Machine Work in Virtual Hospitals: Life Behind the Scenes in a Telemedicine Unit
Abstract
Implementing processes based on information and communication technologies produces profound transformations in health care systems. This paper explores the experience of technological development and support teams in a telemedicine unit in Chile. Informed by the sociologies of translation and the invisible, I propose understanding the machine work that unfolds on this site in terms of forms of machination. These involve translating and aligning the interests of actors that are both external and internal to the health service. On the internal front, machine work entails sensory and data work, the latter comprising both the articulation of tasks and the care of patients. Addressing the different dimensions allows bringing to light the complexity of the tasks involved and the mechanisms that make them go mainly behind the scenes.
Keywords
Sociology of change, Health services, Telematics, Informatics and development, DatabasesReferences
Aas, I. H. Monrad (2007). The organizational challenge for health care: From telemedicine and e-health. Arbeidsforsckningsinstituttet. https://doi.org/10.7577/afi/fou/2007/6
Angrosino, Michael V. (2012). Etnografía y observación participante en Investigación Cualitativa (T. del Amo & C. Blanco, Trads.). Morata.
Berg, Marc (1999). Accumulating and Coordinating: Occasions for Information Technologies in Medical Work. Computer Supported Cooperative Work (CSCW), 8(4), 373-401. https://doi.org/10.1023/A:1008757115404
Bossen, Claus; Pine, Kathleen H.; Cabitza, Federico; Ellingsen, Gunnar & Piras, Enrico Maria (2019). Data work in healthcare: An Introduction. Health Informatics Journal, 25(3), 465-474. https://doi.org/10.1177/1460458219864730
Bowker, Geoffrey & Star, Susan Leigh (1999). Sorting Things Out: Classification and Its Consequences. MIT Press.
Braithwaite, Jeffrey; Vining, Ross F. & Lazarus, Leslie (1994). The boundaryless hospital. Australian and New Zealand Journal of Medicine, 24(5), 565-571. https://doi.org/10.1111/j.1445-5994.1994.tb01759.x
Callon, Michel (1986). Some elements of a sociology of translation: Domestication of the scallops and the fishermen of St Brieux Bay. En John Law (Ed.), Power, Action and Belief: A new sociology of Knowledge? (pp. 196-229). Routledge.
Callon, Michel (1987/2012). Society in the Making: The Study of Technology as a Tool for Sociological Analysis. En Wiebe E. Bijker, Thomas P. Hughes & Trevor Pinch (Eds.), The social construction of technological systems: New directions in the sociology and history of technology (Anniversary Edition, pp. 77-97). The MIT Press.
Carvajal, Yuri; González, Ingrid & Pacheco, Jorge (2013). Francisco Albornoz o moviendo la prodigiosa red pública en las proximidades de C. Rev Chil Salud Pública, 17(2), 147-150.
Castillo-Sepúlveda, Jorge; Espejo, Marjorie; Tapia, Jorge; Catalán, Miguel; Toro, José & Gálvez, Mariana (2017). Tecnologías, episteme y subjetivación en un régimen de garantías en salud. Psicoperspectivas. Individuo y Sociedad, 16(3), 6-16.
Denis, Jérôme & Pontille, David (2012). Workers of writing, Materials of information. Revue d’anthropologie des connaissances, 6(1), a-s.
Gattini, Cesar (2018). El Sistema de Salud en Chile. Observatorio Chileno de Salud Pública. https://www.ochisap.cl/wp-content/uploads/2022/04/Sistema_Salud_Chile_Gattini_2018.pdf
Gold, Raymond L. (1958). Roles in Sociological Field Observations. Social Forces, 36(3), 217-223. https://doi.org/10.2307/2573808
Hatton, Erin (2017). Mechanisms of invisibility: Rethinking the concept of invisible work. Work, Employment and Society, 31(2), 336-351. https://doi.org/10.1177/0950017016674894
Latour, Bruno (1987). Science in Action: How to Follow Scientists and Engineers Through Society. Harvard University Press.
Latour, Bruno (1991/2007). Nunca fuimos modernos: Ensayos de antropología simétrica (V. Goldstein, Trad.). Siglo Veintiuno.
Latour, Bruno (1999/2001). La esperanza de Pandora: Ensayos sobre la realidad de los estudios de la ciencia. Gedisa.
Latour, Bruno & Woolgar, Steve (1986). Laboratory Life: The Construction of Scientific Facts. Duke University Press.
