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She sets the strategic direction for Tia’s growth, culture, and clinical innovation—guiding a fast-scaling team that’s redefining what comprehensive women’s healthcare looks like."}],"markDefs":[],"style":"normal"},{"_key":"b3fffdb5b399","_type":"block","children":[{"_key":"b5dd3b80bcba0","_type":"span","marks":[],"text":"Felicity brings a rare combination of analytical rigor and human empathy to her leadership. A data enthusiast with a deep passion for health and wellness, she believes healthcare should be both evidence-based and deeply personal. Under her leadership, Tia has expanded into a full-spectrum model that integrates primary care, gynecology, mental health, fertility, perimenopause and menopause support, skin care, and longevity services—delivered through seamless in-clinic and virtual experiences."}],"markDefs":[],"style":"normal"},{"_key":"3d6ac562358b","_type":"block","children":[{"_key":"da501b100faa0","_type":"span","marks":[],"text":"Before founding Tia, Felicity held roles at Bridgewater Associates and Owler, where she developed her expertise in data-driven decision-making and high-velocity team execution. She is a graduate of Cornell University and serves on the board of Columbia University's School of Public Health."}],"markDefs":[],"style":"normal"}],"title":"Felicity Yost"},"meta":{"_type":"metaCard","metaDescription":"Meet Tia CEO Felicity Yost. 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Prior to Tia I “cut my teeth” at Bridgewater and Owler, where I worked as a “traditional” product manager in very non-traditional company cultures. These experiences shaped my entree to Tia with deep regard for the impact structure and culture of a team can have on the end product."}],"markDefs":[],"style":"normal"},{"_key":"4ce7773d91da","_type":"block","children":[{"_key":"133d987bd06a","_type":"span","marks":[],"text":"As the incarnating blog post, I seek to describe what "},{"_key":"2afa3234b575","_type":"span","marks":["em"],"text":"Product"},{"_key":"d5026bdca791","_type":"span","marks":[],"text":" is at Tia. For, it’s something it’s not at most other places, or it’s not something it is at most other places. ;)"}],"markDefs":[],"style":"large"},{"_key":"15a236000d8b","_type":"block","children":[{"_key":"a4cac281e844","_type":"span","marks":[],"text":"Below I describe in a narrative fashion, how we’ve arrived at the product-centric approach to development at Tia. Immediately below (if you’re not prone to prose) I also summarize the key differentiators/takeaways."}],"markDefs":[],"style":"normal"},{"_key":"86edf8e48df8","_type":"block","children":[{"_key":"48e0d0698cf40","_type":"span","marks":[],"text":"In one phrase, though, "},{"_key":"48e0d0698cf41","_type":"span","marks":["em","strong"],"text":"we are different because we aren’t limiting the traditional product development principles to one tool kit (code) but, instead, liberally applying them across our various users and their needs in ways that healthcare has never seen before."}],"markDefs":[],"style":"normal"},{"_key":"127698635ed1","_type":"sectionHeader","headerLevel":"h2","title":"The Summary"},{"_key":"d9b885f32a77","_type":"block","children":[{"_key":"15ac3a565ad2","_type":"span","marks":[],"text":"Our approach is different in the following ways:"}],"markDefs":[],"style":"normal"},{"_key":"5ad0fe017438","_type":"block","children":[{"_key":"4dba881e17d70","_type":"span","marks":[],"text":"We believe that a massive contributor to the issues plaguing healthcare is the technology systems that have been incalculably thrust upon the industry, and the way we’ve operationally and technically shifted from relationships and longitudinal health and wellness to transactional, moment in time visits and care. As our core insight, we strive to build a system that is explicitly oriented around supporting the many people participating in a patient’s care community, as well as acknowledging that health and wellness are ongoing activities through life, necessitating more than just a visit."}],"markDefs":[],"style":"normal"},{"_key":"53f86ff36f70","_type":"block","children":[{"_key":"192b7036f6230","_type":"span","marks":[],"text":"In order to effectuate our core thesis into a system, we have taken two differentiated steps in building our products: we’ve greatly expanded our notion of “user” and we’ve greatly expanded how we think about product."}],"markDefs":[],"style":"normal"},{"_key":"d0cd88ac4105","_type":"block","children":[{"_key":"83170518b0aa","_type":"span","marks":["strong"],"text":"We have multiple users, we’re building for the patient, we’re also building for the provider."},{"_key":"ae6a12178830","_type":"span","marks":[],"text":" This means our gynecologists, Primary Care Physicians (PCPs), Licensed Clinical Social Workers (LCSWs) — but it also means the Medical Assistant, care team, the front desk associate, and the ultrasound tech (traditionally forgotten)… we’re building for each individual on our team, and for the team collectively.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f51d3c838c8b","_type":"block","children":[{"_key":"dc22fbcf25ba0","_type":"span","marks":["strong"],"text":"We view product more expansively than our tech platform, product is our service line, it is our community support, it’s our content."},{"_key":"0a20bdaef09b","_type":"span","marks":[],"text":" With this perspective, we apply the traditional “user-centered thinking” to every problem/issue we encounter (there’s many, we’ve no shortage of “TODOS”), and design solutions under traditional product management strategies (cult of WWUD, or what would the user do?”). This is surprisingly differentiated in healthcare, a space that is still run by the “bottom line”. We take the belief that, if we do what’s best for our users, the needed behavior and the right bottom line will fall into place.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"4044ab598dce","_type":"block","children":[{"_key":"3b4800b1ca790","_type":"span","marks":["strong"],"text":"Expanding our view of product beyond tech alone has necessitated our “architects” to deploy more than code to stand up our differentiated systems. "},{"_key":"a6149a7bdbf0","_type":"span","marks":[],"text":"Our product teams use technology, process, protocols, norms, principles, and culture to build our system. The toolkit is far more expansive, but enables us to not only deploy new service lines, and do the much more challenging (and in my book innovative) which is to deploy tech features that don’t just ladder up to and support clinical processes, but actually help promote/reinforce our clinical model.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3e044e5cd656","_type":"block","children":[{"_key":"571f4fcab75f0","_type":"span","marks":[],"text":"In order to do this, "},{"_key":"0db4e76cfd06","_type":"span","marks":["strong"],"text":"we elevate engineers, designers, and clinical operators alike into the role of “builders”, and employ them all under the umbrella of the “product organization”."},{"_key":"41a8a65c30ca","_type":"span","marks":[],"text":" Given our platform is not just tech, it necessitates builders of all different skills and licenses to bring our interdisciplinary vision to fruition."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8904519af8dc","_type":"editorialImageCarousel","items":[{"_key":"8aa8e64f316e","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_id":"image-744becbbd3aa4a93740f80b3acf17062c74a3e0a-2103x562-png","_type":"sanity.imageAsset","_createdAt":"2022-12-27T08:50:58Z","_rev":"8ycwaKn5PLURgEeFH54Hu1","_updatedAt":"2022-12-27T08:50:58Z","assetId":"744becbbd3aa4a93740f80b3acf17062c74a3e0a","extension":"png","metadata":{"_type":"sanity.imageMetadata","blurHash":"D7ST5JR*r?]mr?{}Jmofw{of","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":3.7419928825622777,"height":562,"width":2103},"hasAlpha":true,"isOpaque":true,"lqip":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABQAAAAFCAYAAABFA8wzAAAACXBIWXMAAAsTAAALEwEAmpwYAAAA2klEQVQYlV1PXW+DMBDLj2tCRoFthIQW2Fd/fLvuoQLUddyTJ0OKpj1YubMc26du3mCsDPpKrxgi7vtYaVA3eQOJ719ISNZZfXuDi9M4lxt8lhucOTuNo9M4lRonp/FFU59gCnb5XFvIf4RkhvrxBtfYcggWY5Nh6Ar0TYZ+l2LYpRjbHLeuwNTmkGYLaTNIV0BeHhdw3m8hwULNzrG27FPI6xPk4CEfbhF2OeS9hBwqyNvzstOEHDXkOTOstlBTvH82rB8gTUznR6YyhGJybEZubXnnqU3nk38BVIAC8PHtDDwAAAAASUVORK5CYII=","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#900a08","foreground":"#fff","population":0,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#8f0a08","foreground":"#fff","population":0.05,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":57.57,"title":"#fff"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#950b03","foreground":"#fff","population":0,"title":"#fff"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#fc837c","foreground":"#000","population":0.13,"title":"#fff"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#9c4c44","foreground":"#fff","population":0.01,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":57.57,"title":"#fff"}}},"mimeType":"image/png","originalFilename":"Revolutionize_Inline-1.png","path":"images/8qqycr4y/production/744becbbd3aa4a93740f80b3acf17062c74a3e0a-2103x562.png","sha1hash":"744becbbd3aa4a93740f80b3acf17062c74a3e0a","size":35772,"uploadId":"HBTvRGVL4tB69GakVLO1acdvWQ094nkZ","url":"https://cdn.sanity.io/images/8qqycr4y/production/744becbbd3aa4a93740f80b3acf17062c74a3e0a-2103x562.png","id":"image-744becbbd3aa4a93740f80b3acf17062c74a3e0a-2103x562-png","parent":null,"children":["2b4c8244-567e-5384-8f6e-ff437295953b"],"internal":{"type":"SanityImageAsset","contentDigest":"b84c54d4abb7eb5d13976b20a44e0df7","counter":6149,"owner":"gatsby-source-sanity"}}}}}]},{"_key":"ce38dfd8863c","_type":"sectionHeader","headerLevel":"h2","title":"The story version: Our early days set up our differentiated approach"},{"_key":"9edfe4cf7568","_type":"block","children":[{"_key":"8d00f6568720","_type":"span","marks":[],"text":"When we first set out to build Tia, we were on a journey to “de-fragmentize” healthcare, and also to “democratize” access to reliable healthcare information so that women could make better decisions. We knew that this system must leverage technology — but in our early days — we hadn’t fully found what our product needed to be. In silicon valley terms, we hadn’t arrived at product-market fit. "}],"markDefs":[],"style":"normal"},{"_key":"4ee4bf48d6d0","_type":"block","children":[{"_key":"fe75a925d6dd","_type":"span","marks":[],"text":"For the first 9 months of Tia’s life, we were really focused on building a 1-to-1 personal health assistant. It was part human and part bot, and provided personalized and largely instantaneous answers to common women’s health questions such as “I forgot my birth control pill” or “my period is late, should I be concerned?”. Our sweet spot was urgent/anxiety-provoking questions requiring more personalization than a blog post. While this experience gave us an unparalleled front-row seat to over 200,000 different conversations with women about their health, we quickly learned that we needed to supply more than just digital answers on an iPhone to meet women’s needs. Women really wanted Tia to actually deliver their healthcare, not just advice on what and where to get it. We learned that our superpower was not only providing women information but a trusted relationship — one that made women feel seen heard and cared for in outsized ways. We had cracked one of the hardest things to do in healthcare — cultivate trust. "}],"markDefs":[],"style":"normal"},{"_key":"9b66809c5330","_type":"editorialImageCarousel","items":[{"_key":"f49d1bd31725","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_id":"image-3d60fdc3083e7c9cd9e7acc97c2133910454b789-2103x549-png","_type":"sanity.imageAsset","_createdAt":"2022-12-27T08:49:31Z","_rev":"8ycwaKn5PLURgEeFH5413C","_updatedAt":"2022-12-27T08:49:31Z","assetId":"3d60fdc3083e7c9cd9e7acc97c2133910454b789","extension":"png","metadata":{"_type":"sanity.imageMetadata","blurHash":"DAS9?tso]n=KS2}EfQoKo1a|","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":3.830601092896175,"height":549,"width":2103},"hasAlpha":true,"isOpaque":true,"lqip":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABQAAAAFCAYAAABFA8wzAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAm0lEQVQYlYWPywrCMBRE+21NGrd5NH6+omKrVFGw1bgamTaRUBUXw9w85jC3eC4XCF4h+cMrDF7hVn+qj+J7nglxpoo5sPcKnZNojMDeiNEbI9FaiYOV6KzEta5w/wcMUWzA8EqXWOsSGy2w1WL0nRE4WomLm4B57iuQM9c5uwqtiY3cJIKok6veDfPNfgLp/EwwxTk/p7t5JgFfVcj+qqYSIt4AAAAASUVORK5CYII=","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#8e1a0a","foreground":"#fff","population":0,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#971c0b","foreground":"#fff","population":0.15,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":78.35,"title":"#fff"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#940904","foreground":"#fff","population":0,"title":"#fff"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#f9524c","foreground":"#fff","population":2.68,"title":"#fff"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#960f02","foreground":"#fff","population":0,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":78.35,"title":"#fff"}}},"mimeType":"image/png","originalFilename":"Revolutionize_Inline-3.png","path":"images/8qqycr4y/production/3d60fdc3083e7c9cd9e7acc97c2133910454b789-2103x549.png","sha1hash":"3d60fdc3083e7c9cd9e7acc97c2133910454b789","size":39442,"uploadId":"VeB4rwRTOCufheBoyobit6WCATwyKRhI","url":"https://cdn.sanity.io/images/8qqycr4y/production/3d60fdc3083e7c9cd9e7acc97c2133910454b789-2103x549.png","id":"image-3d60fdc3083e7c9cd9e7acc97c2133910454b789-2103x549-png","parent":null,"children":["37edd530-3fec-5901-aa73-45d8d759240e"],"internal":{"type":"SanityImageAsset","contentDigest":"5ca02baaa3cc2caa6a40c3741425f8b0","counter":4674,"owner":"gatsby-source-sanity"}}}}}]},{"_key":"44c1774f77eb","_type":"block","children":[{"_key":"eeeb961d1555","_type":"span","marks":[],"text":"Why then, would we refer women into the healthcare system then for actual healthcare, which they more often than not, distrusted so much? Women wanted real “hardcore” care from Tia, a place to get pelvic exams, STI tests, ultrasounds, breast exams, Pap smears, and phlebotomy. Unlike many of the virtual care platforms that were taking off that the moment, we saw that to bring our women what they needed from Tia required physical sites for care. So, like any good product organization, we bent to our users’ demands."