Academic journal article Journal of the Association for Information Systems

The Role of Information and Communication Technology in Self-Management of Chronic Diseases: An Empirical Investigation through Value Sensitive Design

Academic journal article Journal of the Association for Information Systems

The Role of Information and Communication Technology in Self-Management of Chronic Diseases: An Empirical Investigation through Value Sensitive Design

Article excerpt

1 Introduction

Advancing patients' ability to engage in self-managed health through information and communication technologies (ICTs) is increasingly a top health-care priority (e.g., The National Health Service, 2013, The Office of the National Coordinator for Health Information Technology, 2014). Broadly, this study supports this goal by focusing on the design of sociotechnical artifacts to improve patients' selfmanagement (SM) of their health (hereafter referred to as ICT-enabled SM systems). Despite technological advances in healthcare ICTs that improve care and reduce costs, patients often avoid using them, perhaps because patients are often ignored in their design (Dadgar, Samhan, & Joshi, 2013; El-Gayar, Timsina, Nawar, & Eid, 2013a, 2013b; Koch, Jenkin, & Kralik, 2004; Vuong, Ory, Begaye, & Forjuoh, 2012; Waite, Curtis, & Nugrahani, 2013). Thus, on one hand, as indicated in the call for this special issue, ICTs (e.g., the mobile revolution) have "improved the health in healthcare services, as reflected by the delivery of high-quality patient care at low cost," (Acquisti, Oh, & Sia, 2016, p. 1), but on the other hand, the development of ICTs that focus chiefly on patient-centered care is still in its infancy (Jacelon, Gibbs, & Ridgway, 2016; LeRouge, Hevner, & Collins, 2007).

The spirit of patient-centered care is reflected in the meaning of care manifested in ethics and morals. In order for ICTs to fulfill the true promise of patientcentered care, ICT designs must move beyond clinical, functional, and legal aspects, to also deliberately care about the beliefs and values that are deeply significant to patients. More importantly, ICT designers and the patients who use ICTs must guard against succumbing to societal pressures to either relinquish or compromise patients' beliefs about care under the guise of improving health at low cost. The central focus of this study addresses sensitivity towards patients' values in the designs of ICTs. By examining ICTs for patient empowerment in healthcare, this study illustrates the role ICTs can play in building a Bright Society (Lee 2015; Association for Information Systems 2015; Eymann, Legner, Prenzel & Krcmar, 2015) where patients can take control of their illness and wellness. The notion of an ICT-enabled Bright Society, the focus of this special issue (Acquisti, Oh, & Sia, 2016), is an Association of Information Systems initiative that frames ICT -centric Grand Challenges which, if addressed, will have a broad societal impact (Lee 2015; Association for Information Systems 2015; Eymann et al., 2015). Specifically, this initiative calls to investigate "the problems in societal knowledge infrastructure and to design the vision of an ICTenabled Bright Society" (Association for Information Systems 2015). Value sensitive ICTs can help mitigate the negative impact of technocentric designs and help protect patients from undesirable consequences resulting from use of the commercialized ICTs proliferating in the healthcare industry.

We draw on value sensitive design (VSD) theory (Friedman, Kahn, & Borning, 2008) to conduct an indepth interpretive field study (Galliers & Land, 1987; Orlikowski & Baroudi, 1991; Walsham, 1995) to first reveal the values that are important to diabetic patients, and then apply work system theory (Alter, 2013b, 2015) to explain how these values that are implicated in ICT features afford or constrain patients' abilities to self-manage their activities. This study's findings reveal how the values important to diabetic patients that are embedded in ICT features, in part, (de)motivate the self-management of their illnesses. The findings also illustrate that incorporating patients' values into ICTs to manage their diabetes is not simply a matter of preference (Norris, Engelgau, & Narayan, 2001), but also a means of provisioning care sensitively. Theoretically, we contribute to design research through extending the VSD literature by introducing a VSD perspective to examine a complex sociotechnical system. …

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