Health Innovators
Health Innovators

Episode · 2 years ago

Product Co-Creation, Adoption Strategies & The Power of Engaging With Patient Leaders w/David Goldsmith


Thousands of apps, devices, and wearables are brought to market with good intentions of solving real problems, but they just don’t get any adoption. Part of the problem is a disconnect between the innovation and the patient’s needs. What are patient leaders, and why is it so important for innovators to engage with them? How can involving a patient in the co-creation process help uncover hidden insights? What are some of the problems that can arise in these engagements?

On this episode chief strategy officer of WegoHealth, David Goldsmith, and I dig into why product co-creation is so critical in order to successfully bring an innovation to market.


3 Things We Learned


How patient leaders benefit your marketing

Working with the patients helps get the word out about your product to other patients. The information will have a far greater impact with other patients coming from them than if that same message is being delivered by the company creating the innovation.  

How to get the most valuable contribution from patient leaders

When it comes to patient leaders, most innovators don’t know where to find the right people to put into the room. They struggle to know who to draw in and what their contribution will be. Start with something along the lines of a patient advisory board. By creating a board that includes the very same people you want to reach, you boost the commercialization potential of your innovation.  


What can go wrong with patient leader engagements

The one thing that many companies get wrong is engaging with patient leaders and then choosing to ignore or dismiss what was put forth. You could get backlash, and this might really affect your reputation in the market.


The landscape of failed products and solutions targeting patients in healthcare is vast and highly documented. For a lot of innovators, the first mistake they make is in what they fail to do, and that’s bringing in the right voices and influencers from the market they are trying to serve. A lot of things get overlooked when you don’t involve the right stakeholders in your commercialization process. By choosing to co-create with the people your innovation is going to serve, you increase your chances of success significantly.


Guest Bio-

David is the Chief Strategy Officer at WEGO Health. WegoHealth is the world’s largest network of patient leaders to help health innovators access patient experiences and expertise in the designs, development, and promotion of products and services. Connect with him on LinkedIn

