Empowering Patients through Healthcare Technology and Information? The Challenge of becoming a Patient 2.0

Abstract: In the mid-2000s, the term Patient 2.0 began to be used to denote a new patient role: empowered patients were expected to engage with various types of information and specific technologies in order to manage their own illnesses. Headlines such as Future patients will take care of themselves appeared in newspapers, and self-management and telecare technologies were seen as ways to change elderly patients practices. Transformation of the traditional healthcare system remains on the agenda, and it continues to challenge the traditional view of the patient role (framed in this article as Patient 1.0). Based on several empirical field studies, interviews and written material, we argue that changes to socio-material assemblages may have implications beyond the immediate gains anticipated by politicians (e.g., reduced hospitalisation time, investments in new technology, patients and relatives who function as expert caregivers). To accurately reflect this phenomenon, Mort et al. (2003) suggested using the terms 'remote doctors' and 'absent patients'. Likewise, Oudshoorn (2008) highlighted how the absence of face-to-face interaction implies that healthcare professionals rely more on numerical representations of illness (i.e., metrics) than on direct observations of patients. Through ethnographic research in the Danish healthcare sector, we show how this new healthcare vision actually manifests in practice by presenting cases of elderly heart and diabetes patients. Technologies aimed at patient empowerment (e.g., pamphlets, training instructions) change how patients are framed in established networks; the emergent chronic patient frame challenges the traditional functioning of established patient-doctor relationships. Theoretically, we draw on the concepts of discipline (Foucault, 1975), and domestication (Silverstone, 1989; Lie and S
Keywords: patient empowerment; Patient 2.0; self-management; future healthcare system; change in healthcare practices; chronic/treated challenges