9. Rate Your Health: Finnish Online Media Reports of Digital Innovation in Healthcare
- Side: 186-203
- DOI: https://doi.org/10.18261/9788215040844-2020-10
- Publisert på Idunn: 2020-09-11
- Publisert: 2020-09-11
- Creative Commons (CC BY-NC-ND 4.0)
Hailed as “the land of future health” (Upgraded, 2017) and home to the annual SLUSH event (the world’s largest start-up event and community of entrepreneurs), Finland embraces and actively supports innovation and entrepreneurship as viable solutions to societal pressures and needs. With an emphasis on creativity in the workplace, an openness to natural exploration into alternative approaches in the social system, and an economic sector that strongly supports individual endeavours, Finland offers an interesting case study as to how the individualism of healthcare may be facilitated in the future. This study therefore considers how Finnish online health news sites discuss technological innovation in relation to the individual’s healthcare needs. The study is based on online articles collected from three main online health information providers from 1 January 2016 to 31 December 2017. The analysis shows that while social impact is presented in a limited manner, more emphasis continues to be placed on innovations (potential and actual) as well as the technology itself. This is despite growing concerns over data privacy.Keywords: Health technology, Self-care, Quantified self, Health reform, Health sites
Exports of health technology expand – the two billion target is exceeded11Translated from Finnish: Terveysteknologian vienti paisuu – kahden miljardin raja ylittyi.
In the future, health information can be shared directly via your mobile phone to your physician
Virtual therapy improves the treatment of depression22Translated from Finnish: Virtuaaliterapia tehostaa masennuksen hoitoa.
As with many of the Nordic social welfare states, there is much discussion in Finnish healthcare circles about the need to emphasise self-care and the empowerment of the individual in health-related matters. This focus is given additional impetus by technological advances in the digital and technical fields. The sentiment to encourage the public to utilise digital tools for self-care builds on existing online health practices – according to the Pew Internet & American Life Project (Weaver, 2019), 80 percent of people will address health concerns or issues via searches on the internet. This behaviour is often attributed to perceptions of self-care being less costly to the individual (in terms of medical fees and time spent in medical facilities), or as an adequate solution to less severe or acute illnesses. From a political perspective, informed self-care is also a means of addressing national welfare systems that are becoming unsustainable in their current format due to increased cost and demand. This is an approach supported by the European Parliament (2016) as a means to decrease state expenditure in the health sector.
This study explores how Finnish online health news sites discuss technological innovation in relation to the individual’s healthcare needs. The research is based on a content analysis of articles collected from three main online health information providers from 1 January 2016 to 31 December 2017.
2 Background and Context
In Finland, internet use is ubiquitous and overall Finnish people have adopted the use of electronic options for engaging with multiple public services. In 2014, 90 percent of Finnish people aged 16–74 used internet-based services. In 2017, 73 percent of the population used the internet several times a day, and 66 percent of the Finnish population aged 16–89 searched for information related to health (Official Statistics of Finland, 2017). For the younger demographic segment aged 25–34, the rate is 82 percent (Official Statistics of Finland, 2017). As Hyppönen et al. (2015) note, Finland is well on the way to digitalising many healthcare services or functionalities. This could safeguard equal opportunities for all individuals to have access to healthcare services. The challenge is to make them user-friendly and show their added value both to citizens and to professionals so as to encourage their use (Hyppönen et al., 2015).
All Finnish people are covered by the Finnish universal public health and social care system. The constitution of Finland states that everyone is guaranteed adequate social, health and medical services (The Constitution of Finland 731/1999). Health and social services are mainly funded by general tax revenues collected by the municipalities and by state-paid general subsidies to the municipalities. The total cost of health expenditure and financing in Finland is rising as the population is aging, and these demographic changes pose the greatest challenge to the Finnish health and social care system (Hyppönen et al., 2015). The Ministry of Social Affairs and Health has deemed the current structures of the health and welfare system as unsustainable in regard to the ongoing demographic changes. Because of this, a health and social care system reform has been on the agenda of several governments, with Prime Minister Sipilä’s (2015–2019) as the latest. In the government program, digitalisation is a key challenge for Finland’s renewal. One of the strategic objectives for 2020 is the “Citizen as service users – doing it yourself”. The objective is described as follows:
Citizens use online services and produce data for their own use and for that of the professionals; reliable information on well-being and services supporting its utilisation are available; and information on the quality and availability of services is available in all parts of Finland (Ministry of Social Affairs and Health, 2015).
