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Societies
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Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies
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Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies

A special issue of Societies (ISSN 2075-4698).

Deadline for manuscript submissions: closed (30 March 2014) | Viewed by 166327

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Prof. Dr. Deborah Lupton

grade E-Mail Website
Guest Editor
Social Research in Health and Social Policy Research Centre, Kensington 2033, Australia
Interests: digital sociology; sociology of health and illness; the body; risk; critical studies of digital health; parenting cultures; obesity politics

Special Issue Information

Dear Colleagues,

Digital health technologies have received a high level of attention of late in the medical and public health literature and popular media. Much of this discussion takes an uncritical techno-utopian stance, representing these technologies as offering great potential for reducing healthcare costs and facilitating ‘patient engagement’ by encouraging lay people to take personal responsibility for their health and medical care and to participate in self-monitoring, self-care and self-tracking activities by ‘digitising’ themselves.

This Special Issue will be devoted to articles that take a more critical approach to analysing digital health technologies, drawing on social and cultural theoretical perspectives from such disciplines as sociology, anthropology, critical psychology, science and technology studies, cultural studies, cultural geography, social computing, media studies and communication. Papers are invited that address any type of digital health technology, including but not limited to telehealth, telemedicine, wearable computing, self-tracking practices (‘the quantified self’), health promotion using digital technologies, digital epidemiology and public health surveillance, digitised medical records, digitised personalised medicine and social media platforms for patients (such as PatientsLikeMe and Patient Opinion).

Professor Deborah Lupton
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Societies is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital health
  • digital technologies
  • the body
  • health and illness
  • self-tracking
  • telemedicine
  • telehealth
  • digital epidemiology
  • public health surveillance
  • social media

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Published Papers (10 papers)

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Editorial

Jump to: Research

6 pages, 50 KiB  
Editorial
Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies
by Deborah Lupton
Societies 2014, 4(4), 706-711; https://doi.org/10.3390/soc4040706 - 8 Dec 2014
Cited by 64 | Viewed by 13879
Abstract
This editorial presents an overview of digital health technologies, discusses previous research and introduces the contributions to the special issue “Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies”. It is argued that thus far, few critical analyses of digital health technologies have been [...] Read more.
This editorial presents an overview of digital health technologies, discusses previous research and introduces the contributions to the special issue “Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies”. It is argued that thus far, few critical analyses of digital health technologies have been published in the social science literature, particularly in relation to the newest technologies. While the articles collected here in this special issue have gone some way in offering a critical response to digital health technologies, they represent only a beginning. Many more compelling topics remain to be investigated. The editorial ends with outlining directions for future research in this area. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)

