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If you feel uncomfortable coming to the clinic for an existing appointment we will waive the cancellation fee at this time."}],"markDefs":[],"style":"normal"},{"_key":"ed9564179106","_type":"block","children":[{"_key":"ed95641791060","_type":"span","marks":[],"text":"What precautions is Tia taking to keep the clinic safe?"}],"markDefs":[],"style":"h4"},{"_key":"5c178de63b34","_type":"block","children":[{"_key":"5c178de63b340","_type":"span","marks":[],"text":"We’ve increased the frequency of cleaning public areas (including door handles, elevator buttons, light switches, iPads, etc.)."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f1c9cacdc550","_type":"block","children":[{"_key":"f1c9cacdc5500","_type":"span","marks":[],"text":"Per CDC guidelines, we are using cleaners and sanitizers with a 60% or greater concentration of alcohol. Sanitizer can also be found throughout the Tia Clinic and, of course, at the front desk."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"452e17203bf3","_type":"block","children":[{"_key":"452e17203bf30","_type":"span","marks":[],"text":"We are screening all patients at check-in and taking appropriate actions as needed, providing masks when appropriate."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"6145708f2f49","_type":"block","children":[{"_key":"6145708f2f490","_type":"span","marks":[],"text":"We’ve confirmed the laundry cleaners and cleaning team for the Tia Clinic are taking additional measures to ensure everything is clean."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0dbf7d015849","_type":"block","children":[{"_key":"0dbf7d0158490","_type":"span","marks":[],"text":"And of course, the Tia Care Team 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you’re not high-risk, you may have the highest impact on the containment of coronavirus. Building a social contract with Tia."}],"markDefs":[],"style":"large"},{"_key":"6fe479be2c38","_type":"block","children":[{"_key":"6fe479be2c380","_type":"span","marks":[],"text":"Being social — togetherness — is what keeps us ticking, transforms the bitter moments in life to sweet ones, and, quite literally, gives us *pleasure*. Research shows that social ties reduce mortality risks among adults with documented medical conditions. Additionally, supportive interactions with others benefit the immune system and help to reduce allostatic load (the cumulative wear and tear on your body from stress — especially chronic stress)."}],"markDefs":[],"style":"normal"},{"_key":"a4fbd5add1dc","_type":"block","children":[{"_key":"a4fbd5add1dc0","_type":"span","marks":[],"text":"So, how in the world are we supposed to do this in the landscape of the coronavirus outbreak?"}],"markDefs":[],"style":"h4"},{"_key":"13405ba8c166","_type":"block","children":[{"_key":"13405ba8c1660","_type":"span","marks":[],"text":"If you’re confused about what to do right now, you’re not alone. It feels like there are different recommendations coming from everywhere and making sense of it, is no easy task. Ultimately, the choices in how *you* navigate through this bizarre time are up to you. These choices are likely dependent on a number of factors such as local context, work obligations, personal health, signature-stress type, etc. We’re here to offer a little more context to help you make more informed choices with confidence."}],"markDefs":[],"style":"normal"},{"_key":"bf40a011b81c","_type":"block","children":[{"_key":"bf40a011b81c0","_type":"span","marks":[],"text":"First things first, what is a social contract? It is an implicit agreement among the members of a society to cooperate for the social benefits of many, rather than few. Cooperation in this agreement may include sacrificing individual freedoms (not going on that hinge date, canceling wine club, or swapping your favorite yoga class for a run outside instead). Here we’ll break down how we’re thinking about the choices we’re making from an individual, local, and global perspective:\n\n"}],"markDefs":[],"style":"normal"},{"_key":"67637d4945af","_type":"editorialImageCarousel","items":[{"_key":"48f9ed2e95f9","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-31cfec25082371da7aba4ca3c4426b97d309fb99-2103x195-png","_type":"reference"}}}}]},{"_key":"bde8d32c1f03","_type":"block","children":[{"_key":"bde8d32c1f030","_type":"span","marks":[],"text":"At Tia, we’ve shared recommendations on how to prepare for coronavirus:"}],"markDefs":[],"style":"normal"},{"_key":"d1f26547da7e","_type":"block","children":[{"_key":"d1f26547da7e0","_type":"span","marks":[],"text":""},{"_key":"d1f26547da7e1","_type":"span","marks":["5aeea2ff1c74"],"text":"Washing hands"},{"_key":"d1f26547da7e2","_type":"span","marks":[],"text":" (obvi!)"}],"level":1,"listItem":"bullet","markDefs":[{"_key":"5aeea2ff1c74","_type":"externalLink","url":"https://www.instagram.com/p/B9j8LnEpJZG/"}],"style":"normal"},{"_key":"9459b6fdf013","_type":"block","children":[{"_key":"9459b6fdf0130","_type":"span","marks":[],"text":"Setting-up your "},{"_key":"9459b6fdf0131","_type":"span","marks":["9c95530d7427"],"text":"medicine cabinet"},{"_key":"9459b6fdf0132","_type":"span","marks":[],"text":""}],"level":1,"listItem":"bullet","markDefs":[{"_key":"9c95530d7427","_type":"annotation","text":[{"_key":"c7d542418228","_type":"block","children":[{"_key":"c7d5424182281","_type":"span","marks":["0742c180e4e9"],"text":"Learn more"},{"_key":"c7d5424182282","_type":"span","marks":[],"text":" about what to include in your medicine cabinet in the Coronavirus climate."}],"markDefs":[{"_key":"0742c180e4e9","_type":"annotationLink","reference":{"_ref":"12f61670-b812-4d44-85bb-7865737b7a5a","_type":"reference"}}],"style":"normal"}]}],"style":"normal"},{"_key":"26c60024ce7e","_type":"block","children":[{"_key":"26c60024ce7e0","_type":"span","marks":[],"text":""},{"_key":"26c60024ce7e1","_type":"span","marks":["23eef6b7547c"],"text":"Proactively preparing"},{"_key":"26c60024ce7e2","_type":"span","marks":[],"text":" you and your household for a number of scenarios that may play out."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"23eef6b7547c","_type":"internalLink","linkType":"text","reference":{"_ref":"84a00f77-6ca4-4dc2-a225-9141889ad4cc","_type":"reference"}}],"style":"normal"},{"_key":"ba02046dd70f","_type":"block","children":[{"_key":"ba02046dd70f0","_type":"span","marks":[],"text":"We do not promote:"}],"markDefs":[],"style":"normal"},{"_key":"b069817c4463","_type":"block","children":[{"_key":"b069817c44630","_type":"span","marks":[],"text":"Stockpiling or hoarding supplies, especially masks which are critically needed for care providers working around the clock right now!"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"727c38242d14","_type":"editorialImageCarousel","items":[{"_key":"0df7908e1a4e","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-3f91d3e1ec95e750d40675f5202a87660383e3a6-2103x195-png","_type":"reference"}}}}]},{"_key":"0b1bee5ad9e8","_type":"block","children":[{"_key":"0b1bee5ad9e80","_type":"span","marks":[],"text":"While young and healthy people are currently considered lower-risk for personally suffering severe illness from coronavirus, it is vital they dramatically alter their daily lives in order to lower risk from a greater local standpoint."}],"markDefs":[],"style":"normal"},{"_key":"9d63dfcbbf5b","_type":"block","children":[{"_key":"9d63dfcbbf5b0","_type":"span","marks":[],"text":"German scientists, some of the first to look at clinical data on this outbreak have concluded two pieces of information that can help us understand the impact of lessening our movement:"}],"markDefs":[],"style":"normal"},{"_key":"84852cc5667c","_type":"block","children":[{"_key":"84852cc5667c0","_type":"span","marks":["strong"],"text":"1. Individuals are most infectious early in the disease."}],"markDefs":[],"style":"normal"},{"_key":"c39adb0ae204","_type":"block","children":[{"_key":"c39adb0ae2040","_type":"span","marks":["strong"],"text":"2. Viral load (how much of the virus is present in an individual) does not necessarily correlate with the isolation of the virus. In layperson terms, you can be carrying and transmitting the virus *and* be completely symptom-free."}],"markDefs":[],"style":"normal"},{"_key":"5a2a54eadbbd","_type":"block","children":[{"_key":"5a2a54eadbbd0","_type":"span","marks":[],"text":"With restricted accessibility and availability to testing right now, one of the greatest measures we can take from a public health imperative is to engage in social distancing. This is because viruses spread easily in dense places (think: a packed subway car, a political rally, or a concert). Social distancing is a spectrum of measures that can be taken to increase the physical space between people in an effort to slow the spread of this virus."