This is why the digitalisation of the government and public services must be implemented as a single service platform. To achieve this, it has been proposed that a service ecosystem composed of several layers will be created to combine the information systems and processes of different actors and enable the smooth transfer of information.
Developments in information and communication technologies have also brought new possibilities for self-care (such as apps), but as indicated earlier in this book, the phenomenon of self-care in itself is nothing new. Self-care can be defined as activities individuals undertake in promoting their own health, preventing disease, limiting the illnesses they suffer, and restoring their own health without professional assistance (Levin & Idler, 1983). Self-care maintenance includes health-promoting habits, adhering to treatment regimens, and monitoring and managing symptoms (Saberi & Johnson, 2011). Although self-care is characterised as mostly non-professional, non-bureaucratic and non-industrial with an emphasis on the individual’s responsibility, professionals often provide technical knowledge and skills, either through guidance or through information (Levin & Idler, 1983). The concept of self-care focuses on risk reduction and disease prevention at the level of personal action within traditional health education (Levin & Idler, 1983).
Today, a wide range of technologies are directed at delivering healthcare, providing health-related information to citizens, and enabling people to engage in self-care and health promotion. Both national health and private medical providers have already introduced online medical consultations as a viable alternative to face-to-face appointments. While not yet able to diagnose, the online doctor is able to renew existing prescriptions, access laboratory results, and give referrals if needed.
Technological innovations in healthcare also mean that there is an increased use of self-monitoring systems – such as pedometers, fitness apps, and home-testing kits. If used correctly, individuals may arguably have better and more reliable data gathered over an extended period that they can then access in order to judge their own performance and well-being. This is referred to as the ‘quantified self’ movement (Lupon, 2016). The phenomenon itself is not new since monitoring, measuring and recording elements of life for self-improvement and self-reflection go back to ancient times. However, recent developments in digital health technologies have led to a renewed and greater interest in wearable devices that measure a myriad of bodily functions and human behaviour. These digital applications are growing rapidly in number, and new products are being launched at an unprecedented pace. One essential aspect of this phenomenon is the digital data produced by individuals, clients and patients that can be seen a prerequisite for a more efficient and precise system of healthcare. However, the accuracy of some of the self-care devices or wearables has been shown to be problematic. Comparisons between different devices for tracing physical activity show large variations in accuracy, with error margins up to 25 percent (Piwek et al., 2016). This serious issue has an effect on the self-care aspect, as consumers can easily become over-reliant on these devices with their automated systems, providing a false sense of security, or even serving as means for misdiagnosis (Hughes et al., 2001). The interaction between devices and individuals is complex, and the perceived usefulness of a device is largely dependent on an individual’s personality, but it is important to note that self-measuring devices can also be experienced as the opposite of useful – even intrusive, uncomfortable and unpleasant (Piwek et al., 2016). The use of new digital measuring devices is also problematic from a privacy and security perspective. These wearable devices continuously collect, transmit, handle and store data considered personal, private, sensitive or confidential. This kind of data collection leads to severe privacy implications, threats and risks, which are not yet fully understood due to their relatively recent adoption (Motti & Caine, 2014). Data from devices are relatively easy to hack since there are many technologies involved in the data transfer. This could potentially lead to data being compromised, lost or distorted. Consumers rarely own the data they collect with devices; instead, this data is collected, stored, and in some cases even sold by the manufacturer, only providing a summary to the consumer (Piwek et al., 2016). And despite the technical advances and possibilities of gathering large amounts of data, few medical practitioners are either prepared to allow, or prepared for its introduction or adoption in their existing diagnostic approaches.
