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Without co-design, technology's healthcare potential is wasted

Clifford Goldsmith, chief medical officer and national director of US providers at Microsoft Health and Life Sciences, discusses best practice for creating tools that engage patients and providers.
By Laura Lovett
03:50 pm

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Without codesign some of the best technologies can be ineffective, or at least not meet their full potential, according Clifford Goldsmith, chief medical officer and national director of US providers at Microsoft Health and Life Sciences. 

During the Cleveland Clinic Patient Experience: Empathy and Innovation Summit, put on in partnership with HIMSS, Goldsmith gave the example of wearables. More and more Americans are now using the technology, but the data they generate is rarely used by clinicians.

“The data in these devices is enormously useful but most doctors will turn around and say ‘I can’t deal with that amount of data’ or will say ‘I’m not sure it is accurate, I don’t want to deal with the false positives,’” Goldsmith said. “But any one of us here could think of a way that that data could be enormously useful.”

The issue is present in how different users are involved right at the beginning of development, he said. In hospitals, when a product or idea is on the table it often gets caught up in the administrative process without getting feedback from the end users. 

“The way we should do this is the leadership plays an important role in what they want to improve but they also play an important role of creating the culture in an organization,” he said. “That culture allows you to create the engaging environment — that codesign environment where everyone’s opinion is valued.”

Goldsmith said he sees the quality improvement department as having a major role in helping this process along. 

“What the role of the quality improvement department becomes is actually [that of] a facilitator,” he said. “They set up the environment so all of us patients, administrators, clinicians and workers in the hospital environment services have support [and] can collaborate.” 

The process doesn’t need to be done in-person. It can be done on a digital platform that lets all stakeholders give feedback and be active participants. 

“Then you can have a virtual ideation platform or a virtual ideation environment where everyone participates. You can now use that data effectively to improve processes,” Goldsmith said. “Really the role of the [quality improvement] department becomes synthesizing this data. It has been supported already by best practices and other ideas, and then ultimately candidates can be put back to everybody for ideas about change, and your implementation is going to be far more successful.”

He also stressed that, while leadership may be important for the culture of innovation, anyone and everyone including patients should have a voice. 

“If we are going to initiate an idea, it is important that they come from the top down and the bottom up,” Goldsmith said. ”What I mean is that people all over the organization are contributing ideas.”

He also stressed that everyone — patients, doctors, nurse and other stakeholders — each have their expertise in systems that will improve care. However, those stakeholders should be able to jump into the process without getting bogged down in the minutia of the whole. 

“Contributing to the idea needs to be done around a framework because we don’t expect every patient to know the entire process. We don’t even expect every doctor, every nurse to know the entire process,” he said. “They can contribute their ideas in the knowing or unknowingly towards the patients journey that we are about to change. So they can contribute the idea for what we can do today and what we think we should do in the future without knowing the whole journey.”


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