Paper short abstract:

Digital healthcare risks becoming a tool for exclusion for digitally marginalised groups due to dominant discourses in research and policy failing to forefront equity and justice. Feminist STS and systems approaches can transform mechanisms of exclusion into opportunities for inclusion in policy.

Paper long abstract:

Digital care strategies in the Netherlands are rapidly accelerating. Whilst eHealth can usually be viewed as a niche innovation, it is currently recognised by the incumbent regime as a promising tool to address burgeoning issues in Dutch healthcare, thus mainstreaming it in such a way that it is undergoing a niche-to-regime transformation. Whilst eHealth is suitable for most, there are still many individuals who face exclusion from healthcare due to a myriad of intersectional factors that stem from an inherently exclusionary socioeconomic and political systems. These underlying mechanisms of exclusion are often ignored, due to dominant frameworks on digital exclusion taking a “user deficit” perspective, where failures in the dissemination of eHealth are framed as the fault of those who cannot use them. This is also reflected in literature, where authors adopt an individualised focus in framing barriers and solutions to low eHealth uptake, as well as in Dutch policy, where digital transformations are distanced from conceptualisations of health equity. In our ongoing research, we use systems and feminist STS approaches to uncover the mechanisms of exclusion used in policy to actively co-create new trajectories for the policy sphere that better include people at a distance to the online world. It is critical prevent eHealth implementation from becoming a persistent problem at this critical moment of transformation in the Dutch healthcare system.