Albert Shum, Corporate Vice President of Design, Microsoft
How can the patient experience be redesigned to build trust? Albert Shum, CVP of Design & Content at Microsoft, rethinks the use of personal medical data as he explores inclusive design principles to dismantle systemic bias and empower the patient to have control of their health care journey.
Albert Shum leads a collaborative team creating the future of experiences and devices at Microsoft. An accomplished designer with over 20 years of global consumer brand and design development expertise, Albert has led strategic design initiatives at Nike and Microsoft, scaling design thinking and launching products that influence millions. He is currently the CVP of Design & Content teams for the Windows & Devices Group at Microsoft. His team drives incubation for the Microsoft Web ecosystem, focused on the responsibility of design to create intelligent and inclusive experiences. Albert is also a sought-after speaker and advisor in the areas of design team building, brand development, and strategic design. Albert holds a master’s degree in Product Design from Stanford University, and a Bachelor of Science in Mechanical Engineering from the University of Waterloo. He also attended the General Management Program at Harvard Business School.
Show Notes
Albert Shum shares his design ethos and the importance of the quality of the customer's experience. [02:58]
The three inclusive design principles that guided the redesign of Microsoft’s Xbox to enable disabled people to play video games. [05:42]
A health scare that showed how the patient experience can be redesigned. [8:50]
What does the patient experience look like in 2049? [11:37]
What happens when trust and safety are not designed into the system? [15:29]
There’s an opportunity to rethink the patient experience around data–how to present it and make it consumable. [16:31]
How can we create an experience focused on making the patient feel confident? [18:35]
What role does ethics play in design? [21:43]
Designing for personas only reinforces the systemic biases. How do we dismantle that system? [23:13]
How can we bring mindfulness into the experience to encourage healthy habits? [25:42]
How does the manufacturing of feelings affect society? [28:01]
We are in an era of mass producing feelings and behaviors at an unprecedented scale. How do we nurture a healthy ecosystem? [31:01]
What are the important factors when creating visual experiences? [33:24]
Transcript
Bisi Williams: I'm Bisi Williams, you're listening to health 2049.
Albert Shum: So what I think design can really do, and this is the power of design, we can create visual communication, use our superpower to bring that empathy to understand what the patient experience is going through. So I really see this opportunity to rethink the patient experience around information and data. How do you present information in a way that enriches, but also informs, creates confidence and then confidence builds trust?
Bisi Williams: I'm excited to introduce you to the man that USA Today says is responsible for leading the design renaissance at Microsoft. He leads a collaborative team, imagining the future of experiences and devices. With over 20 years of product brand and digital design expertise, he led initiatives at Nike and Microsoft to scale design thinking and create compelling experiences for millions. His team drives incubation for the Windows Ecosystem, is focused on coherent inclusive design across diverse platforms to bridge the gap between humans and technology. I'm thrilled to welcome Albert Shum, Microsoft Vice President of Design to our show Health 2049. Welcome Albert,
Albert Shum: Thank you Bisi Williams for that very, very generous introduction.
Bisi Williams: Well deserved. I invited you to talk about health and wellness in the future with me because of your success at Microsoft creating web experiences, including search and discovery across a suite of products that reach customer’s whole lives at work, home, and school. So I'd like you to take a moment and if you would, please explain your design ethos to our listeners.
Albert Shum: Definitely. Thank you, Bisi, I think the key word for me there is it's the whole lives of our customers. And so much of our customer's lives are digital now. In some ways, it's not just the digital life, it's almost this blend between the digital and the real world. We spend so much time online. I think the last report I read even before the pandemic, people were spending on average six hours a day online. So digital experience is so pervasive.
And my ethos is, how do we balance that in a sense of creating value? Are we helping our customers achieve their goals, their purpose, but also how do you use that time to their benefit? And probably for me, the most precious value our customers have is time and how do we think about the time our customers spend online?
I think in digital experiences, oftentimes we think about engagement. It's really the measure of success. How often are you using some product or service? The focus of that is not just about the time, I've been thinking a lot more about the quality of experience. What are you doing with your time? And the products and service that I'm fortunate to be working on at Microsoft, if you’re browsing the web, if you're on your PC, laptop or on your phone, how do we remove a lot of that friction so that it removes the hassle?
So I think that's one element of how people are spending the time, just saving them time. I think the other part in terms of that quality of using their time is, are we enriching their lives, giving our customers information that informs, that helps keep them safe? The pandemic has really shown that we spend so much time online, sometimes it's also important to step back and allow you to focus, but also take time off and take breaks from being online, which I think back to this health question, what is that balance in all things and are you spending your time wisely to have that digital health almost in some ways?
