E-health and the performativity of the 'health democracy'

L’e-santé rend-elle la démocratie sanitaire pleinement performative ?

Hervé Dumez and Etienne Minvielle ()
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Hervé Dumez: CRG I3 - Centre de recherche en gestion i3 - X - École polytechnique - IP Paris - Institut Polytechnique de Paris - Université Paris-Saclay - I3 - Institut interdisciplinaire de l’innovation - CNRS - Centre National de la Recherche Scientifique

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Abstract: Since at least the 1990s, a movement quoted as the "health democracy," has set out to establish new rights for patients, and changes current professional practices. Its dynamic can be analyzed through the lens of performativity, a whole wave of research with the aim to understand how a theory or doctrine can feasibly make real what it theorizes and encourages. "Health democracy" intends to reduce the disproportionate distribution of power in doctor/patient relationships. In parallel, different innovations related to the irruption of E-health (social networks, web applications, and other devices) are currently modifying the practices, and thereby reconstructing the relationships between patients and professionals. Based on a corpus analysis, using a scoping review method, this article explores the ways E-health modifies the process of performativity in the "health democracy". Two effects are identified: a co-production introduced in the classic relationship between patients and healthcare professionals thanks to a better follow-up at distance, and a new form of expertise based on the information circulating on the internet. Each effect develops its own benefits and risks. In order to optimize this new added-value offered by E-health on patient engagement, many managerial consequences must be taken into account. Employing a narrative approach to the dynamics currently at play, it establishes that E-health represents a process of performativity of health democracy by "overflowing". It also highlights a risk of counter-performativity: in that if the traditional patient/doctor relationship is less asymmetric, answering to the "health democracy"'s demand may pose another risk related to the use of internet-based information that threats this equilibrium.

Keywords: Performativity; e-healthcare; Health democracy; Patient engagement; Patient empowerment.; Performativité; e-santé; Démocratie sanitaire; Engagement du patient; Autonomisation du patient. (search for similar items in EconPapers)
Date: 2017-08-01
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Published in Systèmes d'Information et Management, 2017, Special Issue: Health IT, 22 (1), pp.9-37. ⟨10.3917/sim.171.0009⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01616778

DOI: 10.3917/sim.171.0009

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