The Curious Case of Transparency: How Patient Portals Empower Physicians

While increasing public and academic attention is given to transparency of medical records, relatively few studies have approached the use of patient data from the perspective of situated practice. Our observations of 115 patient consultations in oncology surgery department illustrate the different ways in which professionals and patients approach and use personal health data. The physicians are professionally trained to treat data neutrally and flexibly, recognizing the indeterminate nature of test results. The patients, on the other hand, perceive the numbers of their test-results as an objective mirror of their own disease, which makes the constant confrontation with it an emotional event. Our study concludes, that in contrast to the assumed “patient empowerment”, opening up medical records might increase patients’ dependency on their medical professionals, potentially leading to “physician empowerment” instead. Taking a situated perspective on data use helps to illustrate that increased empowerment of patients through transparency might actually be an elusive ideal, and thus highlight the affective and power aspects of transparency technology.