KÜRESEL TEKNOLOJİK DİNAMİKLERLE YEREL GERÇEKLİKLERİN ETKİLEŞİMİ: TÜRKİYE’NİN SAĞLIK HİZMETLERİNDE DİJİTAL DÖNÜŞÜM

Öz

Sağlıkta dijital dönüşüm dünya genelindeki teknolojik gelişmeler, sağlık harcamalarının azaltılması ve artan yaşlı nüfusuyla sağlık harcamalarının artması gibi sebeplerle hızlı bir dönüşüm yaşamaktadır. Buna paralel bir şekilde, Türkiye 2003 yılında başlayan Sağlıkta Dönüşüm Programı (SDP) ile sağlıkta dijitalleşme çağını benimsemiş ve bu süreçte aktif olarak yer almıştır. Bu çalışma, tarihsel söylem, siyasi etkiler ve teknolojik ilerlemelerin arasındaki etkileşimin Türkiye'nin sağlık sisteminin merkezileşmesine nasıl etki ettiğini araştırmaktadır. Özellikle, Türkiye'nin sağlık sisteminin dijital dönüşüm başlığı altında nasıl merkezileştiğine dair ayrıntılara inmektedir. Bu geçiş süreci sırasında merak uyandıran bir soru ortaya çıkmaktadır: Hem kamu hem de otoriter sağlık kurumlarının dijital sağlık yeniliklerine yönelik olumlu algıları, düşük sağlık ve dijital okuryazarlık düzeylerinin yarattığı zorluklarla nasıl bir araya geldi? Bu makale, Türkiye'deki çok-alanlı ve çok-yönlü sağlık dönüşüm süreçlerini kapsamak üzere biyomedikalizasyon kavramını kullanmaktadır. Ülke, biyomedikalizasyon sürecinin eşlik ettiği teknoloji dostu bir ortam oluşturarak, (biyo)dijital vatandaşlar ortaya çıkarmaktadır. Bu çalışma, Türkiye'nin dijital sağlık dönüşümüne ilişkin tarihsel bir anlatıdan yararlanarak, ülkedeki biyomedikalleşme olgusunun hem mikro hem de makro düzeydeki karmaşık ve çok boyutlu faktörler tarafından şekillendirildiğinin, politika yapıcıları, mahremiyet savunucularını ve yasa koyucularını, veri kullanımı, koruma ve gizliliği ile ilgili etkili ve sürdürülebilir düzenlemeler tasarlamaya yönlendirdiğini öne sürüyor. Bu araştırma sıralanan dinamikleri inceleyerek, Türkiye gibi bir ülkenin dijital sağlık uygulamalarının çok yönlü boyutlarını nasıl yönlendirdiğine dair içgörüler sunarak, mevcut sınırlamalara rağmen sağlıkta dijital teknolojilerin başarılı bir şekilde benimsenmesini sağlayan potansiyel stratejilere ve mekanizmalara ışık tutmaktadır. Dijital dönüşüme ilişkin daha kapsamlı söylemlere yapılan bu katkı, özellikle okuryazarlık düzeylerinin sorun teşkil edebileceği bağlamlarda, sağlık sistemlerini geliştirmek için teknolojiden yararlanmanın içerdiği karmaşıklıklara dair anlayışımızı zenginleştirmektedir.

Anahtar Kelimeler

• Dijital sağlık
• biyomedikalizasyon
• dijital teknoloji
• (biyo)dijital vatandaşlık
• sağlıkta dönüşüm
• Türkiye

