Ärzt*in, Patient*in und ein digitaler Dritter: Wie eine online-gestützte Informationstechnologie ärztliche Beratungen standardisiert und personalisiert

How an Online-Based Information Technology Standardizes and Personalizes Medical Consultations

Abstract

Digital technologies that actively facilitate and steer the design of contents and processes of counselling sessions in the interaction between doctors and patients have received surprisingly little attention of social sciences thus far – despite the generally great research interest in both digitization in the field of healthcare and in doctor-patient interactions. In particular, digital tools providing individually tailored information or structured explanations for patients have only been partially investigated to date. This paper discusses how the traditionally dyadic conversation between doctors and patients is transformed through digital information systems, which are not only used for documentation, but also to support the content and structure of the consultation process. Based on empirical ethnographic material on the use of a counseling tool in family cancer counseling – iKNOW – we describe how different relations between physicians, counselees and the digital counseling tool emerge. We Keywords digital medical technologies – digital health interaction – qualitative health services research elaborate on how situationally different forms of knowledge, different actor positions, and different material arrangements become relevant – ultimately co-producing different forms of counseling through iKNOW. Our work illustrates how two seemingly contradictory motives run through the observed consultations: the standardization of medical care on the one hand and its individualization or personalization on the other. The digital counseling tool activates various forms of standardization and personalization and helps to link them in the sense of “situ- ated standardization” (Zuiderent-Jerak 2007: 316). The tool thus acts as a “scientific rallying point” (Timmermans & Mauck 2005: 26) through which the various forms and processes of standardization and personalization – as provided through the moderation performance of the doctors – are brought together and thus can be integrated into the counselling session in a needs-based and patient-centred manner.