Paper short abstract:

This presentation challenges deterministic notions of remote technologies as merely facilitative, rather than constitutive, of care. Studying the case of online group clinics, we explore how particular forms of care are produced through the mutual constitution of technologies, users and practices.

Paper long abstract:

Digital ‘transformation’ constitutes a significant policy priority in health and care, with oft-cited promises of efficiency gains, democratisation, and increased ‘patient choice’. While such promissory narratives of digitalisation generate major interest and resources (Borup et al., 2006), scholars in STS and related fields (e.g. Pols & Willems, 2010; Nicolini, 2006) have highlighted the need to move beyond reductionist ideas of technological interventions as linear ‘solutions’ with stable and predictable outcomes across settings and over time.

This study focuses on the case of remote group clinics where patients receive care in groups, rather than one-to-one, via online platforms (e.g. video-based, hybrid). We draw on ongoing ethnographic and multimodal research (2022-24) at four general practices in England to trace how these new sociotechnical arrangements – or sites of care - come to produce different forms of caring and being cared for across settings. While staff attempt to ‘tame’ (Pols & Willems, 2010) remote technologies in ways to make them fit with organisationally driven objectives (e.g. prescription efficiency, promoting compliance), patients and carers work creatively with the possibilities of these technologies (e.g. selective use of webcam, chat) to negotiate their new responsibilities projected through group-based care (e.g. being a ‘good’ example to others, sharing intimate illness experiences). We conclude by discussing how such practices function to make remote group-based care align with local routines and goals of different users, but can also coalesce in ways that create unexpected forms of exclusion.