Mobile Health in Belgium: Telemonitoring Chronic Obstructive Pulmonary Disease
The eHealth Action Plan 2013-2018 addresses the implementation of mobile health solutions in Belgium. A pilot project consisting of telemonitoring patients suffering from chronic obstructive pulmonary disease took place in 2017, driven by the National Institute for Health and Disability Insurance. The project gathered a tablet, connected devices, a hospital care team, general practitioners, patients, as well as a private firm. The originality of the project lied in the presence of the latter actant within the sociotechnical network (Akrich, 2006a, 2006b; Callon, 2006). It created a double mediation, both induced by the mobile devices as well as by the agents of the private company. Thanks to a qualitative method of data collection (interviews, observation and documentary analysis), we will show how actants deviate from the script inscribed into the technical devices, the medical protocol and the user manual. The double mediation prevents patients from becoming diagnostic agents (Oudshoorn, 2008). The increasing distrust (Marzano, 2010) within the system leads to mutual surveillance and hinder the normalization of the technical solution (Nicolini, 2010).