Patient-generated data as intervention into doctor-patient relationships?

Health data generated by apps and devices are becoming increasingly popular and are expected to affect various aspects of doctor-patient relationships. No longer confined to medically authorised and certified health technologies, a range of biomedical data – from heart rate to blood pressure or oxygen saturation – are captured and processed by consumer health devices. In this article, we compare the practices of physicians and chronically ill patients of integrating, resisting, or neglecting data from popular consumer devices in clinical situations and consider how the data may challenge or reify a doctor’s medical authority. Our study is based on semi-structured interviews with doctors and chronically ill patients in Germany between 2021 and 2023. By contrasting cases from general practice, diabetology, sleep disorder, cardiology, and obesity, we explore when, how, and for what reasons different medical specialists and patients with different chronic illnesses consider patient-generated data (PGD) from consumer devices in clinical situations. While some resist PGD that seem to compete with their diagnostic activities, others incorporate the data more readily into their diagnostic practices. This suggests nuanced strategies for navigating the demarcation between expert and lay knowledge, whereby consumer data can either be ascribed health-relevant meaning or not.