Introduction and review of literature:
This review and user driven learning community ontology transcripts provide an overview of "the emotional economy, a shift where competitive advantage no longer stems from hardware, efficiency, or feature lists, but from the emotions products evoke through experience, interface, and brand identity. It signals an evolution of capitalism itself: from an age defined by industrial efficiency to one driven by experiential meaning.
In many ways, this extends the Business-to-Humans (B2H) mindset. Companies no longer think in terms of markets — B2B or B2C — but in terms of human relationships that hold emotional value. Empathy becomes infrastructure. Trust becomes currency. Emotional resonance becomes strategy."
Unquoted from: https://medium.com/design-bootcamp/the-emotional-economy-how-emotional-experiences-are-becoming-the-next-frontier-dfbfacfdd8b9
The key tool to build an empathic infrastructure for emotional economies to thrive:
"Regularly engaging in volunteer work hones empathy, the ability to understand and share the feelings of another, which enhances emotional intelligence—a critical factor in overall happiness. As volunteers interact with diverse individuals, they develop an aptitude for emotional cues and foster patience, understanding, and attentiveness. Empowered with these skills, volunteers tend to communicate better in personal and professional settings, leading to enriched relationships and personal fulfillment." Unquote: https://fightforright.in/the-health-benefits-volunteers-enjoy#:~:text=Then%20there's%20the%20underrated%20yet,enriched%20relationships%20and%20personal%20fulfillment.
Current postivist research translation barriers to translation of emotional economies at scale:
"Current positivist approaches have largely overlooked consideration of how power works in urban socio-ecological systems. Questions surrounding marginalization and exclusion, of who creates what type of urban ecological knowledge for whose benefit, are often eclipsed by analyses of the extent and benefits of urban greenspace. This is not to say that this work is not important, rather that it needs to be balanced with and supplemented by empirical and theoretical analyses of the power-laden political processes behind the production and distribution of benefits." Unquote: https://www.mdpi.com/2071-1050/13/14/7867#:~:text=Abstract,come%20apart%20or%20change%20directions.
Qualitative solutions to bridging emotional economic power inequity research to translation gap:
"Emotional economies of care are thought of as multiplicities and becomings in the style of Deleuze and Guattari [1], allowing us to think of them as a composition of multiple human and nonhuman bodies joined by their increased capacity to act (their affects). Ref 1: Deleuze, G.; Guattari, F. A Thousand Plateaus Capitalism and Schizophrenia; University of Minnesota Press: Minneapolis, MN, USA, 1987 more: https://en.wikipedia.org/wiki/A_Thousand_Plateaus
"One encouraging prospect for the becomings of emotional economies of care is found in Althusser’s [ref within ref rwf 2] aleatory materialism of the encounter." "if we think of emotion as circulating and creating value, it is apparent that there needs to be an ongoing series of encounters for these emotions to circulate between more and more participants to enable the growth of emotional economies of care and the accumulation of value. However, there is a tension between reading aleatory materialism as completely up to chance and recognizing the effects of previous encounters [ref within ref rwf 3]. What bringing in this sense of history helps to retain is the balance between pure prefiguration and pure contingency, acknowledging that “the present encounter reopens past encounters.” (rwf 2: Althusser, L. Philosophy of the Encounter: Later Writings, 1978–1987; Verso: London, UK, 2006), (ref 3: Pedwell, C. Affective Relations: The Transnational Politics of Empathy; Palgrave Macmillan: London, UK, 2014. ). In recent times healthcare workers, oblivious of previous work as detailed above, have developed emotional economies of care through persistent clinical encounters using academic tools to create user driven community ontologies. (Ref 4 : https://www.researchgate.net/publication/344227236_Persistent_Clinical_Encounters_in_User_Driven_E-Health_Care, ref 5 : https://www.researchgate.net/publication/234164624_Patient_Journey_Record_Systems_PaJR_The_development_of_a_conceptual_framework_for_a_patient_journey_system_Part_1, ref 6: Narketpally syndrome, https://pubmed.ncbi.nlm.nih.gov/40674544/, ref 7: Rethinking complex care: https://pubmed.ncbi.nlm.nih.gov/41364730/)
Methodology:
Participatory action research in regular real time clinical encounters between patient advocate , non commercial volunteers and deidentified patients through a transparent and accountable interface with minimal patient privacy trade offs after a rigorous DPDP compliant consent collection process from the patient.
