Paper short abstract:

This presentation traces the ways through which the promises of 'digital diagnosis' have led to specific forms of digitisation in healthcare practice. Forms that have left healthcare systems without the interconnected and easy-to-access digital records promised at the turn of the millennium.

Paper long abstract:

Digital diagnosis promises various economic, quality, and safety benefits for those engaged in the management and organisation of healthcare. To policy makers it offers resolution to workforce problems through the deskilling of clinical work. When allied with emerging and seductive promises of preventative healthcare, digital diagnosis opens a door to new screening mechanisms that further buttress claims of a future healthcare system radically more economic than those currently available. To managers concerned about the all-too-human workforce — whom are liable to deliver negligent care or malicious harm to patients — it offers a system of control over clinical work. The augmentation and fixing of decision making into pre-defined pathways of best-practice, and evidence-based decision making, is thus a heady cocktail for those challenged to find more-and-better mechanisms of oversight into the increasingly specialised fields of clinical work.

To realise these dreams, an environment must be created in which clinical work can be rendered legible to the numerical logics of computation. Such an environment is incompatible with a medical record settlement that stretches back 100 years, and trades off the expertises of the manager, the doctor, and the researcher in ways that have —for those 100 years— determined the epistemic operations of medical work. In short, I explore the ways that the promises of digital diagnosis have already, and continue to, unsettle the truth games of clinical work.