Why More Data Isn’t Fixing Healthcare: The Case for Embracing Diverse Realities

We spend a lot of our time trying to make sense of reality in healthcare and social services: we lean on data statistics, KPIs, spreadsheets to set standards and track progress. All to tell us what is the true reality we must manage. We build ever bigger systems processes and data sets. In order to better model predict and change reality. But are we missing the point? All too often reality is not one thing, but something that is based on our experiences that are unique to us.

Does More Data Help Us Understand The Right Reality?

When we try to better understand reality in healthcare, the focus often lies on collecting ever more data. Already healthcare data accounts for 30% of all data. The amount of healthcare data we collect is increasing by 36% a year. Meaning that it is taking up an ever increasing amount of all data created.

We build ever bigger systems, processes and institutions as well as ever more complex analytics. All with the promise of if we crunch enough data we will get closer to building an understanding of the one true reality. The promise we are given is that if we collect enough information we can build this one true model of reality then we will be able to diagnose and fix all our problems. 

The Data Does Not Add Up To Our Experience

Despite the amount of data we are collecting growing by about 27% per year (International Data Corporation) our biggest organisations often seem disconnected from the world we live in. 

The 2022 Edelman Trust Barometer reported that trust in major institutions, including big businesses and governments, is declining globally. Only 61% of respondents trust businesses, and trust in CEOs dropped to 44%. Similarly in healthcare with trust in the NHS slumping to just 24% (King’s Fund)

But whether it’s fighting with service providers when you moved home or whether your healthcare provider failing to recognise the different needs of disabled people, our institutions seem more distant from us than ever, despite being flooded with information.

Whilst personalisation does not seem to work very well. For example, recently I’ve been regularly getting adverts for catfood on YouTube. I don’t own a cat. 

Is One Version of Reality An Assumption

Why does more data not build a better understanding of reality? We’re taught to see reality as a singular, objective truth, with one “correct” path forward.  This perspective encourages centralised policies, large scale targets and plans and performance indicators designed to best fit reality. However, that’s a fundamentally flawed assumption. We all have different perceptions and experiences of the same events.  Meaning different realities can be true at the same time.

Social Constructivism:

Rather than having one true version of reality we construct versions of reality between us: Peter L. Berger and Thomas Luckmann in their seminal work, “The Social Construction of Reality“ (1966), argue that our understanding of reality is shaped by social interactions and cultural contexts. They posit that what we consider “reality” is constructed through collective agreement, meaning different groups can have differing realities based on their experiences and interpretations.

Burning Realities

Reality isn’t one-size-fits-all. Take bonfire night for example: This year I had the pleasure of attending the (in) famous Lewes Bonfire night.

Multiple firework societies, parade around Lewes dressed as everything from priests to Mongolian tribespeople, carrying flaming torches, throwing firecrackers, chanting, playing drums flutes and trumpets carrying effigies of people they intend to burn.

But that is just scratching the surface; with each group having rivalries with other societies, places, symbology and rituals and that can be secretive centuries old and unique to each society. All of which creates a unique meaningful reality to the members of those groups.

The event feels mad, hot and semi-chaotic as Lewes is a small castle town with narrow winding streets. There is no fixed route for the parade with each society going their own way. So a random fiery mob can appear right in front of you at any moment.

Whilst my neighbour’s bonfire night was a couple of sparklers and a dozen rockets. Very nice family orientated fun, but a different reality.

Bonfire Night may be the same night across the UK, but the experience couldn’t be more varied. 

Divergent Experiences Create Divergent Realities

This divergence points to a core truth about our world: people experience the same events in different ways, coloured by their context, culture, and history. In systems like healthcare, the tendency to view “reality” through a singular, centralised lens can result in policies that don’t fit diverse communities, leaving people feeling unseen and disconnected. This was most apparent during the covid pandemic where the NHS tried a once size fits all approach that didn’t adapt to the needs of different communities. Leading to nearly 11,000 more excess deaths in the most deprived 80 percent of areas during the COVID-19 pandemic in 2020

Healthcare Data is Different From Healthcare Reality

In healthcare and social services, we plan and fund our entire system based on data statistics, KPIs, spreadsheets to set standards and track progress. Yet these metrics can distance decision-makers from the reality of the people they aim to serve. For example, an A&E target may tell us how long a patient waits, but it doesn’t reveal their emotional state, the support they’re missing, or the stress felt by the nurses and doctors working beyond capacity​.

When Targets Miss the People

Many in health and wellbeing feel this disconnect keenly. People at the heart of these systems see first hand how uniform targets can stifle compassion and creativity, reducing patients and staff alike to mere numbers. The NHS, for instance, has tried to “fix” itself through plans that often overlook the nuances of patient and staff experience, leading to cycles of stress and burnout rather than sustainable improvement​​. (As I’ve detailed in this post)

How a Single View of Reality Leads To Failure.

The problem with creating a single reality for senior decision makers whether they are in our organisations or government is that they mistake that version for the real world. This leads them to make simple decisions that can work in the reality they have created for themselves. But when these decisions our enacted they bump into different versions of reality leading to failure. I’ve described this process here.

Why Lived Reality Matters

Just as Lewes Bonfire Night creates a visceral, in the moment experience that’s impossible to capture on paper, our daily realities are rich, complex, and deeply human. To make a meaningful impact on wellbeing, we must recognise these experiences and encourage decision-making grounded in local communities (Read more about this approach here). This approach doesn’t just improve outcomes; it builds trust and empowers communities to take ownership of their wellbeing.

The Power of Diversity In Understanding Reality

Diversity becomes a superpower when you realise there is not one reality. But in fact different perspectives that create a shared reality. It is only through embracing diverse perspectives and views can we make better decisions. Embracing diversity is therefore not a political figleaf, but an essential part of helping adapt and thrive in an ever changing world. (If you would like to read more about how to improve your decision making with diversity i’ve written about it here)

Conclusion

True impact arises not from systems that impose a single vision of reality, but from those that amplify and adapt to the voices of individuals and communities. For healthcare, social services, and beyond, this means letting lived experience guide the way supported by data. We cannot fit people’s experience ot the data. Instead we have to have the data reflect the reality of people’s different experience.