Transparency. Both an ancient concept (Socrates, Jesus, and Gandhi all spoke of it) and having the shine of being trendy, this idea, which humanity has struggled with for millennia, has become a strong focus in healthcare.
Right now, our industry is asking questions that have been considered for as long as smart people have been thinking about transparency: What transparency really is, the actual benefits of it, and about what we should be transparent.
These are important questions, but for a moment let’s take a step back and look at why transparency can be such a tricky topic and how we might be able to navigate it more effectively.
First, we have to get to the heart of what makes this so hard:
The tension of transparency is between the data we can collect and the story it actually reveals.
For example, imagine if you saw these data points in a report:
- Two families are in a generational feud.
- A girl and a boy meet and fall in love.
- The kids realize their families hate each other.
- The kids push against their parents about the feud.
- The parents won’t change. A family member is killed in tragic encounter as a result of the feud and new love clashing. The kids are separated.
- The kids can’t communicate and form separate plans to be together.
- Due to their inability to communicate, the kids end up killing themselves out of mistaken grief.
What story is actually revealed here? It could be a classic tragedy from Shakespeare rich in meaning and emotion or a cheesy episode of The Jerry Springer Show. How do you know which it is?
The real story behind the data is all about how you frame it.
Or perhaps the real story is a slightly more personal version. Have you ever had a time in your life where the “facts” of the situation just didn’t tell the same story as the actual experience? Maybe you found yourself speaking to someone who had only heard the facts but wasn’t there, and you said these famous words, “But you just don’t understand. You had to have been there!”
Before you say, “I just need more data,” keep in mind that at this point in our technology’s development there isn’t any realistic way to capture all the data you’d need to truly capture the essence of the story. (How can you capture the emotion, nuance, and perspectives surrounding an experience?)
On one side of things, we have the push for 100%, unfiltered, and unedited transparency. Nothing is held back. This side believes in the power of transparency and authenticity to change and empower an industry.
On the other side, we have those pushing for more “thoughtful” sharing. This side understands the idea of framing. The same data framed differently tells a very different story. The wrong data shared openly is more damaging and misleading than helpful. Perhaps, they may say, transparency isn’t actually that helpful after all.
So how can we resolve this tension? I would suggest this isn’t a tension we should try to resolve. Instead, it’s one we need to manage. To be fair, the idea of “a tension to be managed” isn’t mine. I’m sure others have said it in other ways as well, but the way Andy Stanley frames it is the best I’ve heard.
What do I mean by a tension to be managed? Simply put, you have a tension to be managed when both sides of a debate have valid and important strengths. These seemingly clashing sides may not be opposing forces as much as they are intertwined balances. An equation of the tension might look like this:
Strength – opposing force = Destruction
In other words, if you resolve the tension, you lose something important, and what was a good and healthy balance becomes a problem.
Pithy statements aside, the question still remains of what to do with this tension. To begin with, we have to ask ourselves a question:
What are we trying to accomplish – at the core?
Let’s take on a specific area of transparency for this: patient experience.
Yes, capturing data for the patient experience is important and foundational to what we’re all doing. But is capturing the data what we’re trying to accomplish? Is it even the goal to make patients feel good about their experience with us? It may seem like that would be the goal; but I’d submit if that’s the real goal, then we’re likely to begin learning how to manufacture experiences like we do cars – efficiently and with the cold lens of data.
We have to remember that while data is important, it isn’t almighty. When we focus on data, a shift occurs. We forget while data can represent the person, it isn’t the same thing as the person. And this is a subtle but important nuance.
Think of data as the shadow of a person. If it were possible to watch nothing but the shadow of a person 24/7, I could tell a lot about them. With math I could know the person’s height, likely weight, body shape, etc. If I could geolocate that shadow all the time, I could tell a good bit about lifestyle, travel patterns, daily routines, maybe even spending habits and more. If I could see the shadows around that person, I could know about social networks and possibly learn something about how they interact. I could learn about aspects of their personality from body language.
I could know a huge amount of data about the person. But, what if the reason I’m doing all this is to answer this question: Do I want to marry this person? Suddenly, all this massive data can’t actually answer the question. Data can inform my purpose but not fulfill it.
So, what is the mission? Here is what I’d suggest our mission must be for transparency to ever truly find its place in healthcare – to leverage a mix of data collection, analysis, and transparent communication to foster healthier communities.
The mission requires all three elements (data, analysis, and transparent communication), and . . . it will be messy. Will we ever get it 100% correct? No. That’s the nature of managing a tension versus resolving it. This will take us through thousands of iterations, and everyone will have a slightly different take. Both sides will pull on us to resolve the tension. But we have to hold strong to the tension because the tension is what makes transparency effective without being destructive.
When you see this truth, your eyes open to a much bigger reality, which is that our goal . . . no, our opportunity . . . is to create alignment between people and systems that leads to healthier communities.
Not being transparent with the data you have is a bit like learning all about that person you may want to marry but never talking with him or her about what you’ve learned. Neither of you get the real benefit of the data, which comes in the conversation about that data. It is in the conversation where the real picture emerges.
Purpose-driven transparency. Not a marketing ploy and not a trend. For thousands of years, humankind has known the power of transparency to bring about change and to empower communities to improve. This purpose drives actual improvement because people on both sides of the fence pay attention – pushing for more transparency and at the same time taking a more thoughtful approach to using data.
Managing the tension around transparency also empowers decision-making on both sides: data for the organization to improve, data for the community to choose, and data for both sides to stay accountable for their behavior and choices.
Continue to work through all the details and keep your eyes on the purpose. Data isn’t for government compliance nor is it for making an organization data-driven. Having information is most powerful when you use it correctly and transparently for the benefit of all those you serve.