Why expectations of telecare are often wrong
An ethnographic study of a telecare device used by nurses in palliative care
Telecare is increasingly applied in nursing care with the expectation that it will lead to valuable improvements in measurements, data collection, efficiency and communication options. However, science and technology studies have shown that new technology often belies expectations and can lead to unanticipated results. We use an ethnographic approach to study a nursing practice in which nurses introduced a digital ‘symptom diary’ in palliative care. We show that the nurses’ expectations differ from the way patients actually use the device. Furthermore, the nurses realize that the diary conflicted with ideals of good care that are crucial in their practice. Finally, the technology included an ‘extra’ technology, a webcam, that brought difficulties of its own. Nurses’ expectations of the telecare device turned out to be different, but over time nurses and patients deal with them in the changed practice. We add on the knowledge of how expectations work out in practice, but also on how care professionals and patients deal with that. With this knowledge, care can be improved as more founded decisions can be made: what technology is to be used, are (unexpected) outcomes desirable and therefore in the end the question whether the preferred care is given.