Establishing the valuable findings of consumers’ adoption behavior in this study, it is now the time to build up a concept of the patient as an organization, as it is not only the consumer but also the producer of resources.
This study was conducted with urban populations from a particular country region. However, it can be generalized as it is a common phenomenon worldwide.
Second, although the constructs in the theoretical model provide significant explanatory power (i.e.,
R^2 = 0.684) about consumers’ intention to adopt digital healthcare technology will further explore this concept, including interoperability, enhanced data security, and monitoring of healthcare data, which would also incorporate “patient as an organization” as one of the variables. This will infuse more trust and motivation towards the adoption of digital health.
Organization:
Organization is defined as an entity – such as a company, an institution, or an association comprising one or more people and having a particular purpose, commercial unit that involves one or more individuals to achieve a particular goal.
Organization in a nutshell being described in figure (10) with various subsystem.
“The terminology has been drawn from the Greek vocabulary ‘organon’ that denotes a tool, an organ, or a musical instrument. This description describes an organization with a simple premise, now let’ look at it implicitly through metaphors and images, which has been explicitly defined by Gareth Morgan in his literary work “Images of Organization,” where he used different metaphors to describe organization comprehensively to create valuable insights but at the same time, he is also of the opinion that it can be incomplete, biased and potentially misleading”.
To illustrate, he started with a metaphor that “the organization is a machine.” It is related to the creation of in-depth insights for the structuring of the organization and the attainment of previously ascertained goals. However, the metaphor used is not complete because it does not include human perception or, in other words, ignores the human element. Furthermore, when the concept of an organization as a machine is undertaken by managers, it leads to the design of the organization in the form of machines by using interlocking parts. In this system, each part is supposed to execute the allocated responsibilities so that set objectives are achieved. However, if it does not work in the proposed manner, it may lead to unfortunate outcomes.
Another famous metaphor illustrates that organizations are similar to “organisms.” It deals with developing an understanding and carrying out organizational managing activities by focusing on the “needs” of human resources and environmental associations.
Here, organizations have been categorized into different species, of which the bureaucratic type is just one.
It has been seen that different organisms work in different environments based on their suitability. It helps in acquiring better learning about the way organizations are initiated, progressed, developed, decline, and collapsed. It also includes analyzing how organizations adapt to changes under demanding situations and altering environments. In the context of broader ecology, we can study the relationship between species and evolutionary patterns deeply.
Organizations can be considered organisms that interact with each other in subsets that can be distinguished in various ways. The following instance stressed associations among diverse variables that impact the functioning of the organization functioning and provide a critical understanding.
Organizations are also described as brains where information processing, learning, and intelligence form reference frames as political, cultural, instruments of domination even as “psychic prisons” metaphors in which individuals feel trapped because of their values, thought process, or unconscious mind.
Finally, I would like to discuss the understanding of the organization as a center of fluctuation and renovation by focusing on the “logic” social life alterations, as my study also focuses on conversion.
Here, four different metaphors have been used to study the change:
1) It signifies that organizations act as self-manufacturing units that are responsible for creating their image,
2) extract valuable information by analyzing the study of disorder and complication,
3) organization can be termed an output of circular flows of constructive and unconstructive feedback,
4) explores how the features of the contemporary organization have originated from the dialectical logic in which each incident generates altering outcomes. These inputs aid in acquiring a better understanding of the organization that facilitates managing the change process and shaping an organization’s nature at a societal level.
Integrating the insights and joining the dots between the human element and technology, my study looked at the patient as the organization, which I will validate in detail in the following sections.
Patient to be treated as an organization:
After exploring the literature, it has been primarily found that activities/attributes around patients are considered as concepts; for example, in the article “Patient advocacy in nursing” by Mohammad Abbasinia, Fazlollah Ahmadi, Anoshirvan Kazemnejad, Valuing, i.e., upholding self-control, empowering patients to make the decision, upholding humanity, and patient privacy, has been discussed as a concept.
In the article “Unravelling the meaning of patient engagement” by Tracy Higgins et al., four crucial features of patient engagements, customization, admittance, loyalty, and the remedial pact, are discussed as a concept. Patient involvement is referred to as the aspiration and efficiency of the patient to make a selection or become involved in the care-taking process that he/she is best suited for. The decision that is made by the patient includes the active involvement of the other members, such as healthcare practitioners or institutions, so that optimized levels of care are experienced by the patient.
