JMIR Publications

ABSTRACT

Background:

As soon as a new technology is integrated into a care pathway, it inevitably faces resistance and creates obstacles due to the changes it introduces into the existing context whose rules, discourses, and practices are bound to evolve. To understand the success or failure of digital health innovations, it is necessary to pay attention to the adjustments that users must do to make new technologies work within their daily routine, by reshaping the pre-existing situation and sometimes by altering or inventing new ways of doing things. We suggest that all this “user work”, most of which remains invisible, is an important factor in explaining the phenomena of adoption of innovations, but also the way in which they transform existing organizations and care practices.

Objective:

This paper proposes to develop a sociological framework for studying concrete modalities of integration and use of digital health innovations, through a qualitative meta-analysis of different type of tasks and activities that users, both health professionals and patients, have to carry out to integrate and make these technologies work in their daily routine.

Methods:

The paper uses a two-part method to structure a theoretical model to study users’ “invisible work”. First part of the method includes a narrative literature review on definitions and applications of “users work”, conducted at the junction of sociology of professions and medical work, innovation and Science & Technology Studies, internet and web uses. Second part of the method consists of producing an analytical grid to systematically study variations in the users’ work, according to different type of technologies, actors, and digital health practices.

Results:

The paper proposes to study users’ “invisible work” and the different adoption contexts in which it is carried out, through four dimensions (organizational, interactional, practical and experiential).

Conclusions:

Overall, this paper identifies a series of less visible adoption criteria that can allow to produce a comparative analysis of digital health innovations according to the different practices they enable to develop.