ZUSAMMENSPIEL GLOBALER TECHNOLOGISCHER DYNAMIK UND LOKALER REALITÄTEN: DIGITALE GESUNDHEITSTRANSFORMATION IN DER TÜRKEI

Öz

Der digitale Wandel im Gesundheitswesen hat weltweit aufgrund technologischer Entwicklungen, globaler Diskussionen über sinkende Gesundheitsausgaben und steigende Gesundheitsausgaben der wachsenden alternden Bevölkerung eine rasante Wendung genommen. Parallel dazu engagiert sich die Türkei seit 2003 mit ihrem Health Transformation Program (HTP) aktiv auf einer großen Transformationsreise und bereitet sich auf das Zeitalter der Digitalisierung im Gesundheitswesen vor. Diese Studie untersucht das Zusammenspiel von historischem Diskurs, politischen Einflüssen und technologischen Fortschritten, die die Zentralisierung des türkischen Gesundheitssystems geprägt haben. Insbesondere wird untersucht, wie das türkische Gesundheitssystem unter der Ägide der digitalen Transformation eine Zentralisierung erfahren hat. Inmitten dieses Übergangs stellt sich eine zwingende Frage: Wie hat sich die positive Wahrnehmung digitaler Gesundheitsinnovationen sowohl durch die Öffentlichkeit als auch durch maßgebliche Gesundheitsinstitutionen mit den Herausforderungen angeglichen, die sich aus dem niedrigen Gesundheits- und digitalen Kompetenzniveau ergeben? In diesem Artikel wird das Konzept der Biomedikalisierung verwendet, um die standortübergreifenden und multidirektionalen Gesundheitstransformationsprozesse in der Türkei zu erfassen. Durch die Schaffung eines technologiefreundlichen Umfelds fördert das Land (bio)digitale Bürger durch den Prozess der Biomedizinisierung. Basierend auf einem historischen Narrativ der digitalen Gesundheitstransformation in der Türkei geht der Artikel davon aus, dass das Phänomen der Biomedikalisierung im Land, das durch komplexe multidimensionale Faktoren sowohl auf Mikro- als auch auf Makroebene geprägt ist, politische Entscheidungsträger, Befürworter des Datenschutzes und Gesetzgeber dazu zwingt, wirksame und nachhaltige Vorschriften zu erarbeiten Datennutzung, Schutz und Privatsphäre. Durch die Untersuchung dieser Dynamik liefert die Forschung Einblicke in die Art und Weise, wie ein Land wie die Türkei mit den vielfältigen Aspekten der Umsetzung digitaler Gesundheitsfürsorge umgeht, und wirft Licht auf die potenziellen Strategien und Mechanismen, die trotz bestehender Einschränkungen die erfolgreiche Einführung digitaler Technologien im Gesundheitswesen ermöglichen. Dieser Beitrag zum breiteren Diskurs über die digitale Transformation bereichert unser Verständnis der Feinheiten, die mit der Nutzung von Technologie zur Verbesserung der Gesundheitssysteme einhergehen, insbesondere in Kontexten, in denen sich die Alphabetisierungsniveaus möglicherweise negativ auswirken.

Anahtar Kelimeler

• Digitale Gesundheit
• Biomedizinisierung
• digitale Technologie
• (bio)digitale Staatsbürgerschaft
• Transformation der Gesundheit
• Türkei

INTERPLAY OF GLOBAL TECHNOLOGICAL DYNAMICS AND LOCAL REALITIES: DIGITAL HEALTHCARE TRANSFORMATION IN TURKEY

Abstract

Various trends have driven the digital transformation of health: Developments in digital technologies, pressures for cause reduction in healthcare and increasing demand and expenditures from aging populations. In parallel, Turkey is actively engaged in a great transformative journey with its Health Transformation Program (HTP) since 2003, embracing the age of digitalization in healthcare. This study explores the interplay among historical discourse, political influences, technological advancements which shaped the centralization of Turkey's health system. Specifically, it delves into how Turkey's healthcare system has undergone centralization under the aegis of digital transformation. Amidst this transition, a compelling question arises: How has the positive perception of digital health innovations by both the public and authoritative health institutions converged with the challenges posed by low health and digital literacy levels? This article uses the concept of biomedicalization to encompass the multisited and multidirectional health transformation processes in Turkey. By cultivating a technology-friendly environment, the nation is nurturing (bio)digital citizens through the process of biomedicalization. Drawing on a historical narrative of Turkey's digital health transformation, the article posits that the phenomenon of biomedicalization in the country, molded by intricate multidimensional factors at both micro and macro levels, compels policymakers, privacy advocates, and lawmakers to devise effective and sustainable regulations concerning data utilization, protection, and privacy. By investigating these dynamics, the research provides insights into how a country like Turkey navigates the multifaceted aspects of digital health implementation, shedding light on the potential strategies and mechanisms that enable the successful adoption of digital technologies in healthcare despite existing limitations. This contribution to the broader discourse on digital transformation enriches our understanding of the intricacies involved in leveraging technology to enhance healthcare systems, especially in contexts where there are literacy levels might pose.

Keywords

• Digital health
• biomedicalization
• digital technology
• (bio)digital citizenship
• transformation of health
• Türkiye

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