A two-day symposium on ‘Digital Healthcare’ was held last month at the University of Nottingham, focusing on the social logics, ethics and politics of data and technology provision. Speakers and delegates from a range of disciplines came together to discuss and explore the ways (positive and negative) that digital health data and technologies affect healthcare policies and the organisation of healthcare systems, and what this means for patients and healthcare professionals.
The growing importance and sophistication of digital technologies, such as electronic patient records, smart wearable devices, applications and online communities, promises – or threatens – a significant shift in healthcare practices. New kinds of global markets for healthcare and healthcare data are emerging, and responsibility for health and well-being seems to be devolving onto the data-equipped individual. Coupled to political claims of digital ‘revolutions’ and ‘disruptions’ in healthcare policy, the digital transformation of healthcare also marks a shift in the terms on which political economic and ethical decisions about health are made in the context of the sustainability of national health systems, whether by a patient, a clinician or a commissioner. Digital technologies promise smart, convenient and personalisable servicing of individual healthcare needs, but at the same time they threaten significant changes around the ethics of privacy, around evidence-based ‘data driven’ policy formation and around organisational reform affecting patients and medical professionals, amongst other things.
Presentations and discussions focused on questioning some of hubris around the transformation of healthcare and contextualised data and technologies in a broader, historical and institutional questioning of the economic, political and technological drivers of the emergence of digital health.
Case studies presented during the first day included: reflections on the sociotechnical challenges in marketising mundane bodily movements and the ways in which wellbeing itself comes to be enacted differently through different calculative devices and algorithms; classification of work tasks and calculation of probabilities for their automation in GP practices; the ways online patient communities developed by private firms generate a range of financial, political, ethical, reputational and technological values for multiple stakeholders across the health ecosystem; the formality and type of reconfigurations the implementation of hospital electronic prescribing and medicines administration systems bring for roles and professional boundaries in healthcare.
The second day of the symposium included case studies about the way health data have come to serve as a promise for the future while policies of digitalised data collections postpone ‘data-driven healthcare’ to a yet-to-come future; an approach to the examination of informed consent for big data programmes in healthcare (e.g. care.data) as a collective action for shared decision-making on secondary data uses between independent and trustworthy institutions and citizens-patients; potential uses, marketing and users’ perspectives of a programme of healthcare products and services for the Danish healthcare system in the context of patient empowerment a problematic concept; online issue mapping of the Danish General Practice Database (DAMD) controversy and the implications for contemporary governance of patient data; examination of competing logics in Canadian health innovation policy and, how the evidence-based logic and first-to-market logic do not express clear boundaries and are mixed in their healthcare effects; comparison of approaches to healthcare innovation between the Dutch health system and the Silicon Valley and, how the central focus is the profiled consumer, rather than healthcare or the patient.
Lastly, the symposium’s public lecture asked the question and explored, with the help of the audience, possibilities of making money and doing public good while respecting the rights and views of individual patients.
As seen from the above, the symposium drew an international field of speakers from Europe and North America, and fostered cross-disciplinary dialogue. It opened up a wide range of theoretical and substantive areas for consideration and debate nationally and internationally. There was strong representation from Danish and Dutch colleagues, and this raised a lot of interesting parallels between the UK perspective and more international contexts. It suggested a need for more comparative international work and this is something that the symposium organisers (Paraskevas Vezyridis, Andrew Goffey, Lynne Pettinger, Ewen Speed) will seek to pursue in the future.
The symposium ended with suggestions for future events that provide more opportunities for discussing the role of specific technological actors operating in this field across Europe as well as the role of the European Union in shaping research and development in digital healthcare.
Further details about the invited speakers and their presentation topics can also be found here. The symposium was jointly funded by the Foundation for the Sociology of Health and Illness and the European Commission.
About the Author: Paraskevas Vezyridis is a Marie Skłodowska-Curie Fellow at the Centre for Health Innovation, Leadership and Learning (CHILL), Nottingham University Business School. You can find out more about his research here: http://ww.bimeda-project.eu. He also tweets @paravezy.