The digitally engaged patient: Self-monitoring and self-care in the digital health era
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The phenomenon of digital health has emerged as a key dimension of contemporary healthcare policy and delivery in many countries. This review article focuses on one aspect of digital health discourses: the concept of patient engagement that encourages patients to take up the new digital media technologies to engage in self-monitoring and self-care, or what I term ‘the digitally engaged patient’. A critical approach is adopted to examine the sociocultural dimensions of eliciting patients to become ‘digitally engaged’ in their own medical care and preventive health efforts. It is argued that the techno-utopian discourses articulated in the mainstream healthcare policy literature concerning the possibilities and potentialities afforded by digital health technologies do not acknowledge the complexities and ambivalences that are part of using self-monitoring and self-care technologies for monitoring health and illness states, both for patients and for healthcare providers. These include the surveillance and disciplinary dimensions of using these technologies, the emotions and resistances they provoke, their contribution to the burden of self-care and the invisible work on the part of healthcare workers that they require to operate.
Keywordsdigital health digital media healthcare patient engagement telemedicine sociology
- Barello, S., Graffigna, G. and Vegni, E. (2012) Patient engagement as an emerging challenge for healthcare services: Mapping the literature, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504449/, accessed 16 March 2013.
- Cartwright, L. (1995) Screening the Body: Tracing Medicine’s Visual Culture. Minneapolis, MN: University of Minnesota Press.Google Scholar
- Gruman, G. (2013) Patient engagement will be a tough task for health tech, http://www.infoworld.com/d/consumerization-of-it/patient-engagement-will-be-tough-task-health-tech-214148?page=0,0&goback=.gde_2181454_member_222857159, accessed 16 March 2013.
- Hortensius, J., Kars, M., Wierenga, W., Kleefstra, N., Bilo, H. and van der Bijl, J. (2012) Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: A qualitative study BMC Public Health, http://www.biomedcentral.com/1471-2458/12/167, accessed 5 May 2013.
- Lupton, D. (1995) The Imperative of Health: Public Health and the Regulated Body. London: Sage.Google Scholar
- Lupton, D. (1996) Your life in their hands: Trust in the medical encounter. In: V. James and J. Gabe (eds.) Health and the Sociology of Emotions. Oxford: Blackwell Publishers, pp. 157–172.Google Scholar
- Lupton, D. (1997b) Foucault and the medicalisation critique. In: A. Petersen and R. Bunton (eds.) Foucault, Health and Medicine. London: Routledge, pp. 94–110.Google Scholar
- Lupton, D. (2013) Quantifying the body: Monitoring, performing and configuring health in the age of mHealth technologies. Critical Public Health, advance online publication 3rd May, doi:10.1080/09581596.2013.794931.Google Scholar
- Malykhina, E. (2013) Home is where the health is: Obamacare positions ‘telehealth’ tech as a remedy for chronic hospital readmissions, http://www.scientificamerican.com/article.cfm?id=affordable-care-act-technology, accessed 12 April 2013.
- Ringquist, L. (2013) Re-admissions: Is telehealth the answer?, http://www.bhmpc.com/2013/04/re-admissions-is-telehealth-the-answer/, accessed 14 April 2013.
- Salander, P. and Moynihan, C. (2010) Facilitating patients’ hope work through relationship: A critique of the discourse of autonomy. In: R. Harris, N. Wathen and S. Wyatt (eds.) Configuring Health Consumers: Health Work and the Imperative of Personal Responsibility. Houndmills, UK: Palgrave Macmillan, pp. 113–125.CrossRefGoogle Scholar
- Thielst, C.B. (2011) Social media: Ubiquitous community and patient engagement. Frontiers of Health Services Management 28 (2): 3.Google Scholar
- Topol, E. (2012) The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. New York: Basic Books.Google Scholar
- Waldby, C. (1997) The body and the digital archive: The Visible Human Project and the computerization of medicine. Health 1 (2): 227–243.Google Scholar