Digital Health | Platypus

Co-signature Event Context: Toward a Participatory Electronic Health Record

 Naomi Schoenfeld  October 21, 2021

The days of doctors scratching illegible notes in charts fated to hide in obscure files never read by another soul is long gone. Over the last two decades, paper charts have nearly disappeared as the evolution of the electronic health record (EHR) has come to dominate the healthcare environment not only in the US, but globally. The health record performs multiple types of labor. It serves to facilitate communication in medical care or research; it is a legal document and a record to justify billing. A new diagnosis and billing code must make its first entry into the medical record accompanied by the signature of a clinician authorized to determine this diagnosis. After this initial entry, non-professional personnel may then use this diagnosis for any of the above purposes (communication, billing, legal). This blog post explores how developments like the patient portal of the EHR create new opportunities for interpretation, (read more...)

“I’m Not an Anti-Vaxxer, I Just Don’t Want This Vaccine”: Understanding Vaccine Hesitancy among Pregnant Women

 Kate Dielentheis  August 31, 2021

“The world isn’t made up of good people and death eaters.” -JK Rowling The world isn’t made up of people who choose to vaccinate and those who are vehemently opposed. With the evolution of the COVID-19 pandemic, understanding has changed rapidly. With the development of three effective vaccinations, there has emerged a group of people that exhibit what has been dubbed “vaccine hesitancy.” This is a relatively new phenomenon in terms of new vaccination–the uptake, for example, of the polio vaccination in the early 1950s, was more immediate and widespread. The Zika epidemic also provides an interesting contrast to the current situation as well. I use these examples simply as a foil to the current pandemic and draw a number of interesting similarities and differences. (read more...)

Dark Patterns, or Shades of Grey?

 Alex Beattie  December 17, 2019

Auto-playing videos. Bottomless social media newsfeeds. Accentuated “I consent” buttons. The internet may appear as a Choose Your Own Adventure, but some pathways and actions are more enticing than others. Persuasion has become part of the online furniture and is largely by design; central to the architecture of user experience (UX) is the use of behavioral and social psychology to make particular aspects of digital products or services engaging and easy to use. (read more...)

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

 Julie Armin, Ellen Estrada, Rebecca Bedwell  September 3, 2019

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

 Daniel White  July 23, 2019

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

 Rebecca Jablonsky  June 4, 2019

Shortly after giving birth to her son, Jessica 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

 Samantha Gottlieb  April 23, 2019

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

 Meg Martin  April 16, 2019

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...)