Changing Categorical Work in Healthcare: the Use of Patient-Generated Health Data in Cancer Rehabilitation

Abstract

Categorical work in chronic care is increasingly dependent on digital technologies for remote patient care. However, remote care takes many forms and while various types of digital technologies are currently being used, we lack a nuanced understanding of how to design such technologies for specific novel usages. In this paper, we focus on digital technologies for patient-generated health data and how their use changes categorical work in chronic care. Our aim is to understand how categorical work changes, which novel forms of categorical work emerge and what the implications are for the care relation. This paper is based on an ethnographic study of healthcare professionals’ work at a pelvic cancer rehabilitation clinic and their interactions with patients. In this setting, supportive talks between patients and nurses are central. To understand the complexities of categorical work in chronic care when patient-generated health data are introduced, we contrast the traditional supportive talks with supportive talks where the nurses had access to the patients’ patient-generated health data. We identify and analyze challenges connected to novel forms of categorical work. Specifically, we focus on categorical work and how it can undergo changes. Our empirical findings show how changes occur in the way patients’ lived experience of the chronic disease aligns with the categories from chronic care, as well as in the way the nurse works with clinical categories during the talk. These insights help us further understand the implications of patient generated-data use in supportive talks. We contribute to an improved understanding of the use of patient-generated health data in clinical practice and based on this, we identify design implications for how to make categorical work more collaborative.