Sociotechnical imaginaries in academic medicine strategic planning: a document analysis.

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.

Imagining genomic medicine futures in primary care: General practitioners' views on mainstreaming genomics in the National Health Service.

Genomic medicine has captured the imaginations of policymakers and medical scientists keen to harness its health and economic potentials. In 2012, the UK government launched the 100,000 Genomes Project to sequence the genomes of British National Health Service (NHS) patients, laying the ground for mainstreaming genomic medicine in the NHS and developing the UK's genomics industry. However, the recent research and reports from national bodies monitoring genomic medicine's roll-out suggest both ethical and practical challenges for health-care professionals. Against this backdrop, this paper, drawing on qualitative research interviews with general practitioners (GPs) and documentary analysis of policy, explores GPs' views on mainstreaming genomic medicine in the NHS and implications for their practice. Analysing the NHS's genomic medicine agenda as a 'sociotechnical imaginary', we demonstrate that whilst sociotechnical imaginaries are construed as collectively shared understandings of the future, official visions of genomic medicine diverge from those at the forefront of health-care service delivery. Whilst policy discourse evokes hope and transformation of health care, some GPs see technology in formation, an unattainable 'utopia', with no relevance to their everyday clinical practice. Finding space for genomics requires bridging the gap between 'work as imagined' at the policy level and 'work as done' in health-care delivery.

The imaginary of precision public health.

In recent years, precision medicine has emerged as a charismatic name for a growing movement to revolutionise biomedicine by bringing genomic knowledge and sequencing to clinical care. Increasingly, the precision revolution has also included a new paradigm called precision public health-part genomics, part informatics, part public health and part biomedicine. Advocates of precision public health, such as Sue Desmond-Hellmann, argue that adopting cutting-edge big data approaches will allow public health actors to precisely target populations who experience the highest burden of disease and mortality, creating more equitable health futures. In this article we analyse precision public health as a sociotechnical imaginary, examining how calls for precision shape which public health efforts are seen as necessary and desirable. By comparing the rhetoric of precision public health to precision warfare, we find that precision prescribes technical solutions to complex problems and promises data-driven futures free of uncertainty, unnecessary suffering and inefficient use of resources. We look at how these imagined futures shape the present as they animate public health initiatives in the Global South funded by powerful philanthropic organisations, such as the Bill & Melinda Gates Foundation, as well as local efforts to address cancer disparities in San Francisco. Through our analysis of the imaginary of precision public health, we identify an emerging tension between health equity goals and precision's technical solutions. Using large datasets to target interventions with greater precision, we argue, fails to address the upstream social determinants of health that give rise to health disparities worldwide. Therefore, we urge caution around investing in precision without a complementary commitment to addressing the social and economic conditions that are the root cause of health inequality.

Reordering the "World of Things": The Sociotechnical Imaginary of RFID Tagging and New Geographies of Responsibility.

The aim of this study is to investigate radio frequency identification (RFID) tagging as a form of sociotechnical experimentation and the kinds of sociotechnical futures at stake in this experimentation. For this purpose, a detailed analysis of a publicly available promotional video by a tag producer for the fashion industry, a sector widely using RFID tags, was analysed in detail. The results of the study indicated that the sociotechnical imaginary of RFID tagging gravitates around the core value of perfect sociotechnical efficiency. This demands a high degree of readiness to engage in standardization efforts, which performs a specific materialized understanding of ethics by other means. Furthermore, the analysis points to the importance of considering the spatiotemporal dimensions in which RFID tags work when reflecting on how this technology matters to society. Finally, the analysis shows a tacit effort to keep RFID technology and thus any questions of responsible innovation confined to the shop floor. However, given the spreading of the use of RFIDs, much wider-ranging considerations are called for.

Panacea or diagnosis? Imaginaries of innovation and the 'MIT model' in three political cultures.

