Clinical self-tracking and monitoring technologies: negotiations in the ICT-mediated patient–provider relationship

Piras, Enrico Maria; Miele, Francesco

doi:10.4324/9781315108285-4

Cited by 23 publications

(45 citation statements)

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“…It is important to note that the present analysis does not provide the basis for making substantial claims about existing inequalities in technological use, and that it is always an empirical question whether variations in technological practices and perceptions map onto other social hierarchies and inequalities. The meaning of medical technologies do not exist a priori , but are shaped by emergent and non‐predictable human practices (Piras and Miele ). However, these practices are fundamentally embedded in a political economy of self‐management, shaped among other things by cultural expectations and the social organisation of the health care system (Hinder and Greenhalgh ).…”

Section: Theoretical Discussionmentioning

confidence: 99%

Stratified users and technologies of empowerment: theorising social inequalities in the use and perception of diabetes self‐management technologies

Øversveen

2020

Sociology Health & Illness

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Medical technologies of various kinds play an increasingly important role in medical treatment, but may also increase health inequalities if they are primarily used by high-status patients. While many have problematised inequalities in the material access to medical technologies, differences in use and perception are also salient for explaining the relationship between medical technologies and health inequalities. This article attempts to theorise these inequalities by bringing health inequality research into dialogue with social constructivist perspectives on usertechnology relations. Based on qualitative interview data from a case study of the technological self-management of type 1 diabetes, I construct three clusters of technological practices and perceptions corresponding to three broad user types. These user types are then discussed in the context of patient empowerment and the promotion of the active, autonomous and self-reflective 'expert' patient in European health care systems. To the extent that they materialise and enforce institutional expectations which only the most resourceful patients will be able to live up to, medical technologies may serve to entrench and legitimate social inequalities in health and medical care. Research therefore needs not only to consider how medical technologies are distributed, but also their design and appropriation by users.

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Section: Theoretical Discussionmentioning

confidence: 99%

Stratified users and technologies of empowerment: theorising social inequalities in the use and perception of diabetes self‐management technologies

Øversveen

2020

Sociology Health & Illness

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“…Self-monitoring one's health is an old practice. In the past, self-tracking practices were based on journaling and diary-keeping, whereas nowadays these practices draw on a variety of methods (Lupton, 2014) due to the development of miniaturized and easy-touse devices (Piras and Miele, 2017), and more recently of digital technologies. More specifically in diabetes healthcare, since the introduction on the market of glucometers and, more recently, of low-cost continuous wearable sensor patches (Swan, 2012), healthcare professionals delegate a series of tasks and measurements to patients and relatives (Danholt, 2013;Hinder and Greenhalgh, 2012;Mol, 2000;Mol and Law, 2004;Schüll, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, patients become responsible for collecting, assembling and interpreting data about themselves. They are also expected to report details about themselves during the clinical encounter, and to support and share the work of healthcare professionals in the management of their disease (Bruni and Rizzi, 2013;Piras and Miele, 2017). It is not only a matter of enhancing patients' responsibility for producing and sharing more data on their 'medical lives' but also on their 'everyday actions' (Schüll, 2016: 319).…”

Section: Introductionmentioning

confidence: 99%

“…Not only patients become responsible of self-managing their health risks by producing, consuming, and interpreting data made available by these new devices but also healthcare practitioners have the professional responsibility to maximize data collection through the education of patient to engage with these new devices for research and public health (Kerr et al, 2019). Piras and Miele (2017) call 'clinical self-tracking' a form of pushed self-tracking in T1D self-care and observed that while patients at times follow the path prescribed by the provider, at times unexpected self-tracking practices emerge. In her analysis, Schwennesen (2017) underlines that pushed self-tracking in physical rehabilitation is 'as an ongoing and contingent process through affective and affecting encounters between human … and nonhuman actors' (p. 7).…”

Section: Introductionmentioning

confidence: 99%

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Techno-social reconfigurations in diabetes (self-) care

Danesi¹,

Pralong

Panese

et al. 2020

Soc Stud Sci

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This article focuses on the ways in which a flash glucose monitoring system, FreeStyle Libre®, is introduced and used by people living with type 1 diabetes, their relatives and healthcare professionals. It draws on a multi-sited ethnography in a variety of clinical and daily situations, and on interviews with caregivers and people living with diabetes. We explore how the users develop knowledge-in-practice, and consider the use of self-management technologies to be largely dependent on locally grounded and situated care acts, and resulting from the relational, pragmatic and creative maneuvering of technology-in-practice. Our findings show that adjustments between users, their bodies and the technology are required, and show the reflexive work and practices of patients and relatives who learn to use the device in a proper way. Moreover, we reveal that practitioners see this technology as a tool that not only improves self-care practices but also clinical practices, and that wearing and using this new medical device may become a moral injunction for self-improvement. Our results illustrate the techno-social reconfigurations at work and the development of new ways of feeling, thinking and acting in diabetes (self-) care.

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“…This involves being selective in relation to what information to provide and has a particular, dialogic, orientation; patients imagined the receiver, and shaped their entries in line with conversations they hoped to pursue or avoid. Work on the development of a clinical self-monitoring system for diabetes similarly showed how patients might decline to share data or respond to clinicians' messages (Piras and Miele, 2017). All of the studies discussed so far illustrate selectivity in records made or shared, suggesting there is value in the concept of curation in relation to self-monitoring.…”

Section: Adding a Curatorial Lensmentioning

confidence: 99%

Everyday curation? Attending to data, records and record keeping in the practices of self-monitoring

et al. 2020

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This paper is concerned with everyday data practices, considering how people record data produced through self-monitoring. The analysis unpacks the relationships between taking a measure, and making and reviewing records. The paper is based on an interview study with people who monitor their blood pressure and/or body mass index/weight. Animated by discussions of ‘data power’ which are, in part, predicated on the flow and aggregation of data, we aim to extend important work concerning the everyday constitution of digital data. In the paper, we adopt and develop the idea of curation as a theory of attention. We introduce the idea of discerning work to characterise the skilful judgements people make about which readings they record, how readings are presented, and about the records they retain and those they discard. We suggest self-monitoring produces partial data, both in the sense that it embodies these judgements, and also because monitoring might be conducted intermittently. We also extend previous analyses by exploring the broad set of materials, digital and analogue, networked and not networked, involved in record keeping to consider the different ways these contributed to regulating attention to self-monitoring. By paying attention to which data is recorded and the occasions when data is not recorded, as well as the ways data is recorded, the research provides specificity to the different ways in which self-monitoring data may or may not flow or contribute to big data sets. We argue that ultimately our analysis contributes to nuancing our understanding of ‘data power’.

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Clinical self-tracking and monitoring technologies: negotiations in the ICT-mediated patient–provider relationship

Cited by 23 publications

References 0 publications

Stratified users and technologies of empowerment: theorising social inequalities in the use and perception of diabetes self‐management technologies

Stratified users and technologies of empowerment: theorising social inequalities in the use and perception of diabetes self‐management technologies

Techno-social reconfigurations in diabetes (self-) care

Everyday curation? Attending to data, records and record keeping in the practices of self-monitoring

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