}],"markDefs":[],"style":"normal"},{"_key":"0c105e655eee","_type":"block","children":[{"_key":"0ef80267e55a0","_type":"span","marks":[],"text":"It was at this turning point that we had to face ourselves in the mirror and say: if we are going to become a brick and mortar healthcare delivery organization, what role does technology play in our business? Are we even a tech company? Do we even need a product team? In brief, Carolyn and I would reiterate to ourselves the existential question: “Are we an app with a clinic? Or, a clinic with an app?”"}],"markDefs":[],"style":"normal"},{"_key":"a3c6c42db9ef","_type":"block","children":[{"_key":"33cf1b6052510","_type":"span","marks":[],"text":"I knew we didn’t want to be either. Both sounded small. Not to mention, either way of looking at our future completely missed what we surmised as the core issues in healthcare: information fragmentation, bad patient AND provider experience lacking orientation around cost, a paucity of creative design to make it easy and convenient to use, tawdry technology that belabored simple actions."}],"markDefs":[],"style":"normal"},{"_key":"bdcdb493534e","_type":"sectionHeader","headerLevel":"h2","title":"We couldn’t follow the path of least resistance"},{"_key":"f254b98f9a3b","_type":"block","children":[{"_key":"ca0da4b65ef3","_type":"span","marks":[],"text":"If I am being honest, it probably would’ve been easy to say that “a clinic with an app” alone would solve the problem (it at least would’ve definitely been easier to sell to investors). The problems in healthcare technology are rampant, and most everyone knows this. For example, I’ve never heard a single provider rave about their tech. The brunt of provider complaints arise from the stone-age era Electronic Medical Records (EMR) systems they’re required to use every day, systems that were designed more around the success of the medical biller than the clinician themself. These truths are best described in the poignant article, "},{"_key":"0318a480b2b8","_type":"span","marks":["3b2369a73d90"],"text":"Death by 10,000 Clicks"},{"_key":"049c33b94b91","_type":"span","marks":[],"text":"; an article that every modern-day clinician and “health tech” industry worker has imprinted into their memory."}],"markDefs":[{"_key":"3b2369a73d90","_type":"externalLink","linkType":"text","url":"https://khn.org/news/death-by-a-thousand-clicks/"}],"style":"normal"},{"_key":"0bbeadd0b071","_type":"editorialImageCarousel","items":[{"_key":"081ca21fcc57","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_id":"image-819cd80d214e48bcdd2133263ca6368afcf64b8a-2466x1644-png","_type":"sanity.imageAsset","_createdAt":"2022-09-15T10:18:27Z","_rev":"psZV7jQMyVqczstdRVTewG","_updatedAt":"2022-09-15T10:18:27Z","assetId":"819cd80d214e48bcdd2133263ca6368afcf64b8a","extension":"png","metadata":{"_type":"sanity.imageMetadata","blurHash":"V%L4XI~Lxnj^f,9kx^xuocRj%JM|a#ofj[Rjt3V@WBof","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":1.5,"height":1644,"width":2466},"hasAlpha":true,"isOpaque":true,"lqip":"data:image/png;base64,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","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#342e2b","foreground":"#fff","population":1.37,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#1409b1","foreground":"#fff","population":0.01,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#f8d22b","foreground":"#000","population":12.46,"title":"#000"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#d3bee0","foreground":"#000","population":0.14,"title":"#000"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#ded299","foreground":"#000","population":0.27,"title":"#000"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#766282","foreground":"#fff","population":0.47,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#f8d22b","foreground":"#000","population":12.46,"title":"#000"}}},"mimeType":"image/png","originalFilename":"ProductBlog63 (5).png","path":"images/8qqycr4y/production/819cd80d214e48bcdd2133263ca6368afcf64b8a-2466x1644.png","sha1hash":"819cd80d214e48bcdd2133263ca6368afcf64b8a","size":110686,"uploadId":"XgWRbPPlvFAkZjsCWyRwYF4IlZMB8ybN","url":"https://cdn.sanity.io/images/8qqycr4y/production/819cd80d214e48bcdd2133263ca6368afcf64b8a-2466x1644.png","id":"image-819cd80d214e48bcdd2133263ca6368afcf64b8a-2466x1644-png","parent":null,"children":["c31ffd1c-e845-55d6-ae05-91e78cfb7841"],"internal":{"type":"SanityImageAsset","contentDigest":"9d811babf880ce7318ff3120cd783287","counter":6537,"owner":"gatsby-source-sanity"}}}}}]},{"_key":"aab74a44f11b","_type":"block","children":[{"_key":"fa7cbf952e92","_type":"span","marks":[],"text":"That these technology systems inadvertently and advertently shape modern medicine is a critical vector of our problems. EMRs are no longer just data receptacles, they are actually dictating standard of care — "},{"_key":"162be1e80a24","_type":"span","marks":["em"],"text":"driving,"},{"_key":"6353b6556625","_type":"span","marks":[],"text":" not documenting, clinical actions. And, because of the ways that the systems prevent providers from “progressing” a patient through care if they don’t tap the right button, providers focus more on clicking than actually consulting. Who could blame them, for a standard primary care checkup there can be over "},{"_key":"631f1f84f3a9","_type":"span","marks":["dd265e5e3560"],"text":"400 required actions if the EMR is CMS Medicaid compliant"},{"_key":"f93979047b86","_type":"span","marks":[],"text":". This impacts our patients too — provider eye contact is drawn away from the patient in the visit, focused on the buttons not explaining the recommendations. But, worst of all, these "},{"_key":"e21f3f7c63ae","_type":"span","marks":["em"],"text":"buttons"},{"_key":"b565b465e375","_type":"span","marks":[],"text":" distract the provider from the very reason they got into medicine and spent years obtaining a medical degree. In lieu of medical decision making, providers, via these EMRs, are shoved into a draconian technology system that takes as slim a perspective on the merits and possible vertices of human existence and disease as a 1999 version of The Sims. (like versions pre-dating rosebud!;!;!;!;)"}],"markDefs":[{"_key":"dd265e5e3560","_type":"externalLink","linkType":"text","url":"https://pubmed.ncbi.nlm.nih.gov/240603"}],"style":"normal"},{"_key":"8cf8f66d5bbc","_type":"block","children":[{"_key":"5a0720bbafe4","_type":"span","marks":[],"text":"Just as limited as you might feel like a real human in a Sim life, providers are limited in the seemingly two-dimensional matrix of common EMRs. These collections of 1’s and 0’s have uprooted the art of medicine, the practice of wellness, and healing. The art supplanted not by science, but by code. Code that has been lobbed haphazardly on top of more antiquated code, to form a “system”. With each subsequent CMS guideline, another piece falls into a previously unrecognized crack. This mass of bad tech is a very large nodule on the rhizome of the issues in healthcare (I had to go with rhizome, as the panoply of issues in the healthcare system is certainly so large as to require its own glucose supply)."}],"markDefs":[],"style":"normal"},{"_key":"6b42f1072172","_type":"block","children":[{"_key":"0465b927a0d60","_type":"span","marks":[],"text":"So, it was clear that these issues we set out to solve: worsening outcomes, dissatisfied patients, demoralized providers, skyrocketing costs, layers and layers of institution/fragmentation could not be unearthed with a mere digital re-skinning of current tech. The Frankenstein needs to be put to rest and replaced with a new system more purposefully sewn together. This is why we couldn’t take the easy route — and couldn’t make a ‘clinic with an app’."}],"markDefs":[],"style":"normal"},{"_key":"205c89334b16","_type":"block","children":[{"_key":"bb52c346efa30","_type":"span","marks":[],"text":"Everything that I’ve said over the last 4 paragraphs is trite for someone in healthcare. The real difference is how Tia addresses this. A mini digression before I get to this (now you’re understanding why I wrote a summary!)"}],"markDefs":[],"style":"normal"},{"_key":"07b366d95710","_type":"sectionHeader","headerLevel":"h2","title":"Our society didn’t just have a break up with medicine, it lost all relationships in medicine"},{"_key":"98b982e41468","_type":"block","children":[{"_key":"f4283bdd0e65","_type":"span","marks":[],"text":"Long ago, art, science, medicine, pharmacology, botany, horticulture, spirituality and community were all linked, often tied to the same place, individual, or ritualistic practice. And, in more recent past (a mere decade ago), patients retained their doctor for life — allowing their care providers to amass a world of data about them, that while perhaps not all captured in a clinical note, was fertilizing the ground from which the physician drew clinical insights and took clinical decisions. While I am not insinuating we ought to return to bloodletting practices of the past, I do think that we’ve lost greatly in siloing medicine away from the acts of healing, wellness, and community. But required for those is an element that our society, and medicine, in particular, has waysided: time, continuity, cultivation, iteration, and evolution. The site of the modern medical marvel, the ER, is anything but a site for healing continuity. Instead, it’s a site of “transaction”, “one and done” and “take a pill to make it all go away”."}],"markDefs":[],"style":"normal"},{"_key":"d4098fdf9393","_type":"block","children":[{"_key":"1b24b4c949380","_type":"span","marks":[],"text":"What is elemental to “practice medicine”? Etymologically, practice is derived from the greek and means something that is constantly worked on. Medicine, the observation of what is natural. Both rely on this idea of ‘overtime’ — practice and observe "},{"_key":"9acab55604521","_type":"span","marks":["em"],"text":"over time"},{"_key":"9acab55604522","_type":"span","marks":[],"text":". We need a system that will more deeply support care for a patient through time."}],"markDefs":[],"style":"normal"},{"_key":"bfee497351b4","_type":"block","children":[{"_key":"6d4cc4f8623c0","_type":"span","marks":[],"text":"We want to shift our perspective back towards the ‘practice of medicine’ as longitudinal, as through time. How might we do this in a day where patients now expect to similarly command clinical care as they do Ubers? Where we’re promised “cures” to incurable diseases with symptom masking pills? Where providers are cornered into singular methods of treating patients, regardless of the patient's contextual complexities? And, where quite frankly, our clinicians are so burnt out they are constantly looking for ways to minimize patient-facing care hours?"}],"markDefs":[],"style":"normal"},{"_key":"435fe98da408","_type":"block","children":[{"_key":"ea16711fb45c0","_type":"span","marks":[],"text":"From our estimation the longitudinal shift comes down to two core elements that must be pursued: a focus on the spectrum between illness and health and cultivation of relationships as the core system in medicine. The former is at root Tia’s clinical model, our unique approach to delivering care. It is a topic for another, a stand-alone post. But the latter characterizes our perspective on the system that we need to build to enable success in medicine once again. Designing and building this system is my focus at Tia, I’ll aim to explain deeply yet tactically what we mean in the remainder of this post."