Patient engagement can be regarded as both procedure and behavior that is responsible for shaping the affiliation amid the patient, healthcare practitioner, and the environment in which healthcare services are delivered.
“A Concept analysis of nurse-patient trust” by Liz Bell, Anita Duffy, where “Rodger’s concept analysis” has been used to describe “Trust” as a concept. (Rodgers’s evolutionary concept analysis is termed an efficient approach that can be used to acquire learning about nursing science. A better understanding of Rodgers’s evolutionary concept analysis can be acquired by referring to the data collection and evaluation process. These processes help in understanding the concept and its related terms with the help of explained examples and consequences. A major focus is given to understanding the concept of trust, which is known to be a vital component in the nurse-patient relationship. However, the major issue with the conception of the nurse-patient relationship is that it is loosely applied in daily discourses because its true meaning is not clear. This indicates that patient trust in the nursing profession cannot be simply implicated because it is the basic requirement of nursing care.
“Patient acuity: a concept analysis” by Caitlin W. Brennan, Barbara J. Daly
In the literature of health sciences, patient perception is known to be a widely used term. However, most of the time, it is used without knowing its exact meaning. This increases the need to clarify the concept so that there is a delineation of the significance of patient acuity. It includes focusing on the features of patient acuity, which are relentlessness, concentration, and the coupling of acuity dimensions with supplementary conception. Based on “Holzemer’s Outcomes Model for Health Care Research,” it can be said that features in the patient acuity can be organized in the form of Patient-, provider- or system-oriented. It includes focusing on the subcategories that are identified in the form of physical analysis, psychosomatic, needs for nursing care, workload, work pressure difficulty, case mix, patient categorization systems, exigency/triage scales, etc.
Patients as an organization: Why this conceptualization required
Hence, the Patient as a concept was not identified in any of these articles, whereas the behavioral aspect, engagement, trust, acuity, i.e., attributes, are identified as concepts. Now the question arises, “Why is Conceptualization required?” it is required because
- Digital health will change the paradigm of “patient-centred care.”
- The existing literature still suggests that patient-centredness lacks conceptual clarity.
- Incoherent outcomes of the efficiency of patient-oriented interferences.
- Conclusively, difficulties in the provision of patient-oriented care.
Let us discuss the existing literature, where patient clinician interaction has been discussed in light of patient-centred care to better understand the ramification of patient technology interaction where human beings are replaced or modified by an interface to improve the said model of care.
The article “An Integrative Model of Patient-Centeredness – A Systematic Review and Concept Analysis Isabelle Scholl*, Jo¨ rdis M. Zill, Martin Harter, Jo¨ rgDirmaier.” This article identified 4707 records by using primary and secondary investigation methods. From the total collected data, 706 were retained by carrying out screening of the abstracts and titles. As a result, approximately four hundred seventeen articles were included, of which 59% of the articles provided a specific meaning of patient-centeredness. This approach led to the identification of 15 patient-centeredness dimensions that were related to clinician-patient associations and patients having an individual identity. It also included other features related to clinicians, patient involvement in care, and unification of medical and nonmedical care. Other attributes, such as clinician-patient communication, coordination, patient empowerment, and biopsychosocial perspective, were also given high accreditation. Features such as patient information, continuity of care, emotional support, teamwork, and teambuilding aspects should also be considered. Access to care, emotional support, and patient information are also to be given due importance so that there is a mapping of different levels of care. This study has been done primarily as “Prevailing frameworks of patient-centeredness”, which disclose the absence of clarity in the conceptual understanding of the terminology of patient-centered care. “It results in a heterogeneous use of the term, unclear measurement dimensions, inconsistent results regarding the effectiveness of patient-centred interventions, and finally in difficulties in implementing patient-centred care.” The present review focuses on identifying varied dimensions related to patient-centredness as mentioned in the literature and suggests the implementation of an integrative model that is related to patient-centredness by focusing on these outcomes.
