Digital Health Communications

ECHNOLOGICAL PROSPECTS AND SOCIAL APPLICATIONS SET Coordinated by Bruno Salgues There are many controversies with respect to health crisis management: the search for information on symptoms, misinformation on emerging treatments, massive use of collaborative tools by healthcare professionals, deployment of applications for tracking infected patients. The Covid-19 crisis is a relevant example about the need for research in digital communications in order to understand current health info communication. After an overview of the challenges of digital healthcare, this book offers a critical look at the organizational and professional limits of ICT uses for patients, their caregivers and healthcare professionals. It analyzes the links between ICT and ethics of care, where health communication is part of a global, humanistic and emancipating care for patients and caregivers. It presents new digitized means of communicating health knowledge that reveal, thanks to the Internet, a competition between biomedical expert knowledge and experiential secular knowledge.

Table of Contents:
Preface xi Olivier GALIBERT and Benoit CORDELIER Acknowledgments xxix Benoit CORDELIER and Olivier GALIBERT Author Biographies xxxi Introduction xxxv Benoit CORDELIER and Olivier GALIBERT Part 1. Digital Patient Records: Organizational Adaptations 1 Chapter 1. Paradoxical Changes and Injunctions in an Implementation Project of the Digital Patient Record 3 Benoit CORDELIER, Hélène ROMEYER, Laurent MORILLON and Olivier GALIBERT 1.1. Introduction 3 1.2. Organizational paradoxes and paradoxical injunctions 4 1.2.1. Organizational development and paradoxes 4 1.2.2. Discursive approaches to the organizational paradox 5 1.2.3. The pragmatic paradox: a return to the systemic approach of Palo Alto 5 1.2.4. What divergences and convergences? 8 1.3. A case study of an implementation project for digital patient records 11 1.4. Resolving the organizational paradox at the individual level 13 1.4.1. The injunction to internal mediation: role syncretism 13 1.4.2. The injunction to disappear: exit or integration 14 1.5. Conclusion 14 1.6. References 16 Chapter 2. Identifying Caregiver Practices by Analyzing the Use of Electronic Medical Records 21 Pénélope CODELLO, David MORQUIN, Ewan OIRY and Roxana OLOGEANU-TADDEI 2.1. Introduction 21 2.2. Review of the management science literature on professional practices and uses of electronic patient records 23 2.3. Professional practices and the use of tools at the heart of the conceptual framework: the “instrumental genesis” 25 2.4. Methodology 26 2.4.1. Presentation of the case 27 2.4.2. Data collection and analysis methods 28 2.5. Results 30 2.5.1. Technical dimension of uses 30 2.5.2. System of instruments 32 2.5.3. Relationship with activity, with oneself and with others in the use of EMRs 33 2.5.4. Debates on the common good 36 2.6. Conclusion 37 2.7. References 39 Chapter 3. Communication Approach to Patients’ Health Work: Remote Relationship and Intertwined Powers 43 Anne MAYÈRE 3.1. Introduction 43 3.2. Reconstructing patients’ work 45 3.2.1. Recomposed and multiplied patients’ work 47 3.2.2. Relationship of care and intertwined “pastoral and disciplinary powers” 51 3.3. Field and method 52 3.4. Remote relationship and intertwined powers 53 3.4.1. Establishing the relationship and learning to talk about oneself 54 3.4.2. Intertwined disciplines 56 3.5. Conclusion 58 3.6. Acknowledgments 59 3.7. References 59 Part 2. Care and Social Support: From Institutional Responses to Online Support 63 Chapter 4. The Place of Care in the E-coordination of Home Care and Assistance 65 Géraldine GOULINET FITÉ 4.1. Introduction 65 4.2. Home care coordination issues 66 4.2.1. Reconfigurations at home 67 4.2.2. From computerization to health informatization 70 4.3. Impacts on the logic of care, roles and identities 73 4.3.1. From cure to care 73 4.3.2. Informational and communicational approach to care 74 4.4. Uses and practices of the PAACO-Globule dispositive in a support network for the coordination of complex pathways in the