I have collected all the presentations in the same post to summarise the information. Thank you very much indeed to all the participants for these inspiring and wonderful days. I would like also to express my gratitude to Internet Interdisciplinary Institute (IN3) for its support.

Workshop: Innovative health technologies: health systems in transition
Supported by: Internet Interdisciplinary Institute (IN3)
Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary
Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and
Technology Studies Unit, Department of Sociology, University of York)
Data: 26th and 27th November
Place: Meeting room -1A , UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3,
08860 Castelldefels (Barcelona)

26th November

• Andrew Webster - Innovation in health: a social science perspective
• Michael Morrison - ‘Measuring Innovation - a brief introduction to
  the REMEDiE project’
• Laura Machin - Cord blood banking: initial observations
• Mariann Hardey - Private medical care and the Web
• Eulàlia Hernádez - Providing resources for caregivers trough the
  Internet.
• Flis Henwood - ‘Health-e discourse? Engaging the community in ehealth
  developments for obesity self-management’
• Sue Ziebland - Knowledge is Power? The role of health information

27th November

• Imma Grau - Studying Virtual Communities for patients with chronic
  illnesses, in Forumclinic
• Daniel López - Reframing telecare: an ethical discussion concerning
  ageing-in-place, independence and care.
• Darren Reed - Performativity of Data
• Michael Hardey - Consuming professions: user-review websites and health services.
• Francisco Lupiáñez-Villanueva and Michael Hardey - Health professionals, the Internet and Internet informed patients.

“Innovative health technologies: health systems in transition Workshop”

Supported by: Internet Interdisciplinary Institute (IN3)

Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and Technology Studies Unit, Department of Sociology, University of York)

Data: 27th November

Place: UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3, 08860 Castelldefels (Barcelona)

Daniel López presentation: Reframing telecare: an ethical discussion concerning ageing-in-place, independence and care.

Telecare has been presented by policy-makers and developers as a simple and cheap technology that enable ageing-in-place with autonomy. The aim of this presentation is to critically discuss what ageing-in-place with autonomy mean for elderly people using telecare. According to some results from ethnography conducted 4 years ago in a catalan telecare service, there are different ways of being autonomous enacted and, given that, also different conceptions of the body and of living at home. By presenting these complexities we want to put forward several ethical questions concerning the current telecare developments. First of all, what new arrangements, practices, collectives and relationships of care arise with the implementation of telecare and smart home systems in care for older people? How do these arrangements shape existing care practices? What definitions of care, and good care, are implied and embodied in the new care arrangements? How do these built-in definitions and normativities differ from and change existing practice? What implications do they have for the meanings of place, distance and home in care? These questions, among other, are being discussed in a FP7 project currently carried out by different research teams in Barcelona, Lancaster, Amsterdam and Oslo and coordinated by Maggie Mort. So in order to conclude, I would like to present these questions and make some remarks based on some insights taken from the current fieldwork and from the former research projects.

Daniel López

Assistant Professor at the Universitat Oberta de Catalunya. Currently working on the implementation of new technologies in care settings like Home Telecare from an STS perspective. The main areas of interest are: a) the emergence of new spatialities and temporalities of care; b) the emergence of new practices of caring and security due to the increasing importance of technologies of accountability; and c) the enactment of hybrid forms of autonomy and independence. Currently involved in an FP7 project called “Ethical Frameworks for Telecare Technologies for older people at home (EFORTT) concerned with the implications of the introduction of remote care technologies worn, installed or embedded in the homes of older citizens/frail older people (see http://www.lancs.ac.uk/efortt/index.html) and also a project funded by the Ministerio called CONDEPCIU concerned with the techno-scientific controversies around the new Spanish care policies addressed to elderly/frail people.

I’m deligthed to announce the “Innovative health technologies: health systems in transition Workshop”

Supported by: Internet Interdisciplinary Institute (IN3)

Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and Technology Studies Unit, Department of Sociology, University of York)

Data: 26th and 27th November

Place: UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3, 08860 Castelldefels (Barcelona)

Description

Digital technologies and the Internet are increasingly changing how people understand their health, how health care is organised and delivered to patients and opening up new scientific approaches and innovations. For example, health care records are being digitised and made available though various devices to users in most nations with a centralised health care system. Developments in genetics, imaging technologies, cloning and stem cell research are changing how health is understood and the treatments available to individuals. Such changes in the organisation of health and medical knowledge are increasingly engaging with the public through information that is made available on the Internet.