Welcome to CIQ, at first ofits kind video program about health innovators, early adoptors and influencers and their storiesabout writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy,founder of Legacy DNA marketing group, and it's time to raise our COIQ. Welcome back coiq listeners. On today's show we're digging into product co creationand adoption strategies with David Goldsmith from we go health. David, welcome tothe show. Thank you, Roxy's great to be with you. So,before we get into the meat of this discussion, go ahead for our audienceand tell them a little bit about your background and what you do. Sure. Well, I'm currently the chief strategy officer for we go health and I'vebeen working in digital health for about ten years now. have been really spentmy entire career working in technology, and most of that was focused on buildingsocial networks to connect people and special interest areas, but I shifted to afocus on health after my wife was diagnosed with cancer and got an up closeview of the healthcare system and was frankly a little stunt to see how dysfunctionalit was, and it inspired me to try to be involved and bring mybackground and interest to bear and health care. So ever since I've been working witha number of companies trying to bring new technologies to market to hopefully improvethe patient experience as well as outcomes. MMM, awesome. So what isit like for you writing this crazy roller coaster of healthcare invasion? It dependson which day you ask me. I'll get it, but you know,I will say that it's incredibly exciting and most onmost days and and other daysit's daunting right, because if you've ever attend attended the Hymns Conference, whichI believe you have, you see in the numerous ex exhibition halls how bigand monstrous and powerful these incumbent companies are in healthcare and they control a lotof different dimensions of the healthcare system. So since I've been mostly focused onstartup company, working with startup companies that are trying to gain tractions somewhere withinthis incredibly complex ecosystem. It's just daunting, right. How do you compete withcompanies? How do you partner with them? How do you cut throughthe noise and the height and the you know, the challenges never go away. The flip side is when you do start to get traction. It's sogratifying because of the nature, sure of the work and what we're trying toaccomplish. It just makes it worth it and I will say that I've neverregretted the day I got into healthcare and tech and I can imagine actually notworking at this point within the healthcare system, and that's despite working almost every daywith very large life sciences and pharmaceutical companies who any measure, can posesome substantial challenges to getting things done. But we're making great headway. Awesome, that's great. So I know that you all talk a lot about thisterm called patient leader. So for our audience, help us understand what doyou mean when you say patient leader? So when we look at the communityof patients who are actively engaged online, one of the things that we havenoticed over many years now is that there is a segment of those patients whoreally start to be highly visible because of... not just how active they areonline, but how many followers they have, how how what the they're the natureof their participation is. So, for example, many of them havecreated blogs and are very active bloggers. Some have established the substantial digital footprinton facebook or twitter, and now instagram as well, in even many ofset up youtube channels. You start to see people who are deeply engaged intheir own health, but they're also very active in trying to help other peoplewith similar conditions or the same conditions navigate various aspects of their health and thedecisions they're making daytoday about aspects of their healthcare. And so we just startedmany, many years ago, trying to do a better job of finding thesepeople, connecting with them and and looking at the role they're playing, andit became very clear to us that there is a growing number of people outthere who can who are, of course, patient advocates, their people who arehelping others, their sharing a lot of information, they're connecting their peersto vital resources and so forth, and their playing a very valuable advocacy role. And within that there are also people who are clearly influencer, influencer right. These are people who are, primarily through social media, actually measurably influencinghow other people are managing their care or making certain decisions about things to lookinto, whether that's a new treatment option or a new medication or something alongthose as lines, and we also know that there are people who are clearlythought leaders within this community. Those are the people you often see on themain stage now, sharing their experience and bringing the patient voice into conferences.So when we talk about patient leaders, we're really talking about the the opinionleaders and the health influencers who are not only viewable and findable by virtue oftheir substantial digital footprint, but also by virtue of what we're seeing from theirpeers who, on an annual basis, when we run our awards program stepup in a big way to both nominate these people and different categories or tovote for them once they're actually nominated, and we get tens of thousands ofpeople in patient communities validating that these are the leaders within the patient community theylook to to stay connected, to get support and to learn about new waysof, you know, essentially coping with or managing their health. H absolutely. So why why is it important? You know, majority of our listenersare health innovators, early adopters. So why is it important for health innovators, who may maybe are bringing new products, new innovations to market? Why isit important for them to involve patients or patient leaders in the product cocreation process. Well, it's important because ultimately, if you are hoping orexpecting patients to adopt whatever solution you're bringing to market, then you are wiseto work with them to understand whether what you're introducing to the market is infact going to meet their needs, MMM and be usable and useful. Imean, I know that goes without saying,...