}],"markDefs":[],"style":"normal"},{"_key":"2369b328967b","_type":"editorialImageCarousel","items":[{"_key":"12d53cf0cf81","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-b21456f58736739245c4fea78dab025596ab4117-2103x842-png","_type":"reference"}}}}],"spacing":"pys"},{"_key":"1bdc6235dede","_type":"block","children":[{"_key":"1bdc6235dede0","_type":"span","marks":[],"text":"But what about local businesses? What about people who are financially unable to purchase adequate provisions or work from home? What about considerations for public school closings and the children who only receive meals at school?"}],"markDefs":[],"style":"normal"},{"_key":"6e4202ee7324","_type":"block","children":[{"_key":"6e4202ee73240","_type":"span","marks":[],"text":"There aren’t easy answers. But if you have extra resources we encourage you to donate, check-in with loved ones, and members of your community who may be in need."}],"markDefs":[],"style":"normal"},{"_key":"1680cb8b6a27","_type":"editorialImageCarousel","items":[{"_key":"840cbbc22193","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-815484b03ac66c237e154152daa81d310ebce817-2103x195-png","_type":"reference"}}}}]},{"_key":"a96a78e38025","_type":"block","children":[{"_key":"a96a78e380250","_type":"span","marks":[],"text":"As of now, the Department of State is advising U.S. citizens to reconsider all travel abroad. Many areas throughout the world are experiencing coronavirus outbreaks and taking actions that limit mobility (including everything from quarantines to border restrictions)."}],"markDefs":[],"style":"normal"},{"_key":"1a75bfbc9f5e","_type":"editorialImageCarousel","items":[{"_key":"bfce6b14c254","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-0573a6638628b9ddd5fc8ff947443d67643c1cee-2103x1042-png","_type":"reference"}}}}]},{"_key":"752626dacb99","_type":"block","children":[{"_key":"752626dacb990","_type":"span","marks":[],"text":"Global travel is only one aspect of this perspective. Unfortunately, we are able to see examples of healthcare systems that are completely overburdened by this virus. Our actions on an individual and local level must be considered as an ethical imperative for not only our own communities but also at a global level. It is our responsibility to work to ensure that our healthcare system does not grow overburdened. It is through small everyday choices that we can make an impact on the health and safety for all."}],"markDefs":[],"style":"normal"},{"_key":"2df8b636802d","_type":"block","children":[{"_key":"2df8b636802d0","_type":"span","marks":[],"text":"At Tia, we recommend taking some time to build out a social contract that works *you*. 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We know that for many this is creating a lot of anxiety. We want you to know that you are not alone."}],"markDefs":[],"style":"normal"},{"_key":"0ece38579181","_type":"block","children":[{"_key":"0ece385791810","_type":"span","marks":["em"],"text":"At Tia, we will continue to put out information that is factual, and tactical for navigating this rapidly changing situation. We will also be extending Tia Care digitally through Virtual Visits via chat and video, starting today with Prescription Refills."}],"markDefs":[],"style":"normal"},{"_key":"64b8368d5087","_type":"block","children":[{"_key":"64b8368d50870","_type":"span","marks":["em"],"text":"By doing so, we can increase the capacity of patients we can service, and also help our patients uphold appropriate “social distancing” by minimizing travel to the Tia Clinic for services that don’t require it."}],"markDefs":[],"style":"normal"},{"_key":"7b914fe65de1","_type":"block","children":[{"_key":"7b914fe65de10","_type":"span","marks":["em"],"text":"In the spirit of proactive preparation, we’re encouraging you, our Tia patients, to prepare your medicine cabinets with any prescriptions and over-the-counter medications you take regularly. Whether you need more birth control pills or an extra-month supply of your thyroid medication, your Tia Care Team is here to help."}],"markDefs":[],"style":"normal"},{"_key":"64d8919052a2","_type":"block","children":[{"_key":"64d8919052a20","_type":"span","marks":["em"],"text":"—Team Tia"}],"markDefs":[],"style":"normal"},{"_key":"c4a26e1d12b9","_type":"block","children":[{"_key":"c4a26e1d12b90","_type":"span","marks":[],"text":"Here’s a step-by-step breakdown of how to get your prescriptions refilled with Tia:"}],"markDefs":[],"style":"h3"},{"_key":"e4189934ca9a","_type":"block","children":[{"_key":"e4189934ca9a0","_type":"span","marks":[],"text":"#1: "},{"_key":"e4189934ca9a1","_type":"span","marks":["64069758741d"],"text":"Sign-in"},{"_key":"e4189934ca9a2","_type":"span","marks":[],"text":" to your Tia Clinic Home."}],"markDefs":[{"_key":"64069758741d","_type":"internalLink","linkType":"text","reference":{"_ref":"8a7e7b1e-7485-4a22-be24-9a2005998452","_type":"reference"}}],"style":"h4"},{"_key":"a695a5600c13","_type":"block","children":[{"_key":"a695a5600c130","_type":"span","marks":[],"text":"#2: Message your Tia Care Coordinator with a list of any prescriptions that do not have refills."}],"markDefs":[],"style":"h4"},{"_key":"d77f925c1940","_type":"block","children":[{"_key":"d77f925c19400","_type":"span","marks":[],"text":"Please be prepared with the name of the provider who last prescribed you the medication you’re requesting and the location of the pharmacy that last filled the prescription."}],"markDefs":[],"style":"normal"},{"_key":"54489d44d3ba","_type":"block","children":[{"_key":"54489d44d3ba0","_type":"span","marks":["strong"],"text":"NOTE:"},{"_key":"54489d44d3ba1","_type":"span","marks":[],"text":" To best service all of our patients who need care, if your prescription has an active refill please call your pharmacist directly. Due to high volume, we’re focusing our care team’s efforts on patients who are out of refills."}],"markDefs":[],"style":"normal"},{"_key":"f733ffbc208f","_type":"block","children":[{"_key":"f733ffbc208f0","_type":"span","marks":[],"text":"#3: Ensure your Tia health record is complete, and double-check that your pharmacy, insurance, and credit card info are all up-to-date."}],"markDefs":[],"style":"h4"},{"_key":"1f6dd2eae5ca","_type":"block","children":[{"_key":"1f6dd2eae5ca0","_type":"span","marks":[],"text":"#4: Depending on your specific prescription, we will either refill via chat, or set you up with a short Virtual Visit with a Tia Provider."}],"markDefs":[],"style":"h4"},{"_key":"a318124a7f23","_type":"block","children":[{"_key":"a318124a7f230","_type":"span","marks":[],"text":"Ahead of a Virtual Video Visit, download "},{"_key":"a318124a7f231","_type":"span","marks":["f53b85e7b451"],"text":"Zoom Video"},{"_key":"a318124a7f232","_type":"span","marks":[],"text":" — a free, HIPAA-compliant video chat that you’ll use to interface with your Tia Provider from your own home."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"f53b85e7b451","_type":"externalLink","url":"https://zoom.us/download"}],"style":"normal"},{"_key":"b03a52dd7769","_type":"block","children":[{"_key":"b03a52dd77690","_type":"span","marks":[],"text":"Be sure you are in a quiet place and enable video — “face-to-face” with your Tia Provider is required by law!"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e9f3d897c599","_type":"block","children":[{"_key":"e9f3d897c5990","_type":"span","marks":[],"text":"Be on time! If you are more than 3 minutes late, you will be charged a cancellation fee and need to reschedule. Given capacity, these are highly valued and limited appointments that should be treated just like in-person visits."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"d830c930c47e","_type":"block","children":[{"_key":"d830c930c47e0","_type":"span","marks":[],"text":"#5: We’ll send your prescriptions to Capsule or CVS for delivery (or your preferred pharmacy)."}],"markDefs":[],"style":"h4"},{"_key":"31bc681710ba","_type":"block","children":[{"_key":"31bc681710ba0","_type":"span","marks":["strong"],"text":""},{"_key":"31bc681710ba1","_type":"span","marks":["strong","25f545173a0f"],"text":"Refill Your Prescriptions"},{"_key":"31bc681710ba2","_type":"span","marks":["strong"],"text":""}],"markDefs":[{"_key":"25f545173a0f","_type":"internalLink","linkType":"text","reference":{"_ref":"cb5582f0-024a-4a80-9425-5ce55f0084ff","_type":"reference"}}],"style":"normal"},{"_key":"393cf690d6d5","_type":"sectionHeader","title":"FAQs:"},{"_key":"27749bc0b50a","_type":"block","children":[{"_key":"27749bc0b50a0","_type":"span","marks":[],"text":"Does my insurance cover my Tia Virtual Video Visit?"}],"markDefs":[],"style":"h4"},{"_key":"79a079ce6386","_type":"block","children":[{"_key":"79a079ce63860","_type":"span","marks":[],"text":"If your insurance plan is in-network with Tia, this appointment will be covered! We will submit the claim to your insurance, and we will be waiving all copays at this time."}],"markDefs":[],"style":"normal"},{"_key":"f7e69bc5d4c9","_type":"block","children":[{"_key":"f7e69bc5d4c90","_type":"span","marks":[],"text":"If I am out-of-network or uninsured, how much will my Tia Virtual Video Visit cost?"