Research

Jump to: Editorial

17 pages, 145 KiB  
Article
Apps as Artefacts: Towards a Critical Perspective on Mobile Health and Medical Apps
by Deborah Lupton
Societies 2014, 4(4), 606-622; https://doi.org/10.3390/soc4040606 - 29 Oct 2014
Cited by 187 | Viewed by 30925
Abstract
Although over 100,000 health and medical mobile apps have been placed on the market, few critical social analyses have been yet undertaken of the role of these apps in healthcare, preventive health and health promotion. In this article I present an argument for [...] Read more.
Although over 100,000 health and medical mobile apps have been placed on the market, few critical social analyses have been yet undertaken of the role of these apps in healthcare, preventive health and health promotion. In this article I present an argument for approaching the study of mobile apps as sociocultural artefacts, focusing specifically on those that have been developed on health and medical topics. This perspective acknowledges that apps are digital objects that are the products of human decision-making, underpinned by tacit assumptions, norms and discourses already circulating in the social and cultural contexts in which they are generated, marketed and used. First, I provide the context, by discussing the gradual digitisation of health and medical information since the advent of the Internet and the emergence of health and medical apps as one of the latest developments. Second, I discuss how a critical perspective may be employed to analyse the social, cultural and political dimensions of health and medical apps. Finally I illustrate how such an approach may be applied by giving a case study of an analysis of the top 10 ranked health and medical apps on the Apple App Store on one day, outlining some major themes and discourses that emerge. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
17 pages, 205 KiB  
Article
Exercise as Labour: Quantified Self and the Transformation of Exercise into Labour
by Chris Till
Societies 2014, 4(3), 446-462; https://doi.org/10.3390/soc4030446 - 28 Aug 2014
Cited by 146 | Viewed by 24593
Abstract
The recent increase in the use of digital self-tracking devices has given rise to a range of relations to the self often discussed as quantified self (QS). In popular and academic discourse, this development has been discussed variously as a form of narcissistic [...] Read more.
The recent increase in the use of digital self-tracking devices has given rise to a range of relations to the self often discussed as quantified self (QS). In popular and academic discourse, this development has been discussed variously as a form of narcissistic self-involvement, an advanced expression of panoptical self-surveillance and a potential new dawn for e-health. This article proposes a previously un-theorised consequence of this large-scale observation and analysis of human behaviour; that exercise activity is in the process of being reconfigured as labour. QS will be briefly introduced, and reflected on, subsequently considering some of its key aspects in relation to how these have so far been interpreted and analysed in academic literature. Secondly, the analysis of scholars of “digital labour” and “immaterial labour” will be considered, which will be discussed in relation to what its analysis of the transformations of work in contemporary advanced capitalism can offer to an interpretation of the promotion and management of the self-tracking of exercise activities. Building on this analysis, it will be proposed that a thermodynamic model of the exploitation of potential energy underlies the interest that corporations have shown in self-tracking and that “gamification” and the promotion of an entrepreneurial selfhood is the ideological frame that informs the strategy through which labour value is extracted without payment. Finally, the potential theoretical and political consequences of these insights will be considered. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
18 pages, 205 KiB  
Article
Managers’ Identification with and Adoption of Telehealthcare
by Jane Hendy, Theopisti Chrysanthaki and James Barlow
Societies 2014, 4(3), 428-445; https://doi.org/10.3390/soc4030428 - 14 Aug 2014
Cited by 2 | Viewed by 5703
Abstract
This paper presents managerial attempts at implementing telehealthcare. Our longitudinal, ethnographic case studies document both successful and failed implementations across five health and social care organisations in England. We draw on theories of organisational identity, sensemaking and sensegiving to highlight how managerial organisational [...] Read more.
This paper presents managerial attempts at implementing telehealthcare. Our longitudinal, ethnographic case studies document both successful and failed implementations across five health and social care organisations in England. We draw on theories of organisational identity, sensemaking and sensegiving to highlight how managerial organisational identities can inhibit the uptake of digital health technologies. Managers who strongly identified with their current role at work felt threatened by the intended change; a telehealthcare mode of care delivery. When a strongly identified workforce agrees with this assessment, managerial and employee sensemaking and sensegiving coalesce, forming a united front of resistance that prevents further adoption of the innovation. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
15 pages, 138 KiB  
Article
Detecting the Visible: The Discursive Construction of Health Threats in a Syndromic Surveillance System Design
by Baki Cakici and Pedro Sanches
Societies 2014, 4(3), 399-413; https://doi.org/10.3390/soc4030399 - 28 Jul 2014
Cited by 10 | Viewed by 5027
Abstract
Information and communication technologies are not value-neutral tools that reflect reality; they privilege some forms of action, and they limit others. We analyze reports describing the design, development, testing and evaluation of a European Commission co-funded syndromic surveillance project called SIDARTHa (System for [...] Read more.
Information and communication technologies are not value-neutral tools that reflect reality; they privilege some forms of action, and they limit others. We analyze reports describing the design, development, testing and evaluation of a European Commission co-funded syndromic surveillance project called SIDARTHa (System for Information on Detection and Analysis of Risks and Threats to Health). We show that the reports construct the concept of a health threat as a sudden, unexpected event with the potential to cause severe harm and one that requires a public health response aided by surveillance. Based on our analysis, we state that when creating surveillance technologies, design choices have consequences for what can be seen and for what remains invisible. Finally, we argue that syndromic surveillance discourse privileges expertise in developing, maintaining and using software within public health practice, and it prioritizes standardized and transportable knowledge over local and context-dependent knowledge. We conclude that syndromic surveillance contributes to a shift in broader public health practice, with consequences for fairness if design choices and prioritizations remain invisible and unchallenged. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
21 pages, 526 KiB  
Article
“Maternal Devices”, Social Media and the Self-Management of Pregnancy, Mothering and Child Health
by Sophia Alice Johnson
Societies 2014, 4(2), 330-350; https://doi.org/10.3390/soc4020330 - 13 Jun 2014
Cited by 110 | Viewed by 21776
Abstract
In recent years the smartphone has revolutionised lay people’s management of health and illness, particularly in regards to pregnancy and parenting. This article analyses smartphone applications, or apps, and social media platforms as mediating technologies which act as performative devices. These devices encourage [...] Read more.
