Unequal Consumers: Consumerist healthcare technologies and their creation of new inequalities

Abstract

Consumerist healthcare technologies and their creation of new inequalities This article examines how consumerist technology creates new inequalities among patients in healthcare. More specifically, we analyze a communication technology that presents a case of consumerization of patients. Using critical diversity literature, we aim to theorize how consumerism embedded in technology assumes a 'universal individual', creating a tension for healthcare professionals between acknowledging differences among patients while aiming for equal treatment of all patients. Based on our empirical analysis of so-called Personal Online Health Communities, we explore, at the microlevel, how healthcare professionals deal with this tension. We identify four different practices; lacking awareness of differences, downplaying differences, discomfort around acknowledging differences and actively accommodating differences. We theorize how they ultimately all create new inequalities.

Health care professionals’ experiences of how an eHealth application can function as a value-creating resource - a qualitative interview study

“…When expectations and professional values of providing fair care are not in line with what an eHealth service offers, this may result in value destruction [20,32]. The differences in abilities and capabilities described among patients may result in the emergence of health inequities [42], which would contradict the goal of Swedish care that care provision should be based on assessment of each patient's individual needs and be made available to all patients on equal terms [50]. Therefore, it is necessary to address ethical and social dilemmas in order to promote health equity when using eHealth [41].…”

“…However, problematization on how to close care gaps in vulnerable patient groups is scarce [41]. In fact, as revealed by HCPs, insufficient ability to use the technology, due to either patients' impaired health or low technical competence may create new health inequities and inequalities [42], and result in value destruction.…”

License to Heal: Understanding a Healthcare Platform Organization as a Multi-Level Surveillant Assemblage

“…This has fostered numerous preoccupations about how it secures government collusion, and about the strength of its ideological and narrative justifications, including the free and open network, instant and customized personalization, and new forms of consumer power. However, the 'sharing' economy has been shown to not always deliver on the promise of social connection, and instead, harbors labor exploitation, discrimination, and inequality, as well as power asymmetries, algorithmic biases and discriminations, tailored advertising, and invasion of privacy (e.g., Gillespie, 2017;Schor & Attwood-Charles, 2017;Visser et al, 2019;West, 2019). Reversely, the concept of privacy -which is defined as freedom from and resistance to surveillance (Farinosi, 2011;Lyon, 2001;Solove, 2002) -is also sustained by strong and equally contestable ideologies, and often obscure power dynamics that play out in eminently complex ways in platforms.…”

“…Fotaki, 2009), governments and healthcare providers set boundaries on the distribution of patient health records to third parties with the excuse of protecting patient privacy, and large pharmaceutical companies promote health ideologies structured around their products (such as vaccinology) (Picard et al, 2017), two sensitive issues that the COVID-19 pandemic has recently revamped. At the micro-level, consumerist approaches to healthcare reinforce the myth of patient choice and promote 'prosumption' as a means to exploit patients (by making them produce the service they need, in making them responsible for managing their diseases), thereby increasing patients' vulnerability and inequality in terms of access to care, particularly when it depends on and is mediated by supposedly 'neutral' technologies that gloss over patients' differences (Visser et al, 2019). However, albeit being intertwined, access to healthcare and access to health information are two different things.…”

“Nomen Omen”: Exploring Connected Healthcare through the Perspective of Name Omen

“…Compared to TM and TH, CH has a broader concern, related to the cost, quality, and efficiency of healthcare, especially for chronic conditions. Furthermore, it encourages consumerism through patient education and feedback [14,18]. Many efforts have been made to conduct data integration outside the traditional healthcare setting, such as the implementation of electronic patient records.…”