At this stage, it is important to note that the terms ‘consumer’, ‘client’ and ‘patient’ are all used to describe the individual in the healthcare system. The term ‘consumers’ suggests that health and welfare is seen as a commercial product and reflects the belief that individuals should actively be involved in making decisions about and participate in their own care. This precipitates the paradigm shift from the paternalistic view of the patient as a passive, dependent, receiver of services to the position of an empowered consumer. This is significant since a consumer is able to exercise choice and has a right to self-determination and autonomy, as well as the possibility to exit from any particular provider if their needs are not being met to their satisfaction (Deber et al., 2005; McLaughlin, 2009; Reeder, 1972).
This research employs a qualitative approach in order to analyse the content of online articles that discuss health technology (terveysteknologia). Content analysis is a ‘careful, detailed, systematic examination and interpretation of a particular body of material in an effort to identify patterns, themes, biases and meanings’ (Berg 2009, p. 338). It is a means of eliciting valid inferences from texts and can be used to describe specific phenomena within identified contexts (Bengtsson, 2016). In qualitative content analysis, data is sorted and presented in selected categories, such as words, phrases or themes. This study utilises prioric themes that are discussed in more detail below. This allows for a more focussed interpretation of results.
Globally, the mass media and the medical and public health literature comment on digital transformations in healthcare (Lupton, 2018). This study presents this coverage from a Finnish perspective by examining articles on health technology from three different online sources. These have been chosen as they are among the most popular Finnish sites that the public access for health information. In order to get a more holistic view of this trend, each one represents a specific sector of the media: commercial, government, and news. The first is Terve, owned by A-lehdet, a Finnish commercial media group that claims to create the best content for life’s various needs by placing an emphasis on digital communities and innovations. As part of their online presence, they have four of five topics dedicated to health and well-being sections. When reading the articles, it is clear that they address the reader as both consumer and patient. Terve claims to have an average of 300 000 visits per week, and is often in the top five results of healthcare searches online (http://www.terve.fi/). The second is the website for the national Department for Health and Welfare, Terveyden ja hyvinvoinnin laitos (https://www.thl.fi/en/). The National Institute for Health and Welfare (THL) is a research and development institution whose purpose is to promote the health and well-being of the Finnish population, including the prevention of diseases and social problems. THL’s purpose is also to develop social welfare and healthcare services. They serve everyone from decision-makers to ordinary citizens. THL is mainly active in and works through research, monitoring and evaluation, development, expert opinions and international cooperation. With more than 510 000 visits a month,33Metrics provided by https://www.similarweb.com/ this site provides information about recent research and statistics in health and welfare, new advances, and also has medical expert advice and recommendations for the media and public about general health concerns. The third website, https://www.is.fi/, is the online version of one of Finland’s most prominent newspapers. With just over 43 million visits in December 2017,44Metrics provided by https://www.similarweb.com/ Ilta-Sanomat is a dominant force in public opinion and debate. It is touted as having the best mobile services, making it the most popular online news service in the country. The online news site has a dedicated health section, under ‘Lifestyle’.
All three websites therefore have elements that highlight self-care and the individualisation of healthcare in an age of creativity and technological advances, but all offer three very different perspectives and political agendas. This diversity will allow for a broader reading of how self-care is presented and discussed in the Finnish online public sphere.
For this study, a purposive sample was drawn from articles on health technology from the three different online sources during the period from 1 January 2016 to 31 December 2017. Each article needed to refer to ‘health’ (terveys) in combination with technology (teknologia) or digital (digi- ; digitaalinen*). Of course, there is the possibility that there were more articles that may have been relevant to this discussion that did not include these terms. However, in the interests of research reliability and validity, the search criteria were strictly applied. While the number of articles is not necessary to state in a qualitative approach, it is interesting to know how often the theme appears during the time frame. As such, in the final sample there are 50 articles: 18 from Terve.fi; 21 from THL.fi; and 11 from IS.fi.
