Unintended Consequences of Digitalisation in Health Care

The rapid increase in digitalisation and applications of AI and machine learning provides a timely opportunity to consider unintended consequences. Rather than review the potential and recognised benefits and shortcomings of digital health, our aim in this chapter is to contribute to understandings of the more nuanced patterning of unintended consequences of digitalisation, which are rarely simply positive or negative. We consider unintended consequences of changes to health care work practices and views of the impact of digitalisation on relationships between staff and with patients. Expanding earlier work on the unintended consequences of digitalisation in primary health care, we consider the broader effects of digital health, including AI and machine learning, on health care work, clinical relationships and systems. We also review factors that have the potential to mediate unintended consequences, including trust, evaluation and implementation factors, the transparency and clarity of purpose in the digitalisation, the multiplicity of technologies and the need to focus on alleviating inequalities.