Chrystia Chudczak is Chief Design Officer at University of Ottawa. She discusses how Health 4.0 will have citizen and not patient at the centre and make seeking health a joyful experience. Namrata Bagaria (the host) is Health 4.0 researcher and podcaster based in Ottawa. More info www.namratabagaria.com
Namrata Bagaria 0:00
I'm your host Namrata Bagaria. And our guest today is Chrystia Chudczak. Chrystia is the chief design Officer of University of Ottawa. Welcome Chrystia to health 4.0 leadership podcast.
Chrystia Chudczak 0:15
And I'm glad to be here.
Namrata Bagaria 0:17
As you know, this podcast is for health 4.0 Leadership Institute. And our aim is to create and build leadership for the health 4.0 ecosystem. So I wanted to ask you a few questions. And I want to get started by asking you, where are you contributing in the present health ecosystem? In what capacity and what are your top three mandates.
Chrystia Chudczak 0:39
Um, so my role the University of Ottawa is experimental in the country. As a chief design officer, I bring human centric design philosophy, a set of processes, and a really wide ranging toolkit to help groups solve problems in an ecosystem that's based on empathy. And speaking truth to power. So in the context of 4.0 health, I'd like to think that I in breathe the skillsets of a designer to the table, as well as being a professional photographer, a documentary, journalist, perspective and lens and I to observing what's going on in society and in communities and families and even in my own family with regard to the intersection points between people and their health and the system itself, and finally, I'm a consumer as everyone is in terms of consuming health services in a wide different variety of scenarios and situations. I'm happy to chat about as we go forward in this in this discussion.
Namrata Bagaria 1:49
Okay. So like you mentioned your three mandates. And I was wondering what were your challenges, your learnings, your takeaways so far in your journey and How are you proceeding further with that?
Chrystia Chudczak 2:04
Well, that's a huge question.
Chrystia Chudczak 2:09
I think, and this is not in any specific order. But the first thing that comes to my mind is the personal experience I have had interacting with Canada's health care system, predominantly here in Ottawa, in the Capitol in a number of different ways. My, I have four children. So I had four cesarians here in the city, and, and so my experience in the different hospitals and with my same position that I've had for the last 25 years, you know, that that experience of how does how is one treated in that kind of a context was really eye opening for me in a in a very positive way, a very human sort of way, becoming a mom. And then and then in other ways, it's it was increasingly more challenging for me as I grew Older and had my own family and then started to take care of my mother who lived in Sudbury, Ontario, which is where I'm from originally, and proceeded to have health care and health issues. there and then eventually we moved her to auto, my sister at the time was in Toronto. And there's just the two of us in the family. And my mother ended up getting diagnosed with progressive supranuclear Palsy, which was what we used to call Parkinson's on steroids for the lack of a better term. And she had some amazing caregivers here, who were part of the University of Ottawa medical community, and who were doing groundbreaking research. Dr. Schloss, Schloss mocker it was one of them's from a doctor doing research into Parkinson's disease. And so, you know, I was a caregiver. I was the one who would bring her from when eventually was a seniors residence to to the hospital to see doctor smoker, and, and many for many, many months, we did not have a diagnosis. And it wasn't only until she saw him that it became very clear to him because of his experience what she had. And I'll never forget when he told her how, how relieved in some kind of word How relieved we were to find out what was happening, and that we can now deal with it. However horrible the outcome at the end was going to be, at least we were able to deal with it and then I could tell my kids what was going on, because they saw the grandmother every week. And so um, so, you know, that was another intersection point with the healthcare system. We had a lot of a lot of challenges with the back end of that, you know, the, for the most part, the human centric touch the doctor to patient relationship and the other health care provider relationship was was quite was quite lovely in common. And, and helpful and that but it was on the back end of that I saw of trying to make the connections between how to help her and how to get her from point A to point B. At one point she was moved, we had to move her into another facility because she part of the, the symptoms of this particular disease, it's a lot of falling and similar to Parkinson's and so she she ended up being moved into a long term care facility fairly close to physically fairly close to my house, which was great because then I could go visit her and my kids could see her so there was trying to maintain the continuity of a familial familial relationship. And she she ended up falling in that and I was working full time in the government and she ended up falling one time and the time she felt I got a call from
Chrystia Chudczak 5:50
