New fangled approaches in healthcare will always get some peoples’ backs up and the idea of a virtual medic is about as new fangled as it gets: http://www.express.co.uk/posts/view/190756/Web-Would-you-trust-a-virtual-medic- Both patients and practitioners (http://www.bbc.co.uk/news/10285950) and somewhat inevitably insurance companies with competing premium member services have raised objections to mediated interactions where the purpose is diagnosis or advice. Nevertheless, NHS Direct (a bit of a misnomer given its callcentre and website operations essentially mediate the healthcare experience) has proven enormously popular in England – with 18 million visits to its website in 2009 and 5 million calls to its call centre.
Anecdotally, some of the strongest objections to the ‘re-mediation’ of healthcare come from
where NHS Direct isn’t available. The primary concern there isn’t necessarily about mediation, after all doctors there allocate time in the day to take phonecalls and even emails from patients, a situation also common in the Northern Ireland . It’s the idea that advice should be given by anonymous practitioners who have no idea of your medical history (moreover they are nurses, complain the doctors). US
I have been speaking to some of those within the NHS who would like to get to the bottom of ‘resistance’ on the part of both patients and practitioners to more technology-enabled services. Many share a vision where interactions with health services ultimately become like interactions with banks: the 2020 Public Services Trust is doing some thinktank work on this front.
With the Northern Ireland example alone, it’s clear that a patchwork of values concerning healthcare exist and that’s before considering constituencies such as the poor where issues of access also come into play. Clearly, more work needs to be done to understand what lies behind those values and what the information needs and access issues of patients are. Ethnography can help on these fronts.