}],"markDefs":[],"style":"normal"},{"_key":"ce247c3f8559","_type":"block","children":[{"_key":"1e90a900e5b70","_type":"span","marks":[],"text":"In healthcare, we often talk of the patient <> provider relationship — but, in fact that relationship barely exists today. We insinuated institutions between the patient and the provider (think: “I tried to call my doctor but I was on hold with a call center for nearly an hour”, or “I wouldn’t even know where to go to get my medical records”, or “I got a bill from someplace that I didn’t even know I went to for care”). And, of the other relationships critical to making care delivery “work”, we typically gloss them over: the relationship between the patient <> care team, the provider <> care team, the provider <> medical assistant, the provider <> radiologist … etc."}],"markDefs":[],"style":"normal"},{"_key":"3002460de716","_type":"block","children":[{"_key":"8d106fb7adce0","_type":"span","marks":[],"text":"The premise of a relationship, and how it separates from a transaction, is its specific design to have more interactions between the parties in the future. The intention of the design is to create trust between the parties, and per "},{"_key":"3b843a3b065b","_type":"span","marks":["b5cd7e108ae9"],"text":"Levi Strauss"},{"_key":"745f46dcdac8","_type":"span","marks":[],"text":", even a sense of indebtedness/anticipated return of something. In order to cultivate this, we need a sense of transparency, truthfulness, reliability — a sense of memory of the interaction, and most of all, a sense of reliability."}],"markDefs":[{"_key":"b5cd7e108ae9","_type":"externalLink","linkType":"text","url":"https://www.google.com/books/edition/Tristes_Tropiques/lfrk6HmuN7EC?hl=en&gbpv=1&printsec=frontcover"}],"style":"normal"},{"_key":"40fc13519791","_type":"block","children":[{"_key":"253e3a0602a3","_type":"span","marks":[],"text":"The transactional visits of today mystify these foundational elements of relationships (that EMRs have relabeled “encounters”, so as to truly absolve us of any misconception that there should be a string of interactions between that very patient and that very provider/health system ever again). The button clicking creates the effect of “pushing patients through” a string of digital checkpoints. The operating systems make healthcare point in time, one-off, and absolve it of the human-to-human relationship. It’s our thesis that in order to redesign a successful system, we must re-insert the effect of time on health. There’s that age-old adage “it takes a village” … to raise a child. It also takes a village to ensure health and wellness continuity across that child’s lifetime, through adulthood. We seemed to have lost that part of the phrase. Our healthcare is a lifetime journey, and it’s one that must be explored in concert with a band of supporters, namely a care team."}],"markDefs":[],"style":"normal"},{"_key":"f5902a4ca486","_type":"editorialImageCarousel","items":[{"_key":"0aa429cd63a5","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_id":"image-a7d9359afcdf1ada0156014c08b7376fd2ccbad7-2103x740-png","_type":"sanity.imageAsset","_createdAt":"2022-12-27T08:50:12Z","_rev":"uBZyzL1oEJWqYeY7qEllTO","_updatedAt":"2022-12-27T08:50:12Z","assetId":"a7d9359afcdf1ada0156014c08b7376fd2ccbad7","extension":"png","metadata":{"_type":"sanity.imageMetadata","blurHash":"DJR7D5}ENuJ8=Kw{w{WVa|so","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":2.841891891891892,"height":740,"width":2103},"hasAlpha":true,"isOpaque":true,"lqip":"data:image/png;base64,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","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#684f3a","foreground":"#fff","population":0.1,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#822e0a","foreground":"#fff","population":0.02,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":59.11,"title":"#fff"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#940a04","foreground":"#fff","population":0,"title":"#fff"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#f9534c","foreground":"#fff","population":6.1,"title":"#fff"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#a07056","foreground":"#fff","population":0.12,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#fc5444","foreground":"#fff","population":59.11,"title":"#fff"}}},"mimeType":"image/png","originalFilename":"Revolutionize_Inline-2.png","path":"images/8qqycr4y/production/a7d9359afcdf1ada0156014c08b7376fd2ccbad7-2103x740.png","sha1hash":"a7d9359afcdf1ada0156014c08b7376fd2ccbad7","size":114142,"uploadId":"J5Cf71xkdlme2AHKzWJVFMqsJ0eeZqLL","url":"https://cdn.sanity.io/images/8qqycr4y/production/a7d9359afcdf1ada0156014c08b7376fd2ccbad7-2103x740.png","id":"image-a7d9359afcdf1ada0156014c08b7376fd2ccbad7-2103x740-png","parent":null,"children":["47caf559-1d20-53a1-aa44-63d87d1ab8c0"],"internal":{"type":"SanityImageAsset","contentDigest":"841502878d327d37e89fa5169e88c35b","counter":7569,"owner":"gatsby-source-sanity"}}}}}]},{"_key":"9adc9cb74c68","_type":"block","children":[{"_key":"29b01e1934070","_type":"span","marks":[],"text":"Our deepest insight is then: in order to transform healthcare we need to reorient our systems of delivery not around a single visit in a vacuum, but the healthcare journey of a patient. "},{"_key":"e1bf85cf92331","_type":"span","marks":["strong"],"text":"That journey must be supported through transparent, ongoing, collaborative relationships between patients and providers, providers and providers, and patients and patients, or the care community."}],"markDefs":[],"style":"normal"},{"_key":"19260d742d85","_type":"sectionHeader","headerLevel":"h2","title":"To put relationships back in medicine, we had to put the people back in medicine; to put the people back in medicine, we had to understand our people"},{"_key":"b18dcfa9e2b7","_type":"block","children":[{"_key":"07b6ec17a448","_type":"span","marks":[],"text":"How to do this — my first inclination came on strong, as it would for anyone steeped in Paul Graham's product thinking: user-centric design. But, as differentiated from our compatriots in healthcare, we certainly were not going to start with the medical biller (we don’t even employ a medical biller). But, we wouldn’t end with the patient and the provider either. Each member of the care community needs to be treated as a “user”, and so did the collective community. When designing and building our system, therefore, we dually consider each role in our organization (PCPs to front desk staff) and the interactions between each role type as a “user” itself. How might a patient use this feature? How would the way they use it to impact the provider on the other side? What might the provider need to do with the information? When would they need to involve a Medical Assistant or another provider?"}],"markDefs":[],"style":"normal"},{"_key":"6c8f326fcbea","_type":"block","children":[{"_key":"2879a59e28080","_type":"span","marks":[],"text":"And, we needed to refashion the success of care away from a focus on encounters, visit duration, and button clicks towards a longitudinal care journey rooted in a relationship with the patient. Meaning, based on patient need, we should prepare the patient for multiple appointments, and how the insights about their condition would unravel across those steps; we required a choreographed understanding across the team of the various touchpoints each role would have with the patient."}],"markDefs":[],"style":"normal"},{"_key":"96baf9413b89","_type":"block","children":[{"_key":"3b9514baadde0","_type":"span","marks":[],"text":"But, in order to do this successfully, we could not just depend on our technology system alone. It was clear that if we fell into the same trap as those around us, of thinking tech, could devise a solution that characterized the clinical operations or medical decision making, we’d end up down the same road as so many others, death by clicks."}],"markDefs":[],"style":"normal"},{"_key":"cb743db17c18","_type":"block","children":[{"_key":"bee018296b040","_type":"span","marks":[],"text":"Clinical operations, service line design, clinical research, patient experience, provider documentation, patient registration … even down to that “breath in, breath out” moment at blood draw needed to be redesigned with this altered perspective in mind. We had a long list, to name a few:"}],"markDefs":[],"style":"normal"},{"_key":"f12cf2b928cb","_type":"block","children":[{"_key":"404b35a78537","_type":"span","marks":["strong"],"text":"We need a service line redesign to change the concept of a “once a year preventive healthcare check-up” to “a daily engagement with my health and wellness”."},{"_key":"b3c3f6863066","_type":"span","marks":[],"text":" How can we help our patients translate “eat more fiber” from their digital care plan into a living and breathing action they take every day?"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e63e710ae414","_type":"block","children":[{"_key":"d6fa15a5fd950","_type":"span","marks":["strong"],"text":"We needed altered clinical operations, guidelines, and procedures to support such a longitudinal view"},{"_key":"4012b26922a5","_type":"span","marks":[],"text":" — how might a provider dig into different questions during different visits? How might we recommend different modalities of wellness (acupuncture, nutrition, mental support) given certain conditions?"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2ed3aeb13b9d","_type":"block","children":[{"_key":"00b5799e97be0","_type":"span","marks":["strong"],"text":"We needed patient education initiatives to engage and explain our different ways of doing things"},{"_key":"a2a6ee26bea9","_type":"span","marks":[],"text":". This education needs to extend beyond informational, to curational. It needs to break the long endured stigmas in women’s care, and building community in the experience of our bodies, of our health, of our lives — rehumanize healthcare through and through."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b2eb0d0b02bd","_type":"block","children":[{"_key":"e66fad2e95eb0","_type":"span","marks":["strong"],"text":"We needed differentiated staff and personnel"},{"_key":"1dd9bc596723","_type":"span","marks":[],"text":" who would thrive in the high volume of communication that we are doing between our team and out to patients. We needed training modules on how to speak the language of patients, not the foreboding language of healthcare."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"cdca5180da06","_type":"block","children":[{"_key":"59488a7252f20","_type":"span","marks":["strong"],"text":"We even needed alternate clinical space design"},{"_key":"f726d5fd342b","_type":"span","marks":[],"text":" to support the cross-team collaboration and make “the doctor’s office” a place women wanted to go to — not just when something was wrong but to proactively invest in their health."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"351cde871b67","_type":"block","children":[{"_key":"3779c75984c70","_type":"span","marks":["strong"],"text":"We needed to establish an organizational culture"},{"_key":"6ab074c3d457","_type":"span","marks":[],"text":" that supported our core norms, principles, and philosophies around the critical elements of success in patient-care (longitudinal thinking/the health journey and relationships). This necessitated more than just technologists working on this “product”. This essentially requires our entire organization, from software developers to clinical operators, to NPs and MDs, to designers, to the brand team. Decisions couldn’t be siloed but must be made and executed horizontally across all these functional areas."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"558c73c02c20","_type":"block","children":[{"_key":"ad0cd20227cd","_type":"span","marks":[],"text":"To bring these various minds together, the right org structure became tantamount. As anyone familiar with matrixed decision making, the underbelly of the interdisciplinary team is decision paralysis. In an effort to avoid this, we took the role of the product manager, or the ambassador of the user, and said: you have many tools in your tool kit, use them all to impress your user. PMs at Tia use tech, service line design, patient education, clinical modeling, process/procedures, cultural development and training, and much more to deliver on their goal."}],"markDefs":[],"style":"normal"},{"_key":"59aaa16ce9ad","_type":"sectionHeader","headerLevel":"h2","title":"And, we had to revolutionize the way we organize our people to ensure the best possible collaborative outcomes."},{"_key":"2ec2ca7a695c","_type":"block","children":[{"_key":"c9d791fdc07a","_type":"span","marks":[],"text":"The role of the PM is much expanded from the traditional that typically works across engineering, design, and marketing. And, as is much in vogue at the moment in technical organizations, we’re pulling the “technical design” conversations earlier into the development process. But, we’ve expanded our definition of technical design to include clinical ops, clinical research, and care. After all, we’re in a world where much of our product is actually the care, and the ops are the delivery vessel (akin to businesses where content is the product, and the platform is the delivery vessel aka Instagram). Engineers and operators are our builders, they just have different building blocks. We treat the design and implementation process across the two much the same — and most importantly, the test/iterate cycle much the same. Our operational feature performance is measured and ‘bug fixed’ in much the same way our technical features are."