Innovation studies continue to struggle with an apparent disconnect between innovation's supposedly universal dynamics and a sense that policy frameworks and associated instruments of innovation are often ineffectual or even harmful when transported across regions or countries. Using a cross-country comparative analysis of three implementations of the 'MIT model' of innovation in the UK, Portugal and Singapore, we show how key features in the design, implementation and performance of the model cannot be explained as mere variations on an identical solution to the same underlying problem. We draw on the concept of sociotechnical imaginaries to show how implementations of the 'same' innovation model - and with it the notion of 'innovation' itself - are co-produced with locally specific diagnoses of a societal deficiency and equally specific understandings of acceptable remedies. Our analysis thus flips the conventional notion of 'best-practice transfer' on its head: Instead of asking 'how well' an innovation model has been implemented, we analyze the differences among the three importations to reveal the idiosyncratic ways in which each country imagines the purpose of innovation. We replace the notion of innovation as a 'panacea' - a universal fix for all social woes - with that of innovation-as-diagnosis in which a particular 'cure' is 'prescribed' for a 'diagnosed' societal 'pathology,' which may in turn trigger 'reactions' within the receiving body. This approach offers new possibilities for theorizing how and where culture matters in innovation policy. It suggests that the 'successes' and 'failures' of innovation models are not a matter of how well societies are able to implement a sound, universal model, but more about how effectively they articulate their imaginaries of innovation and tailor their strategies accordingly.

The everyday lives of energy transitions: Contested sociotechnical imaginaries in the American West.

This article brings together two growing literatures - on sociotechnical imaginaries in science and technology studies and on resource materialities in anthropology - to explore how two energy-producing communities in the American West understand the moral salience of energy systems and the place of labor within them. Studies of energy sociotechnical imaginaries overwhelmingly focus on the role that state and transnational actors play in shaping perceptions of the 'good society', rather than how these imaginaries inform and are transformed in the lived experience of everyday people. We illuminate the contested dimension of sociotechnical imaginaries and their positioning within structures of power that inform visions of moral behavior and social order. Whereas the role of energy in national imaginaries is grounded almost entirely in the consumption it enables, examining the everyday ethics of people who live and work in Colorado's uranium-rich Western Slope and Wyoming's coal-rich Powder River Basin reveals an insistence that 'good' energy systems also provide opportunities for dignified and well-paid blue-collar work. This imaginary, we argue, remains 'bounded' at a local scale rather than circulating more widely to gain national or international traction. Theorizing this boundedness illustrates not only the contested nature of sociotechnical imaginaries, but also the constraints that material assemblages and sediments of the past place on imagined futures.

Hearts and minds: The technopolitical role of affect in sociotechnical imaginaries.

Sociotechnical imaginaries (SIs) have emerged as a popular and generative concept within Science and Technology Studies (STS). This article draws out the affective component of SIs, combining a review of relevant literatures with an empirical case study of an anti-fracking imaginary in Ireland to suggest how we might theorize an affective technopolitics of SIs. The literature review identifies three key aspects of SIs that would benefit from a more coherent conceptualization of affect: the utopian, productive, and collectivizing dimensions of imaginaries. Emotions such as desire and fear appear prominently in the SI literature, but in ways that require development. Using empirical examples from my research, I outline what this developed understanding of emotions in imaginaries might look like. I examine the role that emotions played in the development and settlement of an anti-fracking imaginary in Ireland, highlighting how the intensive, multimodal, and dynamic nature of affect underpinned the productive, collective, and utopian dimensions of the SI. I conclude with some remarks about how this developed theory of emotion positions STS researchers to address issues of humanity, representation, and the building of better worlds.

The return of nature? Negotiating the 'renaturation' of the Isar as an envirotechnical landscape.

How can we trace differing normative values, and especially in alternative imaginaries of environmentally sustainable futures? To address this issue, this article extends the sociotechnical imaginaries framework by providing conceptual tools to understand the underlying rationale of alternative environmental imaginaries-through an envirotechnical analysis. I analyse an urban river restoration project called the Isar-Plan in Munich, Germany, where the notion of 'renaturation' was at the centre a controversy over designs for the project. By positing the river as an envirotechnical landscape, the normative dimensions of nature, science and technology within environmental transformations can be constructively integrated within co-productionist analyses in science and technology studies. The article shows how existing societal values are shaped by prior systems and regimes, constructing local imaginaries of desirable environmental futures. Envirotechnical analyses also increase our ability to identify differing normative values, and could thus be further applied in cases where the normative assumptions behind opaque notions otherwise would be left underexplored.

Imagining machine vision: Four visual registers from the Chinese AI industry.