}],"markDefs":[],"style":"h4"},{"_key":"fb0ae245869e","_type":"block","children":[{"_key":"fb0ae245869e0","_type":"span","marks":[],"text":"If you are out-of-network with us or are uninsured, the fee for this Virtual Video Visit is $30."}],"markDefs":[],"style":"normal"},{"_key":"2e0d93a21dbb","_type":"block","children":[{"_key":"2e0d93a21dbb0","_type":"span","marks":[],"text":"Will my insurance cover an extra month’s supply of my medication?"}],"markDefs":[],"style":"h4"},{"_key":"122ffae7864a","_type":"block","children":[{"_key":"122ffae7864a0","_type":"span","marks":[],"text":"While we are seeing most payers and pharmacies cover an additional 30-day supply, we cannot guarantee coverage at this time."}],"markDefs":[],"style":"normal"},{"_key":"ca3586354478","_type":"block","children":[{"_key":"ca35863544780","_type":"span","marks":[],"text":"Is the Tia Clinic still open?"}],"markDefs":[],"style":"h4"},{"_key":"d0c57642dc72","_type":"block","children":[{"_key":"d0c57642dc720","_type":"span","marks":[],"text":"Yes, the Tia Clinic is still open at this time. We are rolling out Virtual Visits starting with prescription management, to help increase the capacity of patients we can service, to help our patients uphold appropriate “social distancing” by minimizing travel and keeping both our patients and Care Team at the Tia Clinic safe and healthy."}],"markDefs":[],"style":"normal"},{"_key":"011a4160d68c","_type":"block","children":[{"_key":"011a4160d68c0","_type":"span","marks":[],"text":"If I have an in-person appointment at Tia, should I cancel?"}],"markDefs":[],"style":"h4"},{"_key":"f99e4498f3f2","_type":"block","children":[{"_key":"f99e4498f3f20","_type":"span","marks":[],"text":"Patients who are not experiencing flu/cold symptoms are welcome to come in for any existing or booked appointments. We are re-evaluating this on a daily basis to ensure the safety of all Tia members and the broader community. If you feel uncomfortable coming to the clinic for an existing appointment we will waive the cancellation fee at this time."}],"markDefs":[],"style":"normal"},{"_key":"ed9564179106","_type":"block","children":[{"_key":"ed95641791060","_type":"span","marks":[],"text":"What precautions is Tia taking to keep the clinic safe?"}],"markDefs":[],"style":"h4"},{"_key":"5c178de63b34","_type":"block","children":[{"_key":"5c178de63b340","_type":"span","marks":[],"text":"We’ve increased the frequency of cleaning public areas (including door handles, elevator buttons, light switches, iPads, etc.)."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f1c9cacdc550","_type":"block","children":[{"_key":"f1c9cacdc5500","_type":"span","marks":[],"text":"Per CDC guidelines, we are using cleaners and sanitizers with a 60% or greater concentration of alcohol. Sanitizer can also be found throughout the Tia Clinic and, of course, at the front desk."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"452e17203bf3","_type":"block","children":[{"_key":"452e17203bf30","_type":"span","marks":[],"text":"We are screening all patients at check-in and taking appropriate actions as needed, providing masks when appropriate."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"6145708f2f49","_type":"block","children":[{"_key":"6145708f2f490","_type":"span","marks":[],"text":"We’ve confirmed the laundry cleaners and cleaning team for the Tia Clinic are taking additional measures to ensure everything is clean."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0dbf7d015849","_type":"block","children":[{"_key":"0dbf7d0158490","_type":"span","marks":[],"text":"And of course, the Tia Care Team is:"}],"markDefs":[],"style":"h4"},{"_key":"023d82a7f9e3","_type":"block","children":[{"_key":"023d82a7f9e30","_type":"span","marks":[],"text":"Being extra vigilant with hand washing and sanitizing between all patient visits."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"c4507722e598","_type":"block","children":[{"_key":"c4507722e5980","_type":"span","marks":[],"text":"Minimizing touching their faces, eyes, mouths, and hair."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"6faf255c95fc","_type":"block","children":[{"_key":"6faf255c95fc0","_type":"span","marks":[],"text":"Minimizing wearing jewelry as it can harbor bacteria."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e6164ec80ded","_type":"block","children":[{"_key":"e6164ec80ded0","_type":"span","marks":[],"text":"Tying hair back and trimming 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With this in mind, we want to help you prepare mentally, physically, and emotionally in this continually changing landscape of coronavirus."}],"markDefs":[],"style":"large"},{"_key":"5e173cca12c9","_type":"block","children":[{"_key":"5e173cca12c90","_type":"span","marks":[],"text":"In the following, you will find a breakdown of some of the terms you are likely hearing on repeat and the actionable things you can do to prepare for any scenario — with confidence."}],"markDefs":[],"style":"normal"},{"_key":"2b58b67061d0","_type":"sectionHeader","title":"Real talk, what is quarantine and how does it work?"},{"_key":"3449573a9770","_type":"block","children":[{"_key":"3449573a97700","_type":"span","marks":["strong"],"text":"Quarantines"},{"_key":"3449573a97701","_type":"span","marks":[],"text":" help to protect the public by preventing exposure to people who have or may have a contagious disease. Quarantine guidance comes from elected officials and can be mandated to protect the public by preventing exposure and encouraging containment. separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a1f8064a6f67","_type":"block","children":[{"_key":"a1f8064a6f670","_type":"span","marks":["strong"],"text":"Here are the definitions to some other terms you might be hearing a lot of:"}],"markDefs":[],"style":"h4"},{"_key":"950c2199ce6d","_type":"block","children":[{"_key":"950c2199ce6d0","_type":"span","marks":["strong"],"text":"Isolation"},{"_key":"950c2199ce6d1","_type":"span","marks":[],"text":" separates sick people with a contagious disease from people who are not sick."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f48ad4fd815b","_type":"block","children":[{"_key":"f48ad4fd815b0","_type":"span","marks":["strong"],"text":"Social distancing"},{"_key":"f48ad4fd815b1","_type":"span","marks":[],"text":" is the practice of limiting exposure to the general public. This means avoiding crowded places, groups, events, and working from home if that option is available."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0afa0fcffa8a","_type":"sectionHeader","title":"How do I (and should I) prepare?"},{"_key":"4aa247058e6f","_type":"block","children":[{"_key":"4aa247058e6f0","_type":"span","marks":[],"text":"To be extra clear, NYC is *not* in a mass state of quarantine like Italy. All that said, preparation is smart for all of us — especially given the speed at which things are changing. With this in mind, here are our quick recs for the varying degrees of quarantine and isolation"}],"markDefs":[],"style":"normal"},{"_key":"5d8986c28dab","_type":"block","children":[{"_key":"5d8986c28dab0","_type":"span","marks":["strong"],"text":"#1: Stock up on your meds"}],"markDefs":[],"style":"h4"},{"_key":"c0b956868129","_type":"block","children":[{"_key":"c0b9568681290","_type":"span","marks":[],"text":"If you take any prescriptions or over-the-counter medications regularly, we recommend stocking up and having an extra month supply in the case that you are not able to get to a pharmacy."}],"markDefs":[],"style":"normal"},{"_key":"e7d61ca16a14","_type":"block","children":[{"_key":"e7d61ca16a140","_type":"span","marks":[],"text":"Starting tomorrow, your Tia Care Team is here to help you prep your medicine cabinet (think: getting your birth control refilled ahead of schedule or any other important medications!)."}],"markDefs":[],"style":"normal"},{"_key":"59ae8676adc7","_type":"block","children":[{"_key":"59ae8676adc70","_type":"span","marks":[],"text":"Stay tuned for more on Virtual Visits from Tia tomorrow."}],"markDefs":[],"style":"normal"},{"_key":"4184108d7692","_type":"block","children":[{"_key":"4184108d76920","_type":"span","marks":["strong"],"text":"#2: Fill up your pantry (and your fridge)!"}],"markDefs":[],"style":"h4"},{"_key":"0029e42007da","_type":"block","children":[{"_key":"0029e42007da0","_type":"span","marks":[],"text":"While there’s been a land grab for hand sanitizer, TP and bleach, don’t forget that it’s food (preferably non-perishable, nutrient-backed food!) that is especially critical to stock up on!"}],"markDefs":[],"style":"normal"},{"_key":"7bb411241527","_type":"block","children":[{"_key":"7bb4112415270","_type":"span","marks":[],"text":"We recommend you get enough frozen and non-perishable foods for a few weeks of eating at home. Look out for a special edition #FoodAsMedicine pantry prep guide coming out in the following week."