In this literature, the integrative framework has been suggested with the essence of empowering each stakeholder and enabling them to speak in identical language, which involves medical and nonmedical care. Here, the interaction between clinician and patient has been described, and 15 dimensions of patient-centeredness have been found to be interrelated rather than independent. For instance, the vital features of the clinician play a significant role in influencing the clinician-patient association. It also emphasizes that the involvement of the patient in care is not feasible without making proper use of patient information. It also requires emotional support so that there is developing good interaction between clinician and patient, which forms a major foundation for developing the supportive association.
For example, the fundamental characteristics of the clinician influence the relationship between the clinician and the patient; the involvement of the patient in care is not possible without patient information; good clinician-patient communication is required for emotional support, and communication is key to building a supportive relationship.
Hence, it throws a fundamental question regarding the role of the patient – still the patient will play the role of a passive event-based entity or with the technology intervention it will get transformed into an active entity to script a “NEW HEALTHCARE MODEL.”
In this article, the discussion is about patient technology relationships; hence, the aspects of vital features of the direct clinician-patient association, direct clinician-patient interaction will not be considered or could be considered through a technological interface in case of teleconsultation.
We have to consider a third element or absence of a clinician, i.e., one of the human actors. Replacement of human actors by non-human actors changes the paradigm that acknowledges patients having an individual identity. It also included other features related to clinicians, patient involvement in care, and unification of medical and nonmedical care. Other attributes, such as clinician-patient communication, coordination, patient empowerment, and biopsychosocial perspective, were also given high accreditation. Features such as patient information, continuity of care, emotional support, teamwork, and team building aspects should also be considered. Access to care, emotional support, and patient information are also to be given due importance so that there is mapping of different levels of care. Therefore, it gives rise to a fundamental question of the role of the patient from a mere event-based entity being transformed into a comprehensive entity playing multiple roles. Hence, a new conceptualization needs to be explored.
Patient as an individual – Can be considered as organization?
Now the question arises can the Patient be considered as Organization to as they are an individual, let’s explore further to find out Why & How patients to be regarded as organizations to achieve an integrated approach of patient-centeredness.
This very idea of developing Patient as an organization got strengthened after going through the book “Medicine as Culture: Illness, Disease, and the Body,” by Deborah Lupton,[21] where she mentioned Deleuze and Guattari’s work, that body, Health, and identity(Patient) are inseparable and interdependent entities’ which constitute each other in a mutually dependent interchange of practice, meaning, social relations and relations with objects.’
She also discussed the state’s role, which executes supervisory action and controlling bodies to determine how persons such as patients implement measures to “self-regulate and regulate their bodily deportment.”
Turner [1] explained “the notion of somatic society, in which the body is a metaphor for social organization and social anxieties, the principal field of cultural and political activities. The regulation, surveillance, and monitoring of bodies, of the spaces between bodies, are central to somatic society.”
Furthermore, several authors and anthropologists, such as Scheper-Hughes, have described three bodies within the physical body of the individual or patient at three separate but overlie theoretical and systematic levels.
“The first is the individual body, understood as the lived experience of the body self; how we each view our bodies, distinct from each -others’ bodies.
The second is the social body, or the symbolic representative uses of the body conceptualizing nature, society, and culture, evident in discourses referring to a “sick society,” the “foot of the mountain” or the “head of state.”
At the third level is the biopolitics of the body, in which the state controls, regulates and surveys the conduct of bodies on the individual and group level to maintain social “stability”.
Frank[22] describes four types of bodies: “1) the medicalized body; 2) the sexual body; 3) the disciplined body; and 4) the talking body. The boundaries between these typologies are necessarily fluid. Although the first typology of the body, the medicalized body, is most directly related in its title to the medical management of disease, it is the case that the other types of bodies are also bound up with the medical system.”
With the advent of digitization, the third level of biopolitics witnessed the birth of another dimension, i.e., the digital manifestation of the body, i.e., virtual self in the form of data. Hence, the surveillance and monitoring by the state was extended to the virtual self and the physical self of the patient.
The care model is to be centered around patients with enhanced coordination and integration of different care processes and access similar to the organization. Improved engagement with the patient and support of emotional and psychological needs will ensure a better outcome.
