HCTP Annual Interdisciplinary Workshop 2004 – Day 1 thoughts…

It’s been a while since I last posted, but I’ve been somewhat caught up on readings and preparing some of the background work for my thesis/dissertation work. In any case, I attended this year’s Health Care, Technology, & Place (HCTP) Annual Interdisciplinary Workshop held at St. Andrew’s Club in Toronto, Canada. Here are some of my thoughts from day one.

Morning Session: How does “place” matter?

1. Ubiquitous health technologies: The research opportunities to 2010 (Guang Zhong Yang)

2. Between everywhere and nowhere: The inescapable emplacement of technology (Pascale Lehoux)

Professor Yang from Imperial College, UK presented current work being undertaken to develop technologies to enable “ubiquitous technologies” for health related purposes. Some of the research is somewhat astounding to me, as the technology to create embedded and implanted monitoring systems that are smaller than a penny currently exists. I was even more surprised at some of the predictions of things to come by the year 2010. Prof. Yang was talking about having a “sensor net” that can remotely monitor any physiological measure using either micro-optics or any other type of implantable technology. The fascinating thing was that this “sensor net” that one (for lack of a better term) wears on the body would be connected to a larger IT infrastructure that allows for remote monitoring for adverse events, and ultimately, pre-event interventions based on risk-factors, genetic pre-disposition, and a host of other issues. Of course, I’m greatly simplifying and summarizing the talk, but to me, it felt as if science fiction was becoming reality.

The second presentation was by Professor Pascale Lehoux, who presented her work assessing remote dialysis programs in Quebed. Specifically, she presented her research comparing a “satellite” hospital type of system that used traditional telemedicine type technologies vs. a traveling bus type model. The questions that were raised centered around the issue of place affecting interactions, technologies, and the substantive experiences of patients and health care workers.

I have a list of different questions and thoughts on the presentations, but one question that I wonder about revolves around the notion of protected and/or restricted place/space. Just because we can monitor or provide services remotely and perhaps even ubiquitously, in ways that are so unobtrusive to the host, does it mean we should? How is choice and preference to be addressed? Are there times/places/areas in which we, as a society, decide not to monitor? I mean, the question of continuous surveillance, even for benevolent reasons, raises some interesting questions.

Some additional random thoughts:

– with increased monitoring, are we moving to “medicalize” normal conditions?

– are we moving toward determinate medicine (what about genetics?)?

– does technology need to be specifically designed for health care?

Breakout session 1: 21st Century Hospitals

We had an interesting discussion around inter/multi-disciplinary research about the 21st century hospital. The most important thing that resulted in this discussion was around the metaphors we use to describe hospitals. For example, many of the “modern” hospitals have been designed and operated (even if subconsciously) as if they were “hotels” or “shopping malls” (or even perhaps department stores). But, Pascale Lehoux wondered if a better metaphor for envisioning a hospital could be a “prison”. One of the PhD students (I’m sorry, but I can’t remember her name) shared an absolutely fascinating metaphor: hospital as “theatre” in which there is the actors and the play as well as the front and back of the stage.

For me, I found the notion of metaphors to be challenging. As ehealth challenges and transforms the health care institutions and systems, the metaphors we use to describe hospitals will ultimately shape the redesign. I wonder why health care continues to borrow metaphors and ideas from other industries to try and describe the relationships within, rather than accepting that health settings (and hospitals) are unique. Why can’t other industries try and use health care metaphors to describe their institutions – a hospital is a hospital is a hospital. Does “technocentricity” lead to behaviour changes and ultimately (improved) outcomes? In what contexts and places can/does this occur?

Afternoon session: Technologies in/on/of the body: Health, self, personhood

1. The body electric online: e-addiction, Penelope complex, e-lag and other e-pathologies (Derrick De Kerckhove)

2. The politics of life in the 21st century (Nikolas Rose)

This afternoon session was started by Prof. De Kerckhove talking about some of the addictive/neurotic behaviours that are beginning to emerge as we become increasingly “connected”. One assertion is that we are beginning to mimic biological systems by recreating them as external (i.e., wireless, pervasive, and always on), digital nervous systems – interesting, huh? He spoke about so many different ideas that I can’t do it justice. However, I will share the one point that struck me: what is health in the digital era? Here’s an interesting word that I heard from the presentation: technobiology.

The second presentation was by Prof. Nikolas Rose and he spoke about “emergent life” citing examples of genetics, miniturization, and a host of other factors. I can’t recall the specifics of the presentation, but he make some very interesting assertions about humanity, the role of technology, future emergent life forms, and notions of citizenry. One of the audience members asked about some of the ramifications on society of becoming inter-connected via digital means, and for whom will this type of scenario apply. I found it interesting that these notions of emergent life, community, and society would only be for those of the privileged, “advanced democratic liberal nations” (I’m not sure what that means, but I think it’s only for those who can afford it).

Breakout session 2: Translating your research for uptake (knowledge translation & transfer)

This session was facilitated by Gale Murray of the Change Foundation, describing the new strategic alliance between the Change Foundation and HCTP. We discussed a number of topics regarding knowledge translation and transfer, and tried to come up with some practical tips on how to do this (with some real life examples). One of the things that I cannot escape thinking about is this assumption that knowledge must be transferred/translated.

Some random thoughts from this discussion:

– we need to consider who the “audience” for research is

– what is the intended outcome of research? Of knowledge transfer/translation?

– how can messages be communicated effectively to the general public?

Closing thoughts

Day 1 was interesting. I had a chance to meet some very bright people from diverse backgrounds. I’m actually interested to see what Day 2 brings. The one thing that I am continuously thinking about is how the ideas presented relate back to my research in ehealth, or what new insight could be found by applying these models/ideas to ehealth?

I’m currently reading the “The Cathedral and the Bazaar” by Eric Raymond. The book is considered to be an absolute must-read for those interested in open source software. I’m reading it to learn more about open source software, and to see what I can learn and apply to ehealth research. It’s an interesting read so far – hopefully I’ll be done by the end of the week. Expect a summary/review once it’s done, as I’m sure I’ll have some thoughts on it. I’ve been discussing open source development with MJ Suhonos, and we’ve been having some really interesting conversations. I hope that after reading the book, I will be able to have a more intelligent conversation with him.