}],"markDefs":[],"style":"normal"},{"_key":"c9940013f0d3","_type":"block","children":[{"_key":"c9940013f0d30","_type":"span","marks":[],"text":"If you’re a filtered-water person, make sure yours is in tip-top shape and buy an extra as back up!"}],"markDefs":[],"style":"normal"},{"_key":"d7517e764d57","_type":"block","children":[{"_key":"d7517e764d570","_type":"span","marks":["strong"],"text":"#3: Nerd out on logistics for you & your loved ones."}],"markDefs":[],"style":"h4"},{"_key":"68b0e0f05bf0","_type":"block","children":[{"_key":"68b0e0f05bf00","_type":"span","marks":[],"text":"Whether it’s adapting to a WFH schedule, prepping childcare, or thinking through how to protect older relatives who are at greater risk, it’s worth thinking through logistics ahead of time. Over-planning and over-communicating is the name of the game!"}],"markDefs":[],"style":"normal"},{"_key":"a469f457bd90","_type":"block","children":[{"_key":"a469f457bd900","_type":"span","marks":[],"text":"Lastly, remember that we all deal differently — some may want to take greater protective measures like skipping out on a concert or big birthday party. Others may be less concerned or in communities with less risk of exposure. The point is that this is all so personal, you have to account for the individualized factors in *your* life."}],"markDefs":[],"style":"normal"},{"_key":"79868c5db1be","_type":"block","children":[{"_key":"79868c5db1be0","_type":"span","marks":[],"text":"Oh and don’t forget to breathe!"}],"markDefs":[],"style":"large"}],"image":{"_type":"image","asset":{"_ref":"image-8d14e481ad105170b345bd1755904fde4cd1674e-2500x866-png","_type":"reference"}},"publishedAt":"2020-03-11T04:00:00.000Z","slug":{"_type":"slug","current":"proactively-preparing"},"status":"production","subTitle":"The things you need to know and do.","title":"How to proactively prepare for Covid-19","topics":[{"_key":"562c4b4ac5d3","_ref":"f7cd4d35-238d-4aef-85e3-748808982d9b","_type":"reference"}]},"metaInformation":{"_type":"metaCard","metaDescription":"We want to help you prepare mentally, physically, and emotionally in this continually changing landscape of coronavirus.","metaTitle":"Proactively Preparing for Covid-19","openGraphDescription":"We want to help you prepare mentally, physically, and emotionally in this continually changing landscape of coronavirus.","openImage":{"_type":"image","asset":{"_ref":"image-5472319cc8499b0515353fdb0db81c5be6552b9a-5000x1600-png","_type":"reference"},"crop":{"_type":"sanity.imageCrop","bottom":0,"left":0.04728950403690886,"right":0.6435986159169549,"top":0},"hotspot":{"_type":"sanity.imageHotspot","height":1,"width":0.3091118800461362,"x":0.20184544405997695,"y":0.5}},"title":"Proactively Preparing for Covid-19","twitterDescription":"We want to help you prepare mentally, physically, and emotionally in this continually changing landscape of coronavirus.","twitterImage":{"_type":"image","asset":{"_ref":"image-5472319cc8499b0515353fdb0db81c5be6552b9a-5000x1600-png","_type":"reference"},"crop":{"_type":"sanity.imageCrop","bottom":0,"left":0.020761245674740483,"right":0.6124567474048453,"top":0},"hotspot":{"_type":"sanity.imageHotspot","height":1,"width":0.3667820069204142,"x":0.20415224913494756,"y":0.5}},"twitterTitle":"Proactively Preparing for Covid-19"}},"id":"9a4b4de8-7cea-5212-837b-c4f7e5609ad7","parent":null,"children":[],"internal":{"type":"SanityEditorial","contentDigest":"a2fe1a3896842ba3409a13569bff0f7b","counter":232,"owner":"gatsby-source-sanity"}},{"_id":"b100e362-4b40-48ce-9d93-b08acd64841c","_type":"editorial","_createdAt":"2020-08-09T18:55:08Z","_rev":"8ycwaKn5PLURgEeFHA7avf","_updatedAt":"2022-12-28T10:30:34Z","content":{"_type":"articleTabs","main":{"_type":"articleContent","articleColor":"bcraspberry","articleType":{"_ref":"6ebe3848-7078-4bbf-890a-e4cee9852934","_type":"reference"},"authors":[{"_key":"d96ac70826e5","_ref":"620445e8-cfbd-40b4-9bd3-1742868efe78","_type":"reference"}],"cardImage":{"_type":"image","asset":{"_ref":"image-bb9b1c6cced2543da1f76913f5e9a07329adba8d-1366x800-png","_type":"reference"}},"editorialText":[{"_key":"526b73da21d7","_type":"block","children":[{"_key":"526b73da21d70","_type":"span","marks":[],"text":"Did you know you have an extensive microscopic collection living on your skin, inside your body, and in your cells? The majority of them are bacteria, some are tiny fungi microbes, and others are viruses that can infect microorganisms and cells. Every day your body is attacked by billions of microscopic invaders. "}],"markDefs":[],"style":"large"},{"_key":"6e397782cfb9","_type":"block","children":[{"_key":"6e397782cfb90","_type":"span","marks":[],"text":"The immune system, composed of a network of cells, tissues, and their products, is on a constant lookout for pathogens (microorganisms, bacteria, or viruses that can cause disease) that are trying to infiltrate your body. As a result, your body is swimming with different kinds of immune cells — some bear the memory of past infections in preparation for future encounters, some vigorously destroy foreign microbes, and others act as a patrol."}],"markDefs":[],"style":"normal"},{"_key":"0e085434460d","_type":"sectionHeader","title":"The Immune System"},{"_key":"1363d2d8549a","_type":"block","children":[{"_key":"1363d2d8549a0","_type":"span","marks":[],"text":"The immune system can be divided into two main groups: the innate immune system and the adaptive immune system."}],"markDefs":[],"style":"normal"},{"_key":"fd0719c806ce","_type":"editorialImageCarousel","items":[{"_key":"0f7757b71a68","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-5d9131740d4df003b70090536bf5eb62d222269e-2103x792-png","_type":"reference"}}}}]},{"_key":"cb129f66abec","_type":"block","children":[{"_key":"cb129f66abec0","_type":"span","marks":[],"text":"If a foreign virus slips past the physical and chemical mechanisms (eg. the skin or mucus lining the inside the nose), it is met by the innate immune system. The innate immune system responds rapidly with inflammation and engages macrophages and neutrophils, white blood cells that devour, eat, and engulf foreign particles. They express receptors that can sense the presence of a foreign invader and sound a cytokine alarm to the rest of the body, like a loudspeaker announcing that an intruder has sneaked in. Innate immunity is activated in all kinds of injuries and illnesses, everything from a scrape on your leg to a splinter on your big toe."}],"markDefs":[],"style":"normal"},{"_key":"c82f399d546e","_type":"block","children":[{"_key":"c82f399d546e0","_type":"span","marks":[],"text":"Now and again, a microbe comes along that gets past the innate immune system. That is when the adaptive immune system, a true powerhouse, rallies to fight back. Only vertebrates (species with backbones like us) have adaptive immune systems, the third layer of defense that adapts to protect against foreign pathogens. Over 99% of organisms on Earth don’t have adaptive immune systems and get along fine with only natural barriers and the innate immune system for defense."}],"markDefs":[],"style":"normal"},{"_key":"072d5f18d7ad","_type":"block","children":[{"_key":"072d5f18d7ad0","_type":"span","marks":[],"text":"When you get a cold, flu, or the novel coronavirus, cells within your adaptive immune system rush out to identify the sickness. Your adaptive defenses come to the rescue by recruiting and activating a specialized team of while blood cells that are best equipped to fight the specific pathogen. For example, if you get infected with E. coli (the pesky bacteria that can cause food poisoning), white blood cells that recognize particular molecules on E. coli are activated. When the human immune system is given time to prepare, it can produce defenses that protect against foreign invaders."}],"markDefs":[],"style":"normal"},{"_key":"83ceab449cfd","_type":"sectionHeader","title":"On Antibodies"},{"_key":"471fcccb9790","_type":"block","children":[{"_key":"471fcccb97900","_type":"span","marks":[],"text":"The adaptive immune system is unique because it creates a special protein complex called an antibody (also referred to as immunoglobulin). Specialized white blood cells produce antibodies, which are uniquely designed to look for antigens, a specific structure found on a foreign virus or particle. Antibodies adhere to antigens, which then signal the immune system to destroy the foreign invader. Although antibodies are incredibly important to defend against pathogens, they do not kill anything! Their job is only to plant the kiss of death on the microbe — tagging it for destruction."}],"markDefs":[],"style":"normal"},{"_key":"649468365586","_type":"editorialImageCarousel","items":[{"_key":"3a996c978479","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-dd28afb65b53bd31e980f7680df9e1adbe09c0f0-2103x929-png","_type":"reference"}}}}]},{"_key":"6d4112673897","_type":"block","children":[{"_key":"6d41126738970","_type":"span","marks":[],"text":"White blood cells created in bone marrow can mature and become antibody factories. It can take antibodies a couple of weeks to develop after being exposed to a virus. IgG has reliably shown up on antibody tests 3- 14 days after a Covid-19 infection."