Encouraging self-management by monitoring will ensure better primary and preventive care.
Delivery of holistic care is limited to communication, measuring, diagnosing, and providing treatment with AI embedded tools, i.e., combining genomics with digitization will facilitate the active participation of patients as an organization.
Digitization led to the creation of virtual self:
Now let’s deep dive to understand the concept of “Patients as an Organization in the healthcare domain,” digital Health gave Patients a unique opportunity to create their own “virtual self.”
Thus, patients have become an integral part of the digital revolution, the supplier of data, and the digital manifestation of their body, developing the unique concept where genetic mapping will complement physical body mapping. It is going to script a new evolution of treatment far from conventional doctor-led treatment. Both genetic coding and coding of the physical body will redefine the healthcare of the connected world.
Here may be a perspective related to the digital archive related to the body. It specifies that when the patient’s body is digitized, they become activated and play a major role in exercising control over their health conditions. It helps in creating data related to self-health along with sharing the information so that there is access to information that has been obtained from medical testing.
“A new vision of the digital archive of the body: Patient bodies that are digitized and thus able to become engaged and activated, to take control of their health and to create their data on themselves and share these data with others also to access the info produced by medical testing.”
Image adaption: DXC Technology.
The above Figure(11) adapted from DXC Technology will help us to better understand that “Patients as an organization are capable of generating and accessing both clinical and non- clinical data for all the relevant stakeholders of healthcare providers.
This has only been possible with the intervention of latest digital tools/wearables which keep them informed as well as provide insights to act upon.
Hence inside or beyond hospital boundaries, patient to be treated akin to organization as a means of producer and consumer of real-time data which will further ensure better coordination of clinical and nonclinical pathways to deliver high-quality care. Access to relevant information in real time will help to overcome potential bottlenecks. For example, if the flow of patients through the care journey is delayed, services such as other appointments, cleaning, transportation, meal ordering, and others are also pushed back. Real-time data will also enable health intervention before problems occur.
Ultimately, all stakeholders benefit from having access to a 360-degree understanding of all relevant data—clinical and nonclinical.
Data will need to be made available and understandable through standardization—outside of the silos where they were generated to achieve the desired goal. The ability to contextualize the data in the right place, at the right time for the right Patient through technologies such as predictive modeling and artificial intelligence will help to support innovative engagement, to ensure 360-degree Patient journey.
Fourth basic need – Envisage the change of paradigm
Today, health is the fourth basic need apart from food, clothing, and shelter. I was listening to the vice president of Manipal Hospital, and he had rightly said the civil war could happen due to inequalities in providing quality healthcare as it is considered a fundamental right for all. The SDG-3 of the WHO also considers good health and wellbeing for all. Here lies the real question: How? If we look at it worldwide, the accessibility of healthcare is one of the significant problems in the USA. India, the ratio between doctor to patient, stands 0.7 to 1156, a recent report, one of the lowest in the world.
Knowledge creation and technology adoption may act as a bridge to effect organizational change, i.e., improve the lives of the people. The telecommunication revolution and penetration of mobiles ushered new opportunities to reach out to the masses. “Dreaming Big” by Sam Pitroda opened my eyes and instilled hope that healthcare in digital form can reach the nondescript lives of the people.
Therefore, to improve patients’ quality in the early detection and prevention of diseases, there must be the involvement of technology (non-human actor) to bridge the gap between doctors and patients.
Now the question arises:will non-human actors limit themselves to ensuring the reach, or will there be more significant involvement in the diagnosis ,i.e., end to end solution?
Do non-human actors change the system – Digital doctors replace human doctors or complement human doctors?
From the above observations, it is amply clear that the event-based healthcare model is clearly at the critical juncture where non-human actors, i.e., technology, will play a vital role. Foucauldian theory draws attention to matters relating to biopolitics, govern-mentality, and monitoring or surveillance of the human body; his work has been discussed and analyzed in the sociocultural context of “medicine and public health” and as a supplement to digital health. It has strong relevance to look critically at the analysis of digital health. His observations about digital technologies and digital surveillance technologies become connected while examining the community impact when this non-human actor (digital technologies) can be utilized both as a monitoring and diagnostic tool to measure the human body.
