Abstract
With e-health technologies, patients are invited as co-producers of data and information. The invitation sparks new expectations, yet often results in disappointments. With persistent ambitions to involve patients by means of e-health, it seems crucial to gain a better understanding of the nature, sources and workings of the expectations that come with being invited. I analyse the use of an e-health system for ICD-patients, focusing on how patients sought to serve as information providers. Continuing STS-research on invisible work in technology use, I show how using the system involved complex work of filtering information. I argue that this ‘filtration work’ was inherently dialogic, that is, characterized by receiver-orientation and the anticipation of response and guided by different communicative projects. For the patients, filtration work thus, first of all, required certain skills and knowledge about the infrastructure of care. Secondly, it entailed the expectation that the system?" for better or for worse?"would facilitate not just information sharing but open up a dialogue, which glaringly contrasted with the clinicians’ expectations of being able to better manage dialogue. I suggest that understanding the dialogic dynamics and ‘overflows’ of information filtration work can help unpack the challenges of facilitating (patient) participation with e-health and other filtration devices.
Highlights
The basic storyline of the following anecdote may sound very familiar to readers acquainted with the field of e-health and telemedicine:A group of researchers and clinicians set out to develop an ICT tool to involve chronic heart patients in their own treatment
Through careful tinkering with prototypes in home and clinic, the contours are drawn for a system that will support the work of both patients and clinicians by enabling patients to provide health related information
Concluding Discussion providers by conducting dialogic assessments of relevance. They shaped their entries as contributions to a dialogue in the anticipation of response
Summary
The basic storyline of the following anecdote may sound very familiar to readers acquainted with the field of e-health and telemedicine:. & Strauss, 1999) is required of both patients and professionals to make use and sense of new technologies (e.g. Mort et al, 2003; Oudshoorn, 2008; Piras & Zanuttoi, 2010; Pols, 2012; Roberts et al, 2012) These studies have given insights into the (re-)distribution of work that is entailed in using telemedicine Producing an utterance involves the anticipation of its prospective interpretation and continuation—in short, “what is going to follow” (Linell, 2001: 100) This claim, I propose, resonates with and usefully sheds light on the use practices that went into making P-Record work as a filtration device. I propose that a dialogic framework very precisely brings forth the challenges and implications of coordinating information filtration practices in the absence of a shared organizational rationale
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