The Virtual Clinical Encounter

Emplacing Patient 2.0 in Emerging Care Infrastructures

Abstract

Telemedical devices such as the Patient Suitcase for treating chronic heart failure patients at home have been suggested to foster new and empowered patients. In this paper we analyse to what extent the ‘virtual clinical encounters’ taking place through the Patient Suitcase can be said to have such effects. We find that new skills are developed for all actors involved and that the work involved in the consultation is largely shared, but the normative claims of an independent and self-managing ‘Patient 2.0’ are difficult to support. Rather than seeing this as a dismissal of the transformative effects of telemedicine, we will suggest the need to decentre the attention from the individual and include the place-making efforts and effects involved in emplacing telemedicine in the home. The technology does not move work, knowledge and power from one actor in the clinical encounter to another – rather it redistributes and transforms it among more actors and more places demanding continuous sharing of work, development of new skills and involvement of distant and at times unruly actors. This may provide more sober accounts of the ways in which telemedicine has implications for the kinds of patients we may fi nd in contemporary healthcare and awareness of the more ambiguous relations between self, place and other in emerging care infrastructures.