...but I think the landscape of failedproducts and solutions targeting patients is, you know, it's kind of vast, right. I mean, we see definitely much on a daily basis wherenew APPS, new devices, new wearables and so forth are brought to marketwith with very good intentions of solving real patient problems, but for a hostof reasons they just don't get adoption. So we often learn that part ofthe failure there was a disconnect between what the entrepreneurs and the innovators thought wasnecessary or what would they thought might be addressing, and what the patients themselvessee as critical for them and they there's an opportunity, by virtue of workingwith patient thought leaders and influencers and advocates early on in the development design process, to really better understand is this something that we can validate through your experiencein your own you know user feedback is in fact going to meet your needs. So it's not unlike the kind of design thinking process that we see inmany other industries where that kind of involvement early on can really make a differencedown the road in terms of adoption. So it's the reason why, increasinglywe are working with a pretty diverse range of pharmaceutical companies and even others nowto bring patients in early for qualitative insights to better understand, for example,what is that patient journey look like, particularly if you're dealing with a chronicor complex or rare condition and you know you can't find a substitute for whenit comes to design thinking. You simply can't find a substitute for the endusers of your attended product. So that's vital. And then I will addthat one of the other things now that we believe off is really proving tobe very promising is working with patient influencers and leaders who do have a lotof followers and social media to help build awareness of your solutions once they're onthe market. Now that is a little easier if what you're talking about isa device or a product or something that is kind of direct a consumer solution. When it's through a beat of be channel like a provider or a payeror potentially even a pharmaceutical company, that can be a little bit trickier.And yet we still see opportunities to work with these individuals, to think verystrategically and also tactically about what can be done to try to really raise awarenesswithin patient communities that these kinds of solutions exist, how they work, whythey would why they are beneficial, and we lot working, you know,with that the patients themselves to help get that word out, because we knowthat, again from our own research, that if they're sharing that kind ofinformation the likelihood of other patients acting on it is far greater than if thatsame message is being delivered by a company itself. Hmm, yeah, absolutely. So, you know, kind of staying with the product co creation,there's a framework that we use with clients. We call it the five codes because, you know, it's not just the actual like you might think of, like hey, at the end I created this product. You know,the validation, the covalidation of what do... think about it? But Ilove what you're saying because it's really about involving the patients much earlier in thatproduct development or commercialization process. So how how do you recommend that health innovatorsengage patients around ideation, valuation, development, all these different stages of the productco creation process? How does a health innovator find and it? Thisis going to sound like it is a absolute direct promotion for for your company. I just think that the work that you guys are doing is really importantand it's something for health innovators to be aware of and then understand how totake advantage of. So help us, our help the audience understand how dothey get patients involved in this process? It's a very good question and Iwill say that one of the barriers to this that we've encountered over the yearsby virtue of talking to lots of companies about this this kind of thing,is that they often simply don't know where to find the right people to bringinto the room. And that's it's not a slam dunk. I have byany means right and and sometimes it's not knowing who to draw in and whatthey can really contribute. Sometimes there's trepidation because they're not sure whether what they'regoing to learn is is is going to provide them with sort of actionable informationor insight. There are sometimes questions, depending on the nature of the companyor, for example, with providers. Sometimes there's real concerns around confidentiality,confidentiality or privacy and not wanting to have any appearance of stepping into a conversationwith a patient but because they know that they have a certain condition, sothey kind of want to create a sort of fire wall there, if youwill. Yeah, but you know, the the thing that is, youknow, I think important to keep in mind is that it's it goes withit kind of goes without saying that the patient population is not a monolith rightwithin any all of us know people, sometimes in our family certainly friends,who are incredibly engaged, very knowledgeable and the kind of people who you wantto bring into a room to have a conversation generally, not to mention onethat is very well informed when it comes to trying to understand how to createa product or a solution that will be well received by people who have,who are affected by a certain condition. So, but you know, justcasting a broad neet isn't always a very efficient way to go about it,and it is one of the reasons why you have companies, you know,like we go health and others, that are trying to do a better job, frankly, of vetting and creating the patient communities that are out there tofind those people who can come in on day one and really add value toyour conversation. And so, you know, the important thing, I believe,is to really consider starting with something along the lines of a patient advisoryboard. You know, rocks and me, and one of one of the thingsthat I'm struck by with so many startup companies, and I've been perfectlyguilty of this myself and my career, we're very quick to want to puttogether some kind of add advisory board that has technologists, for example, or, in the case of healthcare, people with, you know, very strongclinical backgrounds. And that's with good reason,...

