Algorithmic Choreography: Redefining Human and Non-Human Relations in Digital Health

Area of Science:

• Digital Health
• Healthcare Technology
• Sociology of Health

Background:

• The integration of algorithmic technologies into healthcare is rapidly expanding.
• Existing literature often adopts a deterministic view of algorithms' societal impact.
• A new perspective is needed to understand human-algorithmic interactions in practice.

Purpose of the Study:

• To explore the dynamic relationship between humans and algorithmic systems in a healthcare context.
• To move beyond deterministic perspectives on algorithms in digital health.
• To examine how care professionals interact with and shape algorithmic technologies.

Main Methods:

• Ethnographic study conducted in a nursing home for people with dementia.
• Analysis of a telemonitoring algorithmic system designed to prevent adverse events.
• Examination of "algorithmic choreography" – how humans and algorithms "gear together".

Main Results:

• Two distinct choreographies emerged: real-time night monitoring and quantified decision-making for health assessments.
• Care professionals actively manage algorithmic agency, deciding when to use or withhold it.
• Human-nonhuman interactions are continuously reshaped through collective improvisation.

Conclusions:

• Humans remain central in the use of digital health innovations, not passive recipients.
• Algorithmic systems are sustained and adapted by healthcare professionals.
• The concept of "algorithmic choreography" offers a nuanced understanding of human-algorithmic collaboration in care.