Episode 18: Embedding Diversity and Inclusion into Both Product and Culture in the Digital Health Space with the Cofounder of The Darkest Horse

Exploring the intersections of radical inclusion and health tech

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In this episode you’ll discover:

  • What is DEIA (that “A” may be new to you)

  • How to distinguish “leading metrics” and “lagging metrics” when it comes to DEIA work and evaluating results

  • Why fostering inclusion and hiring diverse teams is absolutely vital to the success of companies, and why this is especially important in healthcare.

  • How can companies achieve this?

  • Where do they start?


Learn more from Carrie and Rebecca: 

Healthcare insights (monthly email) | Telehealth/Virtual Care Mgmt Update (biweekly LinkedIn update)

Website | Carrie on LinkedIn | Rebecca on LinkedIn | NGL on LinkedIn

 

Read the transcript here:

Rada Yovovich (00:00):

We really like to start with accessibility and say, who can even get here? It doesn't matter how fairly you're treating or how inclusive you are, if they can't, even

Rebecca Gwilt (00:08):

If they're not. Yeah. Right.

Rada Yovovich (00:10):

And then move to equity and inclusion and then kind of see the fruits of diversity and belonging as a consequence.

Speaker 3 (00:17):

You're listening to Decoding Healthcare Innovation with Carrie Nixon and Rebecca Gwilt, A podcast for novel and disruptive business leaders seeking to transform how we receive and experience healthcare.

Rebecca Gwilt (00:33):

Hello everyone, and welcome to Decoding Healthcare Innovation. I'm so glad you joined us today because we have an amazing discussion upcoming with Rada Yovovich and Chanté Martínez Thurmond who are co-founders of The Darkest Horse which is a minority and women owned, next gen, DEIA consulting firm obsessed with helping the workforce and organizations to explore the intersections of four domains, radical inclusion, the future of work, emerging tech, and health and wellbeing and human potential. I am so excited that both of you are here to join me. We've had a number of conversations before this moment, and I am so glad to share these thoughts with the rest of us. So welcome Rada and Chanté.

Rada Yovovich (01:23):

Thank you. Thank you.

Chanté Martínez Thurmond (01:25):

We said it in unison, but we didn't mean it. <laugh>,

Rada Yovovich (01:29):

We always speak in unison. Yeah.

Rebecca Gwilt (01:32):

So I reached out to both of you because I wanted to do an episode on how to embed accessibility, equity, and inclusion into both product and culture in the digital health space. And we spoke prior to this conversation and I'm really glad that we did because I learned a much better framing of the how and the what and the why of DEIA, and it helped me to reframe this conversation. But before we get to the nuts and bolts, I would love to give each of you an opportunity to just introduce yourselves. Tell us a little bit about your background, what led you to where you are today what grinds your gears and what gets you going and have you start off, Chanté.

Chanté Martínez Thurmond (02:21):

Thank you so much again for inviting us onto the podcast and in bringing us into the conversation. We have been a fan of yours, love partnering with you, and just this is a long time coming, so I'm excited. My name is Chanté Martinez Thurmond. My pronouns are she/her. I am located on the unseated territory of the Council of the Three Fires, which is colonially known as Chicago. I identify as a black Latina. I am a mother of twins. And let me tell you, parenting during the pandemic has been probably the hardest thing I've ever done in my entire life. I love my children, but God, help us all identify as <laugh>.

(03:10):

I can laugh at this, you can laugh with me. Please. I also identify as a neurodiverse person. I am cis and heterosexual, and I have been born and raised in the United States of America, which is a great privilege and honor. And I think the other thing I'd like to just enter into the conversation or bring to the conversation is I definitely identify as one of the older millennials, and that means I'm starting to find myself in that sandwich generation. I mentioned I was a black Latina in my family and my culture, multi-generational households are a thing. And I have that as my great privilege to live with my family. And that also comes with its own set of responsibilities. And so during this pandemic, I lost a parent. And that has been something that I've been trying to let people know because I believe that talking about grief in the context of work, in the context of who you really are is super important. And I recognize that so many other people probably can relate to that given that we are in a pandemic.

Rebecca Gwilt (04:19):

Rada, why don't you go ahead.

