Abstract
The use of telemonitoring services by patients with chronic illnesses is now increasing in many countries. This chapter scrutinises technologically driven rehabilitation services as a form of collaboration between municipal health centres, general practitioners and outpatient clinics at hospitals in Denmark. Three social worlds of care and their shared discursive spaces, commitment to action and infrastructures are identified. We arranged a workshop for a composite group of stakeholders to discuss care values in light of an impending mandatory national roll-out of telemonitoring. The workshop was based on 16 interviews and participants’ photos and logbooks. The interviews focused on good practices at the sites in question, which we analysed before the workshop so we could start this workshop by presenting key interview themes. At the workshop three issues were discussed: (1) what makes good telemonitoring? (2) Possible future collaboration, and (3) Where are the obstacles? Based on interactionist ideas of learning as reflexism and joint action, we argue that workshops provide the opportunity both to learn and to develop collaboration between healthcare contexts. Collaboration (and obstacles) do not only include people: applications, gold standards, medication and financial arrangements are also involved in both creating and hampering collaboration. The contribution of the chapter is a critical discussion of the contemporary challenges involved in the increased use of technology in healthcare. Overcoming barriers to collaboration between contexts of healthcare is one of the main challenges to the currently strong focus on implementing technologies for chronic disease management. We conclude that the workshop participants learn to cope with telemonitoring as a contested arena inflicted with a number of different values and actions.
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Notes
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In the section ‘Social world 2. COPD rehabilitation as gold standards’ we explain in detail what gold standards entail.
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Acknowledgements
We thank the editors and Roland Bal, Health Care Governance, Erasmus University, NL for inspiration to develop these ideas.
This research is part of “The Infrastructure of Telecare – Imaginaries, Standards and Tinkering” (INSIST), funded by the Independent Research Fund Denmark. Grant no. 8091-00015B.
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Mossfeldt Nickelsen, N.C., Rath, S. (2021). Healthcare Technology and Telemonitoring: Overcoming Barriers to Collaboration Between Healthcare Contexts. In: Elkjaer, B., Lotz, M.M., Mossfeldt Nickelsen, N.C. (eds) Current Practices in Workplace and Organizational Learning. Springer, Cham. https://doi.org/10.1007/978-3-030-85060-9_10
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