Understanding the Advantages of Mobile Solutions for Chronic Disease Management: The Role of ANT as a Rich Theoretical Lens

In an environment of escalating healthcare costs, chronic disease management is particularly challenging, since, by definition such diseases have no foreseeable cure and if poorly managed typically lead to further, complicated secondary health issues, which ultimately only serve to exacerbate cost. Diabetes is one of the leading chronic diseases and its prevalence continues to rise exponentially. Thus it behooves all to focus on solutions that can result in superior management of this disease. Hence, this article presents findings from a longitudinal exploratory case study that examined the application of a pervasive technology solution; a mobile phone, to provide superior diabetes self-care. Notably, the benefits of a pervasive technology solution for supporting superior self-care in the context of chronic disease are made especially apparent when viewed through the rich lens of Actor-Network Theory (ANT) and thus the paper underscores the importance of using ANT in such contexts to facilitate a deeper understanding of all potential advantages. DOI: 10.4018/jantti.2012010101 2 International Journal of Actor-Network Theory and Technological Innovation, 4(1), 1-12, January-March 2012 Copyright © 2012, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. ACTOR-NETWORK THEORY (ANT) Actor-network theory (ANT) provides a rich and dynamic lens of analysis for many sociotechnical situations. Essentially, it embraces the idea of an organisational identity and assumes that organisations, much like humans, possess and exhibit specific traits (Brown, 1997). Although labelled a ‘theory’, ANT is more of a framework based upon the principle of generalised symmetry, which rules that human and non-human objects/subjects are treated with the same vocabulary. Both the human and non-human counterparts are integrated into the same conceptual framework. ANT was developed by two French social sciences and technology scholars Bruno Latour and Michel Callon and British sociologist John Law (Latour, 1987, 2005; Law & Hassard, 1999; Law, 1992, 1987; Callon, 1986). It is an interdisciplinary approach that tries to facilitate an understanding of the role of technology in specific settings, including how technology might facilitate, mediate or even negatively impact organisational activities and tasks performed. Hence, ANT is a material-semiotic approach for describing the ordering of scientific, technological, social, and organisational processes or events. Key Concepts of Actor Network Theory Central to ANT and relevant for this specific context are the six key concepts as follows: a) Actor/Actant: Typically actors are the participants in the network which include both the human and non-human objects and/or subjects. However, in order to avoid the strong bias towards human interpretation of Actor, the neologism Actant is commonly used to refer to both human and non-human actors. Examples include nurses, doctors, thermometers, electronic instruments, technical artifacts and graphical representations. b) Heterogeneous Network: Is a network of aligned interests formed by the actors. This is a network of materially heterogeneous actors that is achieved by a great deal of work that both shapes those various social and non-social elements, and ‘disciplines’ them so that they work together, instead of ‘making off on their own’ (Latour, 2005). c) Tokens/Quasi Objects: Are essentially the success outcomes or functioning of the Actors which are passed onto the other actors within the network. As the token is increasingly transmitted or passed through the network, it becomes increasingly punctualised and also increasingly reified. When the token is decreasingly transmitted, or when an actor fails to transmit the token (e.g., the broadband connection breaks), punctualisation and reification are decreased as well. d) Punctualisation: Is similar to the concept of abstraction in Object Oriented Programming. A combination of actors can together be viewed as one single actor. These subactors are hidden from the normal view. This concept is referred to as Punctualisation. An incorrect or failure of passage of a token to an actor will result in the breakdown of a network. When the network breaks down the result is the breakdown of punctualisation and the viewers will then not be able to view the sub-actors making up the actor. This concept can be referred to as depunctualisation. e) Obligatory Passage Point (OOP): Broadly refers to a situation that has to occur in order for all the actors to satisfy the interests that have been attributed to them by the focal actor. The focal actor defines the OPP through which the other actors must pass through and by which the focal actor becomes indispensable (Callon, 1986). f) Irreversibility: Callon (1986) states that the degree of irreversibility depends on i. 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