Who are health IT stakeholders? I've made a list to make things a little bit easier for you in understanding the typical health IT or digital health stakeholder. You might have guessed, but clinicians and patients are definitely part of this list, and you can see actually in this picture that the Technology Innovation Center at Johns Hopkins is working with clinicians to think about different software applications that we're looking to build. Engaging clinicians of all kinds is important, so don't just think about your typical physician, think about people like nurses who are at the bedside that could provide a different perspective. Some of the health IT stakeholders you see on this list might not be top of mind. Legal Counsel is just one example. If you're engaging in creating something like a mobile medical app, the Food and Drug Administration actually regulates a lot of mobile medical apps, so you need to think about reviewing those policies and what approvals you might need. Engage with Legal Counsel to guide you through, throughout your design and development. Even something like a marketing professional, if you're branding or promoting your application, you're going to want that guidance as well. There are also less typical healthcare information technology stakeholders or digital health stakeholders. You can see a list here that I've created. These are certainly not exhaustive, but you can get an idea of the type of stakeholders, specifically at healthcare organizations that you might be targeting to pilot or sell your app to. I'll pull out a few for you. One really important one is thinking about the patient's families or their caregivers who might also be using your application, or who might be interacting with some of the data from your application. Think about whether they'll see things like test results or treatment information through your application, and how might that information that you provide help them or potentially confuse them and make their lives more difficult. Another one to think about is policy-makers both at the institutions that you're targeting, but also more broadly, so think about security policy, data policy. What could your app violate? and other people that you should be engaging early on to better understand the policies. One stakeholder that people typically don't think about till the very end is the idea of App Stores. Specifically, if you're building a mobile medical app. That includes the Apple iOS Store and the Google Play Store. These stores have very specific recommendations and policies that you have to follow, especially if you're creating healthcare technology. Don't wait until the last minute to read through their policies and reach out for clarification if necessary early on. You will also want to pay attention to overlooked stakeholders or extreme users. In addition to thinking about use extreme users for designing your app, you'll also want to think about who are your extreme stakeholders you need to engage. These are people who often aren't considered. They're not part of the main group that you're considering, but they're really important because failing to address their issues can cause really big problems later on. How to address extreme users. Consider connecting with those who know about accessibility. By accessibility, I mean, people who can tell you about how to deal with screen readers, color blindness, any issues of dexterity, thinking about those things in your app. You also are going to want to speak to or engage people who might speak another language specifically if your app is targeting people that may speak a language other than English. What do you do with users who aren't familiar with apps in general, who maybe have low technology literacy? Maybe they don't have a smartphone, maybe they don't have Internet access. If you need to address those users, you need to be engaging them and thinking about them from the beginning. You also are going to be needing to consider extreme or super-users. To demonstrate what a superuser and extreme user is, I'm going to give you a little bit of an example that's used pretty often, and it's the shopping cart example. If you are a designer working on a shopping cart, redesigning a shopping cart, you would think about your superuser as maybe a mom or a dad who has four children whose at the grocery store and by themselves with their cart piled high. They really just need to get out the door, and they have a lot of extreme needs. On the other end, there's the extreme user, which would be more of an edge case. Somebody who's using the shopping cart in a way that you didn't intend. If you haven't guessed yet, the person that this would be, would it be a person that is homeless? Someone who has actually uses your shopping cart to carry important goods for their lives. You may want to consider this in designing your shopping cart, and same goes for your digital health app. Think about how people might use your app in a way you didn't intend and design for them. After you understand who your stakeholders are, you're going to want to understand a number of factors about them. Mostly about what and how they think. First, you probably want to understand the role, whether they are a user of your application, a customer, a buyer, or the person who signs the checks, an influencer, or somebody who can really influence how people use the application, or a saboteur. Somebody who could potentially block the use of your application. It's really important in healthcare to note that users, customers, and buyers are very much different people most of the time. A lot of times if you were people shopping for your application may be really excited about using it, but they're not the ones signing the checks. In addition to knowing what the role is that these people play, you need to know a little bit about how they think, what their expectations are, their opinions or values, and specifically what their priorities are. Keep in mind that in healthcare, a lot of times priorities do still follow financial priorities. Make sure you understand where the financial priorities are in the organization that you're thinking about selling to. All of these things are really important to stakeholder engagement and making sure that your application is successful.