...right. Those are that those arekey stakeholders, these are the people who know the industry well. Itmay it's perfect sense to have that kind of expertise involved in your enterprise,but it's kind of remarkable if your company is really trying to bring to marketa solution that will be adopted by patients, whether that's to reduce cost and utilization, whether it's ultimately to improve outcomes, medication adherence, you know, whateverit may be, it's a little odd that we don't see more companiescreate an advisory board that consists of the people that they ultimately are trying toreach. So we think that's a really good starting point. It's really goodpoint, you know. And now again that still begs the question last whichis, okay, well, who do we bring in for our advisory board? And depending on your on your on your product or your service, inthe nature of the condition that you were conditions that you're working in, youknow, there are a lot of factors to consider in terms of what's theright representation to bring to the table. We've actually certainly had many companies sayto us, okay, we understand, we go healthy, you can bringthe advocates and the influencers and the thought leaders, but those people aren't representativeof our target population. For example, we you know if you are targeting, you know, segment of the population that's very, very difficult to reach. You know where the barriers to access have been kind of normally high writinghealthcare, low income populations, people in transportation, deserts, lots of examplesthere. You know how you know, don't? We need to have thosefolks at the table as well, because they are, you know, arepresentative of our population. So that is important. And you know, whatwe're finding is that in some cases the people we work with are ideally suitedto something like a patient advisory board. In other cases they're all they becausethey are so connected in patient communities. They're incredibly adapt at helping, helpingus in our clients find other people who would be really well suited to anadvisory board, in part because perhaps they are more representative population. And Ithink, you know, one thing that is just always striking to me,even after having been in the business as long as I have, and especiallyjust in social networking and social media, is that, you know, aswe're having this conversation today, there are literally tens of thousands of patients onlineright now on all these different platforms, having conversations about various aspects of healthcare, maybe newly diagnosed and in the early stages of of a crisis that theynow need to navigate. People, for example, who are newly diagnosed withcancer are often quick to go online to go to support groups and try toconnect with other people who have been in their shoes try to get support there. There are people who are on the opposite end of that spectrum. Youknow, twenty year cancer survivors, for example, who are still very activeand providing pure support online. And you know, I mean just countless kindsof representatives of this patient community. And if you can connect with the leaderswithin some of these patient communities, they...

...can be a great source to helpyou find people who perhaps would be very appropriate to bring onto an advisory boardand you're happy to help do that. So, knowing that you work inthis environment, give us an example of how involving a patient in the cocreationprocess can help uncover, you know, hidden insights for them, how itcan uncover yeah, you know, I'm assuming that with all the different peoplethat you've selected, worked with and placed, you know, is there an examplethat you can share with our listeners to say this is maybe some assumptionsthat the health innovator had beforehand and they put together a patient advisory board orinvolved the patient in the cocreation process and this was some of the Aha momentsthey had or something that they covered that they really didn't see on their own. Sure let me give you one example that I think is is is apretty telling one. Actually, was a project that was spearheaded by folks onthe human centered design team at partners healthcare in Boston. They were assigned tothe task of putting together an advisory board to help some clinicians there create anew figure out, essentially a some kind of new solution to support people withepilepsy, and they came into that conversation with with a bit of a blankslate, right. They really wanted to understand what the needs are. Theyhad their own opinions by virtue of working with people with epilepsy and we're makingcertain assumptions as they is, as as you would expect based on the clinicalcare they provide. But they also felt like there were unrecognized needs that perhapsweren't being addressed. So they put together and again by virtue of the ofthe skill set of the folks who are involved on that team, they cameinto that with a design thinking sort of framework, right, which meant getthe right stakeholders in the room in front of a whiteboard and start to reallywork through those assumptions and work through key questions about where those needs are.What the hospital could be doing differently, etc. And so they they didthe right thing. They not only brought in conditions, they also brought in, believe, a payer. They brought somebody in from a national advocs organization. They brought in a patient leader with epilepsy who is very active in,again, online communities right connecting with lots of people. So she's she wasa great sort of barometer for where the needs are in the community. Shehas her eyes and our ears to the ground just by virtue of participating inthese communities. So when she came into those meetings she was not only againable to speak to her own experience as a person with epilepsy, but shewas able to talk about what she was seeing online, what challenges people weresurfacing, what pain points they were talking about, where they were looking forsupport, etc. And in that process of identifying where the needs were,unmet needs in particular, the clinicians in the room had identified a whole hostof things that they thought that they were seeing, but it really wasn't.There was a main problem that was flagged by the patient advocate herself which hadn'teven really been on the radar and it was in fact transportation issues and theproblem that people who have had an epilepsy...

