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The U.S. healthcare system is in crisis, marked by soaring costs, inefficiencies, and stark disparities in health outcomes. Or at least, this is how U.S. policy makers have predominantly narrated and justified healthcare policy interventions since the 1970s. This dissertation examines how, starting in the 2010s, U.S. policymakers and politicians have turned towards data infrastructures – including new protocols and standards for exchanging clinical, billing, and administrative health data – as the newest site for reforming healthcare markets. Drawing on 24 months of multi-sited ethnographic research in the U.S. healthcare industry, I trace how federal regulations, particularly the 21st Century Cures Act (2016), position data interoperability, or standardized data sharing, as a means to realign a fragmented, profit-driven healthcare market with the efficient production of population health outcomes. I describe this mode of governance, which merges market-solutionism and techno-solutionism, as “computing care.” Through a close examination of “value-based care” policies, social determinants of health data, and the automation of prior authorization, I show how computing care helps to depoliticize the failures of for-profit healthcare markets to produce equitable, accessible, affordable care. The failures of healthcare markets are instead narrated by policymakers as technical problems - of insufficient information and sub-optimal market design. I argue that intensified computation and continually evolving capacities to collect, analyze, and store data help reproduce this depoliticized, market-solutionist mode of governance. Through this project, I interrogate the banal violence of computing care as a mode of governance and point towards the possibility of alternative modes of governance beyond market- and techno-solutionism. I also reflect specifically on the potential role of data infrastructures in advancing alternative modes of care governance. This project contributes to the fields of critical data studies, science and technology studies, and feminist political economy, highlighting the reconfigurations of data and governance necessary to achieve an equitable and just future of healthcare.
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This content will become publicly available on July 17, 2026
Data interoperability and the governance of public value
Data interoperability—or standardized data sharing and use across organizational boundaries—is central to the production of value from big data. Using emerging health data regulations in the United States as a case study, this commentary demonstrates the importance of interoperability as a fulcrum in the governance of data-driven value production in the platform economy. Specifically, I explore how data governance of interoperability data governance: (1) is a foundational enabler of value production from data; (2) shapes processes of value production toward particular ends; and (3) intervenes in the accumulation of power through data.
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- Award ID(s):
- 1901171
- PAR ID:
- 10650520
- Publisher / Repository:
- Platforms & Society
- Date Published:
- Journal Name:
- Platforms & Society
- Volume:
- 2
- ISSN:
- 2976-8624
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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