Rada Yovovich (04:22):

Yeah, yeah. Thanks for starting us off Chanté, and as always love to hear. Yeah, love to hear you speak. So I will be happy to go next. So my name is, Rada. I use she/her pronouns. I identify as a queer cis gender. So my gender identity matches the sex I was assigned at birth. White, mostly able-bodied, actually hearing impaired woman who was also born, raised, educated in the US. And I am also coming to you from the territory, the unseated territory, the Council of Three Fires, colonially known as Chicago. And I think my queerness is a big piece of how I show up in a room. I think other parts of this is less real in a virtual context sometimes, but I think that our bodies in space have a big impact on how we are experienced and how we experience the world. So I am a rugby player big.

(05:33):

I am very strong for women, and I think that that also is a really big piece that comes through in my voice and how I move through the world literally and figuratively. And I'll also offer a visual description that for anyone with visual impairment who is observing this. And I am a white woman in my late thirties with long, dark straight hair wearing large headphones and a cream colored sweater in a room with brown walls a lamp and some art behind me. And I think that in terms of how I show up and why I'm here and why I'm doing this work, my career has been in technology and healthcare primarily. And before that I actually was a teacher and I did a program that was focused on trauma informed education and how do we recognize the kind of privilege gap between educators and those going through the education system.

(06:37):

And so really trying to be aware of that cultural gap and trying to practice equitable education rather than reinforcing sort of norms of supremacy and control and paternalism and that shows up in our work is a huge part of what we carry into more corp corporate context, where then I was working in especially health tech contexts and really thinking about equity and inclusion as a critical lens in not just the people ops, but everything we do. So I was leading data science teams and thinking how do we practice equitable data science? I was leading product innovation teams and saying, how do we think about inclusive product design? And I'll highlight to give a specific example that one place that I spent a bunch of years was a company called Athena Health. And a really cool initiative that I ended up getting to lead was how do we make our electronic medical records software inclusive for identifying patients?

(07:42):

A lot like consuming healthcare and receiving healthcare services is mostly traumatic <laugh> and abusive and extractive and at best sort of undereducated for identifying folks. And so how do we actually make it so that those kinds of folks don't avoid getting healthcare because it is so unpleasant and unsafe, and instead make services that actually make it safe and make it inclusive and make it equitable for all types of humans. So we'll get into lots more on that, but that's really sort of how I show up in this work and why I care so much about it. And it's a huge and great honor to be working alongside Chanté. We've been able to do some really cool stuff as a team.

Rebecca Gwilt (08:32):

So I just want to pause here because there's so many things that I have heard just in the last two minutes that have been things that I haven't heard before ways of showing up to a podcast that I haven't heard before, and kind of a vulnerability that I don't generally hear before. So I first want to say thank you so much for being so very open. One question that I had while you all were introducing yourselves is how important is it to when you are showing up in a new environment and meeting or speaking to new people to describe yourself in the way you described yourself? What difference does that make?

Chanté Martínez Thurmond (09:19):

I'll take, if you don't mind, I'll go. And rather, if I miss something, you know can always add on and help me out here, but it is extremely important. It makes the difference. In fact, that is why we make it a practice to show up to every meeting explaining who we are and providing you with the unique identities that we each hold. Because we believe at our core that those identities and your social location inform everything that you do. It informs your worldview, it informs the way in which you are going to move through the day, the world, how you're going to maybe metabolize a conversation. And we've learned that through our lived experiences working in healthcare. I will say specifically, I skipped over my professional background and I'm happy to offer some of this, but my first job was at Planned Parenthood and I'm really proud of that because I learned so much in that space.

(10:23):

I was raised in the Midwest, grew up in a Latina by, raised by a Latina mother, which meant I went to Catholic school and Catholic church and all the whole Catholic experiences. We were raised to believe that abortion was a really horrible word. I couldn't say the word out loud. However, the reality was I was raised by a single mom who was also a teen parent. And that I learned really young that having teen parents and being of mixed race and where I found myself socially and geographically actually informed how I was going to think about my own sex, my own sexual identity, my own sexual sort of curiosity. And it got me to the place where I became a peer educator and I went into nursing and then worked at Planned Parenthood and found that those unique identities I held actually made me super relatable to all the people who were showing up as me as a healthcare provider in that space.

(11:26):

And the more that I could get people to understand that it is super important to show who you are and say who you are to actually build that humility and to build the rapport that you need in the healthcare context. If you're putting in a catheter with somebody and you're maybe taking blood or they're going to give birth, you want to show some vulnerability and relate to them as a person, which means you have to know who you are and where you come from to recognize yourself and somebody else. And that's just me speaking from the healthcare provider experience. But then that I have carried that with me in all that I've done, and I think it has made the difference. Rada found herself in a different place, but we meet up and we share that value so much. And so if you want to add to that, please, please do.

