, and maintaining confidentiality in the transfer, storage, and sharing of medical data, alongside issues surrounding provider authentication and liability.

On the patient side, virtual care was often associated with convenience, empowerment, and reduced logistical burdens. For example, Peacock et al. noted that patients appreciated telehealth’s efficiency, especially for follow-ups, and valued the reduced stress of avoiding travel (2). In a virtual cardiac rehabilitation program, Mendell et al. reported that participants enjoyed the motivational aspects of digital interaction, though one user preferred phone calls over chat due to usability frustrations (25). Kornelsen et al. provided virtual consultations to patients via videoconference, with phone consultations acting as a backup option to resolve connectivity issues (18). These examples suggest that flexible communication formats can enhance engagement.

Seaton et al. found that patients favored user-friendly tools supported by human assistance, emphasizing that simplicity and reliability often outweighed the benefits of innovation (30). In contrast, Rush et al. observed mixed attitudes: patients who were dissatisfied with existing services showed greater openness to virtual care, while those content with current access were more resistant to change (26). O’Connell et al. highlighted a similar nuanced range of attitudes among older adults, who expressed both anxiety and resilience when navigating technology (27). This ambivalence reflected the tension between discomfort with unfamiliar digital tools and a demonstrated willingness to adapt. Their responses were shaped by perceived usefulness of the technology, confidence in their own ability to use it (self-efficacy), and access to support systems, such as assistance from family or community-based resources, that made engagement with technology more feasible.

Despite overall enthusiasm for home-based digital care, several concerns affected patient attitudes. Giroux et al. noted that patients missed relational depth and emotional clarity in virtual visits, underscoring the importance of relational care elements in digital settings (20). Goodridge and Marciniuk found that some patients feared technical failure, over-reliance on clinicians, and the loss of in-person interactions (28). Likewise, Seaton et al. identified connectivity and complexity as barriers, reinforcing the need for strong infrastructure and intuitive design (30).

Notably, a few studies, including those by Fitzsimon et al. (2023) and Gingras et al., did not yet collect direct feedback on user attitudes, though future data collection was planned (6,17). This highlights a broader critical need across the field for consistent integration of user experience metrics in digital health evaluations. Ongoing measurement of patient and provider experiences is essential for continuous improvement.

In summary, attitudes toward digital health in rural Canada are most favorable when technologies are accessible, supportive, and designed with empathy and practical needs in mind. Successful implementation depends on co-design with patients and providers, developing patient-centered digital solutions, ongoing training, and the inclusion of emotional and relational components. Flexibility in delivery formats and continuous evaluation of user satisfaction can further strengthen adoption and sustained use.