Results:
5000 cases over 5 years here:T
he 5000 records that were made over 5 years largely depended on our student users where we made this a curricular activity that are logged in 1000 student online learning portfolios here: https://medicinedepartment.blogspot.com/2022/02/?m=0
500 cases over last one year here:
Meanwhile here's our currently toned down version since 2024, where we use a single point data capturer and longitudinal follow through moderator and single archivist that clocks near around 500 longitudinal records per year made freely available with the necessary DPDP complaint safeguards using an age old "case reports" model:
https://pajrcasereporter.blogspot.com/?m=1
We still hope to train students inspite of contrarian current curricular demands and scale this learning model (completely non commercial) to map a much wider population more meaningfully than what is perhaps visible currently.
Disease event related conversational transcripts from a single patient PaJR case report published here: https://pajrcasereporter.blogspot.com/2025/03/18f-journey-from-fetal-life-diet.html?m=1
The gist of it is that this patient had a viral fever , which necessitated regular monitoring and conservative management. It may have been managed more rationally and with high value without having to over test and overtreat in a homehealth care setting if only there was such a support system available locally. What actually was available locally made them spend a larger amount of "out of pocket expenses" for a short duration of stay with need for similar meticulous monitoring even after discharge.
This brought out thoughts of how to strategize a working community driven ecosystem of trained nurses and doctor volunteers capable of managing such patients in the community partnering with pre existing government/public health infrastructure.
At a top government think tank policy making level the above problem statement has been currently tackled using "a 250-page document, in which, the Centre’s top think tank suggested a Public Private Partnership (PPP) model under which beds in state-run health facilities could be split as “market” and “regulated”. Offering one kind of beds at market prices would help subsidise regulated ones, suggested the proposal, also endorsed by Union Finance Minister Minister Nirmala Sitharaman in that year’s Union Budget speech. More here: https://theprint.in/health/putting-state-run-hospitals-in-private-hands-is-an-ongoing-experiment-it-doesnt-always-pan-out/2395458/
Discussion:
"Beyond personal motivations, the emergence of medical volunteerism often stems as a response to the politics of needs interpretation within a society, the contestation in determining which welfare needs deserve legitimation and which institutions assume responsibility for its fulfillment. Volunteers and their contributions could be interpreted as a mode of discursive engagement when the state fails to adequately serve marginalized needs." Unquote: https://en.wikipedia.org/wiki/Medical_volunteerism
"Progression towards more ethical and sustainable change necessitates volunteers to prioritize the creation of long-term relationships with local healthcare facilities and providers. Sustainable development in this field can only be achieved once medical outreach is reframed not as isolated interventions but as an ongoing process that strengthens the capacity of local institutional care. Through integrating their mission goals with preexisting local community systems, volunteer collectives can collaborate with local governance to provide care in areas where current state provisioning fails. This collaborative model would ensure the impact of volunteer labor to reach structural inequalities that persist and outlast deployment timeframes, offering systemic aid to unmet health rights within marginalized populations." "Because people's experiences are not entirely bounded by “communities,” developing programs to address health problems and behavior at the “community” level, will always be insufficient – no matter how well designed an intervention may be. To effectively achieve the goals of a Culture of Health, we must work actively to create a more just and equitable society writ large. Vulnerable populations must be shown convincingly that their lives matter. Unquote: Mason, Katherine A.; Willen, Sarah S.; Holmes, Seth M.; Herd, Denise A.; Nichter, Mark; Castañeda, Heide; Hansen, Helena (December 2020). "How Do You Build a "Culture of Health"? A Critical Analysis of Challenges and Opportunities from Medical Anthropology". Population Health Management. 23 (6): 476–481. doi:10.1089/pop.2019.0179. ISSN 1942-7905. PMC 7703238. PMID 31928510.
CC licence: https://en.wikipedia.org/wiki/File:Community_health_worker_gives_a_vaccination_in_Odisha_state,_India_%288380317750%29.jpg
Thematic Analysis:
The text explores the intersection of empathy, technology, and social change, emphasizing:
1. *Empathy as infrastructure*: Building emotional economies requires empathy and trust.
2. *Volunteer-driven care*: Human agentic volunteers play a crucial role in healthcare.
3. *Power dynamics*: Addressing inequities and marginalization is essential.
4. *Collaborative approach*: Community-driven ecosystems and participatory research can drive change.
5. *AI and empathy*: Integrating AI can enhance empathic infrastructure.
