Category: Digital Health

Negotiating Ethical Technology Use: Trust and Care in End-of-Life Conversations

  The headline on the local news station’s website was sensational: “Bereaved Family Upset Kaiser Used Robot to Tell Father He Would Die”. Evoking some sort of post-modern dystopia, the article explains that the family “was taken by surprise when a robot rolled into the room” to deliver the news that an elder family member’s illness had progressed past the physician’s ability to treat it. While the robot actually was a remote physician using teleconferencing software to communicate with the patient and his family, the monitor projecting an image of the physician’s head and shoulders sat atop a tall, narrow metal unit reminiscent of a body. The “robot doctor” story was picked up by national news outlets, like the New York Times, and medical ethicists weighed in on the ethics of communicating “sensitive” topics remotely. The news stories problematized the impersonal, almost routinized, care as it was perceived by the family. In one, a representative from the American Medical Association commented, “We should all remember the power of touch – simple human contact – can communicate caring better than words.” (read more...)

The Future of LOVOT: Between Models of Emotion and Experiments in Affect in Japan

Aya is anxiously waiting for a future in which humans coexist with robots. She didn’t think this was possible in her lifetime, but when she learned about LOVOT, a 43 cm-tall furry robot on wheels designed specifically to seek out and offer affection, she was elated to discover that the future she had imagined was within reach. She urged me to take hold of it—LOVOT, that is. We were chatting at a recent Talk Session for LOVOT fans and a few of the creatures were spinning around a table as we talked. Its wheels folded into its body, and with animated LED eyes it looked up at me and blinked. I picked it up and Aya poked its nose, eliciting something like an irritated giggle from the robot, whose name I learned was Cherry. Aya stroked Cherry’s belly and its eyes blinked a few times and then slowly closed. “It fell asleep! How cute (kawaii)!” Aya exclaimed. Although Aya claimed to be uninterested in robots, technology, or anything in the IT world in general, she was immediately and, as she describes, inexplicably moved by LOVOT. It’s just an emotion (kanjō), she reflected. “You know about lonely people (kodoku na hito) in Japan, right?” Aya asked. “I think that everyone needs to feel affection (aichaku), and everyone enjoys this feeling we can get from cute things. It fulfills your heart (kokoro o mitasu). But not everyone can get this feeling… I think that in the future maybe one or two people out of ten might simply have relationships with things like LOVOT. It’s not really any different from the kind of affection one gets from a dog or cat, or even another person. And it’s their choice! This is a really interesting future!” (read more...)

Listening to/with Technology: Meditation Apps as the New Voice of Mental Health

Shortly after giving birth to her son, Jessica[1] began to experience a health problem that she describes simply as “pain everywhere.” About one month after we initially met at Spirit Rock Meditation Center in Marin County, California, she elaborated on her symptoms: “Joint pain, muscle pain, stabbing pain, stinging pain, burning pain, tingling, numbness…chest pains, palpitations, dizzy spells, headaches. I feel like I’m going to have a seizure, or brain fog, fatigue.” (read more...)

The FDA, Patient Empowerment, and the Type 1 Diabetes Communities in the Era of Digital Health

The day-long September 2018 workshop, “Medical Devices-Patient Engagement in Real World Evidence: Lessons Learned and Best Practices,” sponsored by the Food and Drug Administration (FDA) and University of Maryland (UM), met on the Baltimore campus, the city where I spent my graduate school years. In contrast to Baltimore’s palpable desperation, UMB’s health campus gleamed with newness, its brick walkways and tastefully planted vegetation viewable through floor-to-ceiling windows. In the well-appointed auditorium, Dr. Jeffrey Shuren, director of the Center for Devices and Radiological Health (CDRH, pronounced ‘cedar’), closed his introduction to the conference with the pronouncement that as the FDA moved toward real world evidence (RWE), “patient engagement” and the data patients may collect are invaluable for RWE. (read more...)

The Dawn of Digital Therapeutics

A techno-optimistic attitude tells us we’re living at an inflexion point where care practices are being transformed by technology. Monitoring and attending to health and well-being are no longer activities bound within physical spaces like hospitals and clinics; these activities have extended to the basic functions of smart phones. A new labor force has emerged for this digitized health transformation utilizing open source engineering platforms, structuring work into two-week Agile design sprints, and leveraging professionals from traditional healthcare settings. In many ways, the practices of these workers appear synonymous to those of other start-up companies across industry spaces. Throughout ethnographic fieldwork over the last year, I have explored the evolution of this phenomenon within an emergent area of the digital health sphere: Digital therapeutics. (read more...)