The abstraction of wicked problems has attracted focus on governance and their implications on public organizations. This case study examines the main wickedness dimensions emerging from Care.data. The paper identifies various parameters on wicked problems as exhibited by the Care.data. These details are related to information governance and ethics in Cambridge. The Care.data was launched in 2013 in the United Kingdom as patient privacy and public trust. The aim of the trust was to centralize all patient’s health and social care data for its citizens. However, the initiative faces a number of drawbacks.
Identifying Problem Wickedness
According to Hays and Daker-White (2015), the information problems at Care.data mainly arise from untimely behavioural interventions. First, the initiative experiences problems as a result of mismanagement and miscommunications. For a number of individuals/patients, it is reported that they failed to receive results of their tests on mental illness. As such, the management failed to timely interventions and diagnosis. These resulted in too much crisis, pains, and suffering.
Secondly, the wickedness problems arose from the inadequate protections for patients’ anonymity. The patients’ and personal health care data were so flexible to be shared by non-interested parties. While the common health care practice restricts the mobility of personal health data, this wickedness was reported with the Care.data trust. The healthcare data were entered into the system but were not adequately used downstream by other users. Arguably, lack of healthcare data liquidities, create incredible inefficiencies in the healthcare systems. As such, healthcare systems pose severe effects on the patients globally.
Thirdly, information problems may arise from doctors’ conflicts. This will result in healthcare disparities. This problem is not only wicked but also, unethical, immoral and fatal. Furthermore, it makes healthcare operations poor while exaggerating medical costs. The implications of such care data directly affect overall care administered.
How ‘Wicked’ are these Problems?
The sinful problems in the management and communications surrounding the centralization effort of health care data have displayed a ripple effect that has drawn legal conflicting attentions. There is an increasing demand for unaffordable long-term care as a result of doctors’ conflicts. Many people live with chronic medical conditions. These pose serious healthcare concerns about how healthcare should be delivered and who should cater for damages.
Notably, there high reluctance to discuss the point of death. It is a taboo and more often ignored topics to discuss death. This reluctance results in poor healthcare quality, financial burdens and traumatizing experiences for loved ones and caregivers.
A patient who fails to be diagnosed appropriately due to healthcare data problems is most likely going to abuse drugs. The abuse and dependence on prescribed drugs is an epidemic. It is not only wicked but it also places a lot of burden on the healthcare systems.
What are the Perspectives that Stakeholders have of these Problems?
The care data problems pose a lot of tension among the stakeholders. There a lot of questions that emerge from these problems which go unanswered. There are growing concerns on the change of various perspectives which are considered as taboo or ancient on healthcare data and systems. Many stakeholders acknowledge the need for computerized systems and diagnosis to maintain patients’ data. The electronic records management is seen by the stakeholders as the most effective tactic to be designed in order to curb the wicked problems related to caring data. Through the strategic approaches, the stakeholders believe that this perspective of enhancing digital technologies will address wicked problems as posed by care data.
Examining System Properties
The care data systems provide an interdisciplinary framework to examine multiple biological, physical and social properties. The prevalence of a system can be checked by analysing its complexity, the various dynamics, their diversities as well as their scale. Systems share heterogenic properties. In this paper, the systems examined are under the UK Care.data and the components are restricted to their relationships, interactions and the extent with which the system can cover.
What are the Features and Properties of these Systems?
The greatest component of care data systems is the human resource. Managing the workforce is the leading priority in the care data systems as this has a direct impact on patients. Healthcare data systems are made up of several components. First, there is an infrastructural component in the form of a hospital. Hospitals have information systems for data collection. The systems are used for capturing data. The hospitals use the systems to organize data for quality improvement service delivery.
The other component of a healthcare system is the inventory management system which keeps stock of operations in the healthcare facility. This serves a critical purpose of inducing smooth operations in the organization.
Diversity and Components
There are many software components used in healthcare data facilities. A probabilistically component that detects and link identities of patients and healthcare providers exist in the healthcare systems (Sundaravadivel et al., 2018). Another component is the resource to assess decision service that centralizes all healthcare access decisions for portal queries. The data can then be accessed by various users downstream as per the access control policy structures.
There is also a component called the Secure Query Service that accepts prior configurations on rational queries in order for it to return final results when queried from the system (Sundaravadivel et al., 2018).
Complexity and Relationships
The care data components are geared towards managing large-scale healthcare systems on their operations. They are also used in the registry to produce and maintain strong patients’ relationships. The common relationships that exist at the Care.data systems include the healthcare giver- to a patient relationship, one health giver to many patients’ relationships, and those of many doctors to many patients’ relationships.
