Dissertation Research: An Ethnographic Study of Information and Technology in Transnational Healthcare Markets

本论文提出在当代国际医疗保健中的“信息学和生物学”的战略竞技场中进行民族志田野调查。特别是，研究人员将调查推动或促进不断变化的跨国医疗市场的科学和技术，作为分析和重新映射不断变化的结构和医疗保健，福利国家，临床决策的困境的坩埚实践，以及医疗系统内和跨医疗系统的信息的显示，操纵和转换。该项目分为三个部分-宏观，微观和边缘-这是支持在几个网站的实证实地考察。“宏观”部分概述了从国家福利国家提供的医疗保健到新兴医疗保健市场的国际市场导向的福利资本主义的转变的理论维度。这些经验性的变化将与乌尔里希·贝克和弗朗索瓦·埃瓦尔德关于风险、责任和权利的理论相结合，需要政治经济学、历史学和人类学的理论综合。 “微观”部分包括关于促进和加剧宏观部分概述的变化的科学和技术的详细的经验性实地工作（第一阶段，已完成）。本研究的重点是学术医疗中心内的大型和小型组织的信息和通信技术的设计和实施;特别是，研究重点是在互联网上的视觉图像的操作和通信技术。研究人员已经探索并将继续研究权变设计和标准化之间的紧张关系，以及学术，医学和工业研究策略之间的紧张关系。“保证金”部分将遵循“微”技术的几个国际和国家的远程站点。假设国家边界的不均匀多孔产生资本和专业知识的全球集中，研究人员打算研究如何围绕网络医疗的营销和使用建立一个新的国际地理中心和外围;特别是如何在波士顿设计的技术被使用和理解的医生，技术人员和管理人员远离中心。扩展实地工作的潜在地点（基于我目前工作的实地地点建立的现有联系）包括伊斯坦布尔、耶路撒冷、特拉维夫、中央缅因州和马萨诸塞州的罗克斯伯里。这里申请的研究资金主要用于论文的国际实地考察部分：旅行和生活费用，以及用于采访和参与观察的视听设备。

This dissertation proposes ethnographic fieldwork in the strategic arena of "informatics and biology" within contemporary international healthcare. In particular the researcher will investigate the sciences and technologies driving or facilitating the changing transnational medical care markets, as a crucible for analyzing and re-mapping the changing structures and ever-present dilemmas of health care, the welfare state, decision-making in clinical practice, and the display, manipulation and transformation of information within and across healthcare systems. The project is divided into three sections-Macro, Micro, and Margin-which are supported by empirical fieldwork in several sites. The 'Macro' section outlines the theoretical dimensions of the shift from the national welfare-state provision of healthcare to the international market-oriented welfare capitalism of the emerging healthcare market. These empirical changes will be yoked to the theories of Ulrich Beck and Francois Ewald on risk, responsibility, and rights, requiring a theoretical synthesis of political economy, history and anthropology. The 'Micro' section includes detailed empirical fieldwork (first phase, completed) on the sciences and technologies that facilitate and exacerbate the changes outlined in the Macro section. This research focuses on the design and implementation of information and communication technologies by both large and small organizations within an Academic Medical Center; in particular, the studies focus on technologies for the manipulation and communication of visual images on the internet. The researcher has explored and will continue to study the tension between contingent design and standardization, and among academic, medical and industry research strategies. The 'Margin' section will follow the technologies in 'Micro' to several international and national remote sites. Under the assumption that the unevenly porous boundaries of nations produce global centralizations of capital and expertise, the researcher intends to study how a new international geography of center and periphery is built up around the marketing and use of networked healthcare; in particular how the technologies designed in Boston are used and understood by the doctors, technicians, and administrators away from the center. The potential sites for extended fieldwork (based on the existing connections established by the field sites I am currently working in) include Istanbul, Jerusalem, Tel Aviv, Central Maine, and Roxbury, Massachusetts. The research funds applied for here are primarily for the international fieldwork component of the dissertation: for travel and living expenses, and for the audio-visual equipment used for interviews and participant observation.