The Internet is now a vast repository of information about health and well-being.  Supported by Web 2.0 resources, the Internet has increasingly included information about health, illness and lifestyles provided by individuals.  As more of the public become connected through computers and mobile devices new opportunities are created for the publication of health information and advice.  However, the diversity of health information raises questions about quality and the impact incorrect or poor information may have on individuals.  There is already evidence that the doctor-patient relationship is changing in the face of developments in Information and Communications Technologies.  In addition, while people are the advice people may choose to follow may not necessarily result in health behaviours.  For example, men defined as obese may share information available on the Internet to remain ‘big and fat’ despite medical advice to the contrary.

The desire to provide a seamless inter-agency service built around the needs of individual people (and more broadly clients and patients of national health and welfare services) is a common aspiration in most countries with a centralised welfare system.  Developments in Telecare have seen the growth of ‘smart homes’ that enable people to live safely at home through various monitoring and intervention systems.  Such monitoring devices are also being used by people in pursuit of healthy bodies through exercise.  The iPod or iPhone can, for example, be used to monitor running and other physical activity. These technologies raise questions to do with the privacy and ownership of information.  In other words information technology has become both directly and indirectly part of everyday life for many people and those who play a part in their lives.

In this broad context, the aim of this workshop is seeking to understand how, for whom and to what extend changes in the material conditions of health information and communication is transforming the generation of medical knowledge, the conception of health and the demand and provision of healthcare delivery.

To reach this aim, the workshop is organized in discussion sessions where social researchers will present their recent research results, methodologies and experiences with enough time for rich interaction among the participants.

Program

26th Thursday

10:00 – 10:15 Opening session
10:15 – 12:00 Presentations

• Andrew Webster - Innovation in health: a social science perspective
• Michael Morrison - ‘Measuring Innovation - a brief introduction to the REMEDiE project’
• Laura Machin - Cord blood banking: initial observations

12:00 – 12:15 Coffer-break
12:15 – 13:45 Presentations

• Mariann Hardey - Private medical care and the Web
• Eulàlia Hernádez - Providing resources for caregivers trough the Internet.

13:45 – 15:00 Lunch
15:00 – 16:45 Presentation

• Flis Henwood - ‘Health-e discourse? Engaging the community in e-health developments for obesity self-management’
• Sue Ziebland - Knowledge is Power? The role of health information

16:45 – 17:00 Coffer-break
17:00 – 17:30 Conclusions of the day

27th Friday

10:00 – 10:15 Opening session
10:15 – 12:00 Presentations

• Imma Grau - Studying Virtual Communities for patients with chronic illnesses, in Forumclinic
• Daniel López - Reframing telecare: an ethical discussion concerning ageing-in-place, independence and care.
• Darren Reed - Performativity of Data

12:00 – 12:15 Coffer-break
12:15 – 13:45 Presentation

• Michael Hardey - Consuming professions: user-review websites and health services
• Francisco Lupiáñez-Villanueva and Michael Hardey - Health professionals, the Internet and Internet informed patients

13:30 – 15:00 Lunch
15:00 – 16:00 Conclusions of the workshop

Thanks indeed to the participants, to IN3 for the support and to Laura Vidal for her wonderful organization work. See also information available at IN3.

On 23rd June I had the pleasure to present some of the results of our research in the Brown Bag Seminar Series at Science and Technology Studies Unit (SATSU) in the Department of Sociology at University of York where I’m as a visiting researcher.

I have to thanks all the people who were there for their questions and comments. Special thanks to Michael Hardey who helps me to improve the statistics labels. Now we have to keep working on some papers using these analysis.

From “Disconnected Citizen to “Networked Citizen”

From “Utilized ICT physicians” to “Integrated ICT Physicians”

Of course, any comment or suggestion will be very welcomed indeed

Lately I haven’t posted because I have been developing my thesis site to spread the results of the research. The site is in Spanish and the discussion will be in Spanish too. Here goes the video of my presentation (it’s also in Spanish if somebody likes to subtitle it, will be very welcome).

