Imagined Potentialities of Healthcare Technologies

This paper will focus on health care technologies and initiatives, particularly, Electronic Health Records (EHRs). These technologies are ascribed various potentialities, attributing them the capacity to do a wide range of things, from improving efficiency to saving medical costs and even saving lives. These complex and often conflicting imagined potentialities lead to inflicted burden on designers, policy makers and healthcare practitioners who are faced with different realities on the ground. The conflicting notions have real life effects as these impact our present understanding of, and actions taken toward, these technologies.

To better understand the material and discursive processes that are at play in shaping our present and future understanding of EHR technologies, the paper offers the analytical notion of imagined potentialities, whereby a technology is imagined to possess an inherent capacity to produce a change. The term potentiality has a long history in Western philosophy, in particularly in Aristotle’s metaphysics where he distinguishes between potentiality and actuality. Potentiality refers to the capacity that a thing can be said to have; the capacity to come into existence, to produce growth, development, etc. The adjective imagined is added to convey the resources of imagination that are at play in shaping futures of healthcare technologies. These are derived from the world as it is but also as it is imagined to be.

I argue that imagined potentialities can re-instantiate themselves regardless of whether they become actualized. It is precisely this partial realization and presence of an absence that can carry a forceful generative power both to support—but also to halt—innovation projects. In the case of EHRs, absence of the envisioned dramatic cost reduction or quality improvement in care keeps people engaged in continuous efforts of reproducing the project instantiations. Gradually, what the EHR technologies actually do or do not do become to some degree less significant. In other words, that which is imagined can be transformed into real. Finally, imagined potentialities can have other transformative effects, including transcending the time in such a way that future visions are presented as tangible and accomplishable.