Dynamics to be Considered – Relevance
The Care.data systems have limited considerations on their time scales. However, much of the resistance to change at the Care.data could have been avoided if effective project management principles were enforced from the beginning. The stakeholders ought to identify the root causes of the resistance to change and engage the appropriate resistance rules. Notably, the leading reason for the change at Care.data was associated with bad management at the workplace. There is a need to establish strong oversight authorities over patients and employees at the Care.data trust facility.
Evaluating the Governing System
There are many governing committees working at the Care.data trust, for instance, the executive board member committees, project management committee, etc. the management groups work harmoniously to deliver enhance service deliveries. They also come up and pass policies governing the trust. By so doing, they are involved in commissioning, managing and evaluating the progress of projects such as pathfinder surgeries. Outside the Care.data, the management team works independently at the national panels as oversight governance at the National Data Guardian (NDG) among others (Krumholz et al., 2016)
The governing body operates under the established legal environment of the UK such as the Data Protection Act (DPA) that was passed in 1998. The Act established the principle of fair handling of patients’ data. In 2014, the Health and Social Care Act was passed. This constitutional right gave NHS power to process information that is of public interest fairly while at the same time it allowed patients to object that processing.
The governing and steering bodies at the Care.data are flexible and sufficiently responsive to the needs of the patients and employees. Otherwise, the rigidity and insufficiency of the system cause resistance to new policies governing the system. Communications around the public have also been boosted. This helps in building trust among the patients and management teams.
Within the governing system, there are a number of issues of scale around the design and distribution of forms that are used in the care.dat program. The diversity and sparse nature of data cause difficulties in standardizing formats that can be used across all facilities within the Care.data environment. Although there are no significant project delays, the deployment modes have been captured as one potential delay in the delivery of service. Due to standards demanded to effect a change such as a deployment, the software is not perfect on service-oriented components. Ultimately, the governing system is under intense flexibility and interoperability needs.
The Care.data primarily is concerned with technical aspects of information links more than the ethical principles and privacy rights. The consent of law protects information campaigns. It has established laws that allowed the use of technical systems to manage operations to the limited extent of content sharing.
The current modes of governance are well enough to handle the existing and emerging challenges at the Care.data. The performances at the individual management levels have established effective communication platforms that balance and prioritize urgent information. The mechanisms to express consent are specific and easy to understand. Furthermore, control of data has been centralized on small scales and decentralized on a large scale. Regulations on patients’ data have clearly been outlined by the management and subjected to strong governing oversight authority. The problematic nature in protecting patients’ data has since been partly addressed at the care.data Program.
The flawed nature brought by patients’ anonymity and the unsuitable opt-out system is now clear unlike before. The criteria for accessing the collected health data have since been streamlined. Risks of confusions between the patients and doctors’ data no longer exist.
Governing Interactions Analysis
Types of Interactions
The governing systems at the care.dat program have stipulated designs with established interaction process. The hierarchical governance steers the government policies, law, and personal data. This model at the Care.data uses the top-down management command control. On the other, the professionals are governed by civil society interactions within the legal framework of the program that protects the handling of patient data. The public-private interactions exist as co-governance.
As a state, the government works with the parliament as the mandated body which formulates laws. The formulated laws are combined to the legal system which as a whole regulates practices enjoined in the Care.data program. The NHS is mandated to implement the laws which been made. It is the NHS which interacts with patients as it passes information to them. This is a bi-directional information sharing platform. within the information sharing platform, the interactions raise awareness regarding the patients’ healthcare. In case of any query, the same interaction platform is used to iron out the issues.
As a medium of information sharing, letters, and websites for those interactions which are impossible to be undertaken face to face. Therefore, hierarchical, co-governing and self-governing interactions are available at the Care.data case.
The enabling factors at the Care.data are many. The leading enabling factor is the government working with the parliamentarians. They control the legal systems. Others include the NHS and GPs subsets. The NHS and GPs regulate the controls with the delegated powers. All GPs partner with a range of care.data stakeholders to enable constraining factors not to impinge on the existing interactions (van Staa., 2016).
To sum up, a wicked problem is almost impossible to solve the problem because of incomplete, contradictory and changing needs it requires. It is difficult because it is hard to recognize and fix the problem in the system. The assessment of Care.data portrays a similar difficult state on its governability and the state of governance. The information governance requires substantial commitment to ensure authorized access and management of information. This prompts the functionality of information governance to exercise extensive caution and maximum information security.
Therefore, to improve governance at the Care.data the program requires more stringent formulations in the form of laws. A strict flow of information should be streamlined so that each element takes responsibility for the wickedness experience. Patients data should be protected further against unauthorized users at all costs. Furthermore, there is a need to enhance awareness and break the taboos which serve like unwritten laws. An example of a taboo that should be broken is that of not talking about death even when dying or when a fatal disease is ailing a patient.