Concordance: a critical participatory alternative in healthcare IT

Abstract

The healthcare sector is undergoing large changes in which technology is given a more active role in both in-clinic and out-of-clinic care. Authoritative healthcare models such as compliance and adherence which relies on asymmetric patient-doctor relationships are being challenged as society, patient roles and care contexts transforms, for example when care activities move into non-clinical contexts. Concordance is an alternative model proposed by the medical field that favours an equal and collaborative patient-doctor relationship in the negotiation of care. Similarly, HCI researchers have applied diverse models of engagement in IT design ranging from authoritative models (e.g. perceiving people as human factors to design for) to more democratic design processes (e.g. Participatory Design). IT design has also been crafted as on-going processes that are integrated parts of everyday use. Based on the best practice of participation from the medical and the HCI fields, we identify critical alternatives for healthcare design. These alternatives highlight opportunities with ongoing design processes in which the design of care regimens and care IT are perceived as one process.