Data Paradoxes: The Politics of Intensified Data Sourcing in Contemporary Healthcare by Klaus Hoeyer (review)

Abstract

Reviewed by:

• Data Paradoxes: The Politics of Intensified Data Sourcing in Contemporary Healthcare by Klaus Hoeyer
• Kim Gallon

Klaus Hoeyer. Data Paradoxes: The Politics of Intensified Data Sourcing in Contemporary Healthcare. Infrastructures Series. Cambridge, Mass.: MIT Press, 2023. 314 pp Ill. $50.00 (978-0-262-54541-9).

It is virtually impossible to discuss health care in the twenty-first century without referencing data-driven decision-making. This is the basis for the major arguments of Klaus Hoeyer’s book, Data Paradoxes: The Politics of Intensified Data Sourcing in Contemporary Healthcare. Hoeyer uses Denmark as a case study for exploring what he calls “intensified data sourcing,” the stated drive for more data in health care and the lack of consensus on how the data will be utilized. This is the central paradox [End Page 332] of data in Denmark’s health care system. Hoeyer makes the case for a hyperlocal analysis of Denmark, beyond the obvious explanation that he is a researcher at the University of Copenhagen, because it has established a sophisticated digital health system that runs on an integrated data infrastructure. However, Hoeyer’s focus on Denmark precludes it from being solely a local study. Indeed, he argues that Denmark’s stated drive to be at the forefront of digital health care reflects the larger value other nations ascribe to data. In what he describes as an “ethno-graphic engagement” and anthropological discourse on data, Hoeyer explores the interconnections among policy, practice, and experience in Denmark’s health care system (p. 27).

The book is organized thematically to introduce readers to a series of paradoxes about data that people produce through their belief that it promises new knowledge and the potential to do good. Drawing on interviews with researchers, reports, and strategy papers, Hoeyer argues that promises lie at the heart of the politics of data. These promises produce “data living,” a state of being where people’s well-being and health are inextricably linked to data that stands in as a representative of that person.

Some of the most enlightening discussions in the book occur when Hoeyer explores “data work” and illuminates the multifaceted nature of data work in Denmark’s health system and the relatively large number of people who are involved in creating data infrastructure. The paradox in data, Hoeyer persuasively argues, is that data makes less work and more work at the same time.

In a surprising but ultimately useful turn, Hoeyer uses an autoethnographic method to disclose his own data experiences, to disclose broader meaning about how people interact with data infrastructures in their everyday lives. However, these data infrastructures are often invisible to most people. In other words, they do not manifest themselves in people’s lives. Instead, encounters with data are sensory experiences that are mediated through wires, hardware, and software. For Hoeyer, this raises a dematerialization and rematerialization data process that is paradoxical.

Hoeyer also explores the different responses and engagements people have with data and creates a language for discussing what is often unspoken in these relationships with data. According to Hoeyer, people do not simply communicate or interact with data. Their relationship with data originates in emotionality and a drive for meaning-making. The paradox of data experiences is that crises like the pandemic produced intensified data sourcing, which is conveyed in broadly distributed data visualizations. However, this data simultaneously engenders and closes off political contestation, depending on one’s data experiences.

Hoeyer also explores data wisdom, the ability to produce and apply “robust knowledge” to data to investigate the relationship between data and wise decision-making (p. 151). Those with data wisdom, according to Hoeyer, believe they know when and how to use data in such a way that it reflects one’s ability to acquire more knowledge and make sound decisions. The paradox of this view is that although people readily acknowledge that data is not neutral or objective, they still want more and feel that data creates knowledge that will be useful in the process of [End Page 333] making decisions. An important point Hoeyer makes is that people would rather take the risk of having bad data than no data at all. To make...