Patients’ Knowledge Formations through a Healthcare E‐messaging System

There is an increasing interest in employing e‐mail or other Internet‐based messaging systems in communication between patients and healthcare professionals. Many projects are put into practice, and numerous studies shed light on patients’ preferences regarding e‐messaging and their experience and use of e‐messaging. We argue in this paper that the conventional research in the field to some extent lacks a discussion about what kinds of knowledge an e‐messaging system generates among its users when it is put into practice. We suggest that placing the concept of knowledge as a discourse in focus, stressing how patients make judgements and distinctions in their use of e‐messaging, exposes important aspects not only regarding how patients relate to the system but also what e‐messaging in the healthcare sector means. We illustrate such a perspective with empirical material based on two focus groups of users of an e‐messaging system via a Swedish healthcare Web portal. Three kinds of knowledge formations are illuminated in this context: how patients develop knowledge by comparing e‐messaging services with traditional ways to contact healthcare; how the system generates a further demand for control by its users; and how the e‐messaging system helps users develop knowledge of the healthcare system in general.