: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez
Saul Marquez: [00:00:19] Outcomes rocket listeners, welcome back once again to the outcomes rocket where we chat with today’s most inspiring and successful health care leaders. Thank you so much for tuning into the podcast today if you like what you hear or you just love the show in general, go to outcomesrocket.health/reviews and leave us an Apple podcast review and rating. We’d love to hear from our listeners and can’t wait to hear what you have to think as well. I want to introduce my outstanding guest today. Her name is Olga Elizarova. She’s a senior behavior change agent at MAD Pao. Over there, they’re doing some research strategy and design of digital experiences and health and behavior change intervention. Obviously we all know behavior change is crucial to improving health care outcomes and they do it through user experience design process. From research strategy through design. Olga’s got some really cool experience here so what I want to do is open up the mike so she could fill in any of the gaps in the intro. Olga, welcome to the podcast.
Olga Elizarova: [00:01:21] Thanks for having me. It’s great to be here. And I’m very excited about the interview. So just to add some information to what you already mentioned I work at Mad Pow The senior MBA or change agent. All the analysts I work on the team of change designers we collaborate with strategists and content people researchers. It’s pretty exciting job and we have a lot of interesting projects but some of the side projects that I’m involved with involve social impact work and we work with different organizations such as way to well they’ll help them in different underserved communities to cultivate their resilience and creativity. Disregarding the socioeconomic status and access to resources and opportunities and with some of my friends we volunteer and we coordinate volunteer projects through which we partner with those communities on bringing human centered design to the places that need it most.
Saul Marquez: [00:02:18] I think that’s so great. Olga and you know just focusing on the people that need health care the most you know population health is so crucial to the overall wellness of people our economy. I mean it’s just pervasive. So I think it’s so cool that you guys are doing that even on your time off.
Olga Elizarova: [00:02:34] Yes. Slowly and it’s definitely a passion of ours and we are trying to discover the ways that we can make designing for the underserved communities collaborative and financially sustainable. And also always constantly exploring academically and practically how we can design interventions to address the root causes of recurring public problems not just the symptoms because that is actually one of the patterns that we saw a lot in the last year and also before adjusting the work that we do that some of the companies and organizations are just very focused on fix and the symptoms and are not going deep into the understanding of the problem space and trying to parse out what are the root causes and why these problems are in a cure especially if we’re thinking about people who have less resources and less opportunities.
Saul Marquez: [00:03:24] Yeah. We spend a lot of time focused on the symptoms. And I think it’s true within the walls of the hospital is true within communities. And I know that you guys are very focused on getting to the root cause. And speaking of root causes Olga. What is that root cause that got you into health care.
Olga Elizarova: [00:03:41] Sure. So I went for a step into the medical sector was driven by my curiosity and I thought wow isn’t that going to be cool to go to medical schools spend six years there studying pretty much yourself. It’s going to be amazing. The whole of my anatomy that to me all of the physiology and that’s exciting because if I’m ever going to forget anything I can always look it up and I can always think about something because it’s you. You are. That’s right. Other people like me and I think that human bodies are the most complex and interesting subject for research. So there are many unanswered questions worth exploring but curiosity is also something that in general allowed me to get to where I am right now meet incredible people who taught me everything that I know and helped me not to be afraid of change and new things. And I saved my career from being a dentist when I was 21 to become in a project we had on a ten year long federal project in Russia designing the environmental services for people with disabilities. And when I started my work there when there were jobs job my first big project was designing the environmental services for people with disabilities that never ever happened before it was brand new for while. It was 2012. The director of our department was just getting started on this project. He was looking at examples in other countries how we can train this how we can get support from other ministries from finance from transportation from social development from healthcare. So all the aspects that would be important to make sure that the services and the products are adjusted for people with disabilities. And there were things that I have never thought of before that actually happen and were not adjusted. So we have the team 12 people I was responsible for strategic planning and evaluation of the pilot projects and three federal subjects which are pretty much like states and states and their regions. Okay gotcha. And they Insight’s learned from those three pilots in those three subjects will be applied will be used then to implement this project. Nationwide’s to the whole country. Eighty five different states and it was incredible and challenging to learn how different that level of work. Working at the level of the country would be different from working seeing patients daily just 1 on 1 you and the patient and that actually helped me to understand all the gaps in all the things that I did not know and things that they don’t teach them at school. They don’t tell you that there is such a thing as epidemiology or statistics or it is very important to look at some aspects of intervention design and how would you even design and instrumentation at such scale. And so I get into public health and I went to Brown. I started my public health fast there and then I met Mad Pow and then the conference together factors and that this company human centered design agency and I started as the original analyst and designer and at my current company I’m focusing on design and change interventions primarily in the health care fields and in my three years at the company and worked on so many different projects starting from mental health to healthy lifestyle and wellness to smoking cessation. And it’s incredible to have an opportunity to work so closely with patients providers health insurers other stakeholders communities as a dentist or a public health professional. I would have never been able to see the problems from those Birju perspective and understand them at a system level because there’s clearly a difference between individual level and systemic problems that we are interested in and then looking at the solutions on how systemic solutions would be fundamentally different than the individual ones.