}],"markDefs":[],"style":"normal"},{"_key":"0be06c721645","_type":"block","children":[{"_key":"0be06c7216450","_type":"span","marks":[],"text":"Antibodies stick around for differing amounts of time depending on the illness, creating an immunological memory. This means you are reinfected, the adaptive immune system can bounce into action quickly. Scientists believe SARS antibodies stay in the body for 2 years and MERS antibodies are maintained for almost 3 years. Because Covid-19 is a novel virus, we do not know for sure how long these antibodies last. However, experts generally agree that, based on experience with other viruses, the presence of antibodies does confer some level of protection. In a recent study, researchers infected volunteers with a seasonal coronavirus and around a year later, infected them with the same or similar virus. All of the participants either experienced full or partial protection."}],"markDefs":[],"style":"normal"},{"_key":"b3f9ab293109","_type":"sectionHeader","title":"Antibody Tests"},{"_key":"9bb084c727bf","_type":"block","children":[{"_key":"9bb084c727bf0","_type":"span","marks":[],"text":"Antibody tests also called serology tests, take a sample of your blood to test if your immune system has produced any antibodies in response to an infection. These tests can tell you if you were previously infected but they cannot detect active infections or recovery."}],"markDefs":[],"style":"normal"},{"_key":"273ff965f558","_type":"block","children":[{"_key":"273ff965f5580","_type":"span","marks":[],"text":"The is currently a lot of concern about the accuracy of Covid-19 antibody tests. Accuracy is based on sensitivity and specificity, this is tricky because the tests have to be sensitive enough to detect the presence of IgG-specific antibodies and specific enough to avoid accidentally produce a positive result. "}],"markDefs":[],"style":"normal"},{"_key":"276a2873923c","_type":"block","children":[{"_key":"276a2873923c0","_type":"span","marks":[],"text":"Tia is now offering in partnership with Quest the Abbott antibody test, which is 99.1% accurate. "}],"markDefs":[],"style":"large"},{"_key":"3404b4440ee6","_type":"block","children":[{"_key":"3404b4440ee60","_type":"span","marks":[],"text":"As such, we stand by the quality of the test but because no antibody test can tell you if you are immune we recommend continuing to wear a mask and practicing social distancing even if you have developed antibodies."}],"markDefs":[],"style":"normal"},{"_key":"99b38b438ae8","_type":"sectionHeader","title":"Why Test?"},{"_key":"61cedbd48961","_type":"block","children":[{"_key":"61cedbd489610","_type":"span","marks":[],"text":"Widespread antibody testing will help give epidemiologists a clearer understanding of the scope of this disease. A study from random testing around 3,000 people in New York City recently postulated that as many as one in five residents, or about 2.7 million people, might have contracted the disease without knowing. Antibody testing research may also help identify groups who are more susceptible to infection, and why. It is small steps and bits of information that help scientists build a robust understanding and system to address disease, not much different than the information an antibody holds to respond to infection and protect."}],"markDefs":[],"style":"normal"},{"_key":"f506dd83cb65","_type":"cta","backgroundColor":"bcraspberry","text":[{"_key":"f131d27ba34e","_type":"block","children":[{"_key":"f131d27ba34e0","_type":"span","marks":[],"text":"Ready to get tested?"}],"markDefs":[],"style":"h2"},{"_key":"f37eecd52017","_type":"buttonBlock","items":[{"_key":"3589cb5a9453","_type":"singleButton","linkCta":"Book now","linkType":"button","url":"https://asktia.com/member/appointment/schedule"}]},{"_key":"a360a0733f50","_type":"block","children":[{"_key":"a360a0733f500","_type":"span","marks":[],"text":"Not a member? 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We believed then and we believe now that women want "},{"_key":"c1f0c37c0e551","_type":"span","marks":["em"],"text":"someone"},{"_key":"c1f0c37c0e552","_type":"span","marks":[],"text":", not "},{"_key":"c1f0c37c0e553","_type":"span","marks":["em"],"text":"something"},{"_key":"c1f0c37c0e554","_type":"span","marks":[],"text":" to manage their health. That for women, quality healthcare means a real face and a safe space that makes you feel seen, heard and compassionately cared for — online and offline. And that Tia’s mission and foremost innovation is building a relationship-based care model at a time when “relationships” in healthcare are evermore rare."}],"markDefs":[],"style":"large"},{"_key":"065627a2bee0","_type":"block","children":[{"_key":"065627a2bee00","_type":"span","marks":[],"text":"Eight weeks since opening our first brick-and-mortar Tia Clinic, we’ve proven that women really, "},{"_key":"065627a2bee01","_type":"span","marks":["em"],"text":"really"},{"_key":"065627a2bee02","_type":"span","marks":[],"text":" want a differentiated relationship with the healthcare system, and that they are excited about Tia’s potential to deliver it to them. Despite the influx in demand and pressure to rapidly grow to service more members, we recently made the call to deliberately slow down before scaling up. We continue to believe that changing women’s healthcare is a marathon, and not a sprint, and that unchecked “hockey stick growth” cannot be applied to clinical care delivery when real human lives are at play. Instead, we are taking the approach that growth must be deliberate, thoughtful, and obsessively monitored to ensure care quality is never — not even for a second — sacrificed because of startup “growing pains.”"}],"markDefs":[],"style":"normal"},{"_key":"77d4ce896f7f","_type":"sectionHeader","title":"Clarifying the role of technology"},{"_key":"07a3803de386","_type":"block","children":[{"_key":"07a3803de3860","_type":"span","marks":[],"text":"In this explosive era of direct to consumer healthcare companies, we are repeatedly asked — "},{"_key":"07a3803de3861","_type":"span","marks":["em"],"text":"what is Tia?"},{"_key":"07a3803de3862","_type":"span","marks":[],"text":" — a technology company, a direct to consumer brand, or a healthcare services business? To this, we say we are not one, but all three — or more accurately, a relationship company above all else."}],"markDefs":[],"style":"normal"},{"_key":"adb43c883ca6","_type":"block","children":[{"_key":"adb43c883ca60","_type":"span","marks":[],"text":"More tactically, our approach rests on amplifying best-in-class clinical care with innovations in technology and experience design to strengthen — not replace — the canonical patient <> provider relationship. More than an Instagrammable waiting room, or “tech for tech’s sake”, we are laser-focused on interweaving technology and design into the patient and provider experience — not as a “wrapper around,” but in service of clinical care."}],"markDefs":[],"style":"normal"},{"_key":"f21dd6fa9620","_type":"block","children":[{"_key":"f21dd6fa96200","_type":"span","marks":[],"text":"In the words of our users, there’s an intangible, emotional quality that results from the interwoven-ness of technology, brand and "},{"_key":"f21dd6fa96201","_type":"span","marks":["em"],"text":"amazing"},{"_key":"f21dd6fa96202","_type":"span","marks":[],"text":" clinicians all-in-one:"}],"markDefs":[],"style":"normal"},{"_key":"8715a2b4ffa8","_type":"editorialImageCarousel","items":[{"_key":"5b15ac30b18b","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-8342e73a37f0f415f7e3f9d0eafa2c8c563b9a82-1644x1096-png","_type":"reference"}}},"text":[{"_key":"3f73ba6b8003","_type":"block","children":[{"_key":"3f73ba6b80030","_type":"span","marks":[],"text":"Tia patient reviews"}],"markDefs":[],"style":"normal"}]}]},{"_key":"44ba4663cf57","_type":"block","children":[{"_key":"44ba4663cf570","_type":"span","marks":[],"text":"In short, Tia’s model is about a sum greater than its individual parts. Remove the tech, remove the brand, or remove the care, and the whole thing disintegrates."}],"markDefs":[],"style":"normal"},{"_key":"82c702a83a9e","_type":"sectionHeader","title":"The necessity for innovation in women’s health"},{"_key":"ad5ebfbb5e05","_type":"block","children":[{"_key":"ad5ebfbb5e050","_type":"span","marks":[],"text":"While we believe that every woman "},{"_key":"ad5ebfbb5e051","_type":"span","marks":["em"],"text":"should"},{"_key":"ad5ebfbb5e052","_type":"span","marks":[],"text":" have a deep, loved and trusted 1:1 relationship with her provider, delivering this at scale and at an affordable price-point within the confines of the existing healthcare system is rife with challenges. Specifically, the dominant fee-for-service reimbursement models, women’s health provider shortages, and rapidly changing consumer demands make the historic 1:1 relationship with a provider a utopian concept of the past — increasingly limited to very expensive concierge medicine practices inaccessible to the mass market."