The Dis-Engaged Patient? Chronic Interfacing in a Regime of Digital Health Convenience.

Digital health technologies increasingly promise to alleviate the burden of chronic illness work by automating aspects of care. Rather than demanding constant self-monitoring, automated devices claim to deliver therapy with minimal involvement by patients. This article critically examines such claims through a study of Quell, a wearable neurostimulation device marketed for chronic pain relief in the United States. Drawing on interviews, user diaries and company documents, the article shows that rather than replacing illness work, automation reconfigures it. Patients remain deeply engaged in maintaining, tuning, deciphering and tracking their pain care, all while the device actively participates in it. This reflects a distinctly interfacial relationship between technology and people living with chronic pain. By conceptualising this relationship as chronic interfacing, the article argues that smart health technologies portend a shift away from neoliberal forms of governance. What emerges is a regime of digital health convenience, which partly dis-engages the patient from the chore of chronic living all while re-engaging them in managing the technological milieu required for this very delegation.