}],"markDefs":[],"style":"normal"},{"_key":"ddc48aa57be0","_type":"block","children":[{"_key":"6725889768f00","_type":"span","marks":[],"text":"One of the most important elements of how we’ve thought about this design is that we cut a PM’s responsibility not by tools in the tool kit but by the user, we don’t have operator PMs and tech PMs, just PMs. Our PMs are focused on the patients or the providers or the administrative staff. This means, in order to develop end value for the user, they may / must have to traverse all tools in the tool kit. Take a recent feature we released, an online check-in for patients which allows them to validate their insurance coverage, the card on file for copays, and complete their intakes ahead of their visit. While a substantial portion of this feature was a technical build (and quite a complex one at that), this implicated both our administrative and clinician teams. This information is critical to the workflows of both. So, before even setting out to design or build tech, we said to them, “what are the ways in which you use this information? What are your biggest pain points around it? What do you wish you could do?”. These answers factored directly into the systems that we designed — both technical and operational."}],"markDefs":[],"style":"normal"},{"_key":"12714dd8295a","_type":"block","children":[{"_key":"c43acfa5d3d50","_type":"span","marks":[],"text":"A different, more clinical example is how we redesigned the use of the patient care plan to support our longitudinal care structure. Providers traditionally document the treatments and next steps for patients in the care plan section of the EMR. Similar to others, we use this opportunity to prompt providers to think about our particular care model (eg if a patient is in for a UTI, consider immune support, not just antibiotics). Yet, we also heard from patients and care teams alike that a document to remind the patient post appointment of the plan would be useful, and even more useful would be to have recommendations for how they might secure items in the care plan, or have the opportunity to discuss in more detail the recommendations. While we’re still building out this feature (it’s currently in the MVP phase), this was a perfect example of insights from a trifecta of users coming together to influence both technical features (digitally displaying the care plan to a patient and provider in their respective portals) as well as operations (training our care team on how to chat with patients about this document). 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From there, they will do a series of physical examinations, which can include everything from a pap smear and a breast exam to an ear & nose & eye check, depending on your age, gender, and other risk factors."}],"markDefs":[],"style":"normal"},{"_key":"7e14a49800b8","_type":"block","children":[{"_key":"53a8ab4be6a00","_type":"span","marks":[],"text":"Take the part where the patient is talking to their provider, and have them do this virtually. This allowed providers to understand the patient’s risk factors, determine the urgency of their physical exams, and ensure that the patient was only getting the physical examinations that they needed."}],"markDefs":[],"style":"normal"},{"_key":"4053071bb96c","_type":"block","children":[{"_key":"e9a0800ce8cb0","_type":"span","marks":[],"text":"Thinking we had figured it out, we began to plan for a “Half n’ Half” Well-Woman — half online, half offline."}],"markDefs":[],"style":"normal"},{"_key":"eba3cb389a70","_type":"sectionHeader","title":"Tia Well Woman 2.0: Service Design"},{"_key":"9b3a7d71c730","_type":"block","children":[{"_key":"ab0ef5376dfb","_type":"span","marks":[],"text":"At Tia, we believe in constantly listening to our patients & providers when designing products. We believe that if we listen with open ears, they’ll tell us what they need."}],"markDefs":[],"style":"normal"},{"_key":"de5cb002a27f","_type":"block","children":[{"_key":"29927151e4ea0","_type":"span","marks":[],"text":"As a next step to bring this Half n Half to life, we began reviewing the feedback that we had received on the Well Woman experience we had been delivering to date and did roundtables with patients & providers on the new experiences we were delivering."}],"markDefs":[],"style":"normal"},{"_key":"10a63d751050","_type":"block","children":[{"_key":"703ce216bf040","_type":"span","marks":[],"text":"We heard one thing loud & clear: Tia can do better."}],"markDefs":[],"style":"normal"},{"_key":"5b003b41c99a","_type":"block","children":[{"_key":"a7c25d0c27c90","_type":"span","marks":[],"text":"While the increased access to virtual preventative care was enticing, we repeatedly heard that patients wanted a deeper understanding of the risk factors that providers identified in the visit and a holistic plan on how to address them."}],"markDefs":[],"style":"normal"},{"_key":"67bb5f31fcdb","_type":"block","children":[{"_key":"26e04fe756c90","_type":"span","marks":[],"text":"To meet & exceed our patient’s expectations, we needed to truly uplevel the quality of the consultation portion of the Well Woman experience we had designed. This involved two big changes."}],"markDefs":[],"style":"normal"},{"_key":"8863c28fb5c3","_type":"editorialImageCarousel","items":[{"_key":"0ef0ebc110aa","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-c60fe21384c63ddc718d361b7d875752a0f03878-1679x842-png","_type":"reference"}}}}]},{"_key":"8bfaf907a95b","_type":"block","children":[{"_key":"973dfe86485e0","_type":"span","marks":["strong"],"text":"Delivering patients a Care Plan: "},{"_key":"973dfe86485e1","_type":"span","marks":[],"text":"We heard loud and clear: Tia patients want to take ownership of their health journey. They want a plan, and they want to be a part of designing it. In the new iteration of the Well Woman, every patient would get a documented Care Plan that had the exact plan they had made with their provider. 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Ultimately, we landed on creating new naming conventions and standardizing visualizations of the Care Plans as the tools to explain this to members."}],"markDefs":[],"style":"normal"},{"_key":"b6f6e528b61c","_type":"block","children":[{"_key":"5bfd86a273c7","_type":"span","marks":[],"text":"The team compiled this into "},{"_key":"69b8c90a0b4c","_type":"span","marks":["63d052e7abad"],"text":"a webpage"},{"_key":"d3ab7fda0f88","_type":"span","marks":[],"text":" that took patients through the experience end-to-end."}],"markDefs":[{"_key":"63d052e7abad","_type":"internalLink"}],"style":"normal"},{"_key":"e65c0c5564e3","_type":"block","children":[{"_key":"9aa04d4b822d0","_type":"span","marks":[],"text":"Operationalizing the experience"}],"markDefs":[],"style":"h3"},{"_key":"73bc73a81d83","_type":"block","children":[{"_key":"cac03df2f4ed0","_type":"span","marks":[],"text":"We had introduced an entirely new service line: for one single patient journey, there were multiple providers and administrative staff working behind the scenes to ensure a smooth experience."}],"markDefs":[],"style":"normal"},{"_key":"c04d20a7b2e3","_type":"block","children":[{"_key":"5c6a10af94c00","_type":"span","marks":[],"text":"We doubled down on documentation and training, particularly around the parts of the experience where patients were moving from one step to another — what we like to call at tia “baton passes.”"}],"markDefs":[],"style":"normal"},{"_key":"c20bdae12bb3","_type":"editorialImageCarousel","items":[{"_key":"3564fc63cdde","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-cd12b80e2ea30e51f5bf02c3e2ce18c10f4afcc9-2103x1175-png","_type":"reference"}}}}]},{"_key":"975e4f8dedf4","_type":"block","children":[{"_key":"f31e29a6ff31","_type":"span","marks":[],"text":"Bringing the product into the technology platform"}],"markDefs":[],"style":"h3"},{"_key":"9054bbb00c37","_type":"block","children":[{"_key":"66e9e036e6b50","_type":"span","marks":[],"text":"The online-and-offline experience required a new tech experience, particularly as it related to booking an appointment. We knew that the next experience had to deliver on two key requirements:"}],"markDefs":[],"style":"normal"},{"_key":"d1ccb517fdd8","_type":"block","children":[{"_key":"c76e7f25fde70","_type":"span","marks":[],"text":"Education: it’s a new service, we needed to use this as an opportunity to explain the experience of booking"}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"17a629694195","_type":"block","children":[{"_key":"f385e0b8a3a10","_type":"span","marks":[],"text":"Continuous journey: we needed to show that they were booking the beginning of a journey of appointments, not a one-off appointment."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"64cf3e01f9ad","_type":"block","children":[{"_key":"d00754a3d9ed0","_type":"span","marks":[],"text":"Together, our tech product, product design, and engineering team worked together to shift to a new booking experience that delivered on this requirement."}],"markDefs":[],"style":"normal"},{"_key":"cf14657a28cf","_type":"sectionHeader","title":"It’s just the beginning"},{"_key":"1d824a4ecb8f","_type":"block","children":[{"_key":"5a2dfd292a4d","_type":"span","marks":[],"text":"In June 2020, Tia’s Well-Woman 2.0 was introduced to the world."}],"markDefs":[],"style":"normal"},{"_key":"dcefbf5cdd4f","_type":"block","children":[{"_key":"7ef8da1102140","_type":"span","marks":["strong"],"text":"Patients were thrilled"},{"_key":"d5c524ca72dc","_type":"span","marks":[],"text":" — the new service had both allowed for access to preventative care and created an experience that had up-leveled their preventative care experience."}],"markDefs":[],"style":"normal"},{"_key":"5c7dd3a475d7","_type":"editorialImageCarousel","items":[{"_key":"24a77389a97f","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-427f7de9056483b7a5f896aac7eb7d3e235d690d-1644x424-gif","_type":"reference"}}}}]},{"_key":"7b03da86ab09","_type":"block","children":[{"_key":"4b59e1c2602b","_type":"span","marks":["strong"],"text":"Providers were thrilled"},{"_key":"58f1af6c0b71","_type":"span","marks":[],"text":"-- by creating time for providers to focus on understanding the patient's health history & goals, they were given the space to work collaboratively with their patients to create a truly holistic plan for how to get or keep their patients healthy."}],"markDefs":[],"style":"normal"},{"_key":"6f7bd104dbc4","_type":"editorialImageCarousel","items":[{"_key":"b853a4833da9","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-dbb5b118af5b0396af69731bdca8ffdf71f68095-1644x424-gif","_type":"reference"}}}}]},{"_key":"4010ec4cbdc8","_type":"block","children":[{"_key":"8449a1d1f88b","_type":"span","marks":[],"text":"Launching the Tia Well-Woman 2.0 experience was a huge step forward in delivering on the Tia Care Model. 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Prior to Tia I “cut my teeth” at Bridgewater and Owler, where I worked as a “traditional” product manager in very non-traditional company cultures. These experiences shaped my entree to Tia with deep regard for the impact structure and culture of a team can have on the end product."}],"markDefs":[],"style":"normal"},{"_key":"4ce7773d91da","_type":"block","children":[{"_key":"133d987bd06a","_type":"span","marks":[],"text":"As the incarnating blog post, I seek to describe what "},{"_key":"2afa3234b575","_type":"span","marks":["em"],"text":"Product"},{"_key":"d5026bdca791","_type":"span","marks":[],"text":" is at Tia. For, it’s something it’s not at most other places, or it’s not something it is at most other places. ;)"}],"markDefs":[],"style":"large"},{"_key":"15a236000d8b","_type":"block","children":[{"_key":"a4cac281e844","_type":"span","marks":[],"text":"Below I describe in a narrative fashion, how we’ve arrived at the product-centric approach to development at Tia. Immediately below (if you’re not prone to prose) I also summarize the key differentiators/takeaways."}],"markDefs":[],"style":"normal"},{"_key":"86edf8e48df8","_type":"block","children":[{"_key":"48e0d0698cf40","_type":"span","marks":[],"text":"In one phrase, though, "},{"_key":"48e0d0698cf41","_type":"span","marks":["em","strong"],"text":"we are different because we aren’t limiting the traditional product development principles to one tool kit (code) but, instead, liberally applying them across our various users and their needs in ways that healthcare has never seen before."