Health System Assignment: Paper-Based Recording System Of Patients

Question

Task:
Write a briefing paper on health system assignment on why an issue of your choice does or does not fit the criteria for being classed as a wicked or messy problem.

Answer

Introduction
In order to categorize a problem as being wicked in the present context of health system assignment, many interdependent factors need to appear to be impossible to solve. To categorize a problem to be wicked, the factors need to appear to be incomplete, difficult to define, also solving wicked problems needs a deep understanding of stakeholders involved also an innovative approach using design thinking is needed (DeFries, & Nagendra, 2017). In the current case scenario of health system assignment, a health system of the paper-based recording system of patients in my country does not appear to be a wicked problem.

Analysis
The health system issue faced within my country relates to the maintenance of the physical records of patients. With a high influx of patients and high levels of maintenance records, retrieving such data for particular patients might emerge impossible. With a large population and increasing number of diseases in my country, it is crucial that patients are attended to by refereeing to their health records. But due to physical records, they often get displaced and lost. This leads to an increasing burden of health tests on public health and lag in treatment rendered to patients. This problem can become complex when patients are admitted to emergency departments. Large voluminous physical records can also impose the challenge of handling such data and deriving crucial information thereof. The problem can easily be solved by the implementation of an electronic health record system. With the implementation of EHR, the current challenge faced by the health system in my country can easily be tackled. This problem appears to be a particularly general one and with the implementation of EHR, the current system can be tackled hence it is not a wicked problem.

The problem currently being faced by the health system is not a wicked problem as firstly there is a present definitive approach for solving this problem (Dearnaley, 2018). Wicked problems are generally very complex and dependent on varied factors, so it is extremely difficult to grasp the exact nature of the problem or ways to tackle the same. This problem discussed here is a simple one and does not represent a tangled mess of thread. Generally, in a wicked problem, it is nearly impossible to solve a problem with a definitive approach. Secondly, wicked problem as the term first coined by Horst Rittel at Ulm School of Design, Germany, seems to have no stopping rule (Maron et al, 2016). This implies that there is no manner in which the solution can be deemed to be final as the problem might further get complicated. Also, solutions arrived at wicked problems cannot be true or false, they can be regarded as good or bad (Mette et al, 2017). This leads to no immediate solution for a wicked problem. However, in this scenario of health system assignment absence of an electronic health system has led to the challenge arising and can easily be tackled by implementing EHR. So, the immediate solution to the problem can easily be arrived at, which is not possible in the case of a wicked problem. In the case of devising a solution for a wicked problem, it needs to be a one-shot operation as there remains less opportunity for undertaking trial-and-error methods in the same (Woodford et al, 2016). Once a solution is applied then in case it is not correct then other associate challenges can appear. Wicked problems do not have a set of potential solutions; there can be limited approaches to resolve such a problem. Also, every wicked problem is unique and can be regarded as a symptom of another problem, which is not the case in this problem.

Wicked problems generally present with more than one explanation for the problem as the explanation depends on the individual aspect. A wicked problem can hence represent a series of plausible solutions for a particular problem (Bache et al, 2016). Designers or planners possess no right to be wrong and hence need to be responsible for their actions hence resolving a wicked problem poses much more challenge. The above discussion of the wicked problem states that the definition does not fit into the characteristics features of the problem that is presented. Usually, solutions in case of a wicked problem require changing behaviors or groups of people or citizens. As in this case, it would require that the entire health department as well as health staff in the country transform their behavior and adopt a more technical approach in resolving a problem.

In case the problem identified in the health system assignment would be treated as a wicked or messy problem then this case would need to be diagnosed and resolved in a different manner. There would also be implications in case the problem was to follow a wicked problem criterion. In order to tackle the challenge of handling the physical records of patients, the solution to implement EHR cannot be deemed to be the final solution. This solution cannot be considered as true or false rather it can be considered as a good solution (van Rinsum et al, 2017). Solutions in case of wicked problems cannot be immediate and hence more exploration of the problem might be needed. The problem is considered to be wicked then it might be considered to be a symptom of another problem present in the health system. This problem would require more than one possible explanation, such as physical records are messy present due to a large number of patients, or handling physical patient records is complex due to lacking skills of staff and employees at the public health system and so on and so forth. A design planning initiative such as mind mapping tool could have enabled devising solutions to the problem in a better and more advanced manner. The implication of connecting multiple factors to categorize this problem to be wicked leads to find more possible explanations for each of the connected factors (Arnold, & Wade, 2015). This would not only complicate the issue but also create difficulty in resolving it. This problem is categorized as a wicked problem that will need changing behavior of health staff within the entire country also the implementation of sound policy and its implementation will need to be undertaken for the same, depending upon feedback. This can lead to changes to be brought about in traditional approaches in policy making and implementing programs. Hence it is best that the issues remain not categorized as a wicked problem.

Conclusion
A conclusion can be drawn from the above discussion on health system assignment by stating that the problem existing in my country in the health system does not appear to be a wicked one. In case the problem would have been a wicked, then viewpoints from varied stakeholders will be required to contribute towards the solution. All the changes presented by the problem need to be addressed such that a governance-based approach to the problem can be ascertained. Moreover, wicked problems are categorized as such as they are difficult and nearly impossible to solve. Some risk-free attempts to resolve the wicked problem need to be undertaken for the challenge in the health system.

References
Arnold, R. D., & Wade, J. P. (2015). A definition of systems thinking: A systems approach. Procedia computer science, 44(2015), 669-678. Health system assignment Retrieved from [https://www.researchgate.net/profile/Ross_Arnold/publication/273894661_A_Definition_of_Systems_Thinking_A_Systems_Approach/links/5656054108aeafc2aabee827.pdf]

Bache, I., Reardon, L., & Anand, P. (2016). Wellbeing as a wicked problem: Navigating the arguments for the role of government. Journal of Happiness Studies, 17(3), 893-912. https://doi.org/10.1007/s10902-015-9623-y

Dearnaley, P. (2018). Health, social care and housing: facing a wicked problem. Housing, Care and Support. https://doi.org/10.1108/HCS-12-2018-029

DeFries, R., & Nagendra, H. (2017). Ecosystem management as a wicked problem. Science, 356(6335), 265-270. DOI: 10.1126/science.aal1950

Maron, M., Ives, C. D., Kujala, H., Bull, J. W., Maseyk, F. J., Bekessy, S., Gordon, A., Watson, J.E., Lentini, P.E., Gibbons, P. & Possingham, H. P. (2016). Taming a wicked problem: resolving controversies in biodiversity offsetting. BioScience, 66(6), 489-498. https://doi.org/10.1093/biosci/biw038

Mette, I. M., Range, B. G., Anderson, J., Hvidston, D. J., Nieuwenhuizen, L., & Doty, J. (2017). The wicked problem of the intersection between supervision and evaluation. International Electronic Journal of Elementary Education, 9(3), 709-724.

Van Rinsum, C. E., Gerards, S. M., Rutten, G. M., van de Goor, I. A., & Kremers, S. P. (2017). Health brokers: How can they help deal with the wickedness of public health problems?. BioMed research international, 2017. https://doi.org/10.1155/2017/1979153

Woodford, D. J., Richardson, D. M., MacIsaac, H. J., Mandrak, N. E., Van Wilgen, B. W., Wilson, J. R., & Weyl, O. L. (2016). Confronting the wicked problem of managing biological invasions. Health system assignment NeoBiota, 31, 63. DOI: 10.3897/neobiotaa.31.10038