Innovating Elderly Care During COVID-19: E-prescribing, Digital Therapy, and the "Invisible" Role of Interdigital Mediating Agency

International evidence shows several benefits of the «dematerialization» of medical prescription (e-prescribing) for stay-at-home elderly during the pandemic lockdown. In Italy, the introduction of e-prescribing (ricetta elettronica) relying on the user’s capabilities of using Information and Communication Technology failed to guarantee access to the most digitally illiterate, fragile, in great need of medications and forced to remain-at-home part of the Italian population: the elderly. Building on interdigital mediating agency theoretical work and technology-care approach, the study investigates the introduction of e-prescription in the North and South of Italy during a one-year ethnographic observation. Results highlighted the rise of e-prescribing social health relations, affecting formal and «invisible» human work that acts for and around elderly care. The intervening role of pandemic mobility restrictions, mobile technology, and digital literacy in newly introduced e-prescription health relations (patients, caregivers, family doctors, pharmacists) appear to affect three existing domains by a) redefining objects (prescription dematerialization) b) changing access to health care c) altering networked connections among subjects creating innovative «invisible» workers. Satisfaction toward e-prescribing and its perceived (successful) future evolution in Italy is explored. Previous literature showed the importance of situated practice and informal work supporting aging care besides formal regulation. Results confirm that interdigital agents’ invisible work, securing e-prescribing medication to digitally illiterate home restricted seniors, turned innovation aging failure into success, thanks to techno-knowledge-care fluctuating dynamics