While most of the content appears in Finnish, THL published eight articles in English. As these are predominantly written for an international audience, they were included in the sample in order to determine what the media deemed important enough to be shared with a larger international audience. Finnish articles were translated for the thematic analysis. All efforts were made to keep the translations as true to the originals as possible, bearing in mind that not all words or phrases have the same cultural meaning. Where contextual understanding is required, it has been included in the analysis.
The findings are based on a thematic analysis of all the content in the sample. Four prioric themes were identified and articles were sorted accordingly into: (1) Apps and devices; (2) Health benefits of digital self-care; (3) Challenges to existing medical practices; and (4) Social concerns. A discussion of each theme follows below.
4.1 Apps and devices
Just over half of the articles focussed almost exclusively on the technology itself. A total of 31 articles made some mention of software, devices or apps, either actual or potential. In almost all cases, when discussing the Finnish context, the articles were phrased within a discourse of innovation and growth.
All the articles in the tabloid Ilta-Sanomat are dedicated to technological matters, with only a few mentioning the social ramifications (such as a need for training, access and privacy) in relation to these tools. Of these, the three most common topics included: Nokia’s acquisition of Withings, a healthcare technology provider (Digitoday, 2016a; Linnake, 2016; STT, 2016a; Kärkkäainen, 2017a; Taloussanomat, 2017); Finland’s healthcare exports reaching more than two billion euros and being expected to increase (Niskanen, 2016; STT, 2016b; STT, 2017a); and Apple’s acquisition of the Finnish start-up company, Beddit Oy (Pitkänen, 2017; Kärkkäainen, 2017b).
Most of these articles therefore focus on related industry and commercial actors, such as Nokia, Microsoft and GlaxoSmithKline. Finnish companies Beddit Oy and Elisa are mentioned in terms of technology development and trends. Many of these articles share a common tenet: health technology is a ‘new export currency’ (STT 2016b) that has the potential to allow Finland to become ‘a world-class innovation center for the health sector’ (STT 2016). The greatest challenge to reach this potential is a ‘lack of adequate funding’ and ‘pilot facilities’ (Niskanen, 2016).
It is noteworthy that several of these articles adopt a critical tone. They mention that certain innovations have been unsuccessful, but hope to be developed in the future. There is also discussion of customer’s dissatisfaction with some changes to apps or devices during the acquisition or development process. Articles include Apple’s procurement of Beddit’s app, and its ‘nasty review in a prestigious test’ (Pitkänen, 2017), and the decision by Nokia to transfer Withings’s Healthmate customers to Nokia Health Mate as part of their merger, which resulted in ‘angry customers’ (Kärkkäinen, 2017). It is quite clear from the overall argument in these articles that technological tools in healthcare are a ‘work in progress’ and subject to mixed reviews. However, all emphasise that regardless of their impact, it is clear that the healthcare industry in Finland is changing and becoming more digitised all the time (Kärkkäainen, 2016; Taloussanomat-Bloomberg, 2016; Ranta, 2017; Linnake, 2017; IS 2017a; IS 2017b).
On the THL media portal, more than half of the Finnish articles addressed technology, with an emphasis on apps and hackathons. A hackathon (also known as a hack day, hackfest or codefest) is a gathering or event with a specific focus where computer programmers and other experts in software development work collaboratively on a project of some kind with the ultimate goal to create useable software. Hackathons only last a few days, usually over a weekend (Leckart, 2012; European Commission, 2018). The hackathons in this coverage refer to events organised by THL in order to brainstorm ideas around improving digital health self-care in Finland (Tuomi-Nikula & Vuori, 2016; Tuomi-Nikula & Järvenpää, 2017). Readers are invited to enter a competition in which they can ‘develop an app’ that will encourage self-care via mobile phones (THL, 2017b). In these articles, technology is presented as a way to ‘help’ and these competitions are aimed at creating ‘interesting ways’ to get people to participate in their own healthcare (Tuomi-Nikula & Järvenpää, 2017). The remainder discuss how the introduction of apps to facilitate sharing of personal information across medical services will create easier access to those practitioners. One article discussed the effectiveness of introducing email coaching for mild depression cases, as regular contact was found to be ‘motivating’ and to build ‘confidence’ through online instruction and exercises (Torniainen-Holm, 2016a). Notably, more than half of the English articles also appeared in this theme (Torniainen-Holm, 2016b; Auranen & Shubin, 2017; Järvenppää, 2017; Nurmi, 2017). This demonstrates a similar level of importance placed on technological innovation by the national healthcare provider for both the local and international audience. The difference between them has more to do with the completion of products. While the Finnish articles discuss the possible new apps that may be available and efforts to design new ways of enhancing digital self-care, the English articles tend to discuss completed or existing projects that have been successfully tested and introduced in greater society. This is an important distinction.