Saul Marquez: [00:07:44] Wow that is quite the journey. And you went from med school to dentistry to public servant and dealing in Russia all these these really interesting things. I think it’s so cool that the Russian government is investing in their country that way. I feel like over here in the U.S. we do a really good job but we’ve got to do a little bit better for the public sector and investments such as the ones that you are involved with. I would say listeners if you’re in policy if you’re in the government and encouragement to take a little tidbit from Olga’s story and what the Russian people are up to. Why don’t we learn from them. And why don’t we take a little bit of of action in terms of helping our public services out to the extent that they have over there. Although I think that’s so cool and now you fast forward to today working over there at Mad pow dust Dustin I think for for the intro there was fun to connect with him at Health 2.0. I mean you guys are really doing some cool things in the realm of behavior change. How do you get people to change behaviors. What is the message that you would give to health care leaders on how this should be done.
Olga Elizarova: [00:08:54] Absolutely. So as you said I work in the design agency. We have a lot of exciting interesting projects that also means that we’re exposed to multiple problems coming from different industries and sectors. It’s not just healthcare. And though the sectors are different it is not hard to see a repeat in patterns. As one of those patterns is that we work to sew complex problems systemic problems that are intertwined with elements and touch points both inside and outside of the sector and the change and evaluations are two things that I believe are going together and a very important and critical to success or success of healthcare as an industry and the success of the work that we do overall. And let me explain because for those of you who might not know what behavior change is this wanted to give a brief kind of overview and definition of what it is behavior change as we see it from our perspective the work in intervention design and it is a set of processes and activities that are used to design an intervention whether it’s a product or service that aims to change a defined and modifiable behavior. So those are two key words for us. We want to make sure that we are able to define and make sure that it’s very granular. What exactly do you want to change. And we also are looking at the evidence and looking at the research that was before doing our own primary research with target audience and trying to understand how modifiable this behavior is at all because we don’t want to be investing in just solutions or different products that are created with very little expectation of this behavior to be changed at all. And so behavioral a change in direction design process is something that thrives on the intersection of behavioral and social science motivational psychology, Data Science, human computer interaction and design and it gets all this little bits and pieces from each of those sectors and many others that I didn’t mention and then it combines them together with one object with one goal to understand the behavior and system interactions and context and implement human centered solutions addressing this behaviors and the value of their facts the impact that we’re making.
Saul Marquez: [00:11:11] Olga you just drop so many valuable things here further listeners really appreciate your thoughtful answer. And you know the thing that stuck out to me and listeners that you should think about is definable. You’ve got to set yourself up to success. And is it modifiable. Because if you’re going to be pouring a bunch of resources and time into a problem make sure you have that problem well defined. I know this may seem elementary but so many times people don’t do it. I’ve been guilty of it too.
