Self-management by eCoaching: Redefining roles and blurring borders in health and care
Maartje Niezen (Rathenau Instituut)
Federica Lucivero (King's College London)
Paper short abstract:
Paper long abstract:
Healthcare systems are increasingly challenged to provide high-quality services to more people using less personnel and resources. To meet this challenge governance structures and strategies need to be adapted in order to reorganize care. Policy and practice are increasingly turning to ICT solutions that promise cutting costs and enabling patient-centered care through better information exchange, as well as making individuals more capable of self-care and less reliant on health systems (Harris et al 2010; Oudshoorn 2011; Lupton 2013a). Within a Dutch research programme automated computer supported coaching systems (eCoaching) is prompted as such an ICT solution and offers an intriguing example of lifestyle technology for self-management. However, researchers must be wary of the 'big claims' that accompany self-management by eCoaching. Powerful rhetoric often overshadows the practicalities of daily use and tends to underestimate, or even ignore, a number of theoretical, normative and ethical caveats associated with redefinition of roles and reliance on technology. For example, these technologies become integrated in everyday life, blurring the border between wellness and disease, medicalizing private/personal spaces and enabling new practices of surveilling and steering individual behavior. We will examine these issues by drawing on the first results of a study on the normativities of eCoaching for lifestyle change. We contribute to the theme of this track with an examination of the discourses of responsibility, participation, lifestyle improvement and self-care found in the general program funding call for eCoaching projects, individual project proposals and the eCoaching applications.
Technologies of care and participation: Shifting the distribution of expertise and responsibilities