The relation between human actors and non-human actors can be judged by embracing digital health to improve healthcare through proactive attitudes. These discussions recommend exercising monitoring over one’s black box, i.e., the organization and its peculiarities, which are often better managed by technological means. Common populations are motivated to develop a routine framework through which they could regularly evaluate physiological pointers and thereby create a proactive system for supervising their body health conditions that were monitored by the healthcare providers earlier. The introduction of technology will digitize the human body. The data they will produce will be the source of the evidence-based treatment plan. It will be an inevitable move in practice related to mapping and surveying the blood and flesh to make indoor revelations and scrutinize the functionaries of the body with greater detail. It also includes recording and analyzing the information that has been produced by these activities.
Therefore, it will set the trend towards a “patient-based healthcare model” facilitated by technologies to transform from the process of mechanical medicine to the process of precision medicine. The transformation has involved wearables, mobile connectivity, health information systems, imaging, and less haptic (touch); hence, the concept of medicine is becoming a result of the Digital Revolution + Genomic Revolution. Therefore, it can be said that the attainment of more information will result in the attainment of better healthcare information that leads to economic efficiencies by improving patient participation.
Evolution of patient as an organization :
The implications discussed clearly show the characteristics of open systems, developing a design that effectively manages the exchanges of information in the form of data across different organizations through interoperability of data by ensuring data security through proper surveillance & monitoring. Here, patients in the form of organizations are conceived as consumers of resources (availing healthcare services through the adoption of digital health) and resource exporters (producer of data). To survive and thrive, they are compelled, to adapt the changing environment similar to open systems. In this context, environmental change faced by the open system organization will be akin to the transformation of the healthcare model.
Therefore, it has been observed to operate, survive & exist as an open system organization primarily three challenges need to be addressed namely: 1) regulatory, i.e., standards, 2) different data formats, and 3) data security and surveillance.
To alleviate the first challenge, let us examine the number of initiatives taken worldwide.. Well-being services and legislatures figure at the government policy for both within the country and across the country
Let us briefly understand the steps taken by various countries for the exchange of patient healthcare data.
The Global Digital Health Partnership (GDHP) partners with 40 countries and its government agencies and World Health Patient to promote digital health, i.e., Cultural Change initiatives to blur the borders and ensure seamless interoperability of organizational (Patients)data.
In Europe, the EU EHR Exchange Format is working towards the transformation of patient care by formulating a platform of easy-flowing healthcare data across its member countries, enabling its population to access and exchange healthcare data anywhere within the European Union.
The central infrastructure for the EHR exchange is the eHealth Digital Service Infrastructure. The eHealth Digital Service is ushering in an infrastructure of healthcare data continuity across the borders. The initial focus is on allowing the exchange of basic health information, including the following:
e-Patient Outline to give admittance to confirmed indispensable wellbeing information of a Patient during a spontaneous consideration experience while abroad,
e-Prescriptions empower patients to get comparable medicine treatment while abroad to what they would get in their nation of origin.
Utilizing the X-load Platform, various European Union nations are already sharing e-Patient summaries and e-Prescriptions. Finland and Estonia were the first to take the plunge and implemented the infrastructure to exchange patient summaries protecting privacy. There are further plans to trade diagnostic tests in both radiology and pathology.
To develop improved primary care and optimal usage of medical devices and to ensure evidence-based medicines rather than mechanical medications by sharing and exchanging different forms of healthcare data, for example, EHR, genomics, and registries, by maintaining privacy. The European Commission additionally laid out needs for the “2019-2024 EU Digital Strategy, which included making a European Health Data Space.”
The European Interoperability Framework (EIF) provides specific guidance on the formation of interoperable digital public services. To improve interoperability governance, it formulated forty-seven concrete recommendations to ensure cross-patient relationships and establish end-to-end digital service frameworks without compromising existing and new legislation.
Like the EU EHR Exchange Format, Nordic Countries also have an integrated basic level initiative of patient data exchange within their member countries to ensure seamless treatment of their populations. Its objective is to provide the most sustainable, integrated customized healthcare solutions for all its people by 2030.
