Abstract
Remote patient care has become an important part of how clinicians understand and interact with their patients. Systems that deliver such care are carefully designed and monitored, but are changing the nature of the relationship between clinical practitioners and patients. They are also now being deployed with Artificial Intelligence (AI) to add a further dimension to the relationship. To explore this changing relationship, this paper reports a fieldwork study of a remote patient monitoring system recently implemented in a hospital in the Netherlands. Using an ethnographic approach over 7 months, including participant observation and semi-structured interviews with clinicians and healthcare administrators, the study shows how a kind of 'technological promise’ - framed by system designers as optimizing and problem-solving within clinical workflows - unfolds in practice. There are desires, but also anxieties surrounding AI’s integration into healthcare which reveal tensions between automation and affect, efficiency and empathy, and control and contingency in the digitization of care. We conclude by suggesting that, while new systems are designed to enhance efficiency and enable preventive care, they also redistribute clinical responsibilities and require physicians to engage with new forms of datafication (or what we term ‘data-fiction’) whilst maintaining the relational dimensions of care. This study contributes to a broader discussion about how ideologies of design influence emerging healthcare paradigms, and questions the extent to which AI can uphold, rather than erode, the relational foundations of medical practice.
Keywords
Remote Patient Monitoring (RPM); Artificial Intelligence (AI); Care; Design Ideology
DOI
https://doi.org/10.21606/iasdr.2025.1193
Citation
Ranjbar, S.,and Lloyd, P.(2025) "The Real Patient Often Wonders 'Where is Everybody?'": A Design Ethnography of Remote Patient Monitoring, in Chang, C.-Y., and Hsu, Y. (eds.), IASDR 2025: Design Next, 02-05 December, Taiwan. https://doi.org/10.21606/iasdr.2025.1193
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Conference Track
Track 9 - Healthcare Design
"The Real Patient Often Wonders 'Where is Everybody?'": A Design Ethnography of Remote Patient Monitoring
Remote patient care has become an important part of how clinicians understand and interact with their patients. Systems that deliver such care are carefully designed and monitored, but are changing the nature of the relationship between clinical practitioners and patients. They are also now being deployed with Artificial Intelligence (AI) to add a further dimension to the relationship. To explore this changing relationship, this paper reports a fieldwork study of a remote patient monitoring system recently implemented in a hospital in the Netherlands. Using an ethnographic approach over 7 months, including participant observation and semi-structured interviews with clinicians and healthcare administrators, the study shows how a kind of 'technological promise’ - framed by system designers as optimizing and problem-solving within clinical workflows - unfolds in practice. There are desires, but also anxieties surrounding AI’s integration into healthcare which reveal tensions between automation and affect, efficiency and empathy, and control and contingency in the digitization of care. We conclude by suggesting that, while new systems are designed to enhance efficiency and enable preventive care, they also redistribute clinical responsibilities and require physicians to engage with new forms of datafication (or what we term ‘data-fiction’) whilst maintaining the relational dimensions of care. This study contributes to a broader discussion about how ideologies of design influence emerging healthcare paradigms, and questions the extent to which AI can uphold, rather than erode, the relational foundations of medical practice.