Involving Patients with E-health – The Dialogic Dynamics of Information Filtration Work

Abstract

With e-health technologies, patients are invited as co-producers of data and information. The invitation sparks new expectations, yet often results in disappointments. With persistent ambitions to involve patients by means of e-health, it seems crucial to gain a better understanding of the nature, sources and workings of the expectations that come with being invited. I analyse the use of an e-health system for ICD-patients, focusing on how patients sought to serve as information providers. Continuing STS-research on invisible work in technology use, I show how using the system involved complex work of filtering information. I argue that this ‘filtration work’ was inherently dialogic, that is, characterized by receiver-orientation and the anticipation of response and guided by different communicative projects. For the patients, filtration work thus, first of all, required certain skills and knowledge about the infrastructure of care. Secondly, it entailed the expectation that the system?" for better or for worse?"would facilitate not just information sharing but open up a dialogue, which glaringly contrasted with the clinicians’ expectations of being able to better manage dialogue. I suggest that understanding the dialogic dynamics and ‘overflows’ of information filtration work can help unpack the challenges of facilitating (patient) participation with e-health and other filtration devices.