Abstract
Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a ‘revolution’? We will apply the work of Thomas Kuhn, Larry Laudan, Michel Foucault and other philosophers—which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach—to our analysis. Nowadays, the long-standing curative or reactive paradigm in medicine is facing a crisis due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm with an emphasis on preventive medicine. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. Our approach changes the focus from the technology itself toward the underlying paradigm shift in medicine. We will discuss the relevance of this approach by applying it to the surge in digital self-tracking through health apps and wearables: the recognition of the underlying paradigm shift leads to a more comprehensive understanding of self-tracking than a solely discovery-oriented or technology-focused view can provide.
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Notes
Although minor differences in interpretation exist, we will approach both terms (P4 and precision medicine) as synonyms. Comparable terms are stratified medicine and personalized medicine.
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Acknowledgements
We would like to thank Lisa Parker, Brenda Diergaarde, Jonathon Erlen, Katleen Gabriels and three anonymous reviewers for the useful insights they have provided.
Funding
Funding was provided by University of Gent, Department of Philosophy and Moral Sciences (Mobility Grant of the Faculty Research Fund).
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Moerenhout, T., Devisch, I. & Cornelis, G.C. E-health beyond technology: analyzing the paradigm shift that lies beneath. Med Health Care and Philos 21, 31–41 (2018). https://doi.org/10.1007/s11019-017-9780-3
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DOI: https://doi.org/10.1007/s11019-017-9780-3