South Gironde region 77 4.4.1. Presentation of Escale Santé 77 4.4.2. Presentation of the PAACO-Globule solution: functionalities and organizational framework 79 4.4.3. Study design and presentation of results 80 4.5. Conclusion 87 4.6. References 89 Chapter 5. Breast Cancer Prevention Online in a Crisis of Confidence Context: From Medical–Technical Discourse to Social Support 95 Dorsaf OMRANE and Pierre MIGNOT 5.1. Introduction 95 5.2. Prevention and crisis context 97 5.2.1. The breast cancer prevention in question: its system and players 98 5.3. Methodological choices for the analysis of an online exchange space 104 5.3.1. Boundaries of the field: study by the Facebook group “Cancer du sein, parlons-en” (Breast cancer, let’s talk about it) 104 5.3.2. Online non-participant observation 106 5.4. Results of ethnographic observation and lexicometric analysis 107 5.4.1. The emotional support registry 108 5.4.2. Informational input and tangible support 110 5.5. Conclusion 112 5.6. References 113 Part 3. Rethinking Health Expertise in Light of the Social Web 119 Chapter 6. The Expert Patient in the Digital Age: Between Myth and Reality 121 Hélène ROMEYER 6.1. Introduction 121 6.2. Mutating health care: the professionalization of the patient 122 6.2.1. General framework 123 6.2.2. The slow evolution of the patient’s status and role 126 6.2.3. The evolution towards health information 128 6.3. Societal changes and the emergence of the expert patient in the digital context 132 6.3.1. New modalities of militancy 133 6.3.2. Technological change and empowerment 135 6.3.3. Therapeutic patient education: the unthought of digital culture and literacy 138 6.4. Conclusion 140 6.5. References 141 Chapter 7. Towards an Info-communication Categorization of Expertise in Online Health Communities 145 Stéphane DJAHANCHAHI, Olivier GALIBERT and Benoit CORDELIER 7.1. Introduction 145 7.2. The crises of expertise in research in information and communication sciences 146 7.2.1. The question of expertise in the face of the diversity of forms of knowledge mobilized in socially relevant issues 147 7.2.2. The place of expertise in info-communication and community-based online knowledge mediation dispositives 149 7.3. Info-communicational theory of the online community link as a sociotechnical context for the deployment of online expertise 150 7.3.1. The ICS approach to health communities 152 7.3.2. Specificity of the terrain and the need for a new qualification of expertise 153 7.4. Info-communication approaches to health expertise 155 7.4.1. Expertise and the online health community 157 7.4.2. Negotiation as an info-communication process for legitimizing expertise 161 7.4.3. The legitimation of expertise or the production of a community consensus 161 7.5. Framework for the community validation of expertise 163 7.5.1. The three modes of legitimizing expertise in online health communities 164 7.5.2. Articulation of forms of expertise in the context of digital society 166 7.6. Conclusion 169 7.7. References 170 Chapter 8. Identification Metrics Regarding Lay Expertise in Online Health Communities 175 Damien DE MEYERE 8.1. Introduction 175 8.2. Online health information and the notion of expertise 177 8.3. Data selection and presentation 178 8.4. Description of the measures 179 8.4.1. Characterizing engagement 179 8.4.2. Characterizing content 180 8.4.3. Characterizing the interaction 181 8.5. The multiple facets of lay expertise 182 8.6. Conclusion 190 8.7. Acknowledgments 191 8.8. References 191 List of Authors 195 Index 197

About the Author :
Benoit Cordelier is Full Professor in the Department of Social and Public Communication at the Universite du Quebec a Montreal (UQAM), Canada. His research focuses on organizational change and processes as well as the communicational aspects of online community cultures. Olivier Galibert is Full Professor in information and communication sciences at the University of Burgundy - Franche-Comte, France. His research focuses on community management issues within, above all, patients’, caregivers' and healthcare professionals' online communities.