From Self-Tracking to Tracking Patients? QS and health organizations in France

• In Event: Quantified Patients and Physicians

Abstract

In recent years, in order to improve their efficiency, health organizations in France have been striving to take advantage of innovations stemming from the so-called "Quantified Self" movement (Lupton 2016; Nafus 2016), notably by integrating digital self-tracking technologies into their day-to-day operations. We have been exploring the implementation of a "Smart Flat" experiment in which patients vitals and bodies are monitored and "quantified" through invisible sensors located in their rooms' environment. A second site of investigation consists of a "smart cigarette" project which relies on the interactions between smokers and 'watchers' mediated by digital data and notifications generated by the device, in conjunction with another hospital service. Our contribution aims at showing how tools initially designed from the perspective of individual use are geared towards institutional contexts, and with what effects on actors, technological devices and agencies. We suggest that the original QS' voluntary self-measurement practices are caught up in a tension between experimentation and enforcement within a hospital institution. When the commitment to use is no longer left to individuals, this management is often seen as a form of "nudge", in keeping with recent neo-liberal perspectives of flexible prescribing of action (Thaler & Sunstein, 2009). Comparing these two fields, we discuss this essential tension between flexible guidance and prescription, and how forms of criticism, rejection and negociated appropriation happen. We conclude that critical claims towards those institutional data monitoring practices point towards the impossibility of reflexivity that they entail.

Author

• Eric Dagiral, Paris Descartes University, CERLIS