This study explores how physiotherapists in primary care in Skåne relate to digital communication tools and how these tools are integrated into their clinical workflows. The aim is to deepen the understanding of how digital tools affect work processes and the organizational and social factors influencing their use, considering both the private and public sectors. Through qualitative semi-structured interviews with nine physiotherapists, the study highlights both opportunities and challenges that arise when digital communication tools are used in daily practice. The results are analysed using the theoretical perspectives of the Unified Theory of Acceptance and Use of Technology (UTAUT) and affordances, focusing on experienced usefulness, experienced effort, social influence, and organizational support. The study shows that digital tools can increase accessibility and efficiency in patient interactions, but that poor system integration, unclear workflows and variable organizational support sometimes lead to manual workarounds and cognitive stress. The analysis demonstrates that tool usage is shaped by the interplay between technology, users, social influence and organizational conditions, making the same tools both supportive and limiting. The study emphasizes that digital communication tools are not merely technical aids but also influence how work is organized and carried out, highlighting the complexity of their use in everyday clinical practice. The study also resulted in a competence development model that illustrates how digital communication tools influence physiotherapists’ work and identifies the organizational conditions required to strengthen digital competence in non-integrated systems. The model provides insights that can support the design and implementation of future digital communication tools by highlighting users’ competence needs and the organizational factors that shape technology use. Consequently, the findings may contribute to the development of more user-centered, sustainable and effective digital solutions in healthcare settings.