Olga Elizarova: [00:11:44] I agree with CNN many many many times it’s not something uncommon that happens. But the key here is for us as consultants as people who are subject matter acts words and behavioral change is to guide our clients to guide people we work with through the process of defining what is the problem space which specific behavior you want to change and would specific business objectives. Do you have what health outcomes you want to change. What are your expectations. What is your timeline defining all the long term outcomes that we are aiming to change all that short term outcomes. All the intermediate variables that we might be able to measure earlier because we lie want to reduce the costs of your visits but we are going to have to wait four years in order to be able to measure that whether if we are going to look at some intermediate variables like people’s knowledge or attitudes or beliefs and behavioral determinants we might be able to measure them way earlier than something that is long term.
Saul Marquez: [00:12:50] Olga you work on a lot of projects and you’ve seen behavior change in healthcare and in other industries. Can you give an example to the listeners of some a setback that happen and maybe what you learn from it.
Olga Elizarova: [00:13:04] So something that didn’t quite go right, right?.
Saul Marquez: [00:13:07] Yeah.
Olga Elizarova: [00:13:08] Sure I think that in my experience and again don’t want to be very don’t want to be very negative about this. But I personally don’t really I’m not a big fan. I don’t really like the projects where people come to us and tell us what kind of deliverable they want to see and they and I know they’re all different kinds of restrictions and limitations and we are all having different organizational structures that bound us to a certain kind of work and responsibilities and project types that want to be doing. Let’s say if we work with a digital department of any organization a new large insurance or pharmaceutical company and it says that it’s in the name digital department we kind of expect that they’re going to ask us for some digital product. But the idea is we shouldn’t be doing it that way it’s doing the work backwards if someone comes to us and asks us could you design a digital product to solve this problem. This is not the right direction to go the way we should be going is going backwards from research from talking to people trying to understand their needs trying to understand what are their problems what kind of gaps they have what are the opportunities that we can use and how does it fit in their context of their lives holistically and how does it fit in the context of health industry and where we can really provide value. And I think the best example that I could think of of explaining that if we are a pharmaceutical company and let’s say we’re looking into developing a new medication we are not sitting there in our first kickoff meeting and thinking and brainstorming. Should it be an injection or should it be a pill or should it be the bandaid or whatever. Like We are not brainstorming the vehicle the vehicle yet we are deciding after we chose which is the right molecule and which is the active ingredient. Then we’re thinking okay which mode of delivery which vehicle would allow us to deliver the most of this ingredient people without loss of this active component.
Saul Marquez: [00:15:13] Yeah you know and it’s like you can’t use a hammer for everything. So you got to sit back think through the problem and that hammers not always gonna be that solution. Sometimes you may just need a knife or a towel or a fork anything. Yeah exactly. Love it. And I think that’s a good way to think about it you know. So the question is listeners have you been trying to solve a problem and the way you approach it. Have you been just trying to solve it with some sort of vehicle think outside that one vehicle that you’re approaching it with and ask those fundamental questions about what you’re trying to achieve how you’re trying to change it and then apply the vehicle. I mean that’s a great note there. Olga Kay thank you for sharing that. So OK. Share with us a point that was so exciting so amazing. A proud medical leadership moment.
Olga Elizarova: [00:16:05] Oh OK so there’s going to be a difficult one. I don’t have such an little internet or I think this moment is coming out sometime soon hopefully. But I admit that I’m very grateful and honored every time I’m being invited to Joe’s hackathon so bootcamps and provide feedback just start ups and entrepreneurs because it’s just such a rewarding moment and it makes me feel very happy to know that my experience in the field and feedback that I’m given to those teams can actually help them further improve their products or services and ultimately with the work that they do improve health outcomes. So that would be my proudest moments. Every time I’m on the panel helping to facilitate some process boot camp hackathon or just doing a 101 coaching for start ups. That is something that makes me feel very happy and I hope it’s very helpful for them as well.