}],"markDefs":[],"style":"normal"},{"_key":"ddbad4dac273","_type":"block","children":[{"_key":"ddbad4dac2730","_type":"span","marks":[],"text":"While we know Tia is not "},{"_key":"ddbad4dac2731","_type":"span","marks":["em"],"text":"yet"},{"_key":"ddbad4dac2732","_type":"span","marks":[],"text":" a universally-accessible solution that works for every woman with "},{"_key":"ddbad4dac2733","_type":"span","marks":["em"],"text":"any"},{"_key":"ddbad4dac2734","_type":"span","marks":[],"text":" health need across the socioeconomic spectrum, we are committed to building a best-in-class relationship-based care model where women don’t have to “choose” between the trifecta of care quality, convenience and insurance coverage. Instead at the Tia Clinic, women can get evidence-based integrative care in a non “speed dating” environment — for the price of what you pay for Netflix or Spotify each month. To deliver on this promise involves shifting the historic bi-directional patient <> provider relationship to a triangular one, with Tia as the bridge or liaison between a patient and her provider(s):"}],"markDefs":[],"style":"normal"},{"_key":"41cbaa51efcc","_type":"editorialImageCarousel","items":[{"_key":"1040cc0c11be","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-760c08c810d0f9be6570bfaf4adc76e714f4b30f-1644x1096-png","_type":"reference"}}}}]},{"_key":"aa9f939d7d63","_type":"sectionHeader","title":"Productizing this new care model"},{"_key":"fd462818416a","_type":"block","children":[{"_key":"fd462818416a0","_type":"span","marks":[],"text":"While Tia started out as the go-to “wing-woman” for women seeking health information before and after the doctor’s office, the move into real-world care delivery requires that Tia become the “wing-woman” for providers, too. In the words of Tia’s Chief Medical Officer, Dr. Stephanie McClellan:"}],"markDefs":[],"style":"normal"},{"_key":"724fca95e507","_type":"block","children":[{"_key":"724fca95e5070","_type":"span","marks":["em"],"text":"“Tia must become both healthcare translator, care navigator and research-obsessed thinker. For patients, Tia should act as ‘your best friend in medical school’ who explains things to you without dumbing things down. And for providers, Tia needs to be their ‘full-time research assistant,’ providing data-driven, evidence-based recommendations that at times, may be non-obvious, but clinically important. To create a meaningful patient <> provider relationship in the context of the pressures intrinsic to the modern medical system, Tia can’t just play one of these roles, Tia needs to excel at all of them.”"}],"markDefs":[],"style":"normal"},{"_key":"d77cf9d01341","_type":"block","children":[{"_key":"d77cf9d013410","_type":"span","marks":[],"text":"From a product perspective, this means building tools that:"}],"markDefs":[],"style":"normal"},{"_key":"1c6321fb73eb","_type":"block","children":[{"_key":"1c6321fb73eb0","_type":"span","marks":[],"text":"#1: Give the patient more control and agency over her healthcare:"}],"markDefs":[],"style":"h4"},{"_key":"39100e07fa7c","_type":"editorialImageCarousel","items":[{"_key":"53e2f33aa735","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-ad82fd76266e211f5c05fc94d48c93fd588012be-1644x1096-png","_type":"reference"}}},"text":[{"_key":"151a67289f84","_type":"block","children":[{"_key":"151a67289f840","_type":"span","marks":[],"text":"Tia patients control their own health record & can share their cycle, health & wellness data with their Care Team to personalize their experience."}],"markDefs":[],"style":"normal"}]}]},{"_key":"8a3226505eb5","_type":"block","children":[{"_key":"8a3226505eb50","_type":"span","marks":[],"text":"#2: Equip providers to spend more time interfacing with patients (and less time interfacing with the EHR)"}],"markDefs":[],"style":"h4"},{"_key":"c0e125353b94","_type":"editorialImageCarousel","items":[{"_key":"ec08df1b6f07","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-54f6353aa3bb9ff89dc1bfc1c1dddb311b8dca5d-1644x1096-png","_type":"reference"}}},"text":[{"_key":"217b7f58f542","_type":"block","children":[{"_key":"217b7f58f5420","_type":"span","marks":[],"text":"TiaMD (Tia’s “doctor facing” iPad app) flags relevant health data to providers ahead of a patient visit. During Tia appointments, this information is visualized on a “third screen” for the patient & provider to view in tandem."}],"markDefs":[],"style":"normal"}]}]},{"_key":"96e182439508","_type":"block","children":[{"_key":"96e1824395080","_type":"span","marks":[],"text":"#3: Facilitate transparency and collaborative care"}],"markDefs":[],"style":"h4"},{"_key":"3c3722037bfe","_type":"editorialImageCarousel","items":[{"_key":"b7c5dd8fe8e2","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-bfd9610c83e23525e5390724a7c105312170acba-1644x1096-png","_type":"reference"}}},"text":[{"_key":"5b806cb6d384","_type":"block","children":[{"_key":"5b806cb6d3840","_type":"span","marks":[],"text":"During Tia appointments, patients & providers build a collaborative care plan personalized to the patient’s goal."}],"markDefs":[],"style":"normal"}]}]},{"_key":"7e3b82183a27","_type":"sectionHeader","title":"Why people + tech > tech alone"},{"_key":"d736bca4ad48","_type":"block","children":[{"_key":"d736bca4ad480","_type":"span","marks":[],"text":"Patient reviews like these reinforce our belief that the reimagined patient <> provider relationship of the future is at the nexus of technology, design and clinical care."}],"markDefs":[],"style":"normal"},{"_key":"0c7ca848e3eb","_type":"editorialImageCarousel","items":[{"_key":"b2696cd27b00","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-8c0541e54f41ddb78b02eb522111ef604329c688-1644x1096-png","_type":"reference"}}}}]},{"_key":"768e7a58d64a","_type":"block","children":[{"_key":"768e7a58d64a0","_type":"span","marks":[],"text":"But, we’ve also learned that we need to make further investments in the underlying service model to support this new paradigm — particularly outside of Tia exam room walls. We know that technology alone can’t cut it as an effective bridge between the patient and provider. Instead, successful solutions involve both people "},{"_key":"768e7a58d64a1","_type":"span","marks":["em"],"text":"and"},{"_key":"768e7a58d64a2","_type":"span","marks":[],"text":" technology paired together."}],"markDefs":[],"style":"normal"},{"_key":"4fdd1a3660da","_type":"block","children":[{"_key":"4fdd1a3660da0","_type":"span","marks":[],"text":"As a patient-first company who believes that transparency is the foundation of trust, here are the chief points of feedback we’ve heard from our members the past eight weeks, and the ways we are working to address these wants and needs before releasing new memberships:"}],"markDefs":[],"style":"normal"},{"_key":"de86683b3fd8","_type":"block","children":[{"_key":"de86683b3fd80","_type":"span","marks":[],"text":"#1: “I want more appointment times that work with my schedule!”"}],"markDefs":[],"style":"h4"},{"_key":"1f1fd38225f1","_type":"block","children":[{"_key":"1f1fd38225f10","_type":"span","marks":[],"text":"While non-traditional doctor’s office hours optimized for the working woman have always been part of our care promise, we opened with limited availability for early morning, evening and weekend gynecology appointments, which booked up far more quickly than we anticipated."}],"markDefs":[],"style":"normal"},{"_key":"ad57109fffd2","_type":"block","children":[{"_key":"ad57109fffd20","_type":"span","marks":[],"text":"To address the demand for these hours, and the higher-than-expected utilization we’ve seen amongst our patient population, we have hired two additional women’s health nurse practitioners to our Care Team to support an expanded schedule. Starting this week, the Tia Clinic has:"}],"markDefs":[],"style":"normal"},{"_key":"ceaade647fea","_type":"block","children":[{"_key":"ceaade647fea0","_type":"span","marks":[],"text":"“Pre-Work” morning appointments starting at 7:40AM Monday — Friday"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"811904a3de18","_type":"block","children":[{"_key":"811904a3de180","_type":"span","marks":[],"text":"“Post-Work” evening appointments ‘till 8PM Mondays, Tuesdays & Thursdays"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"62bf68defb67","_type":"block","children":[{"_key":"62bf68defb670","_type":"span","marks":[],"text":"Saturday gynecology appointments 9AM — 3PM once a month starting May 11th (and acupuncture every Saturday!)"