Using Technology to Address Unmet Needs and Health Inequities in Women’s Care
FemTech leaders are leveraging technology, community, and a culture of innovation to create a healthier and more equitable future for women.
By Vicky Zhou, Director and Partner, and Sam Juraschka, GM and Director