Lecture on the “Subject of innovation”


On November 30, I hold a lecture  at the Insitute of Health Policy & Management at Rotterdam University. This is the first time I provide a somewhat comprehensive overview of my PhD research. Below is a short abstract of the lecture topic.

Innovation in healthcare does not leave the patient untouched. The healthcare reforms of the past decades have partly aimed at giving shape to a new type of patient. For the Netherlands, this is probably best summarised by the Public Health Council’s term “good patientship”. Technology and innovation play an important role in this development. First, it is important to consider which measurements are devised to assess the impact of innovation. It is expected to make both patients and care providers more productive. Second, there are a number of policies to stimulate innovation. I restrict myself to attempts – so-far unsuccessful – to roll out an infrastructure for a national Electronic Health Record. The way in which this infrastructure is devised is not neutral in terms of the relations it would mediate between patients, care providers and other players in the healthcare sector. Third, there are the concrete technologies or applications that such policies are expected to generate, with which patients will interact. These three ways of shaping the patient roughly correspond to what the French philosopher Michel Foucault has referred to as three modes in which people are made subjects: “modes of inquiry”, “dividing practices” and “self-constitution. I use this Foucauldian frame to examine these different aspects of innovation in healthcare. Ultimately, there is not one “subject of innovation”, but many.

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Presentations at EASST: constituting people


The first days of September, me and my colleagues presented two papers at EASST2010 in Trento, Italy. EASST is the conference of the European Association for the Study of Science and Technology. Both papers dealt with the question how people are “constituted” in society, how they are given a particular role. And a bit about how they constitute themselves. Michel Foucault has written many interesting things about this topic, about which you can read a bit more in the description of my research area.

The paper that I presented (together with Benoît Dutilleul and Frans Birrer) concerned the phenomenon of Living Labs, about which we have published before. Living Labs are local platforms that involve people  in “making what they use”. By now there are 212 of such sites throughout Europe. Internationally, Living Labs are considered a “movement”. Democratisation has never been an outspoken goal, but many have argued that they may contribute to society this way. Nevertheless, they are considered undemocratic by many commentators.  In our paper, we ask what is needed to democratise Living Labs. Our idea is that this would involve re-thinking how we want people to participate, and how people might want to participate themselves. In order to examine this question, we critically examined work by Eric Von Hippel, Andrew Feenberg and what is often called the “Scandinavian tradition” of participatory design. You can have a look at the slides of my presentation below. This was part of a track on “Speculation, Design, Public and Participatory Technoscience: Possibilities and Critical Perspectives”. Alex Wilkie, one of the convenors, provides more information on his blog.

Apart from that, my colleague Frans Birrer presented our other paper about policy changes in Dutch healthcare. This is a continuation of our earlier work on the Dutch electronic health record and the patient-owned personal health budget (persoonsgebonden budget in Dutch). As part of the session ‘The shaping of patient 2.0 – Exploring agencies, technologies and discourse in new healthcare practices’, we tried to establish how patients are constituted by such major changes in policy.

Other than that, EASST was a good conference. The best I have attended so far. Over 800 presentation, many of which very interesting. A conference in Italy. With good lunch. And good coffee. Served by waitors wearing black bow ties. In the mountains.

New publications


Both papers that we presented with colleagues at last year’s International Conference on Indicators and Concepts of Innovation (ICICI2009) ath the Charles University of Prague were published. Twice. First, instead of conference proceedings, a book with a selection of papers was published under the title The Social Dimension of Innovation. Second, both papers were selected for a special issue on Knowledge Governance of the Central European Journal of Public Policy.

The journal versions of the papers are available for download by clicking on the titles below:

The Role of Expectations in System Innovation: The Electronic Health Record, Immoderate Goal or Achievable Necessity?
Wouter Mensink, Frans A. J. Birrer
Unpacking European Living Labs: Analysing Innovation’s Social Dimensions
Benoît Dutilleul, Frans A. J. Birrer, Wouter Mensink

Please also have a look at the other contributions to the special issue.