The text advocates for a shift towards more inclusive, community-driven healthcare models, prioritizing empathy, trust, and social justice.
### Core Thesis: The Emotional Economy in Healthcare
The central argument is that value creation is undergoing a fundamental shift—from industrial efficiency to
**experiential meaning**. In healthcare, this translates to an **"emotional economy"** where:
* **Empathy is the infrastructure** (the foundational system for care).
* **Trust is the currency** (the medium of exchange that enables action).
* **Emotional resonance is the strategy** (the method for achieving sustainable outcomes).
### The Critical Engine: Human Agentic Volunteers
The text posits that volunteers are not just ancillary helpers but the essential **"agentic"** (active, purposeful) force for building this empathic infrastructure. They are uniquely positioned to:
1. **Hone and Deploy Empathy:** Their work naturally develops the emotional intelligence needed to understand complex patient journeys.
2. **Address Systemic Gaps:** They respond to the "politics of needs interpretation," serving where state or market systems fail marginalized populations.
3. **Create Sustainable Value:** By forming longitudinal relationships, they facilitate the "circulation" of care and trust that defines the emotional economy.
### The Problem: Positivist Research & Power Inequities
Current mainstream ("positivist") health research and systems often ignore critical questions of **power, marginalization, and exclusion**. They may map benefits (e.g., urban greenspace) but fail to analyze who controls knowledge, for whose benefit, and who is left out. This creates a significant gap between research on compassionate care and its practical, equitable application.
### The Proposed Methodology: Bridging the Gap
To overcome these barriers, the authors advocate for **Participatory Action Research (PAR)** embedded in real-world clinical encounters. This involves:
* **Community-Driven Ontologies:** Creating knowledge systems (like the User Driven Learning Community Ontology) from the ground up, based on persistent patient-clinician-advocate encounters.
* **Longitudinal Case Reporting:** The provided examples (5,000 cases over 5 years, 500/year currently) demonstrate a working model for capturing the nuanced, emotional, and socio-economic dimensions of illness that traditional records miss.
* **Rigorous Ethics:** Operating with transparency, accountability, and strong data privacy (DPDP compliance) as a non-commercial endeavor.
### The Strategic Vision: Community-Driven Ecosystems
The ultimate goal is not isolated interventions but the creation of **resilient community-driven healthcare ecosystems**. This involves:
* **Reframing Volunteerism:** Moving from short-term medical outreach to deep, long-term collaboration that strengthens **local institutional capacity**.
* **Integrating with Public Systems:** Partnering with pre-existing government/public health infrastructure to provide scalable, high-value care (e.g., community-based management of viral fevers to prevent costly hospitalization).
* **Leveraging AI in an Empathic Loop:** Proposing a role for AI not as a replacement for human empathy, but as a tool within an "empathic infrastructural loop" to support volunteers and scale insights from qualitative data.
### Thematic Conclusion: A Call for Systemic Change
The text is a call to action for a more just and equitable health society. It argues that:
1. **Technical solutions are insufficient.** Building a true "Culture of Health" requires confronting power inequities and structural inequalities head-on.
2. **Community and relationship are primary.** Sustainable change is rooted in trust and long-term human connections, not just transactional care.
3. **Value is co-created.** Patients, volunteers, and advocates are not passive recipients but active co-creators of health knowledge and systems.
In essence, the post outlines a radical, human-centric blueprint for healthcare where emotional intelligence, volunteer agency, participatory research, and ethical technology converge to build systems that are not only more effective but also more fundamentally caring and just.
Conversational feedback citations:
[29/12, 09:20]hu1: Getting the trained 'volunteers' is the main problem sir. Maybe they can be linked with previous PaJR beneficiaries if they are from the same locality
[29/12, 09:22]hu2: We can easily train them here in our private medical college, free of cost if they are willing.
They could be admitted as patients (with free food and lodging as offered by most private medical colleges in India to ward patients) and they could learn true patient centred care at the bedside 24x7.
[29/12, 09:28]hu1: Yes, the training part can be taken care of.
But what about their day jobs? They ought to have some day jobs since PaJR won't be able to pay the volunteers, since it is purely a non commercial initiative
[29/12, 09:29]hu1: I think the bottleneck in getting volunteers is that very few people would find time to spend with patients, while simultaneously taking care of their day jobs
[29/12, 09:35]hu2: Yes nailed it 👏👏
That's the crux of the issue.
Till AI frees all humans totally from their day jobs, the world is not ready for an emotion driven economy.
