digital health

Intelligences

Designing Virtual Primary Care: Desire or Dread? How Structural Forces Shape the Anticipation of Futures

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MARIE MIKA GRH+DOD* ARVIND VENKATARAMANI SonicRim The COVID-19 pandemic changed many healthcare companies' priorities and dramatically accelerated the drive towards increasingly virtual health care. Grand Rounds Health*, a healthcare startup, decided the time is now to launch its virtual primary care offering. It was assumed that a rural, lower-socioeconomic population would be more eager for, and best served by, virtual primary care, given their greater geographic distance from clinicians and other assumed access deficits. However, ethnographic research revealed that it was the urban, higher-socioeconomic population who both reported far more favorable experiences with remote care and more eager anticipation of virtual primary care. This is partly due to different technological experiences and ecosystems, but more directly due to differing trust in and agency with institutionalized health care. Ultimately, this case study reminds researchers that our experiences are shaped and limited by our social positions, and that we cannot...

Perspectives

How Ethnographic Methods Make APIs More Usable

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abstract design
by LIBBY KAUFER and MARIA VIDART-DELGADO, Ad Hoc LLC Ethnographic methods that center systems-thinking, how knowledge is constructed, and how knowledge is shared among communities are the best approach for developing collective digital products like APIs. Application Programming Interfaces, commonly known as APIs, connect the front-end interfaces we see when we navigate the internet (like websites and apps) to the back-end systems, or databases, that store information. APIs enable people to carry out transactions online, like purchasing goods, booking flights, or applying for government benefits. While they are invisible to end-users, APIs are crucially important to developers and to the way many websites, programs, and applications function. Like codebases and databases, APIs are objects consumed collectively and collaboratively by teams of developers who work together to integrate front-end to back-end systems, run tests, and monitor and troubleshoot integration issues. In the context of APIs, typical UX research methods...

Intelligences

Can I Get a Witness? The Limits of Evidence in Healthcare Quality Evaluation Systems in American Hospitals

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LINDSAY FERRIS Ad Hoc, LLC NICHOLE CARELOCK Ad Hoc, LLC “I got verbals, but verbals don’t hold up in court….I need it in black and white.” After Sheila submits hospital quality data to the Center for Medicaid and Medicare Services (CMS), reports indicate that her data hasn’t been received. She makes countless calls to the CMS Help Desk to get answers. They reassure her numerous times that they have her data, yet Sheila is insistent that she needs to see the change explicitly stated in the report. Sheila makes it her personal crusade to obtain material evidence because only written testimony will prove that her data has been submitted successfully and protect her facility from CMS penalties. At a time when we are becoming increasingly reliant on data and technology as the ultimate bearers of truth, Sheila exemplifies how people become stewards of evidence in service to these technical systems. As she moves her facilities’ data through CMS’ error-ridden reporting system, the burden of proof is on her to provide...

Intelligences

Taking Sides in E-cigarette Research

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RACHELLE ANNECHINO Critical Public Health Research Group, Prevention Research Center TAMAR ANTIN Critical Public Health Research Group, Prevention Research Center In the last ten years, an eclectic mix of electronic nicotine delivery products (‘e-cigarettes’) and practices have proliferated in the US with little restriction, producing a vast array of vaping mechanisms, flavors, and styles. At the same time, anti-tobacco movements have targeted e-cigarettes as a threat to public health and advocated for restricting e-cigarettes in much the same way as conventional cigarettes. While anti-vaping proponents associated with public health movements have typically regarded e-cigarettes as primarily harmful products that should be suppressed, vaping advocates regard e-cigarettes as harm reduction products that should be readily accessible to smokers. Distrust between these two warring “sides” animates the controversy over e-cigarettes. In our role as researchers conducting a qualitative study on e-cigarette use, we encountered...

Perspectives

“Hey, the water cooler sent you a joke!”: ‘Smart’, Pervasive and Persuasive Ethnography

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by NIMMI RANGASWAMY, SAURABH SRIVASTAVA, TEJASVIN SRINIVASAN & PRIYANKA SHARMA (Xerox Research Centre, Bengaluru, India) Article 6 in the series Data, Design and Civics: Ethnographic Perspectives How must we conjure up smart spaces? ‘Smart city’ has become an over-indulged urban metaphor, whipping up an apparition of dispersed, highly networked and interconnected socio-economic, infrastructural and communication nodes. The smart city narrative seems to dwell on the idea of cites as ‘receptacles for technology’—and qualitative transformations are brought about by the application of technologies. Even after decades of research to the contrary, we still tell ourselves stories about the inevitable march of technology and its deterministic effect on culture and behavior. But aren’t cities also places that give birth to technologies? As researchers we are drawn to the miraculous nature of technology to sense, track and quantify not only human use of infrastructure but also the human ‘self’. We are working to...