scholarly journals Of Blooming Flowers and Multiple Sockets: The Role of Metaphors in the Politics of Infrastructural Work

2016 ◽  
Vol 29 (3) ◽  
pp. 68-87
Author(s):  
Marcello Aspria ◽  
Marleen de Mul ◽  
Samantha Adams ◽  
Roland Bal

We explore the role of two metaphors for innovation and infrastructure integration in the development of a regional patient portal. Our premise is that metaphors have real consequences for agenda setting and decision-making; we view them as operationalizations of sociotechnical imaginaries. Drawing on our formative study of the portal project, we focus on the generative character of metaphors and argue that they are constitutive elements of information infrastructures. While the two metaphors in our study helped to make imaginaries of ‘integrated’ and ‘personalized’ health care more definite, cognizable, and classifiable, they also concealed the politics of infrastructural work. We argue that the act of ‘spelling out’ metaphors can open up a space for new imaginaries and alternative strategies. With this study we aim to contribute to existing knowledge about infrastructural work, and to renew the interest among STS scholars for the role of discursive attributes in information infrastructures.Keywords: metaphors, e-Health, information infrastructures

2019 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz

BACKGROUND Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. OBJECTIVE This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. METHODS We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample <italic>t</italic> tests. RESULTS Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). CONCLUSIONS The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.


2011 ◽  
pp. 1030-1046
Author(s):  
Rakesh Biswas ◽  
Joachim Sturmberg ◽  
Carmel M. Martin ◽  
A. U. Jai Ganesh ◽  
Shashikiran Umakanth ◽  
...  

This chapter discusses the role of e-health in creating persistent clinical encounters to extend the scope of health care beyond its conventional boundaries utilizing social networking technology to create what the authors’ term ‘user driven health care’. It points out the necessity to direct the development of health information systems such that they serve as important vehicles between patient and health professional users in communicating and sharing information other than their role in automated alerts and responses. A project is described that plans to create a system of online sharing of health information in a user driven manner that necessarily becomes persistent due to being stored in electronic health records.


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