In Asia and the South Pacific, numerous Asian nations are additionally embracing advanced wellbeing methodologies to guarantee interoperability. Referring to the case of “The Ministry of Health and Family Welfare (MoHFW) of India”, they previously distributed “Electronic Health Record norms and shaped a Center for Health Informatics under the aegis of eHealth Division of “Ministry of Health and Family Welfare” as a feature of their National Digital Healthcare Mission (NDHM).
New Zealand’s medical care offices, patients, and people marked a commitment to “New Zealand health interoperability” to diagram the orders to foster the reception of trade foundations and cycles in their wellbeing area.
- Interoperability of Healthcare Data-Deep dive:
“HIMSS definition of interoperability as being the ability of different information technology systems and software applications to communicate, exchange data, and effectively allow patients and healthcare practitioners to use that information. [23]
FHIR(fast healthcare interoperability resources): To establish standardization of organizational data
Open systems thinking conceives of seamless interaction with the environment; therefore, a normal trade standard is needed to open the information put away inside them. Here, FHIR plays a crucial role in interacting with third-party applications. NIH scientists could then foster outsider applications to remove clinical information from an FHIR API to further develop wellbeing disclosures. “An eBusiness-based Framework for eHealth An eBusiness-based Framework for eHealth Interoperability” in this article authors Kuziemsky, Craig Kuziemsky, Craig E pointed out
On the information and data level, we want to consolidate norms that are available to laypersons. It might incorporate angles, for example, (1) the reception of customer situated phrasings while planning them to clinical codes and (2) the reception of an originally driven worldview of demonstrating data content in a particular and reusable manner, rather than the conventional message-driven worldview.
FHIR workflow-Figure(12). There are three main functional blocks or components considered in the solution, as shown numbered in the diagram below:
1. FHIR API Converter to convert historical clinical data to FHIR format
2. AI/ML engine for prediction, diagnosis, and recommendation
3. FHIR Prediction Bundle to persist predictions
Details around each of the functional blocks are given below:
1. FHIR API Convertor Historic health data come in various formats (JSON, PDF, Excel, Bio market Dataset) from different sources, including existing solutions linked to Social Media and Wearables, HIP, etc. The FHIR converter runs as a REST web service and can be deployed in the cloud. It takes the historical health data as input and converts it to FHIR bundles. These bundles can persist to an FHIR server such as the FHIR API.
2. AI/ML engine for prediction, diagnosis, and recommendation This component accomplishes the following:
This component accomplishes the following:
• Feature Construction: The element development task processes an element vector portrayal for every patient dependent on the patient’s EHR information in the FHIR design. EHR information can be considered to be various occasion successions over the long haul (e.g., a patient can have numerous findings of hypertension at various dates). A perception window (e.g., one year) is determined to change over such occasion groupings into highlight factors. Then, at that point, all occasions inside the window are totaled into a solitary or small arrangement of qualities. Feature Selection. The feature selection component of predictive modeling automatically extracts highlights for hazard forecasting dependent on a pre-characterized and extensible substance diagram (i.e., manifestations and hazard order). The extraction is autonomous of infection type or hazard forecast task. The features selected are typically demographics, diagnosis, lab result, symptoms, medications, vitals, etc.
• Predictive Modelling: Predictive Modelling Pipeline leveraging multiple supervised, unsupervised and deep learning AI/ML techniques as mentioned in the diagram above to perform the following steps:
• On the entrance level, we want to give components that empower secure and reliable division of wellbeing data among customers and suppliers while guaranteeing that protection and precision are saved. Arising advancements, for example, Web 2.0 will be an essential driver of expanded openness.
• Finally, at the framework and responsibility level, we need to devise components that guarantee the nature of purchaser situated eHealth frameworks and the constancy of the administrations they give. Plans for remunerating eHealth parental figures for their administrations should be created.’
- Data Security and surveillance
Blockchain – To ensure organizational (Patient) data security
Sharing and exchanging healthcare data with security is also an essential aspect in line with interoperability to ensure the progress of digital health; therefore, blockchain can play an indispensable role in preventing a breach of healthcare data, which can save millions of dollars. The cloud has started to play a vital role in terms of data storage; this trend has been observed in healthcare as well; there has been a gradual shift of “data and services” to the cloud mainly for two reasons: 1) convenience, as the entire patient history is available in real time, and 2) savings, as it enables healthcare data management at an affordable cost. Interconnecting the different healthcare providers and their Patient Health Record solutions will help them take urgent or proactive action during any eventuality.