Machine vision is one of the main applications of artificial intelligence. In China, the machine vision industry makes up more than a third of the national AI market, and technologies like face recognition, object tracking and automated driving play a central role in surveillance systems and social governance projects relying on the large-scale collection and processing of sensor data. Like other novel articulations of technology and society, machine vision is defined, developed and explained by different actors through the work of imagination. In this article, we draw on the concept of sociotechnical imaginaries to understand how Chinese companies represent machine vision. Through a qualitative multimodal analysis of the corporate websites of leading industry players, we identify a cohesive sociotechnical imaginary of machine vision, and explain how four distinct visual registers contribute to its articulation. These four registers, which we call computational abstraction, human-machine coordination, smooth everyday, and dashboard realism, allow Chinese tech companies to articulate their global ambitions and competitiveness through narrow and opaque representations of machine vision technologies.

Precog visions: Predicting the future with the Minority Report sociotechnical imaginary.

The 2002 film Minority Report regularly appears in tech press articles asking whether it 'predicted the future'. When such publications invoke the film as having 'predicted the future' or 'come true', what social and political claims are being made? How has Minority Report become a discursive tool for imagining, constructing, and criticizing sociotechnical worlds? In this paper, we evaluate the worldbuilding process and real-world trajectories of three technologies 'from' Minority Report, as refracted through the lens of tech journalism: gestural interfaces, targeted advertising, and predictive policing. We argue that science fiction does more than represent technologies; it participates in their social construction. Some technologies imagined in Minority Report operate as 'diegetic prototypes', and the journalistic witnessing public takes them up in complex ways, interpreting, misinterpreting, and remixing the technologies depicted in the film. We further argue that it is not only technologies that move between film and reality in this process, but entire sociotechnical imaginaries. We find that in tech beat interpretations of Minority Report, the interfaces between bodies and technologies reflect a Silicon Valley sociotechnical imaginary of disembodied cyborg subjects and deracialized surveillance that materially and discursively shapes how technologies depicted in the film are developed and received.

Technology and addiction: What drugs can teach us about digital media.

Comparisons between digital media and narcotic drugs have become increasingly common in the vigorous discussion on smartphone addiction and technology addiction. Commentators have used evocative terms such as "digital heroin," "electronic cocaine," and "virtual drugs" when discussing users' growing dependence on their devices. This article looks at the spreading discourse comparing digital media with drugs from a set of interdisciplinary perspectives including media studies, political economy, critical theory, science and technology studies, and addiction studies. It engages several key questions: To what extent can heavy smartphone use be considered an addiction, and how is it similar or different from drug addiction? How do the analogies between media and drugs fit within prevalent imaginaries of information technologies, and within the greater cultural themes and preoccupations of late capitalism? And finally, what can drugs teach us about the possible escape routes from our society's current predicament?

The evolution, devolution and distribution of UK Biometric Imaginaries.

This article critically examines UK biometric policymaking by charting the bodies identified by the 2018 Home Office Biometric Strategy as playing key roles in the oversight of biometric data used in law enforcement and other related functions. The article argues that oversight actors are embedded in biometric imaginaries promoted by the UK Home Office and the devolved Scottish administration. By mapping oversight of UK biometrics policy together with developments in Scotland, the article challenges sociotechnical imaginaries studies which assume the power of national governments to project dominant, cohesive and instrumental visions. The article peels away that image to reveal UK biometric policy as located within a patchwork in which embedded commissioners, regulators and advisors challenge biometric imaginaries through interpretive flexibility and standpoint. By identifying technical, operational, legislative and ethical issues, these actors challenge the UK government imaginary and act as channels of critique between it and wider stakeholder communities. The article further challenges assumptions concerning the cohesion of national imaginaries by highlighting a diverging approach to biometric governance in Scotland. The article uses these observations to sketch a means to further characterise the notion of the biometric imaginary and to address biometric policymaking more widely.

Anticipation and modal power: Opening up and closing down the momentum of sociotechnical systems.

