Safety and Security of a DigiClinic in a Finnish University Hospital Well-Being District.

Digital health services are largely provided, but little is known about the safety and security issues endangering patient safety and data security. In this study, the Bowtie method was used to analyze incidents reported to have jeopardized patient safety and data security when a patient and a healthcare professional used an online chat or video service (DigiClinic) in the Wellbeing Service County of Pirkanmaa, Finland. In 2025, there were ca. 230,000 conversations in DigiClinic. User reports related to DigiClinic were collected from 2024 and 2025 (N=135), of which all resulted in harm: minor (n=117), moderate (n=16), or severe (n=2). Only 2 incidents were due to patients' inability to use the digital service, and 22 were due to technical problems. In conclusion, DigiClinic is a widely used digital healthcare service with a low number of user reports. The primary cause leading to patient harm is deviations in information management across levels. The digital service itself does not compromise patient safety or data security.