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Reconfigurations of the “patient’s work” and of the therapeutic relationship during the implementation of a telemonitoring device. The case of diabetology Volume 41, issue 2, Juin 2023

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Authors
* Sociologue, Université Gustave Eiffel, CNRS, École des Ponts, LATTS, 77454 Marne-la-Vallée, France
** Infirmière spécialiste clinique (mention maladies chroniques), Le Mans, France

The analysis of the implementation of a remote medical monitoring device in diabetology integrating an algorithm for calculating insulin doses shows how its uses contribute to transforming the “patient’s work” and his/her experience of self-monitoring of blood glucose, as well as the therapeutic relationship. Patients develop various additional tasks inherent to the appropriation of the device, including information work that is characterized by various tactics of making blood glucose data visible. The testing of the new tool will help to build trust in it and stabilize its use, as will the regular relationship with the care professionals located at a distance. As the tasks of calculating insulin doses are entrusted to an algorithm, the caregivers are initially confronted with the vagueness that surrounds therapeutic support. Over time, the relationship with patients tends to be repositioned around listening, support, and reassurance, which leads the practitioners involved in the system to give pride of place to the psychosocial dimension in the care relationship that is established at a distance and to (re)discover the diversity and scope of the tasks inherent in “patient’s work”.