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e204429b4f4f","_type":"block","children":[{"_key":"e204429b4f4f0","_type":"span","marks":[],"text":"Designated same and next day appointments for time-sensitive issues (such as UTIs or strep throat) that are released 24 hours ahead of time"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"1d681c32676b","_type":"editorialImageCarousel","items":[{"_key":"4cf14b2459c7","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-229563ce46ccc651888517dd388a3caec1d77cbc-1644x1096-png","_type":"reference"}}}}]},{"_key":"d9919ab32fc3","_type":"block","children":[{"_key":"d9919ab32fc30","_type":"span","marks":[],"text":"As we further expand our Care Team with an additional MD hire over the coming weeks, we will continue to expand our appointment availability, upholding our commitment to convenience and accessibility without compromising care quality or overloading our providers."}],"markDefs":[],"style":"normal"},{"_key":"78b0171933ff","_type":"block","children":[{"_key":"78b0171933ff0","_type":"span","marks":[],"text":"#2: “I love the experience I get at the Tia Clinic, but want that personalized care to extend before and after my visit.”"}],"markDefs":[],"style":"h4"},{"_key":"de01311c9296","_type":"block","children":[{"_key":"de01311c92960","_type":"span","marks":[],"text":"To date, we’ve struggled to ensure patients get the timely communication they desire, "},{"_key":"de01311c92961","_type":"span","marks":["em"],"text":"while also "},{"_key":"de01311c92962","_type":"span","marks":[],"text":"allowing our providers to stay focused on patient care in our exam rooms. To address this, we’re making significant changes to both our staffing model and supporting tech products to improve patient communications pre and post-Tia appointments:"}],"markDefs":[],"style":"normal"},{"_key":"8cb7522f634a","_type":"block","children":[{"_key":"8cb7522f634a0","_type":"span","marks":[],"text":"Specifically, we are introducing:"}],"markDefs":[],"style":"normal"},{"_key":"a167cf6eab7f","_type":"block","children":[{"_key":"a167cf6eab7f0","_type":"span","marks":["strong"],"text":"Care Coordinators"},{"_key":"a167cf6eab7f1","_type":"span","marks":[],"text":" "},{"_key":"a167cf6eab7f2","_type":"span","marks":["em"],"text":"— "},{"_key":"a167cf6eab7f3","_type":"span","marks":[],"text":"a dedicated human face assigned to members when they join to help them navigate every touch point of Tia Care. From questions about scheduling and billing, to referrals and labs, this person will act as our members’ “personal concierge” to streamline all communications between a patient and her provider team at Tia. We believe the addition of Care Coordinators will facilitate higher touch communications, faster response times, and enable continuity of care — without overburdening our providers."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"00ec77ccc726","_type":"editorialImageCarousel","items":[{"_key":"28d66f72a3b1","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-c42b6075306e8790ef7e2326161e52c3ab763e74-1644x1096-png","_type":"reference"}}}}]},{"_key":"f9c02c957190","_type":"block","children":[{"_key":"f9c02c9571900","_type":"span","marks":["strong"],"text":"Chat with the Care Team"},{"_key":"f9c02c9571901","_type":"span","marks":[],"text":" — and in a few weeks, we are launching a private, secure inbox for ALL communications with the Tia Clinic. These past few weeks, we’ve seen that administrative questions (“I need to reschedule my appointment”) can quickly become clinical (“Do I need an ultrasound?”), and clinical questions can quickly become administrative. We are streamlining communications with a single inbox, staffed by each member’s personal Care Coordinator."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a8d08efdf8e2","_type":"editorialImageCarousel","items":[{"_key":"191d27b0fa04","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-eab4564bf89867c7a0ae624ce965bfe1736803f8-1644x1096-png","_type":"reference"}}}}]},{"_key":"c0784da2db82","_type":"block","children":[{"_key":"c0784da2db820","_type":"span","marks":["strong"],"text":"A single front door to the digital Tia Care experience"},{"_key":"c0784da2db821","_type":"span","marks":[],"text":" — from text messages to the app to the Tia Clinic Home on the web, we know it can be confusing to know where to go for information from Tia. To solve this, we are introducing a single doorway to all-things Tia Clinic where members can book appointments, edit their health record, find pre-appointment reminders (and soon, chat with the Care Team, too!) — accessible from "},{"_key":"c0784da2db822","_type":"span","marks":["c5f547860f98"],"text":"our iPhone app"},{"_key":"c0784da2db823","_type":"span","marks":[],"text":" or our website. We will continue to use text message as a notification and reminder system to ensure members don’t miss a beat."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"c5f547860f98","_type":"externalLink","url":"https://apps.apple.com/us/app/ask-tia-your-personal-womens-health-assistant/id1184002073?ls=1"}],"style":"normal"},{"_key":"9060c6f80ebc","_type":"editorialImageCarousel","items":[{"_key":"4f56ce90f121","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-54f82cc444c31a96a08baf9ec8817c96eee0eeee-1644x1096-png","_type":"reference"}}}}]},{"_key":"caa151d7e9f2","_type":"block","children":[{"_key":"caa151d7e9f20","_type":"span","marks":[],"text":"#3: “There are so many different services at Tia from workshops to events to different types of gynecology and wellness appointments. But, what’s right for me?”"}],"markDefs":[],"style":"h4"},{"_key":"984d85bc7517","_type":"block","children":[{"_key":"984d85bc75170","_type":"span","marks":[],"text":"Today, orientation is commonplace in college, the workplace, conferences, you name it. We would never think about bringing on a new employee without “onboarding” he or she to our company’s values, processes, and workflows. Yet, in healthcare — one of the most complicated, but important systems we interact with — we leave patients to figure things out on their own, and all-too-often, not until a crisis strikes."}],"markDefs":[],"style":"normal"},{"_key":"79e7ab468ad7","_type":"block","children":[{"_key":"79e7ab468ad70","_type":"span","marks":[],"text":"To address this, we are introducing a program, free for all Tia members, called “Well-Woman Orientation” — quite literally, an orientation to the Tia Clinic, our care philosophy, Care Team, and service offering."}],"markDefs":[],"style":"normal"},{"_key":"bd6482834631","_type":"block","children":[{"_key":"bd64828346310","_type":"span","marks":[],"text":"Starting Wednesday, May 8th, Tia members can sign up for a 90-minute Well-Woman Orientation, during which they will meet our Care Team and other members, set individualized health goals, and design a plan to achieve them with the support of Tia and our community."}],"markDefs":[],"style":"normal"},{"_key":"f63d957178bb","_type":"editorialImageCarousel","items":[{"_key":"b292610dbcfb","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-391e2490ff8af2c433d01cf867602f98824a21da-1644x1096-png","_type":"reference"}}}}]},{"_key":"b5d163974e6b","_type":"block","children":[{"_key":"b5d163974e6b0","_type":"span","marks":[],"text":"While the past eight weeks have reinforced that women want, need and deserve better care, we are dually humbled and evermore motivated by the challenge inherent to delivering that experience — first and foremost to our current members, and slowly and sustainably, to future members in NYC and around the country. 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We’re doing exactly that with regular drops of THE DOSE, your science-backed guide to all things Covid-19 vaccines."}],"markDefs":[],"style":"normal"},{"_key":"33720154e95a","_type":"block","children":[{"_key":"2be8cca6706b","_type":"span","marks":["em"],"text":"THE DOSE is brought to you by geneticist and evolutionary biologist, "},{"_key":"4f4af212a3d9","_type":"span","marks":["em","d1d7e2448576"],"text":"Dr. Ava Mainieri, Head of Research at Tia"},{"_key":"114954eac8c4","_type":"span","marks":["em"],"text":"."}],"markDefs":[{"_key":"d1d7e2448576","_type":"internalLink","linkType":"text","reference":{"_ref":"620445e8-cfbd-40b4-9bd3-1742868efe78","_type":"reference"}}],"style":"normal"},{"_key":"8937ef1d81ab","_type":"block","children":[{"_key":"dded23e65a35","_type":"span","marks":["strong"],"text":"So, why do I need 2 doses?"}],"markDefs":[],"style":"h3"},{"_key":"3a02045c3add","_type":"block","children":[{"_key":"5b03fca155ae","_type":"span","marks":[],"text":"Getting 2 doses of the vaccine gives your immune system more opportunities to figure out exactly how to fight future infection. This means..."}],"markDefs":[],"style":"normal"},{"_key":"99a63611080e","_type":"block","children":[{"_key":"e59f93be4e82","_type":"span","marks":[],"text":"more antibodies"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a7d10e88c9ef","_type":"block","children":[{"_key":"6a169d554afc","_type":"span","marks":[],"text":"a robust supply of memory cells"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a8c2367d0b3c","_type":"block","children":[{"_key":"e546a70d558b","_type":"span","marks":[],"text":"more antigens"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0297df2fe086","_type":"block","children":[{"_key":"45cbb780c43a","_type":"span","marks":[],"text":"...leading to a faster and more effective response in the future."