Communication as Ongoing Care

THIS ARTICLE INVESTIGATES HOW THE PATIENT PORTAL MYCHART IS CURRENTLY EMBEDDED IN THE INFRASTRUCTURE FOR THE COLLABORATIVE CARE FOR PEOPLE IN REHABILITATION OR LIVING WITH CHRONIC DISEASE. WE AIM TO SENSITIZE DISCUSSIONS ABOUT LOGICS OF CARE (MOL, 2008), CARE INFRASTRUCTURES (DANHOLT & LANGSTRUP, 2012) AND THE PUSH FOR SELF-CARE TO THE ROLE OF INFORMATION, MEDIATED COMMUNICATION AND PARTICIPATION IN ACHIEVING GOOD CARE. WE BASE OUR ARGUMENT ON FINDINGS FROM FIELDWORK AMONG PATIENTS AND CLINICIANS AT TWO HOSPITAL UNITS FOR GASTROENTEROLOGY AND CARDIOVASCULAR DISEASES IN COPENHAGEN AROUND THE IMPLEMENTATION AND USE OF MYCHART FOR INFORMATION, COMMUNICATION AND PARTICIPATION IN SELF-CARE. OUR FIELDWORK INDICATES THAT PATIENTS HAVE CLEAR – BUT VERY DIFFERENT – PREFERENCES FOR ACCESSING AND ENGAGING WITH INFORMATION AND COMMUNICATION THROUGH MYCHART. WE LINK THESE MODES TO EXPERIENCES OF AUTHORITY, ROLE-EXPECTATIONS AND THE PROSPECT FOR JOINT DECISION-MAKING IN HEALTHCARE. WE SUGGEST THAT THE INTRODUCTION OF MORE COMMUNICATIVE FLEXIBILITY FOR SOME PATIENTS SPEAKS TO AN IMPORTANT ELEMENT IN CONTEMPORARY CARE INFRASTRUCTURES, REGARDING MEDIA CHOICE. THIS CHOICE, WHILE SEEMINGLY TRIVIAL, GRANTS THE PATIENT COMMUNICATION AGENCY AT A POINT WHERE THE PATIENT CAN ACTUALLY MASTER THE ROLE OF ACTIVE PARTNER IN CARE. WE FURTHER SUGGEST THAT ATTENDING TO OFTEN OVERLOOKED RITUAL ASPECTS OF COMMUNICATION MAY HELP QUALIFY ANALYSES OF CARE IN PURSUIT OF A GOOD LIFE.