}],"markDefs":[],"style":"normal"},{"_key":"127698635ed1","_type":"sectionHeader","headerLevel":"h2","title":"The Summary"},{"_key":"d9b885f32a77","_type":"block","children":[{"_key":"15ac3a565ad2","_type":"span","marks":[],"text":"Our approach is different in the following ways:"}],"markDefs":[],"style":"normal"},{"_key":"5ad0fe017438","_type":"block","children":[{"_key":"4dba881e17d70","_type":"span","marks":[],"text":"We believe that a massive contributor to the issues plaguing healthcare is the technology systems that have been incalculably thrust upon the industry, and the way we’ve operationally and technically shifted from relationships and longitudinal health and wellness to transactional, moment in time visits and care. As our core insight, we strive to build a system that is explicitly oriented around supporting the many people participating in a patient’s care community, as well as acknowledging that health and wellness are ongoing activities through life, necessitating more than just a visit."}],"markDefs":[],"style":"normal"},{"_key":"53f86ff36f70","_type":"block","children":[{"_key":"192b7036f6230","_type":"span","marks":[],"text":"In order to effectuate our core thesis into a system, we have taken two differentiated steps in building our products: we’ve greatly expanded our notion of “user” and we’ve greatly expanded how we think about product."}],"markDefs":[],"style":"normal"},{"_key":"d0cd88ac4105","_type":"block","children":[{"_key":"83170518b0aa","_type":"span","marks":["strong"],"text":"We have multiple users, we’re building for the patient, we’re also building for the provider."},{"_key":"ae6a12178830","_type":"span","marks":[],"text":" This means our gynecologists, Primary Care Physicians (PCPs), Licensed Clinical Social Workers (LCSWs) — but it also means the Medical Assistant, care team, the front desk associate, and the ultrasound tech (traditionally forgotten)… we’re building for each individual on our team, and for the team collectively.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f51d3c838c8b","_type":"block","children":[{"_key":"dc22fbcf25ba0","_type":"span","marks":["strong"],"text":"We view product more expansively than our tech platform, product is our service line, it is our community support, it’s our content."},{"_key":"0a20bdaef09b","_type":"span","marks":[],"text":" With this perspective, we apply the traditional “user-centered thinking” to every problem/issue we encounter (there’s many, we’ve no shortage of “TODOS”), and design solutions under traditional product management strategies (cult of WWUD, or what would the user do?”). This is surprisingly differentiated in healthcare, a space that is still run by the “bottom line”. We take the belief that, if we do what’s best for our users, the needed behavior and the right bottom line will fall into place.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"4044ab598dce","_type":"block","children":[{"_key":"3b4800b1ca790","_type":"span","marks":["strong"],"text":"Expanding our view of product beyond tech alone has necessitated our “architects” to deploy more than code to stand up our differentiated systems. "},{"_key":"a6149a7bdbf0","_type":"span","marks":[],"text":"Our product teams use technology, process, protocols, norms, principles, and culture to build our system. The toolkit is far more expansive, but enables us to not only deploy new service lines, and do the much more challenging (and in my book innovative) which is to deploy tech features that don’t just ladder up to and support clinical processes, but actually help promote/reinforce our clinical model.\n"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3e044e5cd656","_type":"block","children":[{"_key":"571f4fcab75f0","_type":"span","marks":[],"text":"In order to do this, "},{"_key":"0db4e76cfd06","_type":"span","marks":["strong"],"text":"we elevate engineers, designers, and clinical operators alike into the role of “builders”, and employ them all under the umbrella of the “product organization”."},{"_key":"41a8a65c30ca","_type":"span","marks":[],"text":" Given our platform is not just tech, it necessitates builders of all different skills and licenses to bring our interdisciplinary vision to fruition."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8904519af8dc","_type":"editorialImageCarousel","items":[{"_key":"8aa8e64f316e","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-744becbbd3aa4a93740f80b3acf17062c74a3e0a-2103x562-png","_type":"reference"}}}}]},{"_key":"ce38dfd8863c","_type":"sectionHeader","headerLevel":"h2","title":"The story version: Our early days set up our differentiated approach"},{"_key":"9edfe4cf7568","_type":"block","children":[{"_key":"8d00f6568720","_type":"span","marks":[],"text":"When we first set out to build Tia, we were on a journey to “de-fragmentize” healthcare, and also to “democratize” access to reliable healthcare information so that women could make better decisions. We knew that this system must leverage technology — but in our early days — we hadn’t fully found what our product needed to be. In silicon valley terms, we hadn’t arrived at product-market fit. "}],"markDefs":[],"style":"normal"},{"_key":"4ee4bf48d6d0","_type":"block","children":[{"_key":"fe75a925d6dd","_type":"span","marks":[],"text":"For the first 9 months of Tia’s life, we were really focused on building a 1-to-1 personal health assistant. It was part human and part bot, and provided personalized and largely instantaneous answers to common women’s health questions such as “I forgot my birth control pill” or “my period is late, should I be concerned?”. Our sweet spot was urgent/anxiety-provoking questions requiring more personalization than a blog post. While this experience gave us an unparalleled front-row seat to over 200,000 different conversations with women about their health, we quickly learned that we needed to supply more than just digital answers on an iPhone to meet women’s needs. Women really wanted Tia to actually deliver their healthcare, not just advice on what and where to get it. We learned that our superpower was not only providing women information but a trusted relationship — one that made women feel seen heard and cared for in outsized ways. We had cracked one of the hardest things to do in healthcare — cultivate trust. "}],"markDefs":[],"style":"normal"},{"_key":"9b66809c5330","_type":"editorialImageCarousel","items":[{"_key":"f49d1bd31725","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-3d60fdc3083e7c9cd9e7acc97c2133910454b789-2103x549-png","_type":"reference"}}}}]},{"_key":"44c1774f77eb","_type":"block","children":[{"_key":"eeeb961d1555","_type":"span","marks":[],"text":"Why then, would we refer women into the healthcare system then for actual healthcare, which they more often than not, distrusted so much? Women wanted real “hardcore” care from Tia, a place to get pelvic exams, STI tests, ultrasounds, breast exams, Pap smears, and phlebotomy. Unlike many of the virtual care platforms that were taking off that the moment, we saw that to bring our women what they needed from Tia required physical sites for care. So, like any good product organization, we bent to our users’ demands."}],"markDefs":[],"style":"normal"},{"_key":"0c105e655eee","_type":"block","children":[{"_key":"0ef80267e55a0","_type":"span","marks":[],"text":"It was at this turning point that we had to face ourselves in the mirror and say: if we are going to become a brick and mortar healthcare delivery organization, what role does technology play in our business? Are we even a tech company? Do we even need a product team? In brief, Carolyn and I would reiterate to ourselves the existential question: “Are we an app with a clinic? Or, a clinic with an app?”"}],"markDefs":[],"style":"normal"},{"_key":"a3c6c42db9ef","_type":"block","children":[{"_key":"33cf1b6052510","_type":"span","marks":[],"text":"I knew we didn’t want to be either. Both sounded small. Not to mention, either way of looking at our future completely missed what we surmised as the core issues in healthcare: information fragmentation, bad patient AND provider experience lacking orientation around cost, a paucity of creative design to make it easy and convenient to use, tawdry technology that belabored simple actions."}],"markDefs":[],"style":"normal"},{"_key":"bdcdb493534e","_type":"sectionHeader","headerLevel":"h2","title":"We couldn’t follow the path of least resistance"},{"_key":"f254b98f9a3b","_type":"block","children":[{"_key":"ca0da4b65ef3","_type":"span","marks":[],"text":"If I am being honest, it probably would’ve been easy to say that “a clinic with an app” alone would solve the problem (it at least would’ve definitely been easier to sell to investors). The problems in healthcare technology are rampant, and most everyone knows this. For example, I’ve never heard a single provider rave about their tech. The brunt of provider complaints arise from the stone-age era Electronic Medical Records (EMR) systems they’re required to use every day, systems that were designed more around the success of the medical biller than the clinician themself. These truths are best described in the poignant article, "},{"_key":"0318a480b2b8","_type":"span","marks":["3b2369a73d90"],"text":"Death by 10,000 Clicks"},{"_key":"049c33b94b91","_type":"span","marks":[],"text":"; an article that every modern-day clinician and “health tech” industry worker has imprinted into their memory."}],"markDefs":[{"_key":"3b2369a73d90","_type":"externalLink","linkType":"text","url":"https://khn.org/news/death-by-a-thousand-clicks/"}],"style":"normal"},{"_key":"0bbeadd0b071","_type":"editorialImageCarousel","items":[{"_key":"081ca21fcc57","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-819cd80d214e48bcdd2133263ca6368afcf64b8a-2466x1644-png","_type":"reference"}}}}]},{"_key":"aab74a44f11b","_type":"block","children":[{"_key":"fa7cbf952e92","_type":"span","marks":[],"text":"That these technology systems inadvertently and advertently shape modern medicine is a critical vector of our problems. EMRs are no longer just data receptacles, they are actually dictating standard of care — "},{"_key":"162be1e80a24","_type":"span","marks":["em"],"text":"driving,"},{"_key":"6353b6556625","_type":"span","marks":[],"text":" not documenting, clinical actions. And, because of the ways that the systems prevent providers from “progressing” a patient through care if they don’t tap the right button, providers focus more on clicking than actually consulting. Who could blame them, for a standard primary care checkup there can be over "},{"_key":"631f1f84f3a9","_type":"span","marks":["dd265e5e3560"],"text":"400 required actions if the EMR is CMS Medicaid compliant"},{"_key":"f93979047b86","_type":"span","marks":[],"text":". This impacts our patients too — provider eye contact is drawn away from the patient in the visit, focused on the buttons not explaining the recommendations. But, worst of all, these "},{"_key":"e21f3f7c63ae","_type":"span","marks":["em"],"text":"buttons"},{"_key":"b565b465e375","_type":"span","marks":[],"text":" distract the provider from the very reason they got into medicine and spent years obtaining a medical degree. In lieu of medical decision making, providers, via these EMRs, are shoved into a draconian technology system that takes as slim a perspective on the merits and possible vertices of human existence and disease as a 1999 version of The Sims. (like versions pre-dating rosebud!;!;!;!;)"}],"markDefs":[{"_key":"dd265e5e3560","_type":"externalLink","linkType":"text","url":"https://pubmed.ncbi.nlm.nih.gov/240603"}],"style":"normal"},{"_key":"8cf8f66d5bbc","_type":"block","children":[{"_key":"5a0720bbafe4","_type":"span","marks":[],"text":"Just as limited as you might feel like a real human in a Sim life, providers are limited in the seemingly two-dimensional matrix of common EMRs. These collections of 1’s and 0’s have uprooted the art of medicine, the practice of wellness, and healing. The art supplanted not by science, but by code. Code that has been lobbed haphazardly on top of more antiquated code, to form a “system”. With each subsequent CMS guideline, another piece falls into a previously unrecognized crack. This mass of bad tech is a very large nodule on the rhizome of the issues in healthcare (I had to go with rhizome, as the panoply of issues in the healthcare system is certainly so large as to require its own glucose supply)."}],"markDefs":[],"style":"normal"},{"_key":"6b42f1072172","_type":"block","children":[{"_key":"0465b927a0d60","_type":"span","marks":[],"text":"So, it was clear that these issues we set out to solve: worsening outcomes, dissatisfied patients, demoralized providers, skyrocketing costs, layers and layers of institution/fragmentation could not be unearthed with a mere digital re-skinning of current tech. The Frankenstein needs to be put to rest and replaced with a new system more purposefully sewn together. This is why we couldn’t take the easy route — and couldn’t make a ‘clinic with an app’."