Yeah, I got a call from the the the nurse the front desk nurse at the at the seniors residence basically saying she fell me but she broke her neck. Oh, So, so from there on in for the next almost a year and a half, it was it was heavy interaction with, for example, for example, in that case a trauma unit at the Ottawa General, excuse me, the Ottawa civic hospital. And they were amazing. Everyone who, who told me that came across from the from the system, who saw her got to know her got to know her story. were amazed that the amount of sensitivity and expertise that the first responders had to bring her to the hospital because she could have been a quadriplegic. She wasn't well, a lot of other things happen in terms of our health, which was declining. And she ended up being every year for the last part of her life. And again, you know, the ability to create an environment that's loving and caring with with challenges, right, like it's, it's still an institution, it's still it's still not home. So So, you know, and I think it's, it's, it's part of the learning process of life and and going through that lifestyle. call that one learns about, you know, how help and how the system is doing air quotes here, how the system really needs to be understood even before you get in so that you can get the maximum you know, the maximum out of it in the least amount of time with the least amount of stress. Yeah. And just to add to that, the story as a consumer again to the end, at that point, when my mother was in Bruyere and my sister got diagnosed with ALS, in Toronto, and so, so, I was juggling two, two sets of intersection points to two different jurisdictions with the healthcare system in Ontario. And, and it was it was mind boggling and and i don't know to this day how I did it, still having a job a full time job as an executive in government and having four kids and and trying to maintain a semblance of life. But I think you know, being persistent and Persistent being kind in, in those interactions and firm when you need to be where some of the lessons and I was learning as I was going through it.
Chrystia Chudczak 8:11
But also,you know, one of the things that was very difficult for me and it this kind of cuts through the three sort of, you know, roles that I've described the designer role, the journalist kind of documentary journalist, photographer kind of role and consumer role is this stress that the mental stress that this kind of intersection with the system places on as a consumer, but also as an example, as a documentary photographer, I grabbed my camera every time I go somewhere where the right where I traveled. And what's really interesting as a as a photographer in that genre, I mean, I'm capturing life as it unfolds. And you know, the natural inclination if you see a problem At least in my case, as a designer, if I see a problem, I want to help fix that, that's sort of like that, that polar opposites of, as a citizen, as a journalist, as a documentary photographer, you're arm's length at the problem. But you're observing, you're actually observing it, you're gathering evidence, you're telling a story, in my case, it's a visual story. But then on the other hand, as a designer, you I look at the same situation or scenario and in that with those eyes, and it's like, I know how to fix this, I know how we can fix this, I don't know what the end game is going to look like. But I have a pretty good sense of how to do that process, and how to get the right people in the room and create an environment that's safe, that will allow that ecosystem to come up with what they need to do to be able to resolve this. And so it's this yin and yang pull and push that I find in this in this sort of environment. So it you know, it's an interesting it's an interesting challenge to, to look at, but also it's a it's a learning at the same time that you know, how can one How can we manage this dichotomy in a way that's meaningful and impactful?
Namrata Bagaria 10:06
I think you pointed out some very, very important aspects, which actually kind of partially answers, how helpful points you could be envisioned. And I think the first thing which you mentioned, and if I have to summarize it in a sentence would be responsiveness of the system. And as we seen today with the covert 19 epidemic, or rather, the pandemic, how systems are responding at a global level at a country level, the inertia and the lag time that there's there and, and the other thing that you mentioned is the non exclusivity of the caregiver as a part of the system, because that's something we don't think of when we think of the old school health systems that we have right now. And the third thing that you mentioned about the human side stories Like lens looking at different lenses, right? So I think if you had to sort of get this all together, and if I would ask you what, what do you think is the vision, the opportunity, and some kind of any technologies or regulations that you think being relevant for health? 4.0? Like, how would you summarize this?
Chrystia Chudczak 11:25
Okay, let me let me be bold and just say, there needs to be a national focus. I think personally, a very strong national view of health is country. You know, constitution divides the responsibilities of policymaking in sector and healthcare delivery with with provincial governments. So the federal government floats the money to be able to implement what they're supposed to be implementing. I think that that's the national strategy, national vision national strategy, which you know, reflects and respects the constitutional paradigms that exist now, but but are for thinking in the future. You know, there's no reason why we don't have a pharmacare program in this country. Well, fine to me logically, as a consumer, both it makes sense.
