Abstract
Behind every medical device and clinical decision is a patient whose health outcome is determined by more than technology alone. As healthcare needs evolve, systems must respond not only through technological advancements but also through improvements in the organization and delivery of care. The organization of care includes the relationships between providers and patients, the policies that guide clinical practice, and the degree to which patients feel heard and supported. At the same time, technological innovation enhances precision and the overall effectiveness of treatments. Social structure and technical design are woven together, each shaping the patient experience in distinct but interconnected ways.
In the technical portion of my research, I address a problem in the field of prosthetics that directly impacts patient outcomes. Many amputees experience discomfort and worsened residual limb health due to high interface pressures caused by inadequate socket fit, a condition known as socket misfit. Existing prosthetic fitting assessments rely heavily on subjective patient feedback and clinician observations, which can prolong fitting sessions, limit precision, and contribute to prosthesis dissatisfaction and abandonment. To address this, my capstone team developed a prototype for measuring and visualizing pressure at key areas on the residual limb during the test socket fitting phase. This technology enables clinicians to make more informed adjustments, ultimately improving comfort and continuity in prosthetic use. However, even advanced devices must be understood within the social environment it operates within, as its effectiveness depends on how it is integrated into clinical care.
The need to consider the human and social dimensions of care led me to my STS research on maternal mortality in the United States. Despite significant investment in healthcare infrastructure and innovations in health treatments, the U.S. continues to have higher maternal mortality rates than other high-income nations. I explore this disparity by focusing on the limited integration of midwives within the U.S. maternal healthcare system. Using Actor Network Theory (ANT), I identify the human and non-human actors, including midwives, physicians, patients, hospital systems, and insurance policies, and analyze how they interact to shape maternal health outcomes. ANT was an appropriate framework as it moves beyond a single-cause explanation and instead examines how complex relationships within a system produce certain outcomes. My analysis highlights key issues such as medical mistrust, fragmented continuity of care, and regulatory barriers that limit midwifery integration. I also reveal how midwives can serve as critical actants who improve trust through continuous care and reduction of unnecessary interventions, ultimately leading to better maternal outcomes.
When considered together, my capstone and STS research demonstrate that improving patient outcomes requires more than technological advancement alone. They reveal that healthcare outcomes emerge from complex interactions between people, technologies, and systems. A pressure sensing device may improve prosthetic fit, just as integrating midwives may improve maternal care, but for an effective solution both must consider technological and social improvements. Therefore, meaningful improvement depends on aligning innovation with empathy and ethical intention, ensuring that both technological and human experience remain at the forefront of care.