}],"markDefs":[],"style":"normal"},{"_key":"205c89334b16","_type":"block","children":[{"_key":"bb52c346efa30","_type":"span","marks":[],"text":"Everything that I’ve said over the last 4 paragraphs is trite for someone in healthcare. The real difference is how Tia addresses this. A mini digression before I get to this (now you’re understanding why I wrote a summary!)"}],"markDefs":[],"style":"normal"},{"_key":"07b366d95710","_type":"sectionHeader","headerLevel":"h2","title":"Our society didn’t just have a break up with medicine, it lost all relationships in medicine"},{"_key":"98b982e41468","_type":"block","children":[{"_key":"f4283bdd0e65","_type":"span","marks":[],"text":"Long ago, art, science, medicine, pharmacology, botany, horticulture, spirituality and community were all linked, often tied to the same place, individual, or ritualistic practice. And, in more recent past (a mere decade ago), patients retained their doctor for life — allowing their care providers to amass a world of data about them, that while perhaps not all captured in a clinical note, was fertilizing the ground from which the physician drew clinical insights and took clinical decisions. While I am not insinuating we ought to return to bloodletting practices of the past, I do think that we’ve lost greatly in siloing medicine away from the acts of healing, wellness, and community. But required for those is an element that our society, and medicine, in particular, has waysided: time, continuity, cultivation, iteration, and evolution. The site of the modern medical marvel, the ER, is anything but a site for healing continuity. Instead, it’s a site of “transaction”, “one and done” and “take a pill to make it all go away”."}],"markDefs":[],"style":"normal"},{"_key":"d4098fdf9393","_type":"block","children":[{"_key":"1b24b4c949380","_type":"span","marks":[],"text":"What is elemental to “practice medicine”? Etymologically, practice is derived from the greek and means something that is constantly worked on. Medicine, the observation of what is natural. Both rely on this idea of ‘overtime’ — practice and observe "},{"_key":"9acab55604521","_type":"span","marks":["em"],"text":"over time"},{"_key":"9acab55604522","_type":"span","marks":[],"text":". We need a system that will more deeply support care for a patient through time."}],"markDefs":[],"style":"normal"},{"_key":"bfee497351b4","_type":"block","children":[{"_key":"6d4cc4f8623c0","_type":"span","marks":[],"text":"We want to shift our perspective back towards the ‘practice of medicine’ as longitudinal, as through time. How might we do this in a day where patients now expect to similarly command clinical care as they do Ubers? Where we’re promised “cures” to incurable diseases with symptom masking pills? Where providers are cornered into singular methods of treating patients, regardless of the patient's contextual complexities? And, where quite frankly, our clinicians are so burnt out they are constantly looking for ways to minimize patient-facing care hours?"}],"markDefs":[],"style":"normal"},{"_key":"435fe98da408","_type":"block","children":[{"_key":"ea16711fb45c0","_type":"span","marks":[],"text":"From our estimation the longitudinal shift comes down to two core elements that must be pursued: a focus on the spectrum between illness and health and cultivation of relationships as the core system in medicine. The former is at root Tia’s clinical model, our unique approach to delivering care. It is a topic for another, a stand-alone post. But the latter characterizes our perspective on the system that we need to build to enable success in medicine once again. Designing and building this system is my focus at Tia, I’ll aim to explain deeply yet tactically what we mean in the remainder of this post."}],"markDefs":[],"style":"normal"},{"_key":"ce247c3f8559","_type":"block","children":[{"_key":"1e90a900e5b70","_type":"span","marks":[],"text":"In healthcare, we often talk of the patient <> provider relationship — but, in fact that relationship barely exists today. We insinuated institutions between the patient and the provider (think: “I tried to call my doctor but I was on hold with a call center for nearly an hour”, or “I wouldn’t even know where to go to get my medical records”, or “I got a bill from someplace that I didn’t even know I went to for care”). And, of the other relationships critical to making care delivery “work”, we typically gloss them over: the relationship between the patient <> care team, the provider <> care team, the provider <> medical assistant, the provider <> radiologist … etc."}],"markDefs":[],"style":"normal"},{"_key":"3002460de716","_type":"block","children":[{"_key":"8d106fb7adce0","_type":"span","marks":[],"text":"The premise of a relationship, and how it separates from a transaction, is its specific design to have more interactions between the parties in the future. The intention of the design is to create trust between the parties, and per "},{"_key":"3b843a3b065b","_type":"span","marks":["b5cd7e108ae9"],"text":"Levi Strauss"},{"_key":"745f46dcdac8","_type":"span","marks":[],"text":", even a sense of indebtedness/anticipated return of something. In order to cultivate this, we need a sense of transparency, truthfulness, reliability — a sense of memory of the interaction, and most of all, a sense of reliability."}],"markDefs":[{"_key":"b5cd7e108ae9","_type":"externalLink","linkType":"text","url":"https://www.google.com/books/edition/Tristes_Tropiques/lfrk6HmuN7EC?hl=en&gbpv=1&printsec=frontcover"}],"style":"normal"},{"_key":"40fc13519791","_type":"block","children":[{"_key":"253e3a0602a3","_type":"span","marks":[],"text":"The transactional visits of today mystify these foundational elements of relationships (that EMRs have relabeled “encounters”, so as to truly absolve us of any misconception that there should be a string of interactions between that very patient and that very provider/health system ever again). The button clicking creates the effect of “pushing patients through” a string of digital checkpoints. The operating systems make healthcare point in time, one-off, and absolve it of the human-to-human relationship. It’s our thesis that in order to redesign a successful system, we must re-insert the effect of time on health. There’s that age-old adage “it takes a village” … to raise a child. It also takes a village to ensure health and wellness continuity across that child’s lifetime, through adulthood. We seemed to have lost that part of the phrase. Our healthcare is a lifetime journey, and it’s one that must be explored in concert with a band of supporters, namely a care team."}],"markDefs":[],"style":"normal"},{"_key":"f5902a4ca486","_type":"editorialImageCarousel","items":[{"_key":"0aa429cd63a5","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-a7d9359afcdf1ada0156014c08b7376fd2ccbad7-2103x740-png","_type":"reference"}}}}]},{"_key":"9adc9cb74c68","_type":"block","children":[{"_key":"29b01e1934070","_type":"span","marks":[],"text":"Our deepest insight is then: in order to transform healthcare we need to reorient our systems of delivery not around a single visit in a vacuum, but the healthcare journey of a patient. "},{"_key":"e1bf85cf92331","_type":"span","marks":["strong"],"text":"That journey must be supported through transparent, ongoing, collaborative relationships between patients and providers, providers and providers, and patients and patients, or the care community."}],"markDefs":[],"style":"normal"},{"_key":"19260d742d85","_type":"sectionHeader","headerLevel":"h2","title":"To put relationships back in medicine, we had to put the people back in medicine; to put the people back in medicine, we had to understand our people"},{"_key":"b18dcfa9e2b7","_type":"block","children":[{"_key":"07b6ec17a448","_type":"span","marks":[],"text":"How to do this — my first inclination came on strong, as it would for anyone steeped in Paul Graham's product thinking: user-centric design. But, as differentiated from our compatriots in healthcare, we certainly were not going to start with the medical biller (we don’t even employ a medical biller). But, we wouldn’t end with the patient and the provider either. Each member of the care community needs to be treated as a “user”, and so did the collective community. When designing and building our system, therefore, we dually consider each role in our organization (PCPs to front desk staff) and the interactions between each role type as a “user” itself. How might a patient use this feature? How would the way they use it to impact the provider on the other side? What might the provider need to do with the information? When would they need to involve a Medical Assistant or another provider?"}],"markDefs":[],"style":"normal"},{"_key":"6c8f326fcbea","_type":"block","children":[{"_key":"2879a59e28080","_type":"span","marks":[],"text":"And, we needed to refashion the success of care away from a focus on encounters, visit duration, and button clicks towards a longitudinal care journey rooted in a relationship with the patient. Meaning, based on patient need, we should prepare the patient for multiple appointments, and how the insights about their condition would unravel across those steps; we required a choreographed understanding across the team of the various touchpoints each role would have with the patient."}],"markDefs":[],"style":"normal"},{"_key":"96baf9413b89","_type":"block","children":[{"_key":"3b9514baadde0","_type":"span","marks":[],"text":"But, in order to do this successfully, we could not just depend on our technology system alone. It was clear that if we fell into the same trap as those around us, of thinking tech, could devise a solution that characterized the clinical operations or medical decision making, we’d end up down the same road as so many others, death by clicks."}],"markDefs":[],"style":"normal"},{"_key":"cb743db17c18","_type":"block","children":[{"_key":"bee018296b040","_type":"span","marks":[],"text":"Clinical operations, service line design, clinical research, patient experience, provider documentation, patient registration … even down to that “breath in, breath out” moment at blood draw needed to be redesigned with this altered perspective in mind. We had a long list, to name a few:"}],"markDefs":[],"style":"normal"},{"_key":"f12cf2b928cb","_type":"block","children":[{"_key":"404b35a78537","_type":"span","marks":["strong"],"text":"We need a service line redesign to change the concept of a “once a year preventive healthcare check-up” to “a daily engagement with my health and wellness”."},{"_key":"b3c3f6863066","_type":"span","marks":[],"text":" How can we help our patients translate “eat more fiber” from their digital care plan into a living and breathing action they take every day?"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e63e710ae414","_type":"block","children":[{"_key":"d6fa15a5fd950","_type":"span","marks":["strong"],"text":"We needed altered clinical operations, guidelines, and procedures to support such a longitudinal view"},{"_key":"4012b26922a5","_type":"span","marks":[],"text":" — how might a provider dig into different questions during different visits? How might we recommend different modalities of wellness (acupuncture, nutrition, mental support) given certain conditions?"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2ed3aeb13b9d","_type":"block","children":[{"_key":"00b5799e97be0","_type":"span","marks":["strong"],"text":"We needed patient education initiatives to engage and explain our different ways of doing things"},{"_key":"a2a6ee26bea9","_type":"span","marks":[],"text":". This education needs to extend beyond informational, to curational. It needs to break the long endured stigmas in women’s care, and building community in the experience of our bodies, of our health, of our lives — rehumanize healthcare through and through."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b2eb0d0b02bd","_type":"block","children":[{"_key":"e66fad2e95eb0","_type":"span","marks":["strong"],"text":"We needed differentiated staff and personnel"},{"_key":"1dd9bc596723","_type":"span","marks":[],"text":" who would thrive in the high volume of communication that we are doing between our team and out to patients. We needed training modules on how to speak the language of patients, not the foreboding language of healthcare."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"cdca5180da06","_type":"block","children":[{"_key":"59488a7252f20","_type":"span","marks":["strong"],"text":"We even needed alternate clinical space design"},{"_key":"f726d5fd342b","_type":"span","marks":[],"text":" to support the cross-team collaboration and make “the doctor’s office” a place women wanted to go to — not just when something was wrong but to proactively invest in their health."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"351cde871b67","_type":"block","children":[{"_key":"3779c75984c70","_type":"span","marks":["strong"],"text":"We needed to establish an organizational culture"},{"_key":"6ab074c3d457","_type":"span","marks":[],"text":" that supported our core norms, principles, and philosophies around the critical elements of success in patient-care (longitudinal thinking/the health journey and relationships). This necessitated more than just technologists working on this “product”. This essentially requires our entire organization, from software developers to clinical operators, to NPs and MDs, to designers, to the brand team. Decisions couldn’t be siloed but must be made and executed horizontally across all these functional areas."