Not all challenges are created equal. Some are straightforward, others require expertise, and some are so intricate that they defy predictable solutions. Understanding the nature of a problem is the first step toward solving it—and this is especially true when it comes to Canada’s fragmented health data system.
Our health data system isn’t just broken in one place; it’s a tangle of misaligned processes, siloed stakeholders, and differing priorities. These characteristics make it a complex problem, not just a complicated or simple one. To address it effectively, we need to use approaches tailored to its complexity.
The Spectrum of Problems: Simple, Complicated, and Complex
To understand why the health data system is complex, let’s explore the three types of problems using health data examples:
- Simple Problems
- Example: Correcting an error in a patient’s health record.
- Simple problems have clear cause-and-effect relationships and predictable outcomes. Fixing a typo in a patient’s date of birth or updating an address in a database follows a clear, replicable process. Once you know the steps, anyone can achieve the same result.
- Complicated Problems
- Example: Implementing a new electronic health record (EHR) system in a hospital.
- Complicated problems require expertise and coordination among specialists. There are multiple steps—like configuring software, training staff, and ensuring compliance with regulations—but the outcome is predictable with the right knowledge and planning.
- Complex Problems
- Example: Creating an interoperable health data system across Canada’s provinces and territories.
- Complex problems involve dynamic, interdependent factors that evolve over time. They include navigating jurisdictional policies, addressing privacy concerns, aligning stakeholders with competing interests, and adapting to technological advancements. These problems have no single “right” solution and require continuous learning, adaptation, and collaboration.
Why Canada’s Health Data System is Complex
At first glance, it might seem that improving Canada’s health data system is a complicated problem. Can’t we just standardize processes, improve technology, and align stakeholders? While those elements are essential, they only scratch the surface. The real challenge lies in the system’s complexity:
- Fragmentation Across Jurisdictions: Health data governance spans federal, provincial, territorial, and local levels, each with its own priorities, policies, and systems.
- Diverse Stakeholders: Governments, healthcare providers, researchers, data stewards, and patients all have differing needs and goals.
- Rapidly Changing Contexts: Technology evolves quickly, and societal demands for equity, privacy, and transparency add layers of unpredictability.
- Emerging Interdependencies: Decisions in one part of the system often have unforeseen consequences elsewhere.
These characteristics mean that there is no single “recipe” or expert solution. Instead, we must adopt approaches that embrace complexity.
Addressing Complex Problems Requires Different Approaches
Complex problems cannot be solved using top-down directives or rigid plans. Instead, they require systemic leadership and approaches designed for flexibility, iteration, and collaboration. Here’s how the Healthy Data Collective is tackling this complexity:
1. Building Shared Understanding Through Learning Communities
- Why It Works: Complex problems require diverse perspectives to identify contributing factors and develop solutions. Learning communities foster trust, dialogue, and co-creation, helping stakeholders navigate complexity together.
- Our Approach: The Healthy Data Collective is convening a learning community to align stakeholders, share knowledge, and generate innovative solutions for health data challenges.
2. Co-Creating a Common Agenda
- Why It Works: In complex systems, no single actor has control. A shared vision ensures all participants are working toward the same overarching goals.
- Our Approach: Using the pan-Canadian Health Data Charter, we will create space for conversations to unpack what we mean by each principle and explore what needs to change in our systems so it is aligned with those principles. The pan-Canadian Health Data charter acts as a guiding compass for collective efforts.
3. Using Adaptive Practices
- Why It Works: Complex problems require constant learning and adjustment. Iterative approaches allow us to test ideas, learn from failures, and refine strategies in real time.
- Our Approach: We’re piloting collaborative projects and small-scale initiatives to explore what works before scaling solutions across the system. And, we will share these lessons so others can benefit from them.
4. Emphasizing Relationships Over Solutions
- Why It Works: Trust and collaboration are the foundation of effective action in complex systems. Solutions emerge when relationships and communication channels are strong.
- Our Approach: The Healthy Data Collective is creating spaces for continuous communication, enabling stakeholders to build the trust needed for sustained action.
Moving Forward: Embracing Complexity Together
The fragmented state of Canada’s health data system is a textbook example of a complex problem. It can’t be solved with a single plan, policy, or technical fix. Instead, it requires us to rethink how we work together, share knowledge, and adapt to an ever-changing landscape.
The Healthy Data Collective’s approaches—learning communities, common agendas, adaptive practices, and relationship building—are designed to address these complexities. By embracing the messiness of complexity rather than trying to force simple solutions onto it, we can begin to untangle the challenges and create a more connected, equitable, and effective health data system.
What’s Your Role in Addressing Complexity?
Whether you’re a patient, caregiver, policymaker, a data steward, a healthcare provider, a researcher, a journalist, or healthcare administrator, you are part of the system. What complexities do you see in your corner of the health data world? How can we work together to navigate them?
Let’s continue the conversation—because in complexity, collaboration is key.
