Abstract
Introduction. Since the launch of Web 2.0, we have witnessed a trend towards digitizing healthcare tools for use by both patients and providers. Clinical trials focus on the ways that digital health technologies result in better outcomes for patients, increase access to healthcare and reduce costs. Critical approaches which explore how these technologies result in changes in patient embodiment, power relations and the patient-provider relationship are badly needed. Objective. To provide an instruction case example of how Light, Burgess and Duguay’s (2018) walkthrough method can be mobilized to study apps to address critical health communication (CHC) research questions. Methods. We apply the walkthrough method to the BEACON Rx Platform. In doing, we conduct a detailed technical walkthrough and evaluate the environment of expected use to answer the following questions: How does the platform shape (and how is it shaped by) understandings of what it means to be healthy? Who are its ideal users? How does this impact its environment of expected use? Conclusions. This paper demonstrates the potential contributions of the walkthrough method to critical health communication research, namely how it enables a detailed consideration of how an app’s technical architecture and environment of expected use are embedded with symbolic representations on what it means to be healthy and what practices should be engaged in to maintain “good” health. It also demonstrated that, despite the rhetoric that digital health technologies democratize healthcare, the BEACON Rx platform is a risk monitoring tool by its very design.
Highlights
Since the launch of Web 2.0, we have witnessed a trend toward digitizing healthcare tools for use by both patients and providers
In order to take up this call for critical scholarship, this paper seeks to provide an instructive example of how to mobilize Light et al.’s (2018) walkthrough method to answer critical health communication research questions specific to health apps. We will apply this method to an analysis of the BEACON Rx Platform to assess the following questions: How does the BEACON Rx platform shape understandings of what it means to be healthy? Who are its ideal users? How does this impact its environment of expected use? In answering these questions, we will advance the argument, using the BEACON Rx platform as a case example, that, despite the neoliberal rhetoric that mental health apps encourage users to take control of their own care, they are, risk monitoring tools by their very design
The primary objective of this study is to provide an instructive case example of how the walkthrough method (Light et al, 2018) can be mobilized in the study of apps to address critical health communication research questions
Summary
The BEACON Rx platform includes both a patient-facing app and a health provider-facing dashboard. The app includes eight integrated sections, including: a user profile; a home page, where users can monitor any number of “trackables” (e.g., diet, hygiene and exercise) and mental health outcomes (e.g., mood); materials designed to support face-to-face psychotherapy; a journaling function; a connect feature which allows users to instant message their healthcare provider in between visits; a progress tab where users can review changes to their trackables and mood over time; a resource section which allows their healthcare provider to push out targeted content through the app; and, “the BEACON button” which users can press should they find themselves in a mental health crisis to be connected to their provider, emergency contact or crisis support line (Figure 1). Through the Clinician Dashboard, the provider can access anything that is inputted into the app by the patient, including responses on mood logs, trackables, journal entries, and BEACON button presses
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