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"558c73c02c20","_type":"block","children":[{"_key":"ad0cd20227cd","_type":"span","marks":[],"text":"To bring these various minds together, the right org structure became tantamount. As anyone familiar with matrixed decision making, the underbelly of the interdisciplinary team is decision paralysis. In an effort to avoid this, we took the role of the product manager, or the ambassador of the user, and said: you have many tools in your tool kit, use them all to impress your user. PMs at Tia use tech, service line design, patient education, clinical modeling, process/procedures, cultural development and training, and much more to deliver on their goal."}],"markDefs":[],"style":"normal"},{"_key":"59aaa16ce9ad","_type":"sectionHeader","headerLevel":"h2","title":"And, we had to revolutionize the way we organize our people to ensure the best possible collaborative outcomes."},{"_key":"2ec2ca7a695c","_type":"block","children":[{"_key":"c9d791fdc07a","_type":"span","marks":[],"text":"The role of the PM is much expanded from the traditional that typically works across engineering, design, and marketing. And, as is much in vogue at the moment in technical organizations, we’re pulling the “technical design” conversations earlier into the development process. But, we’ve expanded our definition of technical design to include clinical ops, clinical research, and care. After all, we’re in a world where much of our product is actually the care, and the ops are the delivery vessel (akin to businesses where content is the product, and the platform is the delivery vessel aka Instagram). Engineers and operators are our builders, they just have different building blocks. We treat the design and implementation process across the two much the same — and most importantly, the test/iterate cycle much the same. Our operational feature performance is measured and ‘bug fixed’ in much the same way our technical features are."}],"markDefs":[],"style":"normal"},{"_key":"ddc48aa57be0","_type":"block","children":[{"_key":"6725889768f00","_type":"span","marks":[],"text":"One of the most important elements of how we’ve thought about this design is that we cut a PM’s responsibility not by tools in the tool kit but by the user, we don’t have operator PMs and tech PMs, just PMs. Our PMs are focused on the patients or the providers or the administrative staff. This means, in order to develop end value for the user, they may / must have to traverse all tools in the tool kit. Take a recent feature we released, an online check-in for patients which allows them to validate their insurance coverage, the card on file for copays, and complete their intakes ahead of their visit. While a substantial portion of this feature was a technical build (and quite a complex one at that), this implicated both our administrative and clinician teams. This information is critical to the workflows of both. So, before even setting out to design or build tech, we said to them, “what are the ways in which you use this information? What are your biggest pain points around it? What do you wish you could do?”. These answers factored directly into the systems that we designed — both technical and operational."}],"markDefs":[],"style":"normal"},{"_key":"12714dd8295a","_type":"block","children":[{"_key":"c43acfa5d3d50","_type":"span","marks":[],"text":"A different, more clinical example is how we redesigned the use of the patient care plan to support our longitudinal care structure. Providers traditionally document the treatments and next steps for patients in the care plan section of the EMR. Similar to others, we use this opportunity to prompt providers to think about our particular care model (eg if a patient is in for a UTI, consider immune support, not just antibiotics). Yet, we also heard from patients and care teams alike that a document to remind the patient post appointment of the plan would be useful, and even more useful would be to have recommendations for how they might secure items in the care plan, or have the opportunity to discuss in more detail the recommendations. While we’re still building out this feature (it’s currently in the MVP phase), this was a perfect example of insights from a trifecta of users coming together to influence both technical features (digitally displaying the care plan to a patient and provider in their respective portals) as well as operations (training our care team on how to chat with patients about this document). Only when paired together does the vision become successful."}],"markDefs":[],"style":"normal"},{"_key":"c4263718e9f2","_type":"editorialImageCarousel","items":[{"_key":"6f7ed55aac4c","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-cb7098945684d174a607b3cf3a966d79bcc7bb46-2466x1644-png","_type":"reference"}}}}]},{"_key":"a86712270ecc","_type":"block","children":[{"_key":"f5934f87c170","_type":"span","marks":[],"text":"By explicitly defining the systemic principles that we believe need be upheld to deliver on clinical success, and explicitly choosing to design for how our core “users” (all of them!) must interrelate to engender success within it we believe we can avoid the Frankenstein systems all their negative tertiary consequences that balloon into the “problems of our healthcare system today” (worsening outcomes, dissatisfied patients, demoralized providers, skyrocketing costs, layers and layers of institution/fragmentation)."}],"markDefs":[],"style":"normal"},{"_key":"7af718a58699","_type":"block","children":[{"_key":"15bee01d138d0","_type":"span","marks":[],"text":"For details on how what, when we bring these philosophical practices into our making process, take a deeper dive into the content of this blog. I hope you’ll enjoy!"}],"markDefs":[],"style":"normal"}],"image":{"_type":"image","asset":{"_ref":"image-b8c73f9b79faf8822915f589e3b10bfb76b1f03c-2500x866-png","_type":"reference"}},"modules":[{"_key":"8590070cb49b","_type":"shape","backgroundColor":"bcb","shapeColor":"bcw","shapeType":"shape-2"},{"_key":"fa03ff8a5b3f","_type":"furtherReading","articles":[{"_key":"823275844ba7","_ref":"b2e53a55-277a-4d09-8a30-05a1a69cca7a","_type":"reference"},{"_key":"9794a7a310ad","_ref":"ec340f5f-8022-4846-8122-dba8db963129","_type":"reference"}],"title":"MORE READS"}],"publishedAt":"2021-01-03T05:00:00.000Z","slug":{"_type":"slug","current":"what-is-product-at-tia"},"status":"production","subTitle":"A deep dive from Tia's Chief Product & Operating Officer","title":"How Tia aims to revolutionize Healthcare Products","topics":[{"_key":"a0e5c173e60a","_ref":"2ecf8ed7-ad18-4303-b514-c3787f84908d","_type":"reference"}]},"metaInformation":{"_type":"metaCard","metaDescription":"Our people-first model puts relationships back in care & acknowledges that health and wellness is an ongoing journey, as such, healthcare should be too.","metaTitle":"How Tia aims to revolutionize Healthcare Products | The Tia Take","openGraphDescription":"A deep dive from Tia's Chief Product & Operating Officer","openImage":{"_type":"image","asset":{"_ref":"image-8d7e74b9f396bd5b2ee07c156dde77e2752ee475-7500x2400-png","_type":"reference"},"crop":{"_type":"sanity.imageCrop","bottom":0,"left":0,"right":0.5331632653061216,"top":0},"hotspot":{"_type":"sanity.imageHotspot","height":0.9840561224489796,"width":0.3750000000000008,"x":0.1875000000000004,"y":0.5079719387755102}},"title":"What is Product at Tia?","twitterDescription":"A deep dive from Tia's Chief Product & Operating Officer","twitterImage":{"_type":"image","asset":{"_ref":"image-8d7e74b9f396bd5b2ee07c156dde77e2752ee475-7500x2400-png","_type":"reference"},"crop":{"_type":"sanity.imageCrop","bottom":0,"left":0,"right":0.5408163265306121,"top":0.015943877551020412},"hotspot":{"_type":"sanity.imageHotspot","height":0.9840561224489796,"width":0.3979591836734695,"x":0.19897959183673475,"y":0.5079719387755102}},"twitterTitle":"What is Product at Tia?"}},"id":"84ea5d8b-9b34-5a1e-bf78-8be846931e2c","parent":null,"children":[],"internal":{"type":"SanityEditorial","contentDigest":"9cc1e65e52634078f2707186f69e5ac9","counter":308,"owner":"gatsby-source-sanity"}},{"_id":"ec340f5f-8022-4846-8122-dba8db963129","_type":"editorial","_createdAt":"2021-01-13T22:42:19Z","_rev":"RdixGn6lpDGH89K9LFGgVW","_updatedAt":"2022-09-15T12:26:53Z","content":{"_type":"articleTabs","main":{"_type":"articleContent","articleColor":"bcraspberry","articleType":{"_ref":"6ebe3848-7078-4bbf-890a-e4cee9852934","_type":"reference"},"authors":[{"_key":"c5fa21f800d5","_ref":"1d6ce256-595a-4357-89ae-bda37a32224e","_type":"reference"}],"cardImage":{"_type":"image","asset":{"_ref":"image-6015abc4a944b1372eda964681e4fcf60fde505c-2800x1600-png","_type":"reference"}},"editorialText":[{"_key":"2b95844c0316","_type":"block","children":[{"_key":"31649892bfdf","_type":"span","marks":[],"text":"Last week, Tia’s Care Team received their first dose of the Covid vaccine — a celebratory moment instilling hope after many harrowing months, and positioning us to be able to one day soon, provide the vaccine to you, too."}],"markDefs":[],"style":"large"},{"_key":"dc8ebb80b3e7","_type":"block","children":[{"_key":"cd1a05b1b9b1","_type":"span","marks":[],"text":"We chose to get vaccinated not only for our health but also for the health of our families and communities that depend on our collective participation to achieve herd immunity and combat the pandemic. We’ve done our research and scoured the data, and we would never encourage you to do something we weren’t willing to do ourselves."}],"markDefs":[],"style":"normal"},{"_key":"3c1fbe087bff","_type":"editorialImageCarousel","items":[{"_key":"119f960914dc","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-35612920b2c14cd492255c430162360722a3c211-7200x4302-png","_type":"reference"},"crop":{"_type":"sanity.imageCrop","bottom":0,"left":0,"right":0,"top":0},"hotspot":{"_type":"sanity.imageHotspot","height":1,"width":0.9139344262295082,"x":0.5430327868852459,"y":0.5}}}}]},{"_key":"6d79f4f19d24","_type":"block","children":[{"_key":"ce95c74c8fc2","_type":"span","marks":[],"text":"As an infectious disease specialist and Internal Medicine doctor with more than two decades of experience designing complex care delivery models, I am proud to be at the helm of Tia's Covid vaccine efforts. While we can’t give you an exact vaccination date just yet to bookmark your calendar, here’s what you can expect from Tia over the coming months:"}],"markDefs":[],"style":"normal"},{"_key":"572cb27d4382","_type":"editorialImageCarousel","items":[{"_key":"119f960914dc","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-c1f33402d6e2021fef63a55bd9f96d2c3bf0ef9e-7200x1530-png","_type":"reference"}}}}]},{"_key":"f1e4f9546bca","_type":"block","children":[{"_key":"fac99837e424","_type":"span","marks":[],"text":"As always, Tia’s first & foremost priority is arming women with "},{"_key":"7a47c61061e6","_type":"span","marks":["430cbb40cef1"],"text":"trusted information "},{"_key":"2e5d1918d353","_type":"span","marks":[],"text":"to make informed decisions for their bodies and lives — with confidence. 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While we can’t give you an exact vaccination date just yet to bookmark your calendar, here’s what you can expect from Tia over the coming months:"}],"markDefs":[],"style":"normal"},{"_key":"572cb27d4382","_type":"editorialImageCarousel","items":[{"_key":"119f960914dc","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-c1f33402d6e2021fef63a55bd9f96d2c3bf0ef9e-7200x1530-png","_type":"reference"}}}}]},{"_key":"f1e4f9546bca","_type":"block","children":[{"_key":"fac99837e424","_type":"span","marks":[],"text":"As always, Tia’s first & foremost priority is arming women with "},{"_key":"7a47c61061e6","_type":"span","marks":["430cbb40cef1"],"text":"trusted information "},{"_key":"2e5d1918d353","_type":"span","marks":[],"text":"to make informed decisions for their bodies and lives — with confidence. As care providers, we are here to be your objective guide, counselor, and educator, but never your decision-maker.\n\nJust as in our core primary care and gynecology practice, we deploy a sex-specific, distinctly female approach to vaccines — assessing female-specific risk-factors, side effects, and translating the hard data to counter misinformation. Radical transparency and nothing but the facts will forever and always be our priority."}],"markDefs":[{"_key":"430cbb40cef1","_type":"annotation","text":[{"_key":"488368f78962","_type":"block","children":[{"_key":"ea15421d258e","_type":"span","marks":[],"text":"Want to learn more about the Covid Vaccine? "},{"_key":"c67979d60ba8","_type":"span","marks":["d3bad22f936b"],"text":"We covered your most asked questions!"