Saul Marquez: [00:17:00] I love it, Olga. I’m sure it is. And so if you have a hackathon coming up or if you’re a startup that wants some expert advice we’ll give you a chance to have Olga’s best way to contact Olga here at the end of the show so that you could tap into her passions and she can help you make your business more successful and improve outcomes. Olga tell us a little bit about an exciting project or focus that you have today.
Olga Elizarova: [00:17:26] Absolutely, love to. So there are two projects that I want to talk about. One of the projects that I’m most proud of is a project where we worked really closely with patients who have an autoimmune disease clinicians and a client to design a patient centered solution tool that would help to address their unmet needs and hopefully will make their life a little bit more positive and easier. And we aim to create a motivational and empowering experience and address some of the things that doctors currently might not be addressing because they don’t have time for it or they just not sure how to better address it or whether they have the right access to some emotional aspects of the problem. And it was just so heartwarming to hear the feedback from people during the tests of the application. So it was the mobile app and we did the first usability testing and the results of this test were the positive feedback from people sharing how this is really very different from everything else that is out there how this is very supporting and empowering all the different design criteria that we have identified for us that we want to make sure that this tool is hitting on scored really high on all of them. So that made me feel very happy because we were working on this project for almost a year and it’s going to be launched in January 2018 and signed. Yeah it is very exciting. And the credit Arwed is that we were able to be on this project from the very beginning which means your view of the evidence. Guidelines looking at what actually could help. So just reviewing the evidence like no design yet no prototypes like would make sense to integrate what makes sense to put in this tool and then tested it with patients and code design and asking clinicians for their input and testing that again. So it was just such a great workflow and creative process. And the second project that I recall of the second project that are really like is our imagine care which was done together with Dartmouth Hitchcock and Dartmouth Hitchcock is a leader in population health management. The work that they wanted to do as accountable caring innovation was very much focused on how can we keep patients out of the hospital this is exciting isn’t it. We help patients to avoid being in the hospital in the first place. So they wanted to create this remote patient monitoring system that is going to have both patient centered interface and clinician centered interface. And we were involved in building this tool as well. I was a mobile and web application that supports this virus and it disrupts the healthcare as we know it. It is having all those different components the blood pressure Kov Kales the wearable devices they’re all wirelessly connected to the application that has the complicated algorithm developed to code developed together with clinicians that allows us to notice when a patient starts trending that and send the alert early on and it has a really interesting aspect of algorithm when it’s going to go to the nurse versus when it’s going to go to the child but or a system that has said it will then some problems there and there were some really good results for this project as well.
Saul Marquez: [00:20:52] Well you’re definitely up to some really amazing things. Oh that’s exciting. You know on the two fronts you know the remote monitoring system and also your project for the mobile device for the immune disease. I think it’s such interesting projects that you have I’m excited to keep up with them so you’ll have to send me the links to those companies I’d love to learn more. Let’s pretend you and I. Oh thank you so much. So Olga you and I are going to build a medical leadership course right here. It’s a syllabus it’s 101 or the ABCs of Olga and so I’m going to give you four questions lightning round style and then we’re going to finish up with a book for the listeners. You ready. That’s awesome. All right. What’s the best way to improve healthcare outcomes.
Olga Elizarova: [00:21:37] The best way to improve healthcare outcomes surprise cert measuring them. Now you know said the best technique ever. We have two types process evaluation and impact were fact evaluation. I think that as soon as companies and organizations are going to start measuring things create and benchmark baselines and actually evaluating both the process and the impact then the final outcomes we’re going to move towards improvements in the healthcare outcomes.
Saul Marquez: [00:22:09] Awesome. What is the biggest mistake or pitfall to avoid.
Olga Elizarova: [00:22:13] In healthcare and in life for confidence. I think that that is probably one of the biggest mistake to be made when you were sure that you know everything and you’re making assumptions and I don’t think there ever ever are stupid questions to ask and people should be asking more questions. They should be checking their assumptions and making sure that they are not being too confident and not jumping into conclusions too fast.
Saul Marquez: [00:22:41] I love that. How do you stay relevant as an organization despite constant change.