Terve.fi has the smallest contribution to this category as, unlike the other two, any innovations that are discussed tend to be placed in a broader social context and are related to their impact on society – or their desired impact, at least. For example, there are reports on a new video game that will assist ADHD children (Takamäki, 2016a), how email and virtual therapy may support patients with mild depression (Rytkönen, 2016a; Takamäki, 2016b), and how the development of a 3D-printed superpill will cater to individual medical needs (Takamäki, 2016c). All present possibilities for easier and less stressful self-care procedures.
4.2 Health benefits of digital self-care
Interestingly, while every article was included in this research due to a reference to health technology, less than a quarter actually speak to the benefits of digital health self-care. Ilta-Sanomat has only four references to health benefits, although these are all within articles that focus predominantly on healthcare as an export industry (such as Niskanen, 2016) or as a consequence of possible industry partners arriving in Helsinki (STT, 2017 a and b). Benefits mentioned include the potential for: improved healthcare equipment; less frequent visits to the hospital; greater financial support for small innovative companies; increased employment in the health sector; and increased reach of health services.
The commercial site, Terve, has even less. Three articles focus specifically on digital solutions in therapy. They argue that in some ways, digital apps and email especially may be used to create a ‘closeness’ or daily interaction between practitioner and patient that is not possible otherwise (Leinonen, 2016; Takamäki, 2016b). A third is dedicated to discussing the possible benefits of virtual reality glasses in roleplay for self-reflection and development exercises in the treatment of depression (Rytkönen, 2016a).
Not surprisingly, THL, the national healthcare provider, has the most articles dedicated to promoting digital healthcare in society. The English articles discuss how apps could assist in the monitoring of diabetes and blood pressure levels at home (Järvenpää, 2017), the fact that 99 percent of prescriptions are issued electronically (Nurmi, 2017), how the use of email as part of a health intervention can improve mental well-being (Torniainen-Holm, 2016a), and that the client must be placed at the centre of health data usage (Kahri & Vuori, 2016a). In all four cases the emphasis rests on improving the user experience in terms of ease of access to medical care without them needing to resort to visits to medical facilities. The Finnish articles follow a similar theme – the customer’s needs should drive technological advancement (see Kahri & Vuori, 2016b) – although there is a slight difference in that the themes of self-help (Anttila et al., 2017; Hammar, 2017; THL, 2017b) and innovation (Tuomi-Nikula & Vuori, 2016; THL, 2017b) once more come to the fore. One article truly highlights that the team that won one of the THL hackathons was given additional points as they were the only ones to actually include user interviews during the development of their project in order to determine how best to benefit social impact (Tuomi-Nikula & Järvenpää, 2017).
4.3 Challenges to traditional medical practices
Less than one-fifth of the sample addresses how technological advances in the healthcare industry will challenge or affect traditional medical practices. The importance of training medical staff to use and better understand the benefits of digital healthcare is a prevalent argument. In other words, there is a perception that a major challenge to the success of digital health-care methods in a broader sense is linked to human ability or willingness to engage, and not necessarily technological development. Interestingly, Ilta-Sanomat has no articles with this theme. This is largely due to their complete focus on the technology itself.
