HITECH / HIPAA Compliance is a Wicked Problem

The HITECH Act transforms HIPAA from a "paper tiger" to an "electronic beast." Compliance with HIPAA's Privacy & Security Rules are now part of HHS' meaningful use criteria. Few in heath care have a good sense for what this new regulatory environment looks like, but one thing is certain, a new paradigm looms in the near future.

That said, the way forward is not at all clear since HIPAA compliance is a classical "wicked problem."

A “wicked problem” is one that has the following characteristics:

• You don’t understand the problem until you have developed the solution. Essentially the problem is ill defined and “what the problem is” depends on who you ask—different stakeholders will have different views.
• Wicked problems have no stopping rule. Since there is no definitive “problem” there can be no definitive “solution.”
• Solutions to wicked problems are not right or wrong. They are just “better” than others, or “worse” or “good enough”—there is little objective criteria by which they can be judged.
• Every wicked problem is essentially unique and novel. No two organizations are exactly alike, and even different functional units within a given organization may have radically different management styles and/or team dynamics.
• Every solution to a wicked problem is a “one shot operation.” Every attempt made at solving the problem has consequences in terms of time and money spent and therein the “wickedness” is best exposed.

Compliance is a wicked problem partly due to the number of organizational stakeholders involved: legal, management, health care professionals, information technology, etc. It is people and process intensive and does not lend itself readily to a technology based solution, despite the fact that technology will play a key role in addressing the challenge. To be successful, there must be a method in which the human element merges with technology, but that will require changes in the way healthcare is managed and delivered.

The HIPAA Survival Guide is a good starting point to become grounded, and when all the relevant regulations are online and "linkable" it will be even better, but getting grounded is just an invitation to the party, the real fun starts after that. :)

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Comments

[Celeste Epstein]

Thanks for posting this. This whole area of HIPPA is definitely a "wicked problem". Folks who are interested in finding out more about Wicked Problems should check out CogNexus Institute (http://www.cognexus.org), and Jeff Conklin, whose definition of Wicked Problems you reference in your blog. Again, thanks for your post!