The illnesses we face, cope and live with as individuals and populations, grow increasingly complex, chronic and co-morbid, in nature. This has complicated in turn the practices of care necessary to enhancing our quality of life despite such conditions. And it is general practitioners (GPs) whom often serve as the human and organisational face for the coordination and provision of interdisciplinary care.

Despite a long-standing focus on person-centred care, patients and GPs in Ireland as elsewhere speak often of the challenge of managing complex multi-morbidity as overwhelming — requiring the coordination of care across services and specialities, as well as practices of medical decision-making not only in support of diagnosis and acute intervention but the provision and organisation of long-term care.

Prior research conducted in the international context of general practice, has revealed a long-standing desire on behalf of patients for support managing medications, communicating wellbeing-related needs, and improving daily functioning, and on behalf of GPs for support managing clinical complexity, polypharmacy, and the coordination of care across the primary-specialty care divide — a task particularly challenging in the Irish context given limited sharing of electronic health records and the lack of a national summary care record.

It is quite possible that digital technologies of diverse kinds may be able to play a role in overcoming such challenges, and yet general practice has to date received less focus among technology developers than many other care contexts, perhaps in large part to the very complex nature of this ecology. While many researchers have spoken of the adoption of novel digital tools as a step towards increasingly patient-centred approaches to care, others have at the same time subjected these same systems to critique for reinforcing data-centric design paradigms, centralising power and expertise with health professionals, prioritising a model of care medical-first in nature, and exposing patients, health professionals and systems of care to the risks of increased healthism, medicalisation, overdiagnosis and datafication.

Although recent work has therefore surfaced new and fruitful directions for digital health technology design, there remains much we do not know in this regard, including precisely how digital tools may be designed to create space for worthwhile conversations while providing GPs new opportunities to demonstrate care. These challenges, María Paula Silva is tackling head on through her PhD research, embracing a participatory and mixed-methods approach to developing new insight into the black box of the clinical encounter, while realising new avenues for patients and healthcare professionals alike to foster caring relationships in support of increasingly positive experiences and effective practices of care.

Building on the work of her interdisciplinary team of supervisors - spanning Human-Computer Interaction (Dr. Kevin Doherty), Computer Science (Dr. Lucy Hederman) and Medicine (Prof. Susan Smith) - María Paula is currently working closely with Irish general practitioners practicing care in among the most under-resourced contexts to realise the opportunities provided by primary care to inform an increasingly human-centred approach to health technology development.

To learn more about this work, contact María Paula Silva, and otherwise watch this space!