I’m sorry but I do not have enough time to translate the whole document, but I have started to write some papers in English so soon I’ll be sharing some parts of them for a kind of peer review taking into account the restrictions of the Journals.

This post will be for sure my longest post ever. I would like to share my thesis’s references. You could also find them at my personal references manager. Enjoy them!

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I would like to thank indeed Ruslan David, eHealthNews.EU Portal Administrator/Editor, for his help to disseminate the results of the research project E-Health and Society: An Empirical Study of Catalonia and also for his wonderful job as Editor of eHealthNews.EU - the First European eHealth News Portal.

Between 2005 and 2007 I worked in a research project titled Project Internet Catalunya - Technological Modernisation, Organisational Change and Service Delivery in the Catalan Public Health System (PIC Salut) directed by Prof. Castells and supported by Catalonia Government. I’m glad to announce that the English summary is already available: E-HEALTH AND SOCIETY: An Empirical Study of Catalonia (see Spanish version PIC Salud - Modernización tecnológica, cambio organizativo y servicio a los usuarios en el sistema de salud de Catalunya).

Summary

This study examines the health related uses of the Internet and information and communication technologies (ICTs) in Catalonia. It is a multilevel study that comprises the observation of the population at large, of health professionals, and of health care organizations, such as Primary Care and Hospitals.

It is based on 7,784 on-line interviews, and on 106 face to face interviews, as well as on extensive field work research and direct observation of health organizations in Barcelona, Vic, Sabadell, Palamós, and Tarragona. It was conducted between April 2005 and July 2007.

Conclusions

The different studies we have conducted show a generally positive feeling among health
care professionals, patients, and the population at large on the uses of Internet and ICTs in the health care processes. Furthermore, most professionals, doctors and nurses alike, are intensive Internet users at home. Patients are eager to consult health matters on the web.

Primary care centers and hospitals are also gradually using e-health management and service delivery systems, although the introduction of SAP-Health is still exceptional and the training of the personnel to use advanced health care systems is limited and critically perceived by the nurses and auxiliary personnel.

While the uses of Internet and Intranets for information are widespread, the uses for communication are very limited, with the exception of communication among physicians and among researchers. Patients are largely excluded from online interaction with health care professionals and their online support groups rarely receive permanent advice. While doctors are positive towards the health uses of the Internet, they distrust the use that patients could make of unguided information and prefer to maintain the traditional, personal interaction with their patients.

Thus, the uses of ICTs in the health system do not seem to yield significant increases in productivity, efficiency and quality because their introduction is rarely accompanied by the organizational, managerial, and cultural changes necessary to set up an interactive network at the heart of the health delivery system. ICTs are tools confined in specific functions, not a platform permeating the entire process of health delivery. Furthermore, the updating of the technological infrastructure of the health system would require considerable investment whose justification is not obvious in the absence of an organizational restructuring of the health care units, particularly of the large public hospitals.

Thus, cultural resistances and organizational routines present a major obstacle to the technological overhauling of the health care system, a project that appears to be indispensable to be able to simultaneously control health costs and improve health care quality.

Empirical data of chapter one and two and the results of another research project titled Citizens, Health and the Internet in Catalonia directed by Prof. Castells and based on a telephone survey (2,000 interviews) are the materials of my dissertation. So comments will be very welcome, specially those related to chapter one, chapter two and conclusions.

I have been studying some issues related with Innovation and with Telemedicine (if you follow the links you can see some references about them). In my case the key issue of both items is Information and Communication Technologies. To tackle the complex of these three concepts (Innovation, Telemedicine and ICT) I am following the Conceptual Model proposed by Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O (2004) Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 82(4):581–629

Abstract

This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.

In this article there is a very interesting figure (Figure 3. Conceptual Model for Considering the Determinants of Diffusion, Dissemination, and Implementation of Innovations in Health Service Delivery and Organization, Based on a Systematic Review of Empirical Research Studies) that shows the unifying conceptual model that they derived from their synthesis of theoretical and empirical findings

This conceptual model helps me to understand the relationship among Innovation, Telemedicine and ICT.