Digital Health Communications

Benoit Cordelier is Full Professor in the Department of Social and Public Communication at the Universite du Quebec a Montreal (UQAM), Canada. His research focuses on organizational change and processes as well as the communicational aspects of online community cultures.Olivier Galibert is Full Professor in information and communication sciences at the University of Burgundy - Franche-Comte, France. His research focuses on community management issues within, above all, patients’, caregivers' and healthcare professionals' online communities.

• Preface xiOlivier GALIBERT and Benoit CORDELIERAcknowledgments xxixBenoit CORDELIER and Olivier GALIBERTAuthor Biographies xxxiIntroduction xxxvBenoit CORDELIER and Olivier GALIBERTPart 1. Digital Patient Records: Organizational Adaptations 1Chapter 1. Paradoxical Changes and Injunctions in an Implementation Project of the Digital Patient Record 3Benoit CORDELIER, Hélène ROMEYER, Laurent MORILLON and Olivier GALIBERT1.1. Introduction 31.2. Organizational paradoxes and paradoxical injunctions 41.2.1. Organizational development and paradoxes 41.2.2. Discursive approaches to the organizational paradox 51.2.3. The pragmatic paradox: a return to the systemic approach of Palo Alto 51.2.4. What divergences and convergences? 81.3. A case study of an implementation project for digital patient records 111.4. Resolving the organizational paradox at the individual level 131.4.1. The injunction to internal mediation: role syncretism 131.4.2. The injunction to disappear: exit or integration 141.5. Conclusion 141.6. References 16Chapter 2. Identifying Caregiver Practices by Analyzing the Use of Electronic Medical Records 21Pénélope CODELLO, David MORQUIN, Ewan OIRY and Roxana OLOGEANU-TADDEI2.1. Introduction 212.2. Review of the management science literature on professional practices and uses of electronic patient records 232.3. Professional practices and the use of tools at the heart of the conceptual framework: the “instrumental genesis” 252.4. Methodology 262.4.1. Presentation of the case 272.4.2. Data collection and analysis methods 282.5. Results 302.5.1. Technical dimension of uses 302.5.2. System of instruments 322.5.3. Relationship with activity, with oneself and with others in the use of EMRs 332.5.4. Debates on the common good 362.6. Conclusion 372.7. References 39Chapter 3. Communication Approach to Patients’ Health Work: Remote Relationship and Intertwined Powers 43Anne MAYÈRE3.1. Introduction 433.2. Reconstructing patients’ work 453.2.1. Recomposed and multiplied patients’ work 473.2.2. Relationship of care and intertwined “pastoral and disciplinary powers” 513.3. Field and method 523.4. Remote relationship and intertwined powers 533.4.1. Establishing the relationship and learning to talk about oneself 543.4.2. Intertwined disciplines 563.5. Conclusion 583.6. Acknowledgments 593.7. References 59Part 2. Care and Social Support: From Institutional Responses to Online Support 63Chapter 4. The Place of Care in the E-coordination of Home Care and Assistance 65Géraldine GOULINET FITÉ4.1. Introduction 654.2. Home care coordination issues 664.2.1. Reconfigurations at home 674.2.2. From computerization to health informatization 704.3. Impacts on the logic of care, roles and identities 734.3.1. From cure to care 734.3.2. Informational and communicational approach to care 744.4. Uses and practices of the PAACO-Globule dispositive in a support network for the coordination of complex pathways in the South Gironde region 774.4.1. Presentation of Escale Santé 774.4.2. Presentation of the PAACO-Globule solution: functionalities and organizational framework 794.4.3. Study design and presentation of results 804.5. Conclusion 874.6. References 89Chapter 5. Breast Cancer Prevention Online in a Crisis of Confidence Context: From Medical–Technical Discourse to Social Support 95Dorsaf OMRANE and Pierre MIGNOT5.1. Introduction 955.2. Prevention and crisis context 975.2.1. The breast cancer prevention in question: its system and players 985.3. Methodological choices for the analysis of an online exchange space 1045.3.1. Boundaries of the field: study by the Facebook group “Cancer du sein, parlons-en” (Breast cancer, let’s talk about it) 1045.3.2. Online non-participant observation 1065.4. Results of ethnographic observation and lexicometric analysis 1075.4.1. The emotional support registry 1085.4.2. Informational input and tangible support 1105.5. Conclusion 1125.6. References 113Part 3. Rethinking Health Expertise in Light of the Social Web 119Chapter 6. The Expert Patient in the Digital Age: Between Myth and Reality 121Hélène ROMEYER6.1. Introduction 1216.2. Mutating health care: the professionalization of the patient 1226.2.1. General framework 1236.2.2. The slow evolution of the patient’s status and role 1266.2.3. The evolution towards health information 1286.3. Societal changes and the emergence of the expert patient in the digital context 1326.3.1. New modalities of militancy 1336.3.2. Technological change and empowerment 1356.3.3. Therapeutic patient education: the unthought of digital culture and literacy 1386.4. Conclusion 1406.5. References 141Chapter 7. Towards an Info-communication Categorization of Expertise in Online Health Communities 145Stéphane DJAHANCHAHI, Olivier GALIBERT and Benoit CORDELIER7.1. Introduction 1457.2. The crises of expertise in research in information and communication sciences 1467.2.1. The question of expertise in the face of the diversity of forms of knowledge mobilized in socially relevant issues 1477.2.2. The place of expertise in info-communication and community-based online knowledge mediation dispositives 1497.3. Info-communicational theory of the online community link as a sociotechnical context for the deployment of online expertise 1507.3.1. The ICS approach to health communities 1527.3.2. Specificity of the terrain and the need for a new qualification of expertise 1537.4. Info-communication approaches to health expertise 1557.4.1. Expertise and the online health community 1577.4.2. Negotiation as an info-communication process for legitimizing expertise 1617.4.3. The legitimation of expertise or the production of a community consensus 1617.5. Framework for the community validation of expertise 1637.5.1. The three modes of legitimizing expertise in online health communities 1647.5.2. Articulation of forms of expertise in the context of digital society 1667.6. Conclusion 1697.7. References 170Chapter 8. Identification Metrics Regarding Lay Expertise in Online Health Communities 175Damien DE MEYERE8.1. Introduction 1758.2. Online health information and the notion of expertise 1778.3. Data selection and presentation 1788.4. Description of the measures 1798.4.1. Characterizing engagement 1798.4.2. Characterizing content 1808.4.3. Characterizing the interaction 1818.5. The multiple facets of lay expertise 1828.6. Conclusion 1908.7. Acknowledgments 1918.8. References 191List of Authors 195Index 197