Blockchain’s relevance in healthcare: Blockchain is an innovation stage ready to assemble an open and disseminated online data set, consisting of a rundown of information structures (otherwise called blocks) connected (i.e., block-focuses to the ensuing one, thus the name blockchain). These squares are spread across various hubs of the framework and are placed discreetly. Each square contains a creation of its timestamp, the hash of the past block and the exchange information, and in our specific situation, medical care information of the patient and the medical services supplier data. Hence, Blockchain has been designed to be secure, ensuring decentralized agreement and consistency and insuring against cyber attacks that are either intentional or unintentional in nature.
Disciplinary and surveillance capabilities of digital health technologies
Explicit expectations of patients are set by them, expecting patients to participate in self-observing practices at specific intervals, for instance, or ensuring that they remind them to take medicine on time, mention them to rate and rank their medical services suppliers on an assessment site, or transfer their encounters of ailment and clinical therapy on persistent help sites. In the talk of the carefully connected with the patient, hence, ‘strengthening’ turns into a lot of commitments. [24]
Accordingly, for instance, research on “Dutch heart patients utilizing telemedicine gadgets,” for example, a framework to quantify body weight and pulse of the patients, a cell phone fit for directing and communicating an ECG, and a gadget to analyze heart-cadence anomalies, observed that the bodies and home conditions of the patients were focused on the expected schedules. They were relied upon to adjust to exact day-by-day timetables of observing their bodies and sending information to their medical care suppliers and to react to messages and markers shipped off them at different occasions every day. [25]
Patients might estimate these innovations as a method of keeping away from a visit to the specialist when they would prefer not to see them eye to eye and subsequently set up a separation from clinical reconnaissance. [26] On the other hand, they might observe the commitment of self-observation overpowering, driving them to defy their ailment, participate in routine activities they would prefer to stay away from, or manage advanced co-operations that are tedious. A few patients react to the “disciplinary and observation” objectives of self-care and self-checking by opposing or avoiding medical care suppliers’ headings and the commitments expected of them. People might have different needs, and in this manner, they avoid the utilization of the gadgets given to them in the ways that are usually expected of them. Patients may “play the framework,” explore different avenues regarding their treatments or pull out data from the medical services suppliers if it does not adjust to assumptions. [27]
Patients’ protection from the utilization of computerized wellbeing gadgets for self-care is regularly clarified by factors such as ineptitude, apathy, obliviousness, or even technophobia concerning more seasoned individuals corresponding to utilizing these technologies. However, considerably more youthful individuals who are more knowledgeable about the utilization of advanced advances all the more, by and large, might disdain, challenge, or essentially overlook the undertakings and obligations requested of them by “telemedicine.”34 Certain individuals like to participate in physical rather than virtual experiences with medical care suppliers, needing what they consider to be more close-to-home cooperation, as well as utilizing telemedical innovations for certain reasons. [28][29]
The techno-idealistic beliefs of the advances utilized for these designs are habitually tested in the real-life encounters of the patients who make use of them. Mol directed an investigation of “Dutch individuals” suffering from diabetes who were needed to routinely screen the glucose levels of their blood for the day. She takes note of the intricacies and troubles of utilizing self-checking advances and in deciphering the information created: ‘practically speaking everyday care pivots muddled, material, malodorous, wicked, alarming, or dreary exercises that will generally be hard to accomplish (for experts just as patients)’. [30]
Mol and Law 2009; [31] proceeds to bring up that endeavors to practice command over the diabetic body, including utilizing checking and self-care gadgets, are ill-fated to fall flat, essentially given the notions and inconsistent nature both of the body and the advances intended to help individuals take control. As she contends, ‘innovation is never entirely subdued. It does not provide control, and it changes along with different components of everyday practices of care. [30]
Surveillance tool for organizational data (biomets)
As the organization, i.e., the human body, is the source of data, it monitors clients’ qualities identified with cognizant and oblivious changes in human attributes and body boundaries, similar to demeanor, inspiration, temperature, skin conductance, pose balance, mind action, pulse elements, and other crucial boundaries, to survey clients’ more complicated attributes, such as feelings and conduct. With the Internet of Things (IoT) innovation, each biometric observing gadget can remotely discuss and send this information. With the advent of remote care technology, home care is gaining prominence; therefore, home care devices are now equipped with technologies that enable clinicians to monitor and check patients from a remote location with a click of a button.