...seizure often face, which is thatthey lose their license and they lose driving privileges for a period of time byvirtue of their seizure or they're simply anxious about driving for obvious reasons. Soit's not a classic example of a kind of transportation desert issue that we dosee in a lot of communities. It was more a very, you know, kind of use case conditions, specific example, where these are people whooften isolated and end up not making it to their appointments and and, youknow, for whatever reason, don't feel like there's an easy solution for them, sometimes at the spur of the moment. So they essentially were in that process, able to work with a P and leader who flagged something surface,something for them that simply hadn't been recognized, and it kind of steered them awayfrom thinking about this and kind of more high tech, so to speak, ways. I mean they I guess, been very interested in looking at perhapsbring in a new APP to market the people with epileps you could useor something else, and it turns out that that this issue, if itcould be addressed, in a in a very direct way, would actually beviewed by the by those patients, as incredibly helpful and solve a very realproblem. Yeah, and I think that there's many times where those things areoverlooked and lest you're involving the stakeholders, the right stakeholders, in that process. Absolutely. So let's kind of just flip the coin again, because youknow, just because on the other side of this, just because you havea patient involved in the process doesn't mean that you're going to automatically reach commercialsuccess. They're definitely some pitfalls just to be mindful of. I kind ofrefer to them as guard rails to have in place whenever you're involving patients orreally any stakeholder group in the product co creation process. Is there anything thatyou've stumbled upon of just kind of something that could be a pitfall of aninclude them? Well, it's a good question, I think you know.I'll tell you what the you know, one one pitfall is that there isa risk that if you have engaged one or several patients like, for example, and an advisory board, with the intent of listening to them and usingtheir insights and feedback to guide your road map. MMM. And at theend of that process you, for whatever reason, and it may be fora for good business reasons, you choose to essentially ignore or just or kindof, in a sense, dismiss what was you know, what was putforth in that advice among the folks on that advisory board. There there's somerisk of backlash there unless they are clear on on the basis for your decision, I mean, or your if they understand your thinking. I mean thereare plenty of examples that we've heard of, mostly mostly anecdotal, where where peoplefeel the patients who are brought into some of these kinds of add boardsor or panels where they're asked to share their insights and perspective, they feellike they've shared a lot of information but they don't see it really go anywhere. It doesn't manifest itself in any obvious...

...way in terms of the future courseor the future path that organization takes. So while you may start the processout with a in, with a real with good intentions and a spirit ofgood will, it ends up in some cases looking like you were essentially payinglip service to those individuals and not really intending to take their advice. Butultimately to be able to say, at the end of the day, youlistened to them. Right, right, yeah, and again, there maybe perfectly logical, defensible reasons for not necessarily moving forward with whatever recommendations were, advice, an add word like that put on the table, but ifthey haven't been brought along with your process after, let's say you've convened thatmeeting or several meetings and don't know why you ended up where you did,then you know there can be some backlash there. So, yeah, theother thing that is is a pitfall, and we hear this certainly from companiesthat are where there's if kind of trepidation about working with patient leaders. Isthe the concern is that patient advocates in particular can simply be very difficult towork with because they come in with a real some very strongly held views onon how the system has failed them or where the shortcomings are in various aspectsof their of their healthcare experience, and those people can be, you know, strident, that can be agitators. It's becauses. They've been deeply affectedby what has transpired to act why they are now advocates. Right. They've, for example, that you know, in the serious cases they've they've hadtheir own issue with, you know, surgical procedure gone wrong and medical devicethat turned out to have been unsafe. I mean, you know, there'sa littany of issues out there and it's entirely possible that in some cases peoplewith those experiences will come in and use these opportunities to vent at great lengthand quite adamantly, and then people feel like, you know, we hearyou, we understand this, but that's not really why we invited you hereand it's not to help us solve the problem. And so that twhere againthere's trepidation, sometimes some real ambivalence, and it is again erected as abarrier to working with patients because of that fear. And it's a reason whywe believe part of our role that we go health is to do vetting inorder to, you know, to try to find people who it's not thatthey won't be passionate and have some strongly held views, but they will beclear, coming into those kinds of meetings or playing those roles, what theexpectations are and prepared to be a very constructive, you know participant trying tohelp Sol problems is opposed to just seeing it as an opportunity to vent somespleen. Yeah, and I think that it's important to acknowledge that and then, you know, that doesn't that doesn't prevent us from engaging those patient leaders. It just helps us form the relationship and manage those expectations communicate that upfront, like you know, like I said, guard rails for the engagement, for the relationship. One of the...

