Search

The umbrella term ‘telehealthcare’ denotes an array of information and communication technology-based solutions for digitally connecting citizens with healthcare services. Guided by the conviction that bodies can be translated into digital data which may serve as the basis for clinical decisions made elsewhere, these designs are widely assumed to enable a mode of healthcare delivery which is independent of space and time. Addressing the increasing use of telehealthcare for personalized health monitoring targeting the growing populations of elderly and chronic-care patients, this paper suggests that such designs invariably unfold new spaces of visibility. Based on an analysis of articles published in a leading telehealthcare journal, I argue that these new visibilities do not provide a window onto something that is already there. Instead, such visibilities are shaped by the way techno-medical practices and knowledge production processes are intertwined with a specific politico-economic agenda. The paper explores differences with respect to the positioning of older people and chronic-care patients in relation to two versions of health monitoring. While each version represents an attempt to promote individual freedom, improve health outcomes and ensure a functioning healthcare system, contrasting rationales are involved and different types of spaces are being unfolded. [ABSTRACT FROM AUTHOR]

This paper examines some of the current challenges surrounding the implementation of information and communication technology systems to support the delivery of care within health services. These highly complex electronicinformation infrastructuressupport an increasingly broad array of functions and actors. They are being supplied in the UK National Health Service by commercial vendors as Commercial Off-The Shelf solutions. Vendors have struggled to developgenerification strategiesthat can accommodate the diverse practices and requirement of adopter organisations within their more-or-less standardised packages. At the same time there is enormous demand for improvements, coupled with a huge reservoir of potential innovations particularly where health practitioners interact with technology entrepreneurs. However, many outcomes of this bottom-up innovation process have struggled to be taken up more widely. As a result there has been markedly uneven progress in achieving radical visions that are being mapped out of how technology might transform healthcare. Drawing insights from Science and Technology Studies and related Information Systems research, the paper explores conceptual frameworks and methodologies that may help us better understand these challenges: the barriers to exploiting local innovations and taking them upon a wide basis and the tensions that need to be managed in the process. [ABSTRACT FROM PUBLISHER]

The socio-technological context of health care wherein patient-consumer involvement is central increases the importance of examining the impact of Internet information on health-related attitudes and behavior. This paper examined the extent to which deployment of e-health information is associated with patient distrust and non-adherence. We examined the hypothesized associations in gender-stratified subsamples to uncover whether any differential patterns of associations exist among women and men. Our analyses allowed for estimation of significant covariate effects at the composite index and item level for both men and women while controlling for the moderation effect of race/ethnicity. Results indicate differential outcomes for patient distrust and non-adherence depending on socio-demographic characteristics. Findings suggest that it is not just health-related information that influences health-related behavior, but also mechanisms through which socio-demographic characteristics shape whether Internet use is associated with distrust and patient non-adherence. e-Health information consumers are overall less trustful and more likely to deviate from health care provider treatment. Non-adherence among those who consume e-health information is more pronounced for non-white women. Highly educated non-white men were more likely to diverge from their medical care provider's treatment recommendations than White men. Given the increasing diversification of the demographic profile of the U.S. population, understanding the dynamics though which health-related Internet use becomes racialized and gendered represents a critical contribution to the literature on Internet and health. [ABSTRACT FROM AUTHOR]

Healthcare is the recipient of significant expenditure throughout the world today. With ageing populations, rising expectations, and the development of advanced health treatments, expenditure is not only significant, but also increasing. Control of rising costs has been a common theme of health technology projects, particularly those in health informatics. Yet application of advanced technique to the management of health and health information lags behind many other industries. This paper considers the relationship between three potential drivers of technology projects in health: technologists, management, and medical practitioners. It places each of these in the context of general information technology projects. It concludes with current developments that may advance or hinder the future success of health-related technology initiatives. [ABSTRACT FROM PUBLISHER]

The concept of e-health has come to assume a key place within a larger Canadian governmental discourse that lauds the benefits of supplying Internet-based services to as wide an audience as possible. In order to fulfil its vision of a connected public accessing services cheaply and easily through electronic media, the federal government has assumed that the potential exists for all Canadians to use the Internet and has done its best to achieve this result through programmes aimed at ameliorating accessibility issues. There is particular enthusiasm over the possibility of moving some health services online, thus reducing costs incurred through personal patient-practitioner meetings while ostensibly creating more informed, proactive and healthy Canadians. This paper discusses whether or not the enthusiasm of the government, and of individual users, regarding e-health practices is merited, focussing particularly on the consumption of online health information by patients. Numerous consequences and conflicts can accompany such practices, but this paper specifically addresses the negative aspects of promoting informed health choices through a medium inaccessible to all members of Canadian society, such as the aged, the poor, rural dwellers and some ethnic minorities. The paper also assesses the potential risks of acting upon incorrect information provided online and addresses the possibility that health professionals' workloads will increase rather than decrease. However, as this paper also notes, e-health does contain potential for improving the delivery of medical services in Canada if contained within clearly defined parameters, and if alternatives still exist for those who cannot or will not benefit from such technology. [ABSTRACT FROM AUTHOR]

This paper presents a simple typology of different forms of engagement with the Internet by families with children with various forms of chronic illness. The analysis is informed by ongoing debates about the nature, distribution and efficacy of reflexivity in contemporary social life, especially as it relates to the changing nature of information and knowledge. Drawing upon qualitative interviews with sixty-nine parents and sixteen children, the paper offers a nuanced account of the manner in which laypeople are engaging with e- health. It is an account that argues that any reading of the 'digital divide' that is based upon a simple homology between socio-structural location, reflexivity and differential ability to gain material purchase from information in the 'information age' is misjudged. [ABSTRACT FROM AUTHOR]