Chrystia Chudczak 12:15
In a pandemic, having having and knowing that pandemics are coming. I mean, this is this, I think this COVID 19 thing. You know, we as collectively, as society and parts of society understood that this is going to happen, when maybe not quite when, but understood. It's coming. And so what does all the planning leading up to the actual event due if the plans aren't executed? So in advance, you know, for example, I don't understand why we have face masks shortages now. To meet to me, and maybe there's a really good explanation for it, but I don't I don't understand how we allow ourselves to get into this just in time medical delivery, of supplies, which in a pandemic doesn't make sense. So So I think like there was a national, national strong national perspective where provinces and the federal government puts aside their, you know, the posturing in terms of jurisdiction, and actually puts the, the citizen at the center of the health care experience in Canada is what is needed. You know, so and that same thinking on a policy sort of political policy level, I think needs to be brought down into designing the ultimate experience for Canadian to have a joyful experience with their, with their interaction with with the healthcare system. It sounds kind of weird, and I mean, joyful. And I mean, Canadian, I didn't say Patient Centered Design, because that's happening. It some, some are doing it better than others, but it's but it's understanding and acknowledging that Canadians can have a joyful interaction with their health care that have joyful interaction with their healthcare system and experience that isn't negative. Is it? anxious isn't stressful. And actually delivers the results on the back end that you would want, which is healthier Canadians that are following the advice of practitioners who are well schooled and well researched and what advice they're offering. And you know, and if they do get sick, that there's a there is a way to embrace them as they go through that process. And that they're taken care of as a whole, both physically and spiritually mentally. Because that's what I found. That's what I found the hardest when I was dealing with my mom and my sister situations, which I'll be at were pretty crazy. At the same time, yeah, two different looking at two different towns, two different sets of doctors, two different whatever. But I had to navigate For example, when my mom when my mom was being pushed and pushed because they needed the best out of trauma into a place where they could find some space. The choice was, well, she can we can't keep her on award, because she's too sick. But she's not sick enough to be an ICU so we think and, you know, at that point was that she's never gonna walk again she did but I mean it was it but but the point being was where was the hope? And then the other alternative was well perhaps flew here but we don't even know if we are there a hospital has an actual bed for so so and then I'm and so so I'm dealing with three people I'm dealing with the doctor, doctor one doctor two plus a social worker for my mom and I'm dealing with, you know, a doctor, caregiver and sister in Toronto who has got ALS going through pretty much hell. And I'm in the middle of it trying to negotiate what's best for everyone and making decisions. I mean, ultimately, I would have loved both of them to be at home with me. Right? I would have loved to have the support. The support that the community writ large would have offered me as part of the system because that would have meant that the community was also taking care of me. And then by taking care of me As a Canadian wanting a joyful experience in the interruption of this, I wouldn't have been taken care of both my sister and my mother. And so so to go back to the bottom line here is putting the Canadian citizen or the citizen or the person living in Canada, at the center of the experience and creating a medical joyful experience. And that sounds funny, but it isn't, can, I think, enable us to understand what kinds of technical infrastructure operational regulatory legislative changes need to be made in order to achieve that, because now we're looking at it. And this is that this is typical of lots of large institutions that are trying to innovate, quote, unquote, and are doing it on the margins, if they're lucky, they're not doing it with the right attitude, typically, or the right air cover, I call it from a leadership perspective. And so that's where I would I would start I would sit down with a group of people Who are patients who are not patients? Who are have experiences like me, doctors and others in the healthcare system? Who have different roles to play the social worker, the administrator, the finance person would have you actually designed through what could have paid a citizen centered, joyful experience with Canada's health care system look like?
Chrystia Chudczak 17:22
Chrystia Chudczak 17:23
Namrata Bagaria 17:24
what you're trying to say is the couple of things. The first thing is, we need to get the consumer health mindset in in Canada and move away from paternalistic care that we have. The second is we need continuum of services, from home to hospital, from hospital to home. And I think the third part, which you're saying is, there's a lot of autonomy and decision making and the option to have choices which need to make a joyful and also would, I guess, from my perspective, open space for different kinds of players. Not just public sector services, because that's only so much you can stretch the existing healthcare services.
