August issue: Technology use in health care – the “missing link”

The voices are numerous and loud when it comes to the opportunities of technologisation in health care. This has been the case for many years. Technologisation is supposed to improve patient outcomes, enhance quality of life, promote independence, in short: life is supposed to “remain” worth living with health-related technologies despite illness or limitation. Also on everyone’s lips are the risks associated with the use of technology. These include possible financial or social disadvantages if digitally recorded data about health, illness and limitations end up in the wrong hands – or, today, in the software programs of the “wrong” PCs. Addressing opportunities and risks is important and necessary. And yet, the discussion of opportunities and risks seems simplified, like a binary argument, like a black-and-white drawing, and carries the whiff of wanting to call good and evil by their names. And now? It is not enough to place opportunities and risks at the centre of attention. They characterise our world, opportunities seized or missed shape human existence. Risks are probabilities that can occur, but do not have to. The technologisation and digital transformation of health care is a reality. Now the focus is on the how and who of technologisation. How can and should the technologisation of health care be shaped in an active, user-oriented and setting-specific way? Who are the actors to be involved? Up to now, it has been mainly computer scientists, software developers, etc. and companies who have shaped and driven forward the technologisation in health care. What is urgently needed is that these technology-driven developments are now more strongly oriented towards the realities of the actors, i.e. the health professionals, citizens or patients, clients and residents. Is that self-evident? Seems obvious at first glance, but so far it is mainly theoretical, still little practical and often in the form of a “fig leaf”. What does this show? It can be seen in all the technologies that were developed with the inclusion of the opinion of future users with regard to user-friendliness, but then remain as a technology in prototype status. Many applications come onto the market, but are hardly used in everyday life or only for a certain time, because they collide with the reality of the users and take too little account of their needs, processes, knowledge and skills. The user-friendliness of a technology is undisputedly central. However, the everyday and social context of use, user characteristics, attitudes, required knowledge and skills in use, social influences and technology-specific implementation processes are hardly explored and understood. What “really” influences use and non-use? It is not a trivial and perhaps even an underestimated question. After all, technologies are used in a “real-life” context, that is, in everyday life and social exchange. Technologies can be a sign of “coolness”, modernity, progressiveness, openness, financial potency, but also simply of frailty, inadequacy and a need for help that cannot be “hidden”. Technology use is influenced by attitudes, behaviours, emotions and experiences that people have with technology in general and specifically. What is special is that in the context of health-related technologies, the attitude and attitude towards one’s own health, illness or the present limitation also plays a role. Often a health weakness, an inadequacy, a physical or cognitive limitation is the trigger for a technology use, such as an alarm device. Here, unsteady gait or risk of falling can be triggers, among other things. Consequently, this can mean that the use of a technology changes the perception of self and others in a crisis-like way for a moment and evokes considerations such as these: What impact does the technology have on my self-perception? Who is “suddenly” in continuous contact with my everyday life? What do others think about me “needing” or using this technology? Who coaches me in the use of the technology and who can spontaneously help me with problems? Furthermore, the use of a health-relevant technology often requires behavioural changes and learning processes as well as adjustments in everyday routines. Compared to the use of technology in everyday working life, the use of technology in a health-related context is much more complex. While there is a certain compulsion to use technology in everyday working life, and technology use tends to be associated with competence and increased efficiency, these aspects are hardly present in the health-relevant context. It can be concluded exaggeratedly: out of the isolated consideration of functionality, manageability and user-friendliness of health-relevant technology and into the “real-life” context of the user. It could be the “missing link” to long-term technology use in everyday life. I wish you an exciting read Friederike Thilo

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AUTHOR: Friederike J. S. Thilo

Prof. Dr Friederike Thilo is Head of Innovation Field "Digital Health", aF&E Nursing, BFH Health. Her research focuses are: Design collaboration human and machine; technology acceptance; need-driven development, testing and evaluation technologies in the context of health/disease; data-based care (artificial intelligence).

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