Platform encounters: A study of digitised patient follow‐up in HIV care

Abstract

Digital technologies are increasingly embedded in clinical encounters, reconfiguring the basis on which health care is delivered. Thereby, the delivery of care shifts from territorial locations in clinics and temporal modes of co‐presence towards digital platforms. Drawing on a sociotechnical evaluation of digitised patient follow‐up in HIV care, this paper argues that the forms of interactivity practised in platform encounters cannot be adequately understood through traditional interaction frameworks such as Erving Goffman's interaction order. To conceptualise the new informational space and temporal mode of ‘response presence’ within which platform encounters are conducted, the paper draws on theoretical advances made by Karin Knorr Cetina who further developed Goffman's interaction order to describe interactions augmented by ‘scopic media’. A comprehensive framework is presented to elaborate the distinct qualities of interactions occurring in face‐to‐face, tele‐interaction and platform encounters and to analyse their affordances based on doctor and patient experiences. This framework is intended to stimulate further research on how new interactional forms between doctors and patients will reconfigure roles and responsibilities as well as wider structures of digital society. Furthermore, it can also support practical guidance of when and how different forms of clinical encounters may be integrated in care pathways.

The cost of care for people living with stable HIV in Croatia and the efficiency of EmERGE

“…Apart from changing the routine measurements of CD4 counts in stable PLHIV, the introduction of the Pathway also changed the way staff interacted with participants, which may have also resulted in cost changes. This was unfortunately not quantified during the study, but medical staff indicated that they were able to spend more time on PLHIV with more complex disease ( 32 ).…”

“…The Pathway was well received by users. When asked, most participants preferred to use the App at home and away from their work ( 32 ). This reduced the risk of disclosure and empowered them.…”

“…Some privacy concerns remained, especially among black and migrant women, but most agreed that the Pathway provided greater privacy. Some remained anxious that the App could be seen on the phone by friends or family members, who could then ask questions ( 32 ).…”

“…The App provided the participants with autonomy, as they depended less on visiting the clinic for routine consultations. Most participants found the test results function the most important; participants, including women and migrants, enjoyed having the EmERGE mHealth App and following the new Care Pathway ( 32 ).…”

Understanding advances in treatment and care of people living with and alongside HIV: Contributions from the Sociology of Health and Illness

“…Our fifth paper, in this May issue, is Marent and Henwood's (2021) Platform encounters: A study of digitised patient follow‐up in HIV care , which keeps the focus on communication between HIV‐positive patients and their clinicians. As the authors note, service pressures from increasing populations with HIV and financial constraints have led healthcare providers, technology developers and other stakeholders to design and implement new digital platforms that can be offered alongside more traditional face‐to‐face consultations.…”