Rada Yovovich (12:15):

Yeah, I mean I love everything you just said, but I guess I would add that I think a big part of doing the hard parts of this work are, they mean a lot of reflection. They mean a lot of self-awareness. They mean a lot of noticing what you have easy access to and what you do not have access to. And that is, I think that's an extension of the humility that Chanté's talking about. And I think that, for example I think that sometimes folks are embarrassed about what they can't observe, and they see that as a deficiency when I think that it's difference. And what I mean by that is that I have a perspective as a white person body moving through the world that grants me access to certain types of witnessing certain types of parts of life where I can see certain power structures.

(13:22):

And I have a really hard time seeing other power structures. And so specifically I would say that one of the things that we've been talking a lot about is really trying to get folks to notice inequity. And I think that there's a lot of work that goes on where we pretend that inequity doesn't exist or we don't take the time to acknowledge how it's playing out in the system, and that our identities in this room are, as virtual room are part of that potential system. Even among the three of us, we're flat, we're having a conversation, you're moderating. So there's a positional authority there, but there's also gender, racial orientation, ability, ability. All of those pieces are unspoken in the dynamic of this conversation. And so being able to say them out loud and saying, okay, given my queerness, what does that mean for how we need to be aware of the language we're using and how it's going to impact me different than other folks given Chanté's blackness? How do we need to be aware of the ways that assumptions of best practices and business as usual are going to be built in opposition to her success? Right? So naming those things and saying, those aren't, we need to bring those in. We need to acknowledge them.

Rebecca Gwilt (14:44):

Yeah. Yeah, I absolutely agree. And what you're talking about a little bit here are two different dimensions of the work that you do, one of which was not top of mind for me when I approached you with this idea to have this conversation, and I really want to, it was when it was made visible to me, it totally clicked and made sense and really resonated with me. So I want to make that visible for others and that I came to you saying, let's talk about how important it is and how difficult it is to integrate a DEIA strategy. We're going to get to the definition of that soon into your healthcare organization. And I was talking about people, I was talking about people ops, which is the term that you just used. I was talking about our relationships with each other, and it's certainly about that.

(15:39):

But what you have revealed to me is it's about a lot more than that. And we have to think, especially those of us in healthcare, a lot more expansively than that. And Chanté, you shared a really moving story with me, but it was acknowledging that we've got problems not just in our companies, but in the products we're building in the healthcare sector. We've got problems that we're not helping to fix in the organizations we're selling into in the healthcare system. So I'd just like to give both of you either the opportunity to talk about your reaction to me maybe when I said, let's talk about DEIA and healthcare and what that means to you.

Chanté Martínez Thurmond (16:19):

Our first couple of thoughts were like, hell yes.

(16:25):

And do you have all day, right?

Rebecca Gwilt (16:28):

You might have to break this into a two-parter.

Chanté Martínez Thurmond (16:31):

I mean, totally. We're here for it because this is actually really important because why healthcare touches everybody in this country and beyond, it is something we believe is a right that everyone should have access to health. And we believe not only that health is the absence of disease, we really think about wellbeing as well. And that's something that we intentionally bring into our consultancy and we name explicitly. But actually before we get into maybe DEIA as a strategy in the application or in the context of healthcare, I do want us to talk a little bit about the words we can define DEIA for you, so that if anybody's like, what the hell is this acronym? And you're using this alphabet soup with me, we can do that for you and we'll kind of redo

Rebecca Gwilt (17:17):

I added it, I added an ampersand as well.

Chanté Martínez Thurmond (17:21):

Oh yeah, no, it's fine.

Rebecca Gwilt (17:23):

Set me straight here.

Chanté Martínez Thurmond (17:24):

I mean, hey, there's a lot of cool, I've seen lots of different acronyms and in different order, and so we're here for all of it. But why don't we go ahead and orient the listeners to that and then tell you how or share with you our approach and framework that we use to help us Rada would, do you mind usually do this one person? Sure. You're really good at it.

Rada Yovovich (17:48):

This is one of my <laugh>, this one, my spiels. Your signature. Sure. Yeah sure. So like Chanté said, we've been seeing every, the DEIA space is blowing up right now and all sorts of folks are making all sort well, and all sorts of folks are making all sorts of acronyms. And like Chanté said, whatever your acronym is, we love it. It's great. It's cool. Not about the acronyms to us, but

Rebecca Gwilt (18:15):

Ampersand is fine.

