Il sistema della salute in transizione. La cartella sanitaria personale tra commodificazione dei dati e blockchain

Journal title SALUTE E SOCIETÀ
Author/s Achille Pierre Paliotta
Publishing Year 2019 Issue 2019/2
Language Italian Pages 16 P. 160-175 File size 215 KB
DOI 10.3280/SES2019-002013
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New technologies, including blockchain, are capable of facilitating the management and ex-change of health-care data (people’s personal health records) while permitting patients to de-cide autonomously to whom and when to make these data available while, at the same time, safeguarding their privacy. One these new technologies have been set up they might impact, however, on traditional «medical dominance » by placing the patient at the heart of the health-care system. The final outcome of a similar process could well lead to the hegemony of forces supporting a neo-liberal vision, with the patient as a consumer of health products and services as well as an informed and attentive self-manager of his/her own medical data and health-care services, both as commodities made available on the market.

Keywords: Digital health; healthcare professions; personal health record (PHR); professional dominance; data commodification; Blockchain.

  1. Appadurai A. (1986). Introduction. Commodities and the Politics of Value. In Idem (ed), The Social Life of Things. Commodities in Cultural Perspective. Cambridge (UK): Cambridge University Press, 3-63.
  2. Ardissone A. (2017). “La relazione medico-paziente nella sanità digitale. Possibili impatti sul professionalismo medico”. Paper presentato a SISEC, Roma, 26-28 gennaio.
  3. Commissione Europea (2018). Comunicazione relativa alla trasformazione digitale della sanita e dell’assistenza nel mercato unico digitale, alla responsabilizzazione dei cittadini e alla creazione di una società più sana. COM(2018) 233 final.
  4. Dingwall R., Hobson-West P. (2006). Litigation and the Threat to Medicine. In Gabe J., Kelleher D., Williams G. (eds). Challenging Medicine, II edition. London: Routledge, 40-64.
  5. Driscoll K., Walker S. (2014). Working Within a Black Box. Transparency in the Collection and Production of Big Twitter Data. International Journal of Communication, 8: 1745-1764.
  6. Ekblaw A., Azaria A., Halamka J.D., Lippman A. (2016). A Case Study for Blockchain in Healthcare. “MedRec” prototype for electronic health records and medical research data”. MedRec whitepaper, August 2016.
  7. Espeland W.N., Sauder M. (2007). Rankings and Reactivity How Public Measures Recreate Social Worlds. American Journal of Sociology, 1: 1-40. DOI: 10.1086/51789
  8. Espeland W.N., Stevens M.L. (2008). A Sociology of Quantification. European Journal of Sociology, 3: 401-436. DOI: 10.1017/S000397560900015
  9. European Commission (2004). Communication from the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions - e-Health - Making healthcare better for European citizens. An action plan for a European e-Health Area. SEC (2004)539.
  10. Fielding S.L. (1990). Physician Reactions to Malpractice Suits and Cost Containment in Massachusetts. Work and Occupations, 3: 302-319. DOI: 10.1177/073088849001700300
  11. Freidson E. (2002a). La dominanza medica. Le basi sociali della malattia e delle istituzioni sanitarie. Milano: FrancoAngeli.
  12. Freidson E. (2002b). Professionalismo. La terza logica. Roma: Dedalo.
  13. Fourcade M., Healy K. (2013). Classification Situations. Life-chances in the Neoliberal Era. Accounting, Organizations and Society, 3: 559-572.
  14. Gabe J., Kelleher D., Williams G. (2006). Understanding Medical Dominance in the Modern World. In Idem (eds). Challenging Medicine, II edition. London: Routledge.
  15. Glinkowski W. (2006). “Telemedicine and eHealth”. Paper presented at XI Conference “Medical Informatics e Technology (MIT)”, September 25-27, Wisła (PL).
  16. Hampton N. (2016). Understanding the Blockchain Hype. Why much of it is Nothing More than Snake Oil and Spin. Computerworld, September 5.
  17. Kautsch M., Lichoń M., Matuszak N. (2017). Setting the Scene for the Future. Implication of Key Legal Regulations for the Development of E-Health Interoperability in the EU. The International Journal of Health Planning and Management, 4: 637-652.