BioMeT amalgamates both programming and equipment parts for wellbeing applications. Both programming and equipment and their administrative parent businesses from ages included confirmation and approval as a piece of their quality control of the board cycle. “IEEE Standard for System, Software and Hardware Verification and Validation (IEEE 1012-2016) guides the verification and validation of connected devices for both software and hardware.”
Discussion on paradigm shift: Mere consumer to Organization
In the research article “Darwinism and cultural change,” Peter Godfrey-Smith38 states, “Evolutionary models of cultural change have acquired an important role in attempts to explain the course of human evolution, especially our specialization in knowledge-gathering and intelligent control of environments. Different patterns of explanation become relevant at different ‘grains’ of analysis and in contexts associated with different explanatory targets in both biological and cultural change. Existing treatments of the evolutionary approach to culture, both positive and negative, underestimate the importance of these distinctions. Close attention to the grain of analysis motivates distinctions between three possible modes of cultural evolution, each associated with different empirical assumptions and explanatory roles.”
Therefore, considering the evolution of Patient from Consumer to Organization explains the nuances of cultural evolution from individual to an abstract notion the ‘Organization’, as it is hard to see as described in the book “Organization Theory & Design” An International Perspective by Richard L. Draft, Jonathan Murphy, and Hugh Willmott.
Physically, it may be dispersed among multiple locations in different continents and has an uncanny similarity with the patients. Further, the definitions used in the book mentioned above are Organizations are 1) Social Entities, 2) Goal coordinated, 3) are planned as purposely organized and coordinated, and 4) connected to the outer climate. The vital component of an association is not a structure or a set of strategies and methodology; an organization exists where there is interaction within and outside the organization.
This evolution is necessary, as today patients are not mere consumers but also producers of resources. They should be credited similar to the organizations, which include 1) bringing together assets to accomplish wanted objectives and results, 2) Facilitating advancements, 3) Harnessing current data innovations, 4) Adapting to and impacting evolving climate, 5) Creating Value, and 6) Accommodating moral difficulties.
Furthermore, as a contributor to R&D and Businesses, patients should be considered similar to the company as the most important organization, as described in the book “The Company: A Short History of a Revolutionary idea" by John Micklethwait and Adrian Wooldridge.
The organization was the main independent social and legitimate foundation that was inside society yet free of the focal government. The company is the most effective maker of labor and products that has been known by the world at any point in time. Without an organization to outfit assets and put together exercises, the expense for shoppers for practically any item we realize today is difficult to bear.
Generally, the company has been given the power to give individuals beneficial exercises, character, and the local area just as a check. The following examples will make it clear how this evolution will help the patients become organizations.
Taking into consideration “Google,” which came to prominence first as the supplier of the web’s most well-known web index, keeps on adjusting, developing and developing alongside the advancing web. Rather than being unbending assistance, Google is consistently adding mechanical highlights that make an improved proposal by gradual addition. Organizations, for example,” Philips, AES Corporation, Heineken Breweries, and IBM” are associated with vital collusions with organizations throughout the planet. They are additionally occupied with campaigning state-run administrations and controllers and submitting gigantic totals to initiatives that strengthen the position of the organization’s not promotes their brands or avoids taxes (e.g., through transfer pricing and use of tax havens) with an end goal to impact the climate, contend on a worldwide scale, and consequently guarantee that their stock remaining parts appealing to financial backers. Through these exercises, associations create an incentive for proprietors as they convey products and enjoy rights which avoided them to be exploited.
Patient as consumer as well as producer of resources should be treated in a similar way mere protection of patient resources to save them from become “Guinea pig” is not enough as we are all aware of the fate of “Henrietta Lacks” . Hence to avoid such exploitation patient need to be treated as an organization to enjoy the same rights of the said entity.