Bisi Williams: I think that digital health is an interesting concept and I'm going to hold that for one second, and I want to talk about, for me, what I think is a watershed moment in your career was your team's redesign of Xbox to enable disabled people to play video games, too. And can you briefly tell us about that experience and the impact that it had on you as a designer?
Albert Shum: Yeah, that was a great experience and it continues to be an important part of our team's work at Microsoft. It was a time when one of the things we started looking at was around people getting access to technology. Oftentimes there's a lot of barriers, meaning it's not just about how do we provide more technology, but how can people get access to technology and the benefits? And we started thinking about exclusion and reframing it to focus on inclusion in our product experiences.
The team led by a lot of great people with Kat Holmes and others, we worked on developing this concept, building on inclusive design that the first principle, and it's actually really insightful on how the team developed the principle, is to recognize exclusion. In order to create inclusion, we have to recognize exclusion and reach out to people who are excluded, who might be on the margins. That inclusive design principle allowed us to address and focus on the people who were excluded from the experience, address their needs and then solve for those needs. And then those benefits really translate to everyone else.
So in the case of the Xbox team, they took those principles to heart and really focused on, you think about who's being excluded, actually they worked first on identifying exclusion in all forms, but they zero in on physical disability. If you have the loss of limbs and you couldn't even hold the Xbox controller, how do you play games? And I think that that really brought a lot of insights. The team started thinking about, there are ways to adapt the Xbox experience for all different abilities. I think they did an amazing job to not just create a product, but really create an end to end experience, talking to members of the community who were excluded, addressing their needs.
Then the second principle of building those solutions and really learning from them, that's when we ended up creating the Xbox adaptive controller, which leads to the third principle, how do we bring those benefits to all? What we found, even as simple as the packaging, having more accessible packaging that we could bring to our products, that really benefited everyone, not just people with loss of use of their limbs or hands.
And so I feel like the inclusive design principle really, not just opened up our products to many who weren't able to access, but also really created new innovations that benefit everyone.
Bisi Williams: I just love that. That's such an inspiring story and to set the stage for your vision of health and wellness, Albert, let's talk about your own experiences with health and wellness.
Albert Shum: Yeah, just a few weeks ago, I had a bit of a health scare and unfortunately I ended up to the emergency room. It's still a bit of a fog, it was like 10 people working on me. Next thing you know, I'm in the procedure room and in between doctors and going to different places. And eventually I was recovering in my room and I had a chance to step back and say, whoa, what happened? And it really dawned on me that the health care experience, okay, fantastic amazing doctors, nurses and technicians that really helped me. Yet, I felt like that fog, that loss of control, it was so hard to figure out what was going on. And even though people were telling me, here’s what's going to happen next, it was the ability to process, I was just back to that state of mind, maybe I was in shock, but that got me wondering, like, wow, that patient experience, that customer experience, it feels like it could definitely be improved, at least on a personal level. That’s something that really dawned on me, as a designer working on user experience. The patient experience is something that I feel like there's so much opportunity.
Bisi Williams: And I just want to ask you one more question about that Al, I mean, up until a few weeks ago, you've never really had any interaction with it, right? What was your experience with emergency services?
Albert Shum: Yeah, thankfully, again, I feel very fortunate and privileged. I've never even been inside an ambulance. Everyone was very caring, so kudos to all the emergency team staff taking care of me. At the same time, that initial shock, it’s because it's so unfamiliar, it’s literally the language, even. I think everyone was doing an amazing job, like I said. At the same time for me personally, and actually, afterwards talking to my wife, it was harder for her. She didn't have any information with what was going on. So maybe it is that sense of almost being lost. It's about the experience.
Bisi Williams: I'm so glad that you're here with us today. I'm sorry that happened to you and I'm so grateful that you're well, first of all. I share your gratitude that people kept you in good health and in good spirits. So what I'd love for you to do is share your vision with our listeners for how you can imagine the patient experience for health and wellness in the year 2049.
Albert Shum: Yeah, thank you for this opportunity. When I was laying in that room for a couple of days, I really had a chance to think about it. Maybe not 2049, even just now. If you think about it, it's actually not that far, it’s pretty near. If you think back to 1995, what was going on, I think that's when Amazon, sold the first book. We worked on Windows 95 back then as a company. Obviously things have changed so much in terms of the web and how we access information.