  18. Kennedy H., Moss G., Birchall C. et al. (2015). Balancing the Potential and Problems of Digital Methods through Action Research. Methodological Reflections. Information, Communication and Society, 2: 172-186. DOI: 10.1080/1369118X.2014.94643
  19. Lupton D. (2013). The Digitally Engaged Patient. Self-monitoring and Self-care in the Digital Health Era. Social Theory and Health, 3: 256-270.
  20. Lupton D. (2014a). Health Promotion in the Digital Era. A Critical Commentary. Health Promotion International, 1: 174-183.
  21. Lupton D. (2014b). The Commodification of Patient Opinion. The Digital Patient Experience Economy in the Age of Big Data. Sociology of Health and Illness, 6: 856-869. DOI: 10.1111/1467-9566.1210
  22. Maturo A. (2003). Il caso statunitense: dall’assicurazione sanitaria all’insicurezza sociale. In Guido Giarelli. Il malessere della medicina. Un confronto internazionale. Milano: FrancoAngeli, 171-208.
  23. Maturo A. (2015). Doing Things with Numbers. The Quantified Self and the Gamification of Health. eä Journal, 1: 87-105.
  24. Maturo A., Mori L., Moretti V. (2016). An Ambiguous Health Education. The Quantified Self and the Medicalization of the Mental Sphere. Italian Journal of Sociology of Education, 3: 248-268.
  25. Nakamoto S. (2008). Bitcoin. A Peer-to-Peer Electronic Cash System, white paper, (sito visitato nel giugno 2018).
  26. Osservatorio Innovazione Digitale in Sanità (2018). Sanità e digitale. Uno spazio per innovare. Milano: Politecnico di Milano.
  27. Paliotta A.P. (1999a). Gli ordini professionali in Italia. Cenni storici e cambiamenti attuali. Osservatorio Isfol, 1-2: 22-39.
  28. Paliotta A.P., (1999b). Il processo di professionalizzazione in una prospettiva storica. Il caso dei medici. Osservatorio Isfol, 3: 25-57. DOI: 10.13140/2.1.2865.024
  29. Paliotta A.P., Bartoli G. (2002). Gli Ordini inutili? Lo Stato, il mercato e il tramonto delle gilde moderne. Osservatorio Isfol, 6: 79-104.
  30. Puschmann C., Burgess J. (2014). The Politics of Twitter Data. In Weller K., Bruns A. (eds), Twitter and Society. New York: Peter Lang, 43-54.
  31. Quaglio G., Dario C., Stafylas P. (2016). E-Health in Europe. Current Situation and Challenges Ahead Health. Health Policy and Technology, 4: 314-317.
  32. Raval S. (2016). Decentralized Applications. Harnessing Bitcoin’s Blockchain Technology. Sebastopol (CA): O’Reilly.
  33. Salah A.A., Manovich L., Salah A.A., Chow J. (2013). Combining Cultural Analytics and Networks Analysis. Studying a Social Network Site with User-generated Content. Journal of Broadcasting and Electronic Media, 3: 409-426. DOI: 10.1080/08838151.2013.81671
  34. Salmon J.W. (1987). The Medical Profession and the Corporatization of the Health Sector. Theoretical Medicine and Bioethics, 1: 19-29.
  35. Summerton N. (2000). Trends in Negative Defensive Medicine within General Practice. British Journal of General Practice, 50: 565-566.
  36. Swan M. (2015). Blockchain. Blueprint for a New Economy, Sebastopol (CA): O’Reilly.
  37. Szasz T.S., Hollender M. (1955). The Basic Models of the Doctor Patient Relationship. Archives of Internal Medicine, 97: 585-592.
  38. Timmermans S., Epstein S. (2010). A World of Standards but not a Standard World. Toward a Sociology of Standards and Standardization. Annual Review of Sociology, 36: 69-89.
  39. Tousijn W. (2000). Il sistema delle occupazioni sanitarie. Bologna: Il Mulino.
  40. Vicarelli G. (2002). Presentazione. In Freidson E., La dominanza medica. Le basi sociali della malattia e delle istituzioni sanitarie. Milano: FrancoAngeli, 7-21.
  41. Vicarelli G. (2011). Introduzione. In Vicarelli G. (a cura di), Regolazione e governance nei sistemi sanitari europei. Bologna: Il Mulino, 7-20.
  42. Vicarelli G., Bronzini M. (2018). La sanità digitale. Dimensioni di analisi e prospettive di ricerca. Politiche sociali/Social policies, 2: 147-161.
  43. Wolf G. (2010). The Data-Driven Life. The New York Times - Sunday Review, May 2nd.

Achille Pierre Paliotta, Il sistema della salute in transizione. La cartella sanitaria personale tra commodificazione dei dati e blockchain in "SALUTE E SOCIETÀ" 2/2019, pp 160-175, DOI: 10.3280/SES2019-002013