Within STS, there are three approaches to the creation and mobilization of futures: descriptive, normative, and interventive. Visions, expectations, and imaginaries are currently seen as anticipatory artifacts that close down the momentum of sociotechnical systems and, as such, are objects of critical scrutiny. At the same time, interventive techniques engaging with future representations are considered to be useful anticipatory instruments for opening up ranges of envisaged alternatives. This article reviews STS advances concerning the performativity of both de facto and interventive anticipatory practices in shaping the momentum of sociotechnical systems in light of the phenomenon of modal power: the modulation dynamics of what actors deem to be (im)plausible and/or (un)desirable. The diverse attempts of STS scholars and practitioners to understand, critique, and engage with the politics of opening up and closing down the momentum of sociotechnical systems require engaging with the creation, mobilization, and execution of modal power. The heuristics presented here are intended to be useful in framing and recognizing the political-epistemic radicality that the creation and mobilization of sociotechnical futures holds in the constitution of our sociotechnical orders as well as the role that the attribution of (im)plausibility or (un)desirability plays in such processes.

Biometric imaginaries: Formatting voice, body, identity to data.

This article examines the sociotechnical imaginary within which contemporary biometric listening or VIA (voice identification and analysis) technologies are being developed. Starting from an examination of a key article on Voiceprint identification written in the 1940s, I interrogate the conceptual link between voice, body, and identity, which was central to these early attempts at technologizing voice identification. By surveying patents that delineate systems for voice identification, collection methods for voice data, and voice analysis, I find that the VIA industry is dependent on the conceptual affixion of voice to identity based on a reduction of voice that sees it as a fixed, extractable, and measurable 'sound object' located within the body. This informs the thinking of developers in the VIA industry, resulting in a reframing of the technological shortcomings of voice identification under the rubric of big data. Ultimately, this reframing rationalizes the implementation of audio surveillance systems into existing telecommunications infrastructures through which voice data is acquired on a massive scale.

Reframing sociotechnical imaginaries: The case of the Fourth Industrial Revolution.

In recent years, a Fourth Industrial Revolution emerged in public discourse as a narrative of exceptional societal disruption. At the core of this conceptual construct, led by the World Economic Forum, rests a sociotechnical imaginary of future essentialism, based on the revolutionary potential of digital, biological and physical innovations. This article addresses the lack of studies assessing the dynamics between the institutionalisation and the public performance of the Fourth Industrial Revolution concept through news media. We present the results of a quantitative content analysis of how the topic has been covered (frames, sources, tone) by the Portuguese national circulation press (2013-2020). This exploratory case study informs a proposal for an epistemic and methodological articulation between the theoretical frameworks of sociotechnical imaginaries and of media framing.

'Nothing to do with the science': How an elite sociotechnical imaginary cements policy resistance to public perspectives on science and technology through the machinery of government.

That policymakers adopt technoscientific viewpoints and lack reflexivity is a common criticism of scientific decision-making, particularly in response to moves to democratize science. Drawing on interviews with UK-based national policymakers, I argue that an elite sociotechnical imaginary of 'science to the rescue' shapes how public perspectives are heard and distinguishes what is considered to be legitimate expertise. The machinery of policy-making has become shaped around this imaginary - particularly its focus on science as a problem-solver and on social and ethical issues as 'nothing to do with the science' - and this gives this viewpoint its power, persistence and endurance. With this imaginary at the heart of policy-making machinery, regardless of the perspectives of the policymakers, alternative views of science are either forced to take the form of the elite imaginary in order to be processed, or they simply cannot be accounted for within the policy-making processes. In this way, the elite sociotechnical imaginary (and technoscientific viewpoint) is enacted, but also elicited and perpetuated, without the need for policymakers to engage with or even be aware of the imaginary underpinning their actions.

Assembling airspace: The Single European Sky and contested transnationalities of European air traffic management.