So similarly, if we could look back and then project to the future, this idea of immediacy is to be able to access information and to be knowledgeable to what's going on. The immediacy we create in the user-centered design process is in making sure our customer, our end users are always in control. I think in 2049, you should be able to access all your health information, it seems kind of obvious. They did a lot of tests on me and actually, I can't go access it and try to figure out if maybe I should go talk to someone else. Or is there a different way to look at the data?
So the access to your own health information, your data, your fitness. What was going on? How did it happen? Just having that knowledge to act on it, I feel that's going to be much more accessible and open, not so siloed into different areas. Like the emergency room, even looking today, the doctors are different than the doctors that are treating me in the cardiac department, my primary care doctor or other specialists. So all those people that are helping me out, obviously they have an amazing intention, but they're asking me the same questions all the time. And I believe there will be a way where your information just travels with you and it’s part of your digital life. It should be your digital twin and be able to not just look at that information on your health experience, but also to empower you to take care of yourself.
I think so much of the patient journey is about in the moment, in the hospital, but to me, it's what happens after you're outside of the hospital. That's just as important. How you recover. How you take care yourself. How do you think about physical therapy or even nutrition plans. How you use that information and enable you to live a better life. I think that's really going to be key. So I see that in 2049, and I am always an optimist because I work in design, so I'm optimistic that you will have access to all your health information and you can decide how to use it, where to use it and when to use it.
Bisi Williams: So Al, you talked about in your vision the individual having agency and some modicum of control and choices. I like to think, and I say this respectfully, that sometimes while there's a tremendous amount of design in medical and related fields, it's kind of a design-free zone in that comprehensiveness you're talking about. So your digital information traveling with you, if you could do it today, what would that look like? Just paint a picture of a user experience as you understand it.
Albert Shum: Yeah, that's a great question. I've been thinking back to trust and safety, which comes in hand-in-hand. When you're lying on a hospital bed, you’re very vulnerable. And obviously you don't have knowledge and a lot of the terminology. The information presented to you, it's very technical. I don't know how to read an EKG? So, I’m not even at a trust stage. I don't have a choice and once you don't have a choice, it creates anxiety and it's hard to create a sense of safety and wellbeing when you have so much anxiety.
What I think design can really do, and this is the power of design where we can create visual communication, use our super power to connect with that and to bring that empathy to understand what the patient experience is going through. But how do you present information in a way that enriches, but also informs, creates confidence and then confidence builds trust? That's the level of UX that I always try to design for. It's not about doing one thing, it’s building on things as you go through your experience. I really see this opportunity to rethink the patient experience around information and data and how we could present it and make it consumable.
It's interesting if you think about UX, where it came from, if you go to the history and my friend Cliff Kuang wrote a great book called User Friendly, he talks a lot about flight controls, very complicated experiences where professionals, during World War II, were making a lot of errors and how visual affordance or shape affordance can really mitigate lot of disasters. I think similarly, how do we present information for patients in a way that's consumable and also helps them make decisions?
If you look at the history of UX design, going from these typical kind of, how do you control the machine was how we focused a lot of our UX design, to how do we create behaviors and how people feel using the experiences, back to that confidence, that control. I think that's where UX is really heading towards, that it's not just about the features and hey, can I get achieve those tasks, and can I do this with this app or this feature, it's really about how people feel and the feelings we can create in our customers.
Bisi Williams: Can you describe this experience that you're talking about? Can you accomplish that in 30 years? Could you really have that kind of warm, cool experience that empowers people?
Albert Shum: I like to think so. I definitely think if not sooner, I've see a lot of progress on the technology side that we could personalize information for you. Obviously with all the great work in machine learning, AI, where we can take your information and adapt it and tailor it to your needs. There's a lot of breakthroughs and that's already happening from how it's presented and how patients experience, I really like to think more about that sense of it's this belief that design and beauty, and beauty takes away some of the pain. And if we could bring beauty and beautiful experiences to the patient experiences, I do think that would be transformative. In addition, to allow you to have that agency with the information about you.
So I see an experience where it's focused on making you feel confident. So imagine walking in the ER, even just the color and the lighting. I know there's been a lot of great research work on this by many companies, that the environment is just as important and what you hear and see and feel in the environment. And I'm going to segue a bit, I have friends at design agencies working on the airplane lighting and how important that is to set the environment and actually really shifts your perception.