}],"markDefs":[],"style":"normal"},{"_key":"9c634bf7cf75","_type":"block","children":[{"_key":"57777024636c","_type":"span","marks":["strong"],"text":"Can I just get one shot instead of 2?"}],"markDefs":[],"style":"h3"},{"_key":"035289a07ad0","_type":"block","children":[{"_key":"8ec8455386f2","_type":"span","marks":[],"text":"Nope! Pfizer’s data showed a dramatic divergence in efficacy:"}],"markDefs":[],"style":"normal"},{"_key":"8088cb1094e1","_type":"editorialImageCarousel","items":[{"_key":"af6092f6578c","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-905623f30657f8d897d5704f44aab4f569234f2f-2103x1044-png","_type":"reference"}}},"text":[{"_key":"27386bf525f4","_type":"block","children":[{"_key":"01faee2d4812","_type":"span","marks":[],"text":"2 doses is pretty standard for vaccines!"}],"markDefs":[],"style":"normal"}]}]},{"_key":"546597925d22","_type":"block","children":[{"_key":"2a7b2f5ab2ea","_type":"span","marks":["strong"],"text":"What are the short-term side effects?"}],"markDefs":[],"style":"h3"},{"_key":"d825e2a9f300","_type":"block","children":[{"_key":"e5e0a2cae577","_type":"span","marks":[],"text":"A small percentage of patients who’ve received the vaccine have experienced..."}],"markDefs":[],"style":"normal"},{"_key":"01870ac34c6b","_type":"block","children":[{"_key":"f4998fa25bc1","_type":"span","marks":[],"text":"high fevers"}],"level":1,"listItem":"bullet","markDefs":[{"_key":"59d785fa0065","_type":"annotation"}],"style":"normal"},{"_key":"21b74ae8df1e","_type":"block","children":[{"_key":"8ee2cffc3145","_type":"span","marks":[],"text":"arm swelling"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"543bcab7619b","_type":"block","children":[{"_key":"a63fe56145ee","_type":"span","marks":[],"text":"joint pain"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"67f401a6c2c7","_type":"block","children":[{"_key":"aac67e08bfd6","_type":"span","marks":[],"text":"fatigue"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"4ba55b13ea4f","_type":"block","children":[{"_key":"e660b495e286","_type":"span","marks":[],"text":"These side-effects are normal. On a larger scale, when a whole country is vaccinated, millions of people will experience some, or all, of these symptoms.\n\nOther common reactions include:"}],"markDefs":[],"style":"normal"},{"_key":"185e3194cb2a","_type":"block","children":[{"_key":"e8af8a7c8ae8","_type":"span","marks":[],"text":"soreness, swelling, or redness at the injection site"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"471f203cce8d","_type":"block","children":[{"_key":"79b58340f391","_type":"span","marks":[],"text":"headache"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"62e446fbbafd","_type":"block","children":[{"_key":"f9b3825727e2","_type":"span","marks":[],"text":"nausea"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8549ee063a23","_type":"block","children":[{"_key":"51843b128021","_type":"span","marks":[],"text":"muscle stiffness & aches"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"199c8c1e3d0b","_type":"block","children":[{"_key":"438b81cbbf74","_type":"span","marks":[],"text":"These effects are just what happens when your body is responding to a foreign protein and building an immune response to the disease — this is a good thing!"}],"markDefs":[],"style":"normal"},{"_key":"cce93f5cb215","_type":"block","children":[{"_key":"c52d00b21d95","_type":"span","marks":[],"text":"What about allergic reactions?"}],"markDefs":[],"style":"h3"},{"_key":"7319357ed2b3","_type":"editorialImageCarousel","items":[{"_key":"af6092f6578c","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-006cf58101140edd6ac4833294667e6a16b343ef-2103x1044-png","_type":"reference"}}}}]},{"_key":"1f4eb20b8d1b","_type":"block","children":[{"_key":"06d81ee8ba4b","_type":"span","marks":[],"text":"Should I get the vaccine if I’ve had Covid?"}],"markDefs":[],"style":"h3"},{"_key":"d2f083df6ad0","_type":"block","children":[{"_key":"e44ae95f7a24","_type":"span","marks":[],"text":"Yes! Early data strongly suggests that the mRNA vaccines will be more protective than protections from a previous infection."}],"markDefs":[],"style":"normal"},{"_key":"f26557263c13","_type":"editorialImageCarousel","items":[{"_key":"f9190eaa4163","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-e5c47ceb5c39842e84dbbd5f7204832c470509c7-2103x766-png","_type":"reference"}}}}]},{"_key":"5df85e91bd69","_type":"block","children":[{"_key":"8fbd86e6158c","_type":"span","marks":[],"text":"What are the long-term side effects?"}],"markDefs":[],"style":"h3"},{"_key":"2e3e4699b8ba","_type":"block","children":[{"_key":"1c724e0da280","_type":"span","marks":[],"text":" There is limited information on long-term side effects yet but based on a long history of vaccines. 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Trying to treat one illness or injury without the whole person in mind is incomplete care."}],"markDefs":[],"style":"normal"},{"_key":"58716f3beedb","_type":"editorialImageCarousel","items":[{"_key":"9e7565175396","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-271cedf13d5c8b6523a9f4dc030eb5339e46cdbe-2400x1336-png","_type":"reference"}}}}]},{"_key":"7290817af77d","_type":"block","children":[{"_key":"7290817af77d0","_type":"span","marks":[],"text":"If you could wave a magic wand and change one aspect of women’s healthcare, what would it be?"}],"markDefs":[],"style":"h4"},{"_key":"6a2a7c01d1c0","_type":"block","children":[{"_key":"6a2a7c01d1c00","_type":"span","marks":[],"text":"To say we need more women in leadership and government is an understatement. I would also like to see young people demanding more from their healthcare providers and creating an impetus for change."}],"markDefs":[],"style":"normal"},{"_key":"6e6e4ebaca6a","_type":"block","children":[{"_key":"6e6e4ebaca6a0","_type":"span","marks":[],"text":"What do you think is the biggest challenge facing clinicians today?"}],"markDefs":[],"style":"h4"},{"_key":"e333edad6775","_type":"block","children":[{"_key":"e333edad67750","_type":"span","marks":[],"text":"I think that most clinicians are not happy with the state of health care in our country today, but many of them don’t know what they can do to create change. I think young clinicians need to work hard to promote positive changes in health care and more experienced clinicians in the workforce need to listen and be open to the ideas of young clinicians AND patients, of course!"}],"markDefs":[],"style":"normal"},{"_key":"94ff50fa27a5","_type":"block","children":[{"_key":"94ff50fa27a50","_type":"span","marks":[],"text":"When did you know you wanted to get into medicine, and why did you choose to specialize in women’s health?"}],"markDefs":[],"style":"h4"},{"_key":"01e701f27480","_type":"block","children":[{"_key":"01e701f274800","_type":"span","marks":[],"text":"I have always been interested in science and have always felt motivated to care for people. I decided to go to nursing school after earning a degree in Biology. I taught high school biology for one year and realized I really missed hands-on care. After my first rotation in the childbirth unit, I knew I wanted to specialize in women’s health. 10 years later, I am still deeply passionate and excited about this area of healthcare."}],"markDefs":[],"style":"normal"},{"_key":"5e58d91ed187","_type":"editorialImageCarousel","items":[{"_key":"47c879905ce2","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-4b41f5884524251833a3565a84a26867af902dd0-2400x1336-png","_type":"reference"}}}}]},{"_key":"49ba5d7cf9ff","_type":"block","children":[{"_key":"49ba5d7cf9ff0","_type":"span","marks":[],"text":"What does “whole women’s health” mean to you? How do you incorporate this thinking into your practice?"}],"markDefs":[],"style":"h4"},{"_key":"ca1f0a1b4f51","_type":"block","children":[{"_key":"ca1f0a1b4f510","_type":"span","marks":[],"text":"“Whole women’s health” means identifying and sharing the connections within the body and understanding that the person who is best-equipped to provide information about a woman’s state of well-being is herself."}],"markDefs":[],"style":"normal"},{"_key":"30d6e7a43346","_type":"block","children":[{"_key":"30d6e7a433460","_type":"span","marks":[],"text":"What is your care vision for Tia — and women’s health more broadly?"}],"markDefs":[],"style":"h4"},{"_key":"22b793cf3074","_type":"block","children":[{"_key":"22b793cf30740","_type":"span","marks":[],"text":"My care vision for Tia is that we will provide the first “women’s health community” where women meet with clinicians to discuss their health and needs, receive and participate in integrative health modalities, and feel part of something big and great. 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