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ISA paper on digital health platforms, Toronto July 2018

2 August 2018

Last week, Ros presented findings from the first phase of our research at the International Sociological Association (ISA) quadrennial congress in Toronto, Canada. The paper was entitled 'Data Mining in the Cloud? Revisiting the Sociology of Digital Health Platforms'.

In the presentation, we explored data including interviews with commercial stakeholders involved in the production of digital health platforms, alongside analysis of a variety of data from commercial websites, company reports, press releases and news media. The paper argues that it is useful to draw on theory from Science and Technology Studies (STS), particularly theories of infrastructure (from writers like Leigh Star) to explore the wider infrastructures that comprise digital health platforms.

The paper was one of six presented in a session organised by Ben Marent and Flis Henwood from the University of Brighton, which invited contributions focusing on the development of a “Sociological Critique of Digital Health”. Other speakers included Fiona Stevenson, exploring the discussion of internet-sourced information in GP consultations, China Mills who presented her work with Eva Hilberg on the differing imaginaries of mental health and medicine that are enacted in the mental health diagnostic algorithms of the WHO-developed app, mhGAP. Read their abstracts, along with those of the others speakers on the session webpage.

After presenting the papers, we had a rich group discussion about the diverse empirical spaces of interest to sociologists looking at digital health, from digital patient experience (covered in the work of Caroline Sanders et al, who presented a paper on the possibilities and limits of digitally collection patient feedback on their experience of healthcare provision), to the challenges of locating health information online in a post-truth era (as Václav Štětka et al, whose paper presented analysis of social media data concerning the MMR vaccine debate on Facebook).

Abstract

Recent work in digital sociology has shown interest in health platforms as site for intensification of government and value creation. Work by Srnicek (2016) on ‘platform capitalism’ proposes a new typology of online platforms, and argues that they exist to gather data as the new raw material of global capitalism.

In empirical studies of the largest health platforms, especially those focussed on research which have captured most sociological attention, researchers have described the promissory discourses that encourage ordinary people to store and share personal health data, including that produced by self-tracking (eg, Sharon 2016, Van Dijck and Poell 2016).

This paper draws on analysis of a more extended set of platforms using interviews with commercial and policy actors, ethnographic observations of digital health events and ‘walkthroughs’ (Light 2016) of devices, to examine the multiple logics shaping their development – beyond the search for data. Health monitoring helps companies embed their products and services in everyday life producing engagement from ‘activated’ consumers.

At the same time, platforms appeal to governments/health care providers hoping that digital solutions will reduce future spending. Seeking greater specificity around the different platforms and the markets in which they arise, and drawing on recent work in Science and Technology Studies, we suggest that health platforms participate in the negotiation of ‘care’ and care needs at domestic, local and national levels, despite their apparent global reach. The paper argues for an appreciation of the heterogeneous logics and forms contained within commercial attempts to establish and expand digital health platforms as emerging information infrastructures.