Nelly Oudshoorn Winner of the Diana Forsythe Award

Nelly Oudshoorn, Professor of Technology Dynamics and Healthcare at the Department of Science, Technology and Policy Studies at the University of Twente, has been selected as the winner of the 2009 Diana Forsythe Award of the American Medical Informatics Association (AMIA). She received this price for her paper ‘Diagnosis at a distance. The invisible work of patients and health-care professionals in cardiac telemonitoring technologies’ published in Sociology of Health and Illness. 2008 vol. 30, nr 2, 272-295. The Diana Forsythe Award honors either the peer-reviewed AMIA conference paper, or the peer-reviewed article published during the previous year, that best exemplifies the spirit and scholarship of Diana Forsythe's work at the intersection of medical informatics and the social sciences. Nelly Oudshoorn is the first Dutch scholar honored by this Award.

Abstract Diagnosis at a distance’.

Although patients are often absent in discourses on telemedicine, many telemonitoring applications constitute a new medical practice in which patients are expected to play an active role. Based on a study of the use of one specific telemonitoring device, an ambulatory ECG recorder introduced to diagnose infrequent irregularities of the heart rhythm, the paper seeks to examine all the invisible work it takes to produce patients who are active and responsible as participants in the diagnosis of their heart problem. In particular, I address the question of how we can understand that individuals who are anxious about their heart function manage to adopt the role of ‘diagnostic agent’. This research shows that, although many patients managed to become competent users of the new technology, there are important patterns of selective use patients invented to integrate the technology in their daily life. In conclusion, the paper suggests that most patients were able to adopt the role of diagnostic agent not only because of their individual motivation but because of their location in the socio-technical network of this technology, in which the invisible work of home-care nurses and physicians at the telemedical centre made all the difference.

Keywords: ambulatory ECG recorders; invisible work; patients as diagnostic agents;

telemonitoring technologies; telemedical centres.