...other things that I see that seemsto be common to is, you know, listening to one or two people andthen creating your solution around those specific things and then realizing that it wasn'tsomething that was viable for the entire market place. It would they they wouldbuy it, but not necessarily something that would lead to, you know,true commercial success. So I think just acknowledging that there can be some challengesand then working in strategies of overcoming them is very valuable. So want toswitch gears a little bit and make sure that with the last few minutes thatwe have that we're also talking about the product adoption and engagement. You touchedon this a little bit earlier, but you know, adoption and engagement isso difficult. I mean, you said it earlier. Time and time againwe hear of, you know, the the two thousand apps that no one'susing right and for whatever reason that would be. You know, just becauseit's a solution that solves a problem doesn't mean that it's going to reach commercialsuccess. So what does a health innovator need to do to get patients touse their solution? Well, you know, the things that we believe is encouragingfrom what we're seeing is that if you can identify patients who are usingobservers or a product and APP, whatever it may be, with real successand it's clear that it is having the intended effect right, that it's someoneis now in a better place in terms of their health or their patient experienceby virtue of using your solution, that those are the people who really canbe incredibly useful, helpful committed ambassadors. You know, it's the notion ofpatient ambassadors is, you know, in pharmaceutical industry in particular, is kindof well well established. It's and there are provider systems now that are startingto build out patient ambassador programs so that they have patients who've had a verysuccessful outcome in a great patient experience out there in their communities talking about whypatients in those communities ought to go seek care in those areas. So weknow that there is a greater recognition that the voice of a happy, satisfypatient is incredibly valuable. And so in terms of adoption, what we're seeingnow is that in the process that we go through to on unsort of unearthedsome of these really important insights and those in that early phase of a designprocess, we can also learn what what is it that is you think aboutmessaging and communication within patient communities, what is likely to resonate right? Andwe're now working with more and more patients and what we call our content studiospecifically doubt have them Co create the content or in the creative assets that acompany is going to use to help connect, to help them connect with their targetmarket on the patient side. So you'll hear that very often. Youknow, you know and I mean and when you look at that, youknow the primary industry we work in, which is the pharmaceutical industry. Aswe know, especially in most DTC campaigns, the people who are talking about theircondition on commercials are actors and models and those voices simply do not resonate. There's research that shows that and in fact, especially with complex chronic conditionsthat are very challenging to manage, there's...