López Gómez, Daniel; Callén, Blanca; Domènech, Miquel & Tirado, Francisco (2010). How to become a Guardian Angel. Providing safety in a Home Telecare Service. En Annemarie Mol, Ingunn Moser & Jeannette Pols (Eds.), Care in Practice. On Tinkering in Clinics, Homes and Farms (pp. 71-90). Transcript Verlag.
Lupton, Deborah (2013). The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory & Health, 11(3), 256-270.
Lupton, Deborah & Maslen, Sarah (2017). Telemedicine and the senses: A review. Sociology of Health & Illness, 39(8), 1557-1571. https://doi.org/10.1111/1467-9566.12617
May, Carl; Finch, Tracy; Mair, Frances & Mort, Maggie (2005). Towards a wireless patient: Chronic illness, scarce care and technological innovation in the United Kingdom. Social Science & Medicine, 61(7), 1485-1494.
Millerand, Florence (2012). La science en réseau: Les gestionnaires d’information «invisibles» dans la production d’une base de données scientifiques. Revue d’anthropologie Des Connaissances, 6(1), 163-190. https://doi.org/10.3917/rac.015.0201
Mol, Annemarie (2006/2008). The Logic of Care: Health and the problem of patient choice. Routledge.
Mort, Maggie; May, Carl R. & Williams, Tracy (2003). Remote Doctors and Absent Patients: Acting at a Distance in Telemedicine? Science, Technology, & Human Values, 28(2), 274-295.
Oudshoorn, Nelly (2011/2016). Telecare technologies and the transformation of healthcare (2.a ed.). Palgrave Macmillan.
Pols, Jeannette (2012). Care at a distance: On the closeness of technology. Amsterdam University Press.
Sayago, Sebastián (2014). El análisis del discurso como técnica de investigación cualitativa y cuantitativa en las ciencias sociales. Cinta de moebio, 49, 1-10. https://doi.org/10.4067/S0717-554X2014000100001
Shapin, Steven (1989). The Invisible Technician. American Scientist, 77(6), 554-563.
Servicio de Salud Talcahuano [SST] (2016). Población Beneficiaria (FONASA) 2016 Servicio de Salud Talcahuano. Ministerio de Salud. https://sstalcahuano.cl/wp-content/uploads/2019/08/POBLACION-BENEFICIARIA.pdf
Star, Susan Leigh (1991). The Sociology of the Invisible: The Primacy of Work in the Writings of Anselm Strauss. En David R. Maines (Ed.), Social Organization and Social Process: Essays in Honor of Anselm Strauss (pp. 265-284). Aldine De Gruyter.
Star, Susan Leigh & Strauss, Anselm (1999). Layers of Silence, Arenas of Voice: The Ecology of Visible and Invisible Work. Computer Supported Cooperative Work (CSCW), 8(1-2), 9-30. https://doi.org/10.1023/A:1008651105359
Strauss, Anselm; Fagerhaugh, Shizuko; Suczek, Barbara & Wiener, Carolyn (1985/2014). Social Organization of Medical Work (2.a ed.). Transaction Publishers.
Torenholt, Rikke; Saltbæk, Lena & Langstrup, Henriette (2020). Patient data work: Filtering and sensing patient-reported outcomes. Sociology of Health & Illness, 42(6), 1379-1393. https://doi.org/10.1111/1467-9566.13114
Valenzuela, Fernando A. & Ramos Zincke, Claudio (2015). Cómo los maltratos se transforman en ‘violencia intrafamiliar’. El recorrido de la performatividad. Revista de Estudios Sociales, 51, 213–226. https://doi.org/10.7440/res51.2015.16
Valenzuela, Fernando A. & Sibrian, Nairbis (2019). Las Lógicas del Trabajo Moral en Telemedicina: Disputas en Torno a la Legitimidad de Políticas de Salud Digital. Psicología, Conocimiento y Sociedad, 9(2). https://doi.org/10.26864/PCS.v9.n2.11
Vogd, Werner (2015). Arranging medical and economic logics. Investigating the influence of economic controlling in an internal medicine department. En Morten Knudsen & Knut Vogd (Eds.), Systems theory and the sociology of health and illness: Observing healthcare (pp. 103-127). Routledge.
Published
How to Cite
Downloads
Copyright (c) 2022 Fernando Valenzuela
This work is licensed under a Creative Commons Attribution 4.0 International License.