Olga Elizarova: [00:22:46] We as an organization are learning all the time we’re learning from our clients. This is the most exciting part but we’re cannot match. It is that every next project that we work on is different from the previous one and that I think is what allows us to stay relevant. As an organization we are very collaborative. We are working with our clients in a way that allows us to provide the expertise and best knowledge and the best practices to them but also learn from them and learn about the different problems in the industry and learn about the different ways that people and organizations are approaching them so definitely more work and great clients. I still think that allows us to stay relevant.
Saul Marquez: [00:23:30] And finally what’s one area of focus that should drive everything else in the organization.
Olga Elizarova: [00:23:35] Collaboration between different teams. I think that there is never enough of that. There is never enough of this like collaborative spirit of having this entrepreneurs in the company and giving people the opportunity to work on passion projects giving them the opportunity to collaborate across disciplines and working with different departments so we were lucky that at all we have an opportunity to do that. So if I want to work with our development team I can do it and I can go and ask Graham when they’re going to be excited work and some project with me. So I think that that should be something that should be implemented in many organizations allowing people to explore their passion and work with other teams.
Saul Marquez: [00:24:23] Awesome and Olga what book would you add to the syllabus here for the listeners.
Olga Elizarova: [00:24:28] I mean I can add two books.
Saul Marquez: [00:24:29] And you can add two books.
Olga Elizarova: [00:24:30] That’s great. OK. So I think that first line is going to be a Richard Dawkins Selfish Gene that no one else had mentioned that you know and.
Saul Marquez: [00:24:39] That’s the first and I have to take a look at that one.
Olga Elizarova: [00:24:42] Yeah it’s a great book. It’s talking about genes centered view of the evolution which is just a very different perspective and quite interesting for anyone where it can be changed. And I like all the examples that the author promotes in the book with mostly animals and insects but it makes you think about what is the role of genes and behavior and how much they are responsible for the things that we do in our life. So that is a very interesting one. And the second one that I’m finished in right now is how emotional made the secret life of the brain by Liz Feldman Barrett article is also a very interesting book for everyone working in behavior change but in general for people because aren’t interested in how emotions energy absolutely insane insane. How do you fall in love while you’re happy. What are the things that drive you crazy. Why do they drive you crazy. Is it vain that is very intrinsic. Or is it something that just happens to you like the classic theory says I’m just responding to the outside triggers and this is how emotions are made. Or is it something that the book is are gay. Is it something that is being constructed by your brain. So I would definitely recommend.
Saul Marquez: [00:25:57] But I love it. And listeners you have it. You got some great books. Some great takeaways to think about. Don’t worry about writing any of this down go to outcomesrocket.healthdot/Olga. O L G A and you’ll see all the show notes as well as the links to the books and mad pow and all the things that oboes up to. You’ll see it in the show. So check that out Olga, before we conclude can you just share one closing thought and then the best place where the listeners can get ahold of you.
Olga Elizarova: [00:26:25] Sure. The last thought I wanted to leave the listeners with is that if you work in the health care you should be thinking about it differently than any other industry. I realize that it is and that it creates a range of business opportunities to pursue. But healthcare is truly different from retail or any other business. Stakes are high. Decisions are made very fast. You risk losing and everything and incentives are misaligned to the very basic level since what people want is health. And would some companies and organizations ones are producing health care and we shouldn’t be thinking that poking people digitally through another health and wellness app on the App Store without understanding what exactly you were doing and how it works can be harmful. It can harm people emotionally physically financially and that’s why it matters to everyone sitting in the room and listening to this podcast and in the end of the day don’t forget that it’s not about winning. It is about health and you can get in touch with me through that website. so happy to get insights and answer any questions you might have
Saul Marquez: [00:27:38] Awesome, Olga. A powerful ending message there and really really appreciate you taking the time to be on the show.
Olga Elizarova: [00:27:43] Absolutely. Thank you for having me.
: [00:27:49] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration, and so much more.