...a resentment factor that a lot ofpatients will articulate because they see these actors who who simply aren't at all representativeof the patient population, running along the beach. Exactly. You see itand we see it every day and and you know, increasingly, of course, not surprisingly, those those drugs that are being promoted through those channels areoften, you know, big molecule specialty kind of drugs dealing with very,you know, challenging health conditions. So so those people will talk about,I mean a lot of those patients will talk quite freely about how they reallyare turned off by those messages. So we're trying to kind of, whatwe say, flip the script, yeah, and work with the patients themselves tocreate the messaging that is likely going to be heard by their fellow patients. And we're not only taking it and but we're not stopping there. Wherethen, and I think there's a lesson, you know, learned here for forthe innovators, not only work with them to shape the content but,where possible, work with them to get that message out through their channels.So you know, this is again kind of an extension of those sort ofambassador influencer model where people who are, you know, hyperconnected through all thesedifferent social media platforms can say, look, I had a great experience with thisCGM device, I've had a great experience with this CPAP machine, whateverit may be. And here's why. Those are folks who you want toenlist as your allies to get the word out. So that's kind of earlyadopt that's kind of the early adoption curve where we've spent most of our timeworking with companies. But I just want to point out that I do believethere's an opportunity to extend that model further down the down the road, orkind of integrate it more into the sort of care continuum, if you will, because you know, great example here in my backyard with a major providerwas that they wanted to get a bunch of cardiac patients using an APP whenthey went home to better manage their symptoms and have some resources in the eventthat they were thinking they might need to get back into the ED and theydidn't talk to cardiac patients when they designed that APP and they didn't have verymuch success getting it utilized once it was on the market, and so therewas a clear opportunity for them to actually work with cardiac patients, to bein touch with other patients when they went home from the hospital, to sayhey, you know, I just I survived this as well, I knowwhat you're going through, I understand your pain, your anxiety, etc.And here's an APP I've been using provided by this hospital system. Here's whyI think you should use it. If you have questions, we can helpyou. If you have true you know, you need technical support, we canhelp you. But having that message delivered by someone who, again,who's been in their shoes, is is quite likely going to have a greaterimpact act on that individuals willingness to work use that APP than than anybody elsein the system. I'm a big believer. I mean I think that it's justa no brainer. Why wouldn't you? Why wouldn't you ask the people thatyou are expecting to use your solution... help comarket, you know,Co launch and make them a part of that process and so it you know, it sounds, David, like what you're talking about is that our listeners. Health innovators have the opportunity to include patients from end to end, thebeginning. I have an idea. What do you think? All the waytoo, I launched in each place in that continuum, all the way toI launched it, and now help me continue to promote it and to increaseadoption and engagement. That's fantastic, absolutely fantastic. So so, as wewrap up here, what advice? This is our last question. What advicedo you have for health innovators who are in the trenches today? Well,my advice is to keep your eye on the prize, at the risk ofCliche, using a Cliche, Yep, and to be tenacious, of course, because without that you likely will not survive, you know, the healthcaremarket place. I certainly, as you would expect, advise people to findpatients to work with and get advice from, and and then, I would say, try to be very open to the to the prospect of having to, you know, pivot, not just based on what you may be learningfrom your target market, in this case let's say patients, but by virtueof trying to bring a new product or solution to market or get significant marketattraction in an ecosystem, as you know, complex and some would say even Riddas it is that word. But that's another show. That's the wholeother episode and you got to be prepared to really roll with the punches andmake some significant shifts in your plans based on where you see that friction,because it's pretty hard to break through it. Yeah, yeah, absolutely well,thank you so much for taking the time to share your wisdom with ourguests, our audience, I know that they are listeners, are going toget a lot of wisdom, a lot of good strategies and considerations from youtoday. So how can our audience get ahold of you if they've got anyother question about integrating patient leaders into their commercialization process? Well, if they'reon twitter, they can find me at Ds goal. That's my twitter handleand I'm certainly active their DM me. It's an easy way to connect,or David Dot Goldsmith at we go healthcom. I'm happy to have a conversation andjust try to steer people in the right direction provide whatever advice or guidanceI can. Wonderful. Thank you so much for your time today. Thankyou very much. What's the difference between launching and commercializing a healthcare in avation. Many people will launch a new product, few will commercialize it. To learnthe difference between launch and commercialization and to watch past episodes of the show, head to our video show page at Dr Roxycom. Thanks so much forwatching and listening to the show. You can subscribe to the latest episodes onyour favorite podcast APP like apple podcasts and spotify, or subscribe to the videoepisodes on our youtube channel. No matter the platform, just search coiq withDr Roxy. Until next time, LET'S RAISE OUR COIQ.

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