Weak Data: The Social Biography of a Measurement Instrument and How It Failed to Ensure Accountability in Home Care

Abstract

Contemporary health and social care is saturated by processes of datafication. In many cases, these processes are nested within an ostensibly simple logic of accountability: Define a politically and morally desirable goal, then measure the level of achievement. This logic has come to permeate public health initiatives globally and today it operates in most health care systems in various ways. We explore here a particular instantiation of the logic associated with the introduction of a measurement instrument used in Danish home care. Building on ethnographic fieldwork, interviews, and analysis of policy documents, we show how the instigated processes of datafication—despite hopeful political claims—erode care levels and disempower older people.

Today’s healthcare and social services are rife with datafication processes. In many cases, these processes are nested in a seemingly simple logic of accountability: setting a politically and morally desirable goal, then measuring the level of success. This logic now permeates public health initiatives globally and operates in most health systems in a variety of ways. We explore here a specific case highlighting this logic consisting of the introduction of a measuring instrument used in Danish home care. From an ethnographic study, interviews and analysis of public policy documents, we demonstrate how these datafication processes – despite hopeful political demands – erode the general level of care and take away some of their power from older people. Beyond this case study, these results may be relevant for other environments subscribing to the same logic of responsibility and using similar measuring instruments.