So I feel like the hospital experience is about helping you feel safe and secure, giving you the confidence. Then the personal information should really come with you. Like that idea of the chart is somewhere in that computer, somewhere that you can access. We have so much technology on us, you would think we should be able to access that in a way that's consumable for you.
That patient experience, where you can have a device or some way to access your information in real time, I think that's going to be really key to unlocking that experience where everyone, every patient can feel like they're in power, they feel confident and they trust the experience.
Once you’re outside and recovering, how you take that information with you, as you tailor the experience to help you recover, I feel like that's the part that's been so missing. It's still, here’s the medicine you might need to take and read the label, and then there’s sheets of paper they give you, good luck. So again, I'm not criticizing the current experience. I think everyone’s intent is amazing and they've been so helpful. It's just, how do you think systemically, like the system, like the user experience is no longer these discreet moments. I would say it's about the whole end-to-end patient journey.
Bisi Williams: What I'd love for you to discuss now is what role does ethics play in design?
Albert Shum: I think ethics is everything now because it's really the consequences. If you're not intentional, the things that you create will have amazing impact because that's your goal. At the same time, it can have unintended consequences. And like we mentioned about time, often we don't step back and say, hey, what could go wrong with this experience? There's a lot of conversation around screen addiction and how people are using time. But if you go deeper on the ethical side, you really have to think about all the different stakeholders and not just the end user. When someone that works in a night shift because that's their job or they don't have the ability to go to a doctor because they’re holding down maybe a couple of jobs in these tough times, giving access and being inclusive is not just a moral responsibility. It's really how we design experiences that is inclusive of all different backgrounds and needs. So I think ethics is such an important part, both in terms of addressing unintended consequences, but also making sure that you're being inclusive and your experience is accessible to all. It’s the complete, it's the holistic design practice that we all want.
I do want to make this point where I think sometimes we idealize, like we design for the ideal. There's a lot of tension and debate about design for personas where it could create the norm and you end up with the norm solution that benefits and reinforces the systemic biases that are already there. In order for us to dismantle that system, I know that's a very strong word, we really have to look at the edges and again push on those ethical boundaries to understand where things are breaking. It’s that tension that oftentimes we don't bring into our design practice or our process, so you don't really think holistically about the total experience.
I'll make this a bit more provocative, systemic racism is by design. And oftentimes I think designers look at like, well that's the system and we're on the outside versus no, we're part of the system. If we want to create change, we have to break it down and really push on those tensions.
Like in healthcare, there are challenges and how do we dismantle in a way that doesn't break everything up and throw it away. But that thoughtfulness, back to that empathy to understand all the different stakeholders, be it the patient, the doctor, the hospital administrative staff, the government, and audit different institutions and bring people together to understand that multiverse that we live in, it’s not a binary-verse, it’s a multi-verse, and that’s the richness where it will spark creativity. I firmly believe that's where the good stuff will happen if we can have those multiple dimensions in our designs and think through that plural-verse that we live in today. So, I feel it's a moral imperative for designers to think about this dismantling the system in a way that creates positive change.
Bisi Williams: Al, that's fantastic because my next question is what role can mindfulness bring into your product ethos for health and wellness?
Albert Shum: That's a really important thing, it’s around time and what people are spending time on and quality time. Mindfulness is such an important part when we're just inundated with information, we're processing so much. It's the golden age of content. There's so much content out there and it's constant and mindfulness is the ability to actually be able to make time for yourself to look inwards, that inner space. How do you create that mindfulness and what are the practices? Back to UX design and the journey we've been on as an industry, that's so much of what we create in the foreground, it’s literally what's on the screen versus what's inside you. And what creates that behavior are the positive experiences that creates that mindfulness, that creates a balance that lets you know when you are consuming a lot of information. It can create anxiety.
We talked a lot about the reward loop as they're engaged, but also I think there should be a mindfulness loop where it can give you a focus, but also help you step back and refresh and recharge and build healthier habits and change habits back to health. If we don't help people change habits, we're just reinforcing habits and sometimes those habits aren't good. I think it's our job to understand what are some of the not so good consequences of things that we create and help mitigate and address them. So it's a balance.
Bisi Williams: Al you've just hit it. I think that's very interesting. Professionally you create digital experiences that reach millions, often, billions of people instantaneously, experiences that engage you and make you react. And this is a kind of a new thing, which in 2049, we're going to be grappling with a great deal. In what way does the manufacturing of feelings affect society?