Most of the content for this category appears on the national health site, THL. There is only one comment in an English article that the digital health service could be used to record information from personal health monitors, and thereby avoid the need for doctor’s to request ‘additional’ laboratory tests (Järvenpää, 2017). It is presented as an opportunity, but it does of course infer a challenge to existing practices. The eight Finnish articles are more critical and speak frankly to the need for training and better understanding of digital tools. Hyppönen et al. (2016) point out that 85 percent of the Finnish population have access to official electronic services, yet this is not used effectively by doctors as they find the results difficult to access. In the article, medical professionals attribute this to an over-complicated software system, while the government officials attribute it to a lack of training. Notably a later article (Heponiemi, 2017) emphasises that doctors are becoming increasingly stressed by the number of digital tools with which they are expected to engage, especially since these change or evolve at frequent intervals each year.
In Terve, there is a highly critical piece that accuses the medical profession of behaving like a ‘cult’ (Ung, 2017) in that they are unwilling to change and tend to resist more modern means of information sharing. Two others adopt a more constructive tone and emphasise the need for additional training of doctors and nurses about changes in digital self-care, and the new online systems and tools available for their use (Leinonen, 2016; Takamäki, 2016b).
4.4 Social concerns
Only ten articles raise concerns regarding the increased use of digital technology for healthcare needs. Even though such information is both ‘in the public interest’ and ‘of public interest’, only two of the Ilta-Sanomat articles focus on concerns about the privacy of data – linked mostly to the international scandal that some sports apps could reveal geolocation and personal information without the consent of the users (Digitoday, 2016a; Linnake, 2016). Two reports by THL admitted a leak of confidential patient information due to human error and the steps taken to correct the situation (THL 2017a and 2017b). Two others from the same site discuss how technology is only useful if one knows how to use it (Hyppönen et al., 2016; Töytäri, 2016). The concern here is a lack of access or knowledge about how the apps can be used to facilitate better healthcare.
While better at highlighting overall social implications of health technology than the other two online content providers, the commercial media site Terve only has four articles dedicated specifically to social concerns related to technology in healthcare. These discuss the social impact of the youth’s dependency on technology and cites a study that shows decreased empathy for people (JAMA Pediatrics, 2016; Rytkönen, 2016a; Takamäki, 2016a). Another mentions a condition named ‘infocondria’ in which people claim to feel overwhelmed by the sheer amount of information available (Orkla Care Finland, 2017). However, in almost all of these articles, the reporters attribute this behaviour to individual choices or existing habits, and not necessarily the introduction of new technologies in society.
In total, only nine articles make reference to the privacy of data and data management. There are three sub-themes in this section: (1) the potential for a breach (Linnake, 2016); (2) admissions that there has been a breach and steps have been taken to inform those affected (THL, 2017a; THL, 2017c); or (3) acknowledgements that it is a ‘matter of concern’ (Digitoday, 2016b) that needs to be taken into account when introducing technological health solutions in society. None of the latter suggest how these needs will actually be met – only that it is necessary to address data privacy. Similarly, privacy of data is not specifically prioritised in national calls for innovations and health technology development – it is merely noted that ‘secure’ digital solutions should be presented for consideration (THL, 2017b).
The purpose of this study is to explore how Finnish online health news sites discuss technological innovation in relation to the individual’s healthcare needs over a two-year period. When one considers the content of the sample as a whole, it is immediately apparent that the online media providers are not really broadening the range of discussion in the public sphere in terms of health and technology. There is a tendency to focus on ‘hot topics’ already being discussed in society. Much attention is currently given to childhood attention deficit disorders and the growing depression in the Finnish population (particularly the youth), regardless of technological advances. As such, there is nothing really ‘new’ in terms of general health and welfare trends in the sample. To a large extent, most articles therefore address the same themes as ‘non-technological’ reports. Only those focused completely on innovation tend to impart new information.