Rada Yovovich (18:17):

Yeah. Love an ampersand. Love an ampersand. So when we say DEIA, the words that we're using here are diversity, equity, inclusion, and accessibility. And I'll give just super high level. We've got our own podcasts and articles and stuff like that that go into great depth about all these terms.

Rebecca Gwilt (18:36):

But that's right, we'll link to it in the show notes.

Rada Yovovich (18:37):

Perfect. But all the high level here, diversity is about numbers. It's about who's in the room, what are the people, how do we count different types of identities that are being represented in this space. So it tends to be a pretty quantitative sort of piece of it. Equity is about fairness. When people are here when they're in the room, are they being treated fairly? And we specifically like to distinguish between equity and equality where equality is, everybody's getting the same treatment, and equity is everyone's getting the treatment that supports their success or meets them where they're at. And by that, I mean those two things are different because of the systems of inequity that we see different heights, tall and short, are not actually objectively, one is not objectively better than the other, but given a structure that is built for tall people, short, people need a boost literally to be able to see over the wall.

Rebecca Gwilt (19:44):

Yeah, there are great illustrations of this as well. Yeah,

Rada Yovovich (19:48):

I'm going to tree tilting the fence.

Rebecca Gwilt (19:51):

Yeah, the fence,

Rada Yovovich (19:52):

The shoe size is another one. Giving everybody the same shoe size would be equality, giving people the shoe that actually fits their feet would be equity. Right?

Rebecca Gwilt (20:00):

Yeah, that's great. I love the visual.

Chanté Martínez Thurmond (20:01):

And that's also assuming that everyone has a foot to put the shoe on <laugh>.

Rada Yovovich (20:06):

Correct. Exactly. Yeah, exactly. Gives, even saying shoe is the solution is already kind of ableist. Yeah. Yeah. So that's diversity, equity, inclusion is this piece about, okay, if everybody's in the room, are they not just being treated fairly, but are they being hurt? Do we have the systems to say, you belong here. Your difference is actually a value add in this space instead of something we tolerate. And we talk about this umbrella, some people think of an umbrella of culture, and you're trying to fit as many types of folks under that umbrella and try and kind of jam 'em in there. We're kind of inviting a, let's think about culture add instead of culture fit. And let's say when you get somebody who has a quality identity lived experience that is not already represented in this group, that is your umbrella getting bigger.

(20:59):

And that's a really important way of thinking about inclusion. And last is accessibility which is really just how do they get here? And there's the physical, literal accessibility of can they get to our office? Can they attend this meeting? And there's also, and there's ADA technology accessibility, but there's a whole bunch that are not strictly around classic definitions of ability, accommodations for folks with kids. We've got caretakers in the house making it so that meetings, projects, et cetera, are accessible to those types of folks so they can even show up. And the last thing that I'll say about these words is that the first thing we do is we kind of challenge the order of the words. Honestly, I think if we had our druthers, we would choose a acronym that didn't have the word D in it at all. Because we find that tends to be something that folks get blinders on and they get two focused on. And it ends up being a bit of a vanity metric, and it sends people astray a lot when you focus on recruiting as if it's a primary thing.

Rebecca Gwilt (22:11):

You're, yeah, if it's quantitative, then it seems like an easy thing to solve for, right?

Rada Yovovich (22:17):

When really it's a lagging metric, right? That it is. It's not the metric that we like in analytics and data science, we talk about leading metrics and lagging metrics and leading metrics are the ones that you actually take action toward. And lagging metrics are consequences. And so we talk about diversity and belonging as consequences of doing accessibility, equity, and inclusion correctly. I see. So doing those three things well leads to the consequence of diversity and belonging rather than aiming for diversity. And that can kind of spend a lot of money and energy with very little actual results.

Rebecca Gwilt (22:56):

Or something that looks like results but is not felt.

Rada Yovovich (23:02):

Yeah. Well, not long term results. They tend to be short term. When you kind of go the diversity route, you get a lot of turnover and stuff like that. So we really like to start with accessibility and say, who can even get here? Doesn't matter how ly you're treating or how inclusive you are, if they can't, even

Rebecca Gwilt (23:20):

If they're not. Yeah. Right.

Rada Yovovich (23:22):

And then move to equity and inclusion and then see the fruits of diversity and belonging as a consequence.

