IT-based Regulation of Personal Health: Nudging, Mobile Health Apps and Personal Health Data

Abstract

Mobile health applications and devices (“mobile health apps”) are increasingly embedded in organizational programs to regulate the personal health behaviors of individuals and populations. In this paper, we draw on de Vaujany et al.’s (2018) framework for IT-based regulation systems to consider how regulatory outcomes can develop in such settings, in which individual actors have strong agency and regulation is indirect and voluntary. Through an instrumental case of a continuous glucose monitoring system used for self-regulation of diabetes, we examine how IT artifacts become embedded in self- regulation practices, how data generated by these apps are implicated in regulatory feedback loops, and how networks of individual, organizational and technological actors are mobilized in regulatory regimes. We examine how data about bodily states and IT features such as displays and alarms ‘nudge’ individuals towards compliance with expert rules materialized in the IT artifact. We then identify regulatory affordances of mobile health apps for predicting and surveilling personal health. We also theorize how multilevel networks of trifecta of rules, IT artifacts, and practices develop through regulatory episodes as a regulatory lattice, and how social regulation is realized as a result. We conclude by considering the theoretical and practical implications of this analytical approach to investigate IT-based regulation in the open, distributed, and indirect regulatory contexts.