}],"markDefs":[{"_key":"d3bad22f936b","_type":"annotationLink","reference":{"_ref":"1ca555ff-e20e-4ea1-9a0c-7ee4e82ff646","_type":"reference"}}],"style":"normal"}]}],"style":"normal"},{"_key":"c2774ce594fb","_type":"editorialImageCarousel","items":[{"_key":"286b5495b73f","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-a65e47005ebf5825a5c7c0e66eed1645963951c5-7200x1530-png","_type":"reference"}}}}]},{"_key":"788231967aa6","_type":"block","children":[{"_key":"7323d21c64cc","_type":"span","marks":[],"text":"Tia is working tirelessly with our local partners in New York and California to ensure safe and convenient vaccine access for every Tia patient, their partners, and families, following the CDC recommendations and local county roll-out plans. Vaccine efforts are currently focused on healthcare workers and long-term care facility residents, but eligibility criteria (determined at the local level) is changing daily."}],"markDefs":[],"style":"normal"},{"_key":"2eb9405a99c4","_type":"editorialImageCarousel","items":[{"_key":"472f969f2d7e","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-0e9b8e3ac7fa407685c3d6c5193463dee31f383e-7200x1530-png","_type":"reference"}}}}]},{"_key":"e4508c52cfcc","_type":"block","children":[{"_key":"32844a1b7863","_type":"span","marks":[],"text":"The last 9-months have revealed the disproportionate impact of Covid-19 on communities of color — a stark reminder that while a virus can impact us all, it does not affect us all equally. To ensure access to vaccines for all people, especially for those most at risk, Tia will collaborate and prioritize distributing vaccines to BIPOC women and families with our local health system and non-profit partners."}],"markDefs":[],"style":"normal"},{"_key":"030ada04584a","_type":"editorialImageCarousel","items":[{"_key":"472f969f2d7e","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-74db741a54c1439363c2d106ffc5642148100551-7200x4302-png","_type":"reference"}}}}]},{"_key":"b673eb61f6bf","_type":"block","children":[{"_key":"345c28024c74","_type":"span","marks":["strong"],"text":"Stay tuned for more information on the Covid-19 vaccines and how Tia is here to support you through it."}],"markDefs":[],"style":"normal"}],"image":{"_type":"image","asset":{"_id":"image-6015abc4a944b1372eda964681e4fcf60fde505c-2800x1600-png","_type":"sanity.imageAsset","_createdAt":"2022-09-15T10:11:25Z","_rev":"sHpRFPBbkHGijFCjqolTz9","_updatedAt":"2022-09-15T10:11:26Z","assetId":"6015abc4a944b1372eda964681e4fcf60fde505c","extension":"png","metadata":{"_type":"sanity.imageMetadata","blurHash":"M4SP97-oj[?GkC~pV@ozogt8tSWAaeV?o#","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":1.75,"height":1600,"width":2800},"hasAlpha":true,"isOpaque":true,"lqip":"data:image/png;base64,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","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#8f4509","foreground":"#fff","population":0,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#7b3c08","foreground":"#fff","population":0,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#e1d3c3","foreground":"#000","population":0.22,"title":"#000"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#e1d3c3","foreground":"#000","population":0.22,"title":"#000"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#fce6d4","foreground":"#000","population":0.03,"title":"#000"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#8f4509","foreground":"#fff","population":0,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#ee7410","foreground":"#fff","population":0,"title":"#fff"}}},"mimeType":"image/png","originalFilename":"line 11.png","path":"images/8qqycr4y/production/6015abc4a944b1372eda964681e4fcf60fde505c-2800x1600.png","sha1hash":"6015abc4a944b1372eda964681e4fcf60fde505c","size":5897931,"uploadId":"l1B4P0zMZYs8vSo5ulEAzdLCnp16oKAr","url":"https://cdn.sanity.io/images/8qqycr4y/production/6015abc4a944b1372eda964681e4fcf60fde505c-2800x1600.png","id":"image-6015abc4a944b1372eda964681e4fcf60fde505c-2800x1600-png","parent":null,"children":["c6c15b34-c3c3-5058-b9d2-351c97d5b27f"],"internal":{"type":"SanityImageAsset","contentDigest":"c9abda262209339fadd254ce4a461a9c","counter":5618,"owner":"gatsby-source-sanity"}}},"modules":[{"_key":"d621a42528e3","_type":"shape","backgroundColor":"tertiary-3","shapeColor":"tertiary-4","shapeType":"shape-2"},{"_key":"18c9c6212781","_type":"furtherReading","articles":[{"_id":"a8e579e5-f50e-4816-95bb-726b7b1fce9d","_type":"editorial","_createdAt":"2020-12-09T19:07:37Z","_rev":"Pf6WA3QqVnnbHhbAQg2ECI","_updatedAt":"2022-12-28T11:20:55Z","content":{"_type":"articleTabs","main":{"_type":"articleContent","articleColor":"bcraspberry","articleType":{"_ref":"6ebe3848-7078-4bbf-890a-e4cee9852934","_type":"reference"},"authors":[{"_key":"27cef6bb18c6","_ref":"620445e8-cfbd-40b4-9bd3-1742868efe78","_type":"reference"}],"cardImage":{"_type":"image","asset":{"_ref":"image-9fd4b0cde647a98b8d9220ff40f3699c66432237-1366x800-png","_type":"reference"}},"editorialText":[{"_key":"a7807bcc4359","_type":"block","children":[{"_key":"4bec5f594a54","_type":"span","marks":[],"text":"Today, December 10, 2020, the U.S. Food and Drug Administration will meet to discuss the request for emergency use authorization of the Covid-19 vaccine from Pfizer."}],"markDefs":[],"style":"large"},{"_key":"8d81079a7262","_type":"block","children":[{"_key":"9cc5d005efa2","_type":"span","marks":["em"],"text":"With so much information and misinformation about Covid-19 vaccines, we, at Tia, want to help our community understand to help you understand *wtf* is really going on. 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":"0544329801d6","_type":"block","children":[{"_key":"f79ea6ea2da8","_type":"span","marks":["em"],"text":"THE DOSE is brought to you by geneticist and evolutionary biologist, "},{"_key":"a3a5e9ab8e9f","_type":"span","marks":["em","b93558f2ccad"],"text":"Dr. Ava Mainieri, Head of Research at Tia"},{"_key":"13f1e38c349b","_type":"span","marks":["em"],"text":", and infectious disease expert,  Dr. Kathleen Jordan, Senior VP of Medical Affairs at Tia."},{"_key":"88659fc10004","_type":"span","marks":[],"text":"\n"}],"markDefs":[{"_key":"b93558f2ccad","_type":"internalLink","linkType":"text","reference":{"_ref":"620445e8-cfbd-40b4-9bd3-1742868efe78","_type":"reference"}}],"style":"normal"},{"_key":"b694960827e0","_type":"block","children":[{"_key":"f6aedd64f474","_type":"span","marks":[],"text":"How does the Covid-19 vaccine work?"}],"markDefs":[],"style":"h3"},{"_key":"3bb000071222","_type":"block","children":[{"_key":"6773474a0a2b","_type":"span","marks":[],"text":"The first Covid-19 vaccines are mRNA vaccines which act as a set of instructions injected into our cells. "},{"_key":"eef22c3559ef","_type":"span","marks":["strong"],"text":"Our cell machinery uses the instructions to develop a protein that looks *very similar* to the spike protein on the surface of the Covid-19 virus. "},{"_key":"837c053eb24a","_type":"span","marks":[],"text":"Our immune response develops antibodies against that protein and the injected mRNA degrades rapidly."}],"markDefs":[],"style":"normal"},{"_key":"391f7d302a1d","_type":"block","children":[{"_key":"6fffccefab15","_type":"span","marks":[],"text":"Let’s start at the beginning (aka the infection)"}],"markDefs":[],"style":"h3"},{"_key":"dbd22bb28514","_type":"block","children":[{"_key":"49571f24a37f","_type":"span","marks":[],"text":"When germs (bacteria or viruses) invade the body, they attack and multiply. The immune system fights infections with white cells.It can take several days for the body to make and use all these germ-fighting tools (especially if this is the first encounter). "},{"_key":"0c78eb988588","_type":"span","marks":["strong"],"text":"After infection, the body keeps a few T-lymphocytes"},{"_key":"3590d21acac4","_type":"span","marks":[],"text":", memory cells, so, if it encounters the same germ again it can jump into action quickly!"}],"markDefs":[],"style":"normal"},{"_key":"585ae7244b5f","_type":"editorialImageCarousel","items":[{"_key":"70b835f93187","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-12fe9d9a2a3ca874adc7b5b0f4a63d8f97c013d3-2103x792-png","_type":"reference"}}}}]},{"_key":"51e341060aca","_type":"block","children":[{"_key":"a2f115175392","_type":"span","marks":[],"text":"So, what exactly is a vaccine?"}],"markDefs":[],"style":"h3"},{"_key":"a6502c85bae0","_type":"block","children":[{"_key":"c365a2655df3","_type":"span","marks":[],"text":"Most vaccines are substances that simulate an infection with a weakened or dead version of the germs that cause the disease they are protecting against,"},{"_key":"f8e094b7a702","_type":"span","marks":["strong"],"text":" without presenting the danger of infection. "},{"_key":"5737a080f0cf","_type":"span","marks":[],"text":"The immune system response causes the production of antibodies and T-lymphocytes "},{"_key":"3687df1e3fb4","_type":"span","marks":["strong"],"text":"which will protect against an actual infection."}],"markDefs":[],"style":"normal"},{"_key":"3e91d2f7c702","_type":"block","children":[{"_key":"7cd554d9bb30","_type":"span","marks":["strong"],"text":"And what’s an mRNA vaccine?"}],"markDefs":[],"style":"h3"},{"_key":"bb95651a367d","_type":"block","children":[{"_key":"2c06158c650e","_type":"span","marks":[],"text":"Messenger RNA or mRNA vaccines work like an instruction manual, introducing mRNA sequences to encode disease-specific Messenger RNA or mRNA vaccines work like an instruction manual, introducing mRNA sequences to encode disease-specific antigens* to trigger an immune response "},{"_key":"225989828ae5","_type":"span","marks":["e979702f51af"],"text":"antigens"},{"_key":"9935a6691674","_type":"span","marks":[],"text":" to trigger an immune response."}],"markDefs":[{"_key":"e979702f51af","_type":"annotation","text":[{"_key":"80fefeb7bc0f","_type":"block","children":[{"_key":"efeac069643f","_type":"span","marks":[],"text":"Antigens are foreign substances that induce immune responses to produce antibodies."}],"markDefs":[],"style":"normal"}]}],"style":"normal"},{"_key":"8088cb1094e1","_type":"editorialImageCarousel","items":[{"_key":"af6092f6578c","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-d7acca105a420b27e60634a3bc2cc803da883602-2103x929-png","_type":"reference"}}}}]},{"_key":"6b904ce2f061","_type":"block","children":[{"_key":"8fca1946a239","_type":"span","marks":[],"text":"Gossip-ectomy"}],"markDefs":[],"style":"h3"},{"_key":"d319a83b1da1","_type":"editorialImageCarousel","items":[{"_key":"122a9addc678","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-cffd3bb298e717b21405988fc0f7a382eb4ad5dc-2103x934-png","_type":"reference"}}}}]},{"_key":"719f8368f6cf","_type":"block","children":[{"_key":"6a3e823e6e5c","_type":"span","marks":["strong"],"text":"mRNA never enters the nucleus of the cell (where the DNA is). "},{"_key":"be1c28ea6490","_type":"span","marks":[],"text":"The cell breaks down and disposes of the mRNA after carrying out the instructions. It does not affect our genetic code."}],"markDefs":[],"style":"normal"},{"_key":"45077588069d","_type":"block","children":[{"_key":"b6baebc9bbaa","_type":"span","marks":[],"text":"While it’s true that there are currently no licensed mRNA vaccines in the U.S., "},{"_key":"293c9819f2bf","_type":"span","marks":["strong"],"text":"researchers have been working with them for decades. "},{"_key":"fa906b17d2a2","_type":"span","marks":[],"text":"mRNA vaccines have been s"},{"_key":"3382eca929bc","_type":"span","marks":["strong"],"text":"tudied for the flu, Zika, rabies, and cancer research."}],"markDefs":[],"style":"normal"},{"_key":"99b4708c1535","_type":"block","children":[{"_key":"dc6feeee498f","_type":"span","marks":[],"text":"These vaccines have been made in
record time due to collaboration, funding, and the help of research participants."},{"_key":"b58a8b1b22a5","_type":"span","marks":["strong"],"text":"No steps in the normal vaccine development have been skipped or compromised."}],"markDefs":[],"style":"normal"},{"_key":"d8fffa75b209","_type":"block","children":[{"_key":"0ac67196ad1d","_type":"span","marks":["em"],"text":""}],"markDefs":[],"style":"normal"},{"_key":"3f349d3d6188","_type":"block","children":[{"_key":"013e89f2beb2","_type":"span","marks":["strong"],"text":"THE DOSE is your science-backed guide to Covid-19 vaccines, from Tia"},{"_key":"69d4e441086f","_type":"span","marks":["strong"],"text":". 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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. It is unlikely that there will be long-term negative effects. \n\nClinical trials catch all but the rarest adverse events, which will be caught by postmarketing surveillance. These events are rare and do not represent and do not represent a good reason to avoid a vaccine, especially amidst a pandemic. \n\n"},{"_key":"3491e3bf4af1","_type":"span","marks":["strong"],"text":"THE DOSE is your science-backed guide to Covid-19 vaccines, from Tia. 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