Rebecca Gwilt (23:29):

So that's really helpful. In fact, if I could lift that and put it right at the beginning here, I, because I think defining this was the first thing I had to do to educate myself. I run a business, and we talk about this often in that context as well, but you've seen this play out in all sorts of ways. When you are working with a client who has said, increasing accessibility and equity in my organization is important to me. Help me do that. Do I talk about what's inside the four corners? What do you put in that bucket? And are they usually as surprised as I was to learn how this works?

Chanté Martínez Thurmond (24:19):

So they usually, anybody who says that, we're like, okay, now you're woke because you're evolved to saying, I want to start with equity. And inclusion is a huge signal.

Rebecca Gwilt (24:36):

Mean as opposed to starting with diversity, we have diversity problem. I see. Okay. Yeah.

Chanté Martínez Thurmond (24:41):

Most people are coming to us and saying diversity as the number one issue and we're interesting. Okay. That says all that tha tells us a lot. And there's a lot of ways I can go down this path, I guess. But I'll say a few things. And then again, Rada, please keep me honest here and add. But the first thing is that folks often start with their biggest pain point. And most recently it has been talent. It has been like if you Google search anything about the great resignation right now, you'll be like, oh, but you'll get a ton of pages and pages of

Rebecca Gwilt (25:23):

My last podcast would show up.

Chanté Martínez Thurmond (25:26):

Okay. And I argue that that's not necessarily true. I don't know that people are resonating in droves and hundreds of thousands. I mean, I think that what's true is that people are sick of the system. And so I want to actually talk about something that's really important in the context of diversity, equity, inclusion, accessibility. We hear it a lot with related to racism and inequities, but there are sort of four or five levels of this. There's the intrapersonal racism that we talk about. There's interpersonal between you and I. There is cultural stuff that can show up. There is the institutional meaning at a company, you're going to experience inequities or racism. And then there's systemic issues. And where I frankly feel that the people have the of the world or United States specifically, cause that's where we're located, the conversation has been focused a lot on interpersonal racism, interpersonal inequities, and this fighting that we have or this sort of tribalism that exists, which is absolutely true, mean to just reduce it to that though, is the problem.

(26:38):

Because what is actually at play here is systemic issues that have been created by this ecosystem that we find ourselves in. And it's not just unique to the United States. This is a global thing. And I believe that if we went and colonized Mars, it would follow us there. Why? Because we are unique and complex and adaptive systems ourselves as people. And so wherever we go, our problems follow, but we find ourselves in a system. And so I say that to not talk about that and to not address that is I feel like our biggest disservice. And part of the reason why you sometimes have CEOs and venture and venture capitalists not understanding, literally being perplexed as to why they're like, I paid such and such. I gave you all a budget to fix this. And they're like, what's wrong? And we're like, why? Because you all play in a system called capitalism, literally.

(27:41):

Okay. And that system, let's talk about the elephant in the room, that the system itself, the way it was designed and has been operated and has effectively been run for hundreds of years, is to be extractive, is to not put people first. And so if we're in a system that does not put people first, it feels really weird to be like, tell me about your identities. Tell me about your unique intersection realities. And because the system doesn't reward for that, we actually have to put people last in the system that we're playing in. And so I feel that that's where we are. That is the truth. I want to ground us in that reality and to short demonstrate and to the listeners that this is much more than a micro issue and it's a macro issue at the same time. There's lots of things at play. And because of that,

Rebecca Gwilt (28:38):

Oh, sorry, go ahead.

Chanté Martínez Thurmond (28:39):

No, no, go ahead.

Rebecca Gwilt (28:41):

I was just going to ask, because we are likely not going to dismantle capitalism, but if we want the world to be better, more equitable, and we want our work spaces and environments to be more inclusive how do we solve for that? How do we solve for that without dismantling the system? How do we improve things?

Chanté Martínez Thurmond (29:09):

Well, we do want to dismantle the system. Let me just say that. We do, and that's I do think that's unique to what we do. Literally, we dream of the future, and that's part of our actual consultancy is dreaming the future. And I think to do that, you can still live in a house and build a new one. There's nothing wrong with that. You see people right now building the metaverse. Well, there's an opportunity there as well. And I think in the age of digital health, they're building digital healthcare facilities and experiences. So this is an opportunity for us to transition the conversation into what we do best. But like I said, people are thinking about it from this interpersonal issue that exists, which is like, let's talk about unconscious bias and let's talk about racism. And I'm like, you, yes, we can do that, but it doesn't really do us the greatest service if we're not going to also acknowledge the fact that there's systemic issues at play. And so raa, if you wouldn't mind talking about some of that, because I know I want to do it in the spirit of time to transition us there.