Albert Shum: That's so important, the manufacturer feelings, which ties into beliefs. And you think about the last 12 months and how we're heightened about information and how people feel about certain content and information. Obviously it's gotten more polarized. So what we've been thinking a lot about is being very considerate, like with the vaccine rollout, it's unprecedented how quickly they were able to develop tests, do trials and now mass produce and distribute it to millions, if not billions of people.
I think similarly with digital experiences, we have to take the same level of consideration where we are being very concerned about how we try experiences. It’s not a product we're creating, we’re really creating a hypothesis. We're trying and learning from our customers before we roll it out to billions and really iterate and again test those boundaries, those edges, and understand where the tension is before we scale it out instantly to millions, if not billions of people, similar to how a vaccine gets rolled out. Digital experience is viral and that's why it's so incredibly pervasive in our world.
You could create a piece of content like this podcast and get it out to millions of people instantly. It's amazing. We can have conversations now with anyone around the world, that's so amazing and at the same time, that immediacy that you could do something really quickly, I think back to the ethics, how do you make sure we have the level of controls where we can iterate and flight and try and learn and build on? What can we do as designers? I think similar to doctors in the medical field, there's the Hippocratic Oath. For us to be responsible as an industry, we do have to have more thoughtfulness. What is that oath that we keep, that we hold true above and beyond anything we build to take on that responsibility, that mantle of the things that we create?
Bisi Williams: What you're saying is fascinating and I'm going to push you a little bit here. To what extent do you believe that behavioral science needs to play a role in the work that you do? There are a tremendous number of pleasures, I'm agreeing with you, it’s staggering what we can create, but because you influence the entirety of humanity with your experiences and at scale, in 2049 how do you imagine we're taking care of our physical needs, but also our social and emotional needs as well?
Albert Shum: If you look back at even the formation of design itself, a hundred years ago, like Bauhaus and it was always creating the artifact. You can mass manufacturer chairs and use materials and transform it in new ways. Bauhaus led to this whole new design movement that totally transforms product design and design in general. I think similarly, we are in this era where we are mass producing feelings and behaviors at an unprecedented scale. We’re still learning what that process is. Instead of transforming material, we can transform behavior. I’m really passionate that there's new ways of creating and building. Maybe this is the part that I'm really also on the same journey that we are creating systems now, it's not about the end artifact as much. It's still important, but so much about what we create is the system and designing user experiences in the system, nurturing and taking care of that.
Some people call it the ecosystem, almost like a living thing. I feel like our job is almost like gardeners, more than actually planting new seeds and trying to figure out what's the next area to grow, that's important too, but how do we nurture that so we have a healthy ecosystem and design, again back to that plural-verse, that’s the role of design much more than the artifact. How we take care of the system so that they can create goodness and mitigate some of the harm in the system and the challenges in the system. I think that's the tension that I'm trying to promote in my work and my team's work in the industry because ultimately if we don't, the system will just bias towards what everyone else wants it to do. I know I’m talking in some ways, pretty scary things.
Bisi Williams: You're okay. You're among friends.
Albert Shum: I do think we are a force of change if we only recognize the possibilities to create that change.
Bisi Williams: So I'm going to ask you this then, because I love where you're going. How does designing with an inclusive ethos improve the long-term impact of what we create?
Albert Shum: Impact is really important because no longer can you create it and just make more things. I think that’s a key lesson learned even from sustainability and ecology of physical products. We can't just make more things for the planet and just get it up there. So similarly, back to that impact, to really think about the whole life cycle of the experience. To think about impact, not just in this moment, like, hey, I bought this, I downloaded this app, I’m using it. Hey, good. See you later. To really think about the whole life of your customer and end user and what they go through and how the system treats them. How does the system continue to adapt to their needs, to be responsible in a way that it's listening and giving back that agency, that autonomy to the end user always, that's the constant iteration of that experience, that I'm talking about.
It's not about creating the perfect design, getting it out there and it's done. It's this living system that you're creating, where it's adapting, nurturing, and building on your customers, not just needs, obviously we want fulfill their needs, but how they feel, what's their behavior? Are they feeling good about themselves or do they feel good being in control or not? I think those are really important things for us to consider now as we create visual experiences.
Bisi Williams: Wow Al, thank you for your incredible vision of a beautifully designed holistic and powering system for all of us.
Albert Shum: Thank you.
Bisi Williams: And that concludes our show with Albert Shum. Thanks for listening. If you enjoyed our show, please subscribe or share with a friend until next time, I'm Bisi Williams.
