Paper long abstract:

There has been a sharp increase in the number of people diagnosed with a chronic disease. A quick search of major medical journals reveals commentaries and articles with titles such as Preventing chronic diseases: how many lives can we save?, The neglected epidemic of chronic disease, and Rising to the global challenge of the chronic disease epidemic (Strong et al 2005) (Horton 2005) (Quam, Smith, & Yach, 2006). Thanks, in part, to enhanced and increased monitoring of care and bodies in healthcare, a global crisis has been created.

'Chronic disease' has become a technical problem with an associated technical, work-driven solution in the form of disease management programs (Arney & Bergen 1984). Designed to improve processes and tailor care to patients, disease management programs coordinate care on multiple levels - at the patient level, the organization level, the community level. Clinical and administrative data is crucial to this.

Through interviews conducted in 19 practice groups in the Netherlands implementing disease management programs, this research and presentation will explore the changes in the work and workers of healthcare, as well as how and what healthcare data is created, how that data is used, who has access and how, who benefits from the work and data created through the work, and who resists. As the data created by and through disease management programs is often used in resource allocation, guideline development, and the establishment of norms, these changes have important biopolitical implications for ministries of health, clinician, patients, and health policy makers.