Social shaping of technology, the concept of appropriation and the future of ICT in Health Care

Last Monday, 22^nd of March, we had a very interesting talk Cristiano Storni, how is undertaking a post-doc at the Interaction Design Centre (ICD) in University of Limerick. He was speaking to us about the Health Care Sector, which specifically focused on patients with chronic illnesses, particularly diabetics. He spoke at the start of the talk about the Social Shaping of Technology Theory and its application in the Health Care Industry. He spoke about the current hierarchical system that is present in the Health Care system, where specialised doctors and surgeons are seen at the top level and patients are seen at the bottom level of the system. This is dangerous as it creates conflict between chronically sick people and doctors. The system currently being employed by some medical practices, where doctors give orders to patients (traditional practice) must stop as patient and doctor must work in together.

He also spoke about breaking the traditional way of looking at the medical profession, and stated that we have to stop looking at the traditional ways of looking at the body as a machine, at patients as a problems to fix, at data and trying to solve it in a one dimensional way. We must take a more holistic approach, not only examine the disease but rather try and understand the patient. Changes need to be made in the way the practice views things, from the perspective of the patient rather than the disease.

There has been a dehumanising approach when visiting the doctors, where patients are seen as data and doctors are seen as dispensers. In this culture, many people will not ask their doctors on how to deal with the disease, but will turn to other suffers of the ailment, support groups etc..

For product design, it poses huge challenges for the designer, as it is not about decreasing the buttons or making it more usable. It goes deeper than that, in understand and making something that first and foremost understands the patient, their requirements, their wants, while also delivering the correct medicine to correct the disease.

This topic is of great interest to be and it resonated some of the aspects I spoke about in my seminar on the 1^st of March. The current system, as Cristiano highlighted, is not working for those suffering with chronic patient illnesses. In my life personally, this is very true for my uncle who suffers for the past 10 years with diabetes, hypothyroidism and high blood pressure. Because of his age, family history and the degree of severity, he visits the doctors surgery once a month for a check up. He has attended support groups for these illnesses, all of which he sourced himself. He has never once been asked or would feel comfortable discussing how he is being affected by taking 4 tablets per day, how he had to change his lifestyle, his eating habits etc. with his doctor. He is so disconnected from the patient doctor relationship that he never requests to see the same doctor during his monthly visits. When I asked him recently about his view on doctors he told me that “I go in, get my check up done, get my prescription and goes away and that’s the way I want it”. He said that he is not there to chat or get to know the doctor; he is not there on a personal capacity

I really became interested in this topic discussed but questioned how achievable this would be in the “real world”. I did a bit of searching on the topic and found anlink to Experience based design approach which is centred around designing a better healthcare services. This system is being developed by the NHS Institute for Innovation and Improvement as a way of improving the health care service by making patients feel safer, happier and more valued and making doctors and nurses more positive, rewarded and empowered.
But I really question how easy this is to employ, particularly in this economic climate where doctors and nurses hours are being cut, money is not being provided to expand and redevelop hospitals and where there is reduced confidence in the health care sector. Another factor that needs to be considered is the different approaches and personalities of doctors and patients and how easy it could be change their behaviour. And how can this change be achieved? Where does it start? Ideally I think if it could be achieved it would of great benefit to patient and doctor by saving time and saving lives but I question how this could be achieved