Rada Yovovich (30:17):

Yeah, well, what I was going to say is that a really big piece of doing this work is not just change management, but change leadership and transformation. And I hear you, Rebecca, sort of saying, well, that if it's outside of my scope, how can I take action on it? I personally am not the agent of change for, the system of capitalism. And I think that what we're saying is, but maybe you are right. And then the two really important pieces of how we think about this change, one is that it's really, really important, this idea that I hear Chanté sort of teasing out for us here, that is think global, act local, where there is, it's really important to hold this north star vision of what is that dream of the future and to be firmly rooted in where we are right now. And that every day we have thousands of decisions that we make that can either be pointed in the way that it traditionally has been, which is away from equity and away from justice.

(31:21):

The default is toward supremacy culture. So we have a thousand decisions every day as individuals and in our organizations and in our communities, and the spheres of influence that we move through to make those decisions point toward that north star. Each of us has those. And that's where that intrapersonal, right? Because we're both simultaneously saying, you have to zoom out to the system and be aware of the air we're breathing. And you have to be deeply rooted in self-awareness before you even start thinking about your interpersonal pieces, intrapersonal. And so that's piece number one. And I think the other piece that I want to name really quick about, and this one's a quickie for the change management piece, is both having that aspiration and dream for what's possible while you're loving where we are. That it's not that this is broken and that this is bad and we need to reject it, but that we need to notice what's working here, what's really, really good about what we've built and how do we leverage and build on that and do that asset-based approach to say, I don't want to talk about fixing deficits.

(32:26):

I want to talk about building possibility and taking assets and resources and saying, how do I channel this into something that I dream of?

Rebecca Gwilt (32:34):

So I love this framing because I think it actually is what my clients are dealing with day to day, which is trying to be firmly rooted in a healthcare system that it's complex and in many ways broken and siloed and overregulated, some would say and having their businesses be firmly rooted in that now the current, and still be able to see over here the possibility where things could be, if the right now looked a little different, how we could be better, do better, serve better if the world didn't look like it looked today. And I think the, it's probably why you all have been successful. That framing probably resonates with folks like that.

Rada Yovovich (33:31):

I think that's right. And I would go so far as to say and I'm not making this up, not sure who said this first, but the system is not broken. It is designed right to work exactly how it's working. And those design constraints that we brought in the very beginning of healthcare's inception in this country were oriented toward objectives that made a lot of sense at the time, and were solving some really important problems and created other ones around inequity and supremacy and stuff like that. So actually, and I think that's actually a really important distinction because which has been designed can be redesigned, right? And that there is always this opportunity to be revisiting and naming those constraints and naming those design objectives and naming what success looks like, and then rebuilding. And we rebuild the wall or rebuild the house brick by brick. We're moving it from this place to this place. We're eating the elephant one bite at a time. Again, choose whatever metaphor and analogy feels good but that's the only way that we're going to get anywhere.

Rebecca Gwilt (34:41):

Yeah, I mean, I believe that wholeheartedly. Absolutely. Okay. So we don't start with hiring diverse candidates. That's not our first step. I'm a company that believes in these are my values. I know this is good for business, and I know it's the right thing, and I know it's what my people want. Where do I start?

Chanté Martínez Thurmond (35:06):

We feel like culture is a really great place to start because it can address so many of the things that people ideally want to come to you for, which is yes, actually, if you address the culture, it requires you to start to take an examination of what's in the room and who is not in the room. And so you will get to the identities, pieces, and diversity as an outcome or as a consequence. And when you truly address the culture, you may also start to hear the people who work for you or your customers or the constituents in which you serve start to tell you the realities in which they're finding themselves in. And so culture can be internally and it can be externally to that organization. And so that is one thing that we feel like we're in the business of. It's helping people design inclusive, equitable, and accessible cultures, but we also help them design product services and offerings that match that culture.

Rebecca Gwilt (36:13):

It's surfacing for me a bunch of cringey moments that we all witnessed last year when companies started with their external culture before they address their internal culture and forgot exactly that their internal people were going to be seeing it. So I would assume and confirm for me that to Tara's point, looking inward first, it's probably the place to start.

Chanté Martínez Thurmond (36:40):

It is. And it is as a person as well. It is actually as a leader as well. It's really important to start with yourself. But it's interesting because in the context of healthcare specifically, the reason why we find that this is so important, and it's worth spending a few minutes on, is that we did specifically notice healthcare companies putting out statements and saying that they were going to be down for the cause in relation to George Floyd being murdered and Breonna Taylor being murdered. They were outraged, and they were like, we're going to do something about it. And we saw all this movement in awesome activism in terms of being stated from healthcare organizations. And we were like, yes. But where we found the disconnect was that they went to the communities and the patients first. And I'm like, has anybody forgotten that? If you're a healthcare organization and likely a health system, you're likely the biggest employer in town as a fact.

Rebecca Gwilt (37:39):

Right. Right.

Chanté Martínez Thurmond (37:41):

And that your patients and your community members and your employer and your employees are inextricably linked. They are the same. You can't do anything for the community if you're not taking care of your employees because your employees live in the community and they're going to talk about their experience. And if you're doing everything right, they're going to come to your healthcare system. And if they're not coming to your healthcare system, that tells you a lot about the services that you're doing or that you're not actually meeting people where they are. And this is the experience of a lot of healthcare workers, especially allied healthcare workers. My mom is an allied healthcare worker. She can't get time off from work to go to the doctor. My mom is an allied healthcare worker and has a lot of issues with accessibility to care. It's not because she is not educated and doesn't have a daughter that went to nursing school. It's not because she doesn't have a car or transportation. There's a lot of other things about her unique lived experience that make it impossible for her to get to her doctor's appointment, helps her be a healthier patient and a healthier employee that the healthcare health system is caring on their insurance. So it's for everybody's benefit that she gets to do this, but they don't have the time because of the system that we're in healthcare to stop and make that a reality right now.

Rada Yovovich (39:08):

And I think that one of the things that we're kind of pointing to and that people, this question of values comes up a lot. And I think that when people are doing these signals, they're saying, we we're making statements, we're taking action, albeit maybe not necessarily always the most informed action. One of the things that folks talk about is what are our core values? And core values are super, super valuable if you live by 'em, right? If at every level, from the very top to the most junior, and in every level of detail, most strategic to the most tactical, that we're holding those true. And we're saying, okay, is this meeting agenda consistent with these values that we've stated? And one of the things that's tricky is that we don't typically put in our value statements that one of the most important values is keeping this business alive and being able to financially sustain everyone who works here.

(40:13):

And that is also a very important value. And we can't pretend like it's not a part of this landscape. And so the practice not only of always guard grounding back in those values, but going far enough to acknowledge and hold when our values are at odds, when there's tension between those values. Because it is always the case that there are tension that values compete, and that complexity is part of the lived human experience. And if we pretend that it's not true and we bypass that, then we end up defaulting most often to traditional systems that reinforced inequity and supremacy and things like that. And so we really, really urge folks to hold those values, dear, including the part where you can't hold them dear because there's something else you have to do. And saying that out loud and saying, okay, in this instance, I'm valuing blank even over blank,

Rebecca Gwilt (41:13):

Right. Right. Yeah. I read, I'm reading a book right now called What It Takes, and I'm going to forget the author right now, but it's a book about the world's top companies, all of them in this capitalistic system. But one of them was a story about a company that had this values tension, and the old CEO said, customers first always. And the new CEO coming in the next generation sort of said, well, okay, but I think our people are also quite important. And it was a massive fight that happened within this company about their sort of core values. And it was the first time that I had, first time I had thought about this concept that you're going to make, your values are going to show themselves to you. Saying them out loud and using them as tools to make decisions that are in line with them is absolutely the only way that you get people to trust you, basically.

Rada Yovovich (42:19):

Totally. Yeah. And I mean that it has been the topic of so many specific conversations that we've had with our clients is exactly that specific tension. And I think the one other thing that I would throw in also that is one of these aspirational, please do this things is decentralize and distribute. By that I mean voice and choice at every level of every population, every stakeholder. And one of the things that we at the Darkest Horse do is we talk a lot about the distinction between designing four and designing with, and again, we use design as a very expansive term of any kind of sure decision or idea or solution or whatever. And that designing four is how a lot of companies operate, and it tends to be primarily white able-bodied, neurotypical folks designing for as many people as they think they can extract wealth from.

(43:22):

And they design white solutions, white able-bodied, cis- solutions and then just assume that if they give it to people that everybody's going to like it. And that is a very top down, that's very, I am the expert. It's a very kind of, again, supremacy sort of posture, whereas you can shift, how do you shift decision making, how do you shift input? How do you shift this so that we can be designing with and getting participatory design? And in an organization that means voices, that decisions are not just made by the 1, 3, 12 people who are earning the most and have the most education and stuff like that, but are actually being informed and made more decentralized and more distributed.

Rebecca Gwilt (44:08):

And I think the benefits are probably more than twofold. But the two big ones that I've learned in my career are, one, unfortunately the boss doesn't always have the best ideas. In most cases more ideas create a better outcome. And the second big benefit is everybody wants to make their contribution to the world meaningful. We all spend our time working, we all want to contribute, and we all want to have a say in how are the products that our company makes or the processes that we go through, or I don't know, the color of the walls in the conference room, whatever it is. And ultimately, as a business owner, I want that for the folks that work with and for me that they get the same si kind of satisfaction out of us building this company as I do. Okay. So we're coming to the end of our time. I have more questions than I started the day with. But we

Chanté Martínez Thurmond (45:31):

Told you this would take all day.

Rebecca Gwilt (45:32):

I know. Well, I know the two of you personally, so I'll just keep bothering you for private conversations. Yes, please. But so thank you so much, so for joining, and I'll have all of your information in the show notes if anybody else wants to pick your brains or follow you or listen to your podcast. But I wanted to close with maybe one from each of you one thing that digital health innovators can do right now today to supercharge their success as it relates to this conversation.

Chanté Martínez Thurmond (46:11):

One thing? That's hard. I'm kidding. I think that, I guess I'm going to say two things. It starts with self-awareness. Literally just doing your best to take an inventory, take notice of who you are, how we started the conversation with our unique identities. Get in the habit of trying to understand who you are and embrace it and celebrate who you are. And I want to say that a lot of times people will say, I'm white and is it bad? And I'm like, no, that is good. You should recognize and be able to say it comfortably that you are in a white body and that you do see the world through your white gaze. But that to acknowledge it is really important because that means that you have humility. And that also means that perhaps you recognize that that's not the only view in the world. So self-awareness is really important. And then once you get that and you feel comfortable with who you are to recognize, to say, let me go find others, and by others, I literally do mean to find people who are intentionally different than you. Because I feel like the closer you can get to them in proximity and in community actually does expand your worldview. And if you're going to be working in healthcare, that is absolutely needed for the future of this industry.

Rebecca Gwilt (47:32):

It's the work.

Rada Yovovich (47:34):

Yeah. I going to like, yes, I agree with Chanté's. I think I would even bump up the community piece one level and say that we should, that doing this well means both being in community who share with people who share your identities and being where you can be really honest and messy about what it's like to be moving through the world with this body. Because I think that those spaces, those sacred spaces are actually really, really important spaces for healing and honesty, that you can be a little bit safe from doing harm to people who are different from you. And this is, especially from a white perspective, being in community with other white people where we can talk about our whiteness without the harm, the impact on black bodies, by even having that conversation. So I, yes, community, a hundred percent agree. And I think I would also say I have a rule of thumb of listening 10 times about, to the voices, the experts on something before I speak.

(48:42):

So before I try and say anything about what trans-inclusive services will look like, I have been quiet and listened to at least 10 trans identifying folks explain to me what they think. And so I can try and synthesize and make sure that I'm not speaking for someone, but I am lifting up the voices and reiterating and echoing. And so I think that it's like, have you listened to a lot of people who represent the identities that you're noticing are underrepresented in whatever population you're looking at? So again, if you're looking at this diversity question, you're like, wow, we have no black consumers. How many black folks who hold the identities that you or hold, the various demographics and stuff that you wish to invite in, how many of those folks have you specifically personally listened to? How much contact, and this is what Chanté is saying, of being in community, but I actually specifically mean don't just be in community. Be a servant leader. Right? Be humble, be listening. Be a passenger. Be not decenter yourself before you then move into trying to build that bridge.

Rebecca Gwilt (49:57):

I'm ingesting. I'm ingesting. Thank you. Thank you. Thank you so much. I have lots to chew on. Really appreciate your time today and anybody who's listening, go ahead and give us a follow. Listen to The Darkest Horse podcast. Go check out what Rada and Chanté are doing. It's truly radically wonderful, and have a wonderful, wonderful day.

Rada Yovovich (50:24):

Thank so much you.

Rebecca Gwilt (50:25):

Thank you so much.