The Single European Sky (SES) encompasses a series of legislative and regulatory measures reflecting a vision for reforming Air Traffic Management (ATM) in Europe to ultimately transcend national control of airspace. This article considers SES via the conceptual framing of the sociotechnical imaginary, and finds that the embedded, distributed and interpretive character of European ATM invites further conceptualization around how actors may need to engage with infrastructural imaginaries. How is an imaginary perceived and interpreted across its spatial reach? How do the standpoints, interests and interpretations of different groups embedded within infrastructural space play a role in the construction of that spatiality and envisioned territorial assemblages? Do these standpoints and interpretations extend to the perceived imaginings of others, and what might this imply for how sociotechnical imaginaries and spatialities are co-produced? The article outlines the history of European ATM through to the current status of SES. By describing contested negotiations involving the European Union, Eurocontrol, state bodies and organized labour, SES is used as a case study to demonstrate how relations between national sovereignty and transnational governance can be imagined in different ways through ATM. The article identifies a series of interactions and tensions between interpretations of SES, involving instances of perceived appropriation by some stakeholders on the part of others and concerns over emergent risks and uncertainties. The study identifies how relations and interpretations between stakeholders, states and transnational bodies shape and are shaped by the discursive and material projection of assemblages of technology, data, space and political rationality. These projections map European airspace in different ways. Negotiating the SES imaginary has entailed a politics of suspicion and risk that reflects a certain instantiation of interpretive flexibility, involving concerns over how SES is imagined by others.

Heralds of global transparency: Remote sensing, nuclear fuel-cycle facilities, and the modularity of imagination.

How has commercial remote sensing influenced the framing of public narratives about nuclear programs and weapons of mass destruction? This article examines an early and formative case: In 2002, a Washington-based nongovernmental organization used commercial satellite images to publicly identify the Natanz nuclear facility in Iran. The episode helped inaugurate the 'Iran nuclear crisis' as we have known it since. But it also played a role in fomenting a commercial market for remote sensing, adjusting the role of 'citizen scientist' in the nuclear arms-control community, visualizing a new television journalism beat of 'covering the intelligence community', legitimizing a transforming role of nuclear safeguards inspectors at the International Atomic Energy Agency, and solidifying Iran's nuclear program as 'clandestine'. This article follows the images as they pass through these social worlds and examines how heterogenous actors incorporated remote sensing into their identities and commitments to global transparency.

Revolutionary dreams: Future essentialism and the sociotechnical imaginary of the fourth industrial revolution in Denmark.

In 2015, the World Economic Forum announced that the world was on the threshold of a 'fourth industrial revolution' driven by a fusion of cutting-edge technologies with unprecedented disruptive power. The next year, in 2016, the fourth industrial revolution appeared as the theme of the Forum's annual meeting, and as the topic of a book by its founder and executive chairman, Klaus Schwab. Ever since, the Forum has made this impending revolution its top priority, maintaining that it will inevitably change everything we once know about the world and how to live in it, thus creating what I conceptualize as 'future essentialism'. Within a short space of time, the vision of the fourth industrial revolution was institutionalized and publicly performed in various national settings around the world as a sociotechnical imaginary of a promising and desirable future soon to come. Through readings of original material published by the Forum, and through a case study of the reception of the fourth industrial revolution in Denmark, this article highlights and analyses three discursive strategies - 'dialectics of pessimism and optimism', 'epochalism' and 'inevitability' - in the transformation of a corporate, highly elitist vision of the future into policymaking and public reason on a national level.

Sociotechnical imaginaries of low-carbon waste-energy futures: UK techno-market fixes displacing public accountability.

To implement EU climate policy, the UK's New Labour government (1997-2010) elaborated an ecomodernist policy framework. It promoted technological innovation to provide low-carbon renewable energy, especially by treating waste as a resource. This framework discursively accommodated rival sociotechnical imaginaries, understood as visions of feasible and desirable futures available through technoscientific development. According to the dominant imaginary, techno-market fixes stimulate low-carbon technologies by making current centralized systems more resource-efficient (as promoted by industry incumbents). According to the alternative eco-localization imaginary, a shift to low-carbon systems should instead localize resource flows, output uses and institutional responsibility (as promoted by civil society groups). The UK government policy framework gained political authority by accommodating both imaginaries. As we show by drawing on three case studies, the realization of both imaginaries depended on institutional changes and material-economic resources of distinctive kinds. In practice, financial incentives drove technological design towards trajectories that favour the dominant sociotechnical imaginary, while marginalizing the eco-localization imaginary and its environmental benefits. The ecomodernist policy framework relegates responsibility to anonymous markets, thus displacing public accountability of the state and industry. These dynamics indicate the need for STS research on how alternative sociotechnical imaginaries mobilize support for their realization, rather than be absorbed into the dominant imaginary.