It is not surprising that the tabloid Ilta-Sanomat concentrates mostly on devices and apps. Their target group is strictly seen as a ‘consumer’ since this is a commercial news service. According to their website, approximately 17 percent of the 24–54 year age group prefer to receive their news digitally (as opposed to 8–16 percent who prefer the paper). Those over 54 prefer to buy a daily newspaper. The online content is therefore very much geared towards the middle-aged workforce. Most of this content can be found under the ‘financial/business news’ section. However, in light of the role of the media in terms of public service, it is concerning that there is almost no discussion of the social ramifications or impact of these technologies.
While the concept of self-care is present, it is significant that the media practitioners and medical personnel responsible for the content of the articles are careful to acknowledge that it is most likely to help (1) those naturally interested in self-care routines regardless of delivery methods, and (2) mild medical cases. All reports are careful to emphasise that chronic cases should still be referred to medical facilities in person. In a number of instances the greater concern is not the role of technology in society, but rather the more global health challenge that those most in need of assistance are not necessarily the ones to engage with the magnitude of options available to them. One should also be aware that at least two of the articles that warn of anti-social behaviour very clearly attribute that behaviour to existing or inherent personal traits, as opposed to the presence of ubiquitous technology.
In terms of social concerns, one perception is constant across all articles: medical personnel feel overwhelmed. This is understandable when one takes an overview of how rapidly systems are evolving, how quickly start-up companies are emerging, introducing new apps and equipment and then just as quickly fading away or being outpaced, and how many tools in society still require development to reach their potential. While many media reports suggest a lack of training, one cannot help but wonder what extent of training would be required to stay abreast of all these new innovations.
That said, even though there are clear signs that some innovations meet neither expectations nor current needs, and that medical personnel are currently unable to come to terms with those innovations already in the field, the authority of the national medical ‘voice’ in terms of those objectives remains largely unchallenged. Certainly in 2016 and 2017, very few question the continuous investment in technological health solutions or whether such solutions will indeed have a positive impact on overall self-care in Finnish society. Innovation is largely associated with progression and economic prowess.
In certain respects, Finnish media coverage of the digital innovations in the health sector appears to be an extreme case of techno-optimism. This is not too unusual a finding if one considers the impact that technological industries have had on the Finnish local economy, as well as international reputation, in the past – with special reference to Nokia (see Linden, 2012). When one considers that the end users and their actual experiences or needs are not as prevalent in the reports, then one must ask: in whose interests, and to what purpose, do these health news sites act? Since this study concentrates specifically on health journalism, one would assume that they should act in the interests of individual well-being, yet this research demonstrates a clear bias to innovation and economic imperatives. In other words, they do not.
If one continues the argument held by those in authority (as demonstrated at the start of this chapter) that public well-being will improve once these new technological applications and tools are available, then evidence here suggests that one must then accept that this will only be true of those individuals who are already active in this regard, or who have a predisposition to engage with ‘all things digital’. The consequence of the lack of testing or long-term engagement with end-users of the service, and any reporting thereof, is that the people in need of care who are less disposed to online solutions may be marginalised. In fact, their situation may be further exacerbated as many use visits to medical personnel for social purposes, and may now feel less ‘cared for’ as that direct human contact becomes less and less frequent. It is therefore concerning that such little attention is given to the social ramifications that can be associated with ‘distance’ care via digital means. Hardly any consideration is given to this factor across three prevalent Finnish health news sites over a period of two years.
One can only speculate that the commercialisation of health technology has not been politicised nor problematised in the reports analysed due to the fact that economic imperatives are largely the driving force behind the interest in digitalised healthcare. While one anticipates that the national health provider, THL, is unlikely to be overly critical given the government’s mandate, it seems strange that the two other news producers are not at all critical either. If any criticism is raised at all, it is directed at the lack of technological skills on behalf of the users (especially medical practitioners) as opposed to the greater implications that digitalisation and commercialisation of healthcare has for society. And there are serious repercussions when ‘patient’ becomes ‘consumer’, and when the patient becomes part of the diagnostic team. Regardless of whether these may be perceived to be positive or negative, all certainly merit more discussion and contemplation than is currently provided – especially when one considers evolving technological tools, and the apparently temporary lifespan of digital apps.