The use of digital healthcare to complement, aid, or replace traditional healthcare has been debated as having the potential to empower patients to take responsibility in managing their conditions, streamline workloads of healthcare professionals, and be cost-effective for the National Health Service in England. Despite this, national programmes to implement digital health solutions have been problematic, and this has been debated from various perspectives. This paper aims to add to the debate from a perspective that considers whether daily discourses of society play a role in conditioning the public against scalable digital health solutions. [ABSTRACT FROM PUBLISHER]

Blogs have been used extensively to self-document the intimate and often intensive experiences of living with serious illness, charting their author's health and treatment often over many years, connecting with others and drawing attention and concern along the way. This paper analyses a selection of typical ‘cancer blogs’ with the aim of understanding the kinds of personal investment, or labour, involved in the process of forming and maintaining them over a sustained period. Where previous research has investigated what is often seen as the ‘empowering’ role of these blogs, we attempt to qualify these claims. Our qualitative, case study analysis draws on and expands the theory and debates around the nature of immaterial and affective labour. We highlight the value of cancer blogging as personal, in the form of identity and affect management, network-enabling in generating online spaces for shared experience and support, and social in what is recouped in the forms of non-institutional management of serious illness. In addition, this labour helps to shape the broader social understanding of cancer, its experience and personal affects. [ABSTRACT FROM AUTHOR]

The Internet is increasingly used to communicate health knowledge and there is growing belief that it can help transform both personal and public health. There is no lack of information on healthy lifestyles, but the manner of communication of risk and the level of support for lifestyle change need improvement, especially among deprived populations. Assisting vulnerable persons to increase their health knowledge could help them to be more responsible for maintaining their health. The Internet offers potential for interactivity by providing a dynamic medium for influencing learning and behaviour change, especially in so far as it enables inter-subjective communication among peers. This paper examines how the Internet might help tackle health inequalities by improving communication of risk and providing support for those who are most susceptible to changing their behaviour. The authors provide a descriptive account of whether facilitated access to the Internet may improve the capacity of older men to manage their heart conditions. Nine men aged 50 to 74 living in multiply deprived areas of Salford were given computers, Internet access and training for six months. Interviews and qualitative data were collected to assess the influence the Internet had on the management of their heart conditions before they were given the computers, after six months and three years after they were introduced to the Internet. The study was exploratory but its results suggest that interactive learning is worthwhile because it can help strengthen social support and influence behaviour change. Home access to the Internet via their own personal computer had a beneficial influence in building confidence and facilitating healthy behaviour change. Although less than half of the participants had ever used the Internet before the study, the majority of them reported using the Internet and email regularly after their involvement in the project. [ABSTRACT FROM AUTHOR]

Considerable effort has been invested in telemedicine and e-health, but relatively few applications have endured beyond the research and development phase. Research within different academic disciplines points to the significance of established working and organizational relations within healthcare in shaping the outcome of particular projects, whether successful or otherwise. Even so, the findings appear as disparate and discrete observations which make it difficult for those involved in the field to get an overview of ICT in healthcare work and organization or to interpret the implications of the studies. The aim of our article is to demonstrate the importance and value of situating ICT initiatives within a sociological framework of healthcare work and organization and to show how this enables us to carry out systematic analysis across a range of ICT initiatives in different clinical settings. [ABSTRACT FROM AUTHOR]

A few studies examine what types of health information people seek online, yet we know little about how this varies by health status. To examine this question we used data collected from a random sample of 2,038 adults for the Pew Internet and American Life Project, which asked respondents in the United States whether they searched for 16 different types of information. These 16 topics were grouped into three broad areas, including medical conditions and treatments, health issues (e.g. diet and smoking cessation), and providers and payment (e.g. a particular hospital). To build on prior literature, two measures of health status were used: a self-report and the presence of a medical condition. The data suggest that health status impacts the types of health or medical information people seek on the Internet. Self-reported health status was not significantly related to any of the topics; however, respondents diagnosed with a disability or chronic disease were more likely to seek medical information on 13 of the 16 topics addressed. These include specific diseases or medical conditions, medical treatments or procedures, experimental treatments or medicines, alternative treatments or medicines, pharmaceutical or over-the-counter drugs, diet, immunizations, smoking cessation, depression, sexual health, environmental health hazards, a particular physician or hospital, and Medicaid/Medicare (governmental health programs in the United States for the poor and elderly). These results suggest that individuals in the United States who have a medical condition are more likely than healthy individuals to research most health topics online. The Internet can provide consumers with a wealth of information on issues of health and illness, yet healthcare providers need to educate consumers to be cautious given the range in quality. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine how members of an online bulletin board group concerned with sleep paralysis (SP) use the Internet to establish what it means to experience the symptoms associated with a mysterious sleep disorder. Data from 646 posts to the bulletin board, and from ten in- depth interviews with select bulletin board users, revealed that board participants constructed their disorder in three different ways: while some considered it a purely physiological problem, others believed it to be a demonic attack or a paranormal phenomenon. Results indicated that people suffering from SP are driven to the Internet by their desire to make sense of their terrifying nocturnal experiences. Rather than dispelling the myths surrounding this sleep disorder, the Internet in this study was, however, found to reinforce them by offering a forum for the discussion of alternative explanatory frameworks. [ABSTRACT FROM AUTHOR]