In recent years the smartphone has revolutionised lay people’s management of health and illness, particularly in regards to pregnancy and parenting. This article analyses smartphone applications, or apps, and social media platforms as mediating technologies which act as performative devices. These devices encourage particular enactments of subjectivity and technologies of the self which combine the expert patient ideal with ideologies of mothering. Some apps and social media can be disciplinary and invoke biological responsibility in various ways including the monitoring of specific behaviours via “push responsibilisation”. Apps claim to allow for greater convenience, connectivity, flexibility, efficiency, and what will be characterised in this article as the “tidbitisation” of information. This article suggests the ways in which health-conscious pregnant or maternal subjects are likely to view apps and social media sites as a means to improve and monitor their pregnancies, health, and their children’s development and health. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
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14 pages, 209 KiB  
Article
Practicing Patienthood Online: Social Media, Chronic Illness, and Lay Expertise
by Collette Sosnowy
Societies 2014, 4(2), 316-329; https://doi.org/10.3390/soc4020316 - 13 Jun 2014
Cited by 34 | Viewed by 9927
Abstract
The use of digital technologies and social media by people with serious illness to find, share, and create health information is much celebrated but rarely critiqued. Proponents laud “Health 2.0” as transforming health care practice and empowering patients. Critics, however, argue that a [...] Read more.
The use of digital technologies and social media by people with serious illness to find, share, and create health information is much celebrated but rarely critiqued. Proponents laud “Health 2.0” as transforming health care practice and empowering patients. Critics, however, argue that a discourse of developing lay expertise online masks the disciplinary practices of the neoliberal state’s emphasis on individual responsibility. Notably, the perspectives of people who are engaging with social media related to their health and illness are under-represented in this debate. This research examines the experiences and perspectives of women who blog about their lives with Multiple Sclerosis in order to situate them in the context of these conflicting ideologies. Methods consisted of an ethnographic content analysis (N = 40), an online survey (n = 20), and an online discussion forum (n = 9). Findings revealed that blogging is neither inherently empowering nor inevitably disciplinary. Rather, it simultaneously offers opportunities for patients to gain medical knowledge and resist medical patriarchy, as well as compounds expectations placed upon patients to assume greater responsibility for managing their care. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
20 pages, 239 KiB  
Article
Understanding Digital Health as Public Pedagogy: A Critical Framework
by Emma Rich and Andy Miah
Societies 2014, 4(2), 296-315; https://doi.org/10.3390/soc4020296 - 10 Jun 2014
Cited by 111 | Viewed by 18133
Abstract
This paper argues on behalf of a public pedagogy approach to developing a critical understanding of digital health technologies. It begins by appraising the hitherto polarised articulations of digital innovation as either techno-utopian or techno-dystopian, examining these expectations of technology and considering the [...] Read more.
This paper argues on behalf of a public pedagogy approach to developing a critical understanding of digital health technologies. It begins by appraising the hitherto polarised articulations of digital innovation as either techno-utopian or techno-dystopian, examining these expectations of technology and considering the tensions between them. It subsequently outlines how a public pedagogy approach can help mediate between these views, offering a more contextualised, socio-political perspective of mHealth. This approach teases out the nuances of digital health by engaging with the complexities of embodied learning. Furthermore, it urges caution against viewing these pedagogical forces as one of transference, or simple governance. To this end, we therefore contextualise our critique of digital health, within an attempt to reconstitute an understanding of public pedagogies of technology. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
9 pages, 262 KiB  
Article
The Touch Pad Body: A Generative Transcultural Digital Device Interrupting Received Ideas and Practices in Aboriginal Health
by Michael Christie and Helen Verran
Societies 2014, 4(2), 256-264; https://doi.org/10.3390/soc4020256 - 27 May 2014
Cited by 13 | Viewed by 8437
Abstract
Yolŋu Aboriginal understandings of the body, health, life and sickness, and roles their ancestral epistemologies and knowledge practices play in making agreement have seldom been taken seriously in the biomedical world. In this paper, we describe how insights developed in three different cross-cultural [...] Read more.
Yolŋu Aboriginal understandings of the body, health, life and sickness, and roles their ancestral epistemologies and knowledge practices play in making agreement have seldom been taken seriously in the biomedical world. In this paper, we describe how insights developed in three different cross-cultural collaborative transdisciplinary research projects led to the design of a digital device aimed at intervening in communicative practices around body, health, life and sickness, interrupting the received practices and assumptions on both sides of the practitioner-client divide. The interrupting device slows down and opens up communication practices potentially leading to mutual understanding, collective agreement making, and bottom-up changes in remote Aboriginal health policy and practice. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
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17 pages, 299 KiB  
Article
Visualized and Interacted Life: Personal Analytics and Engagements with Data Doubles
by Minna Ruckenstein
Societies 2014, 4(1), 68-84; https://doi.org/10.3390/soc4010068 - 18 Feb 2014
Cited by 269 | Viewed by 26024
Abstract
A field of personal analytics has emerged around self-monitoring practices, which includes the visualization and interpretation of the data produced. This paper explores personal analytics from the perspective of self-optimization, arguing that the ways in which people confront and engage with visualized personal [...] Read more.
A field of personal analytics has emerged around self-monitoring practices, which includes the visualization and interpretation of the data produced. This paper explores personal analytics from the perspective of self-optimization, arguing that the ways in which people confront and engage with visualized personal data are as significant as the technology itself. The paper leans on the concept of the “data double”: the conversion of human bodies and minds into data flows that can be figuratively reassembled for the purposes of personal reflection and interaction. Based on an empirical study focusing on heart-rate variability measurement, the discussion underlines that a distanced theorizing of personal analytics is not sufficient if one wants to capture affective encounters between humans and their data doubles. Research outcomes suggest that these explanations can produce permanence and stability while also profoundly changing ways in which people reflect on themselves, on others and on their daily lives. Full article
(This article belongs to the Special Issue Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies)
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