Chrystia Chudczak 18:06
I agree. And I think those questions need to be put on the table and not be judged for being put on the table. And this is where it, I would argue in a properly set up design experience, design thinking experience, you're able to ask those hard questions and get out those hard questions without being judged about your own Canadian or that you're this or that or whatever. You know, I think that that's really, really important. And the sooner we're able to do that, as a country, the more competitive I would argue we will be in the future, and competitive in terms of marketplace, business competitiveness, but also cultural competitiveness, in the sense that, you know, we're creating, we would be solidifying and creating a culture and maybe augmenting and adding to what we have now, of what Canada means what what it means to be Canadian, and the values inherent in that
Namrata Bagaria 19:02
And so what do you think would be obstacles in adoption of these changes? And what would be the drivers?
Chrystia Chudczak 19:09
Oh, well, first of all, I think there's a lack. And this is me from the outside not being on the inside of a system or healthcare system, or institution. And I think my perspective or perception is that there's a lack of whole of whole of institution whole of system. And I'm thinking on a hospital right now, but a whole, you know, system, strategic viewpoint of what that patient what that looks like, for that citizen coming in that person coming in to experience the system. And, and, and it's almost like universities, like my experiences in learning in, you know, different universities, is, you know, often oftentimes they're almost held like a holding company. Right. The President is the president of a holding company, the faculties are separate companies, essentially. And and it's rare that these they collaborate and are connect with each other, or, or you know, create a multi interdisciplinary sort of environment where people can feed off of each other's expertise in their various domains and actually build something that solves problems for the future. So so that inter inter I don't know if it's interoperability net man, that's the right word. But just this whole whole of institutional perspective, really is important to start breaking down those silos. I also think that this is where I think technology could be used really, for good, not evil. And that's, that's like, and it's I know, it's changed now. Because back when my mom was, was alive, it was it was there's a lot of technology, but it wasn't as integrated, as I believe, now that a lot of these systems are, you know, for the patient. It's great for the it's great for the technologists, it's great for the providers, medical providers and healthcare providers. But as a consumer, if I'm lying in bed, and I'm seeing hooked up to all of these different machines. I don't know what's going on even though I may be totally I still don't understand what really is really going on. I'm scared and nervous. And so having that interaction between the person consuming the healthcare and the technology is done in a way that they can that is non threatening at that. And that is understandable. And I don't know how you do that at this point. But I'm sure there are different ways and techniques of getting APA would be critical, and then actually making investments in future proofing the system. So future proof if we're, if we're in an AI world, for example, we shouldn't be afraid to use data that's already been collected in the system. And I'm sure it is, it's being looked at in different projects. So but we shouldn't we should be willing to experiment on the margins, not the entire population. But like on certain issues, we should have some way of saying we will experiment in this in these spaces. And we'll do it in this way. And we'll do it so that it's open source, so that others will be able to learn from it and others We'll be able to take it and build off of it. So that notion of open sourcing this to me, I feel hasn't. I haven't. I haven't really thought that part through yet in this particular context, but I think that would be something to explore. What does that open source? 4.0? Hell 4.0 look like is, you know, is a technology focused on me? Is it you know, expertise, like, what does it look like? I don't know. But again, something for me. That's an interesting space to play in.
Namrata Bagaria 22:28
And I think, as you talk about these issues, what I could come to is from a design perspective, we just spoke about virtualization of services. I think that's a good starting point, when you can actually make a workflow and understand say a service for example. rehabilitation, broadly speaking, how what part is on site, what part is homecare, what part is preventive what part is prescriptive and I think those kind of could be the starting points with along with interoperability that you mentioned. In terms of open source, definitely technology companies are moving towards more open source. And we have new management practices such as DevOps, which which which enable them, but I guess we are at the stage of inflection in health, because in general, the world today is that health 2.0. So for our listeners, health 2.0 is getting EHR integrated in your health systems. and Canada is just doing some parts of done successfully. Health 3.0 is more getting social media and having also the sort of semantic aspect to your systems and 4.0 is, you know, integrating IoT AI in regular care. So that it's its data and you have faster analysis and real time answers. So I think what Chrystia what, with all that you said and all the obstacles What do you think will become The driver because we have all these issues and all these parallel things, what do you think is that push that will cause this to change? Well, if motivation,
Chrystia Chudczak 24:12
yeah, if this pandemic of ID 19 is not it, then it'll, I think it'll be another pandemic. That's worse. Okay. And I don't I don't need to be alarmist. But I know based on my experience that crises, shift countries, crises drive, you know, innovation faster. Now, I wouldn't even say innovation action faster than then not. And so unless we take this opportunity that's been given to us now, however horrible This is looking for many people in many different jurisdictions and many different countries and their communities and families. There has got to be a way to turn this around. All the experience that's, that's that's happening now in these hospitals and a the inflection They the intersection points in the healthcare systems and turn it around saying, can we do better? How can we make this experience better? For example, how can we make? How can we make Canadians safe during a pandemic? What is the state experience look like for Canadian during the pandemic? And we don't ask those questions because those questions I think, are the ones that are going to drive us and lead us to potential solutions or prototypes of solutions that will be tested. Because I don't think we're living in a static world. This is constantly generating and moving. So, you know, I would hate to think that it would take another pandemic. I would hope that with what we're seeing now, and the kind of ingenuity and openness that we're seeing so far, that will drive us into this new health 4.0 world where we are interconnected, we're, we're concerned About the the the the person at the center of the experience, and that we recognize the the the need to have privacy and dignity surrounding that individuals experience. And if we don't if we don't look at it in those ways, I hesitate to think that society as a result of this experience is going to start to crumble and start to crumble in ways where social cohesion starts dissipating, because we're losing trust in officials trust in the system because the system isn't doing what the officials have said that it's going to do. And and in that context, like that's where I think that the use of the inflection point, I would argue that that inflection point will either explode in conflict or re rejected itself and use that as a platform for actually innovation and ensuring that the system and that this is at that society are in fact stronger, better, faster, nimbler, smarter and healthier.
Namrata Bagaria 27:15
Mm hmm. It's very interesting that towards the almost end of our conversation, he used the word which one of our previous guests also uses the word nimble. And my question is, what are your What are your, I would say, parting thoughts on? Because we know you're coming, you're coming in, you're going to be talking about this, too at the summit. So what are your parting thoughts on expectations from the summit? And what what how are you contributing into summit two, if you can tell our listeners, you know,
Chrystia Chudczak 27:52
so, um, so we're thinking about doing some kind of a design thinking session in the summit. We're just Nam and I, you know, Nam, we're just talking about trying to figure out what that looks like you could possibly look like, I would love to be able to bring in one of my tools, which is Lego 10,000 pieces of Lego, using a technology technique called Lego series play, and merging that with a Canadian technology called Nuereva, will allow us to capture and work digitally with these materials. And I'd like to tackle the question of, you know, what is the what is this citizen and practice is the wrong word. But what is a Canadians perspective? or What does a What does a joyful experience look like for Canadians in interacting with their healthcare system? And I think I think part of the challenge would be is like, even in my conversation today, I've sort of focused in on the immediacy that the interjection introduction point of touching a hospital being involved with someone who's quite sick, but actually I think this is a much larger lifestyle. story where we talk, we should be looking at this from the perspective of once you're born, what does that sort of lifecycle look like in terms of interactions and inflection interactions and, and, you know, supports with the healthcare system for the course of that person's life. And that there's there should be, it could be imagined as being joyful throughout that lifecycle. So I'd like to kind of explore some of those thoughts. Technology is really important. But technology is nothing unless it's been used by people, for people for the right reason. Mm hmm. And so this is where I think as a design as my design hat coming forward, that i think that you know, is people who will make a difference and will make the changes to make the difference for the future. And I'm hoping not through the health health a 4.0 summit, we're able to start you know, playing in some of those some of those ideas and allowing people the creativity and the freedom to be bold and how they see the future.
Namrata Bagaria 30:01
And if you would like to know more about helpful points your summit, you can go to www.health4.tech. And I would really like to thank you chrystia for coming and sharing your thoughts. Very interesting, very provocative, very urgent and very relevant. Thank you so much.
Chrystia Chudczak 30:20
Thank you Nam. Good luck. Thank you
Transcribed by https://otter.ai