Stigma, Silence, and Software: What Are We Really Designing?

Today is World AIDS Day. So many people are affected by HIV/AIDS. As a healthcare system, we're failing too many patients. As many of you know, I work with healthcare organizations to help them simplify risk and ensure health equity when bringing in tech. One organization I'm working with is afraid to include a question about HIV status on intake forms, worried it will offend clients or patients. Personal biases at leadership level block the right care, even though we know HIV/AIDS affects so many aspects of health and care. How is it okay to ask about hypertension or diabetes but not HIV? Even in health tech, a field meant to expand care and build trust for people who can't get in-person care or want something more inclusive, there's still stigma around diseases like HIV. 13% of people living with HIV don't know they have it, and many more are lost to care. This organization isn't the first "patient-first" digital health group to raise this concern. I see it all the time. If we can't ask the hard questions, patients pay the price.

The trust gap is the care gap. Trust is the defining requirement for digital transformation. It shapes adoption, outcomes, and whether tech earns a real place in clinical care. The people behind the tools are the true drivers of trust. When patients hesitate to share data, when clinicians doubt algorithm reliability, or when clinicians feel disconnected from decision-making, the innovations we're celebrating stall. If we skip the right questions just to avoid offending a customer or adding another click, we lose credibility. Medicine should be evidence-based and truly patient-focused.

No shiny gadget can fix this. Trust isn't a magic code you can write. We need to rethink how tech is used and how we can deliver the care patients need-without empty promises or shortcuts that assume what "clients" who are ultimately patients want, while neglecting what they truly need. I don't love adding another role to the executive menu, but maybe it's time for a Chief Trust Officer. Someone dedicated to shaping how an organization protects its community, evaluates new tech, and communicates its decisions. Yes, some orgs have this, but it isn't common in healthcare.

As we celebrate the strides we've made with medical innovations-especially in HIV/AIDS-on this day, we should also acknowledge the long road ahead. Communities want evidence that equity is part of the design process. Maybe we need a designated owner like a Chief Trust Officer who can oversee:

- How algorithms are evaluated before they enter clinical workflows

- How clinical and data risks are monitored

- How staff and patients are informed about digital tools

- How equity considerations shape product decisions

- How vendors are selected, vetted, and held accountable

Or maybe health-tech groups should put more clinicians at the table-not just for show-and actually listen when they push recommendations that can boost trust in ways no marketing team can. The kind of trust that leads to referrals. The relationships that move solutions forward and measurably improve outcomes. Time will tell.

Who's Doing It Right: The Cleveland Clinic

Cleveland Clinic is showing what leading on trust actually looks like. Their AI governance work covers model validation, equity review, clinician training, and patient education. They made a deliberate choice to build responsibly from the start in the absence of a regulation or lawsuit.

Weaving appropriate governance into both clinical and digital teams, proves that ethical design makes innovation sustainable and scalable. Although they don't use the title Chief Trust Officer, the function is very much there. If your organizations doesn't have a system in place for governance, trust, and proper workflow optimization, take a look at their model.

Want to operationalize trust across your organization?

Digital Risk Compliance Solutions partners with digital health companies, health systems, and innovation leaders who are serious about building tech that's equitable, clinically sound, and trust-centered.

If you're designing a new AI workflow, gearing up for expansion, or wondering how to govern product decisions with more transparency, let's chat.

Schedule a meeting with me at https://calendly.com/drerkeda/drcs

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