Rapid innovation depends on patient codesign
The COVID-19 crisis has accelerated innovation throughout much of the healthcare sphere.
At the same time, said panelists at the HIMSS & Cleveland Clinic Patient Experience Digital Series this week, the quick pivot to new policies in response to the pandemic, and the speed at which new technologies were rolled out, carry the danger of leaving some of the most vulnerable people behind.
"We rolled so fast this year," said Adrienne Boissy, chief experience officer at Cleveland Clinic, speaking on the panel titled Setting the Stage: Redefining the Patient Experience.
"There is a call to sort of go back and say, 'Huh, it's great we pushed it out as fast as possible but it wasn't designed the way we would want.'"
One example of the consequences of haste, said Rick Evans, chief experience officer for New York-Presbyterian Hospital, was the complete shutdown of visitation for patients at the beginning of the pandemic.
"We didn't know what we were facing, and everybody did what they had to do," said Evans. Still, he said, "We've learned a lot, and we can never go back there.
"That was an unfolding tragedy alongside the tragedy," added Evans. "We're talking to our patients, and they've got lots of suggestions about how we can do that differently – not only for the remainder of this [COVID-19] crisis, but even in any crises to come.
"Many of us feel distressed by what happened, and we just can't go that way again," he said. "And patients have to lead the way."
Panelists emphasized the importance of building trust between caregivers and patients – especially those who have been left behind by the medical system.
"We haven't had the luxury of time, in many cases," to speak with many patients about improvements in healthcare, said Jen Horonjeff, founder and CEO of Savvy Cooperative, which facilitates patient and professional collaboration in healthcare innovations.
Horonjeff noted that the people most affected by inequity are often not part of conversations about how to solve them. In fact, as she pointed out, the panel itself was made up of "a bunch of white people positing on health disparities in communities we're not a part of."
She stressed the importance of community members leading the discussion around innovation and patient care.
"That's the thing we really need to be taking away – is to deploy something, and then get feedback, and then be able to learn," said Horonjeff.
"Hopefully you're not deploying something before you talk to patients. But if that has already happened, the next steps to get there, to make sure that we are understanding what communities need – and it is going to look different for different types of communities," she said.
When it comes to data collection, she urged attendees to consider patients' valid fears about whether self-identifying might risk their care.
"What are we doing to communicate the purpose of data collection and doing informed consent about where that data is going?" Horonjeff said.
Chrissy Daniels, chief experience officer at Press Ganey, called COVID-19 "the most disruptive thing" that has happened to patient care.
"I have seen experienced leaders brought to the table in ways we haven't regularly seen in the past," said Daniels. "Because patient needs are changing so fast, we've had to really think about, 'How do we not only gather feedback from patients, but how do we support more input?'"
"Our ability to rapidly innovate is dependent on two things I want to keep track of. One is our ability to connect as a community. And learning from colleagues has allowed us all to innovate in real time," said Daniels.
"The second is designing with patients. We cannot afford the wasted time we spend designing for patients. Bringing more patient voices in in real time is key to keeping us agile and consistent," she said.
Patients who participate in codesign "have a greater feeling of trust toward the industry," agreed Horonjeff.
"By doing codesign work and getting patient input, it can help to regain [lost] trust," she said.
As healthcare professionals face down an oncoming COVID-19 wave, panelists acknowledged the vulnerability many feel.
"I don't think we realized how much we needed the appreciation. How do we find those moments when there isn't a pandemic?" said Alan Dubovsky, chief experience officer for Cedars-Sinai Health System in Los Angeles.
Overall, he said, "The work has shifted. I think it's brought us more to the table" as patient experience professionals.
Evans said that the pandemic has emphasized the power of transparency and vulnerability in leadership.
"Part of living through this is, I'm out of patience. I'm not as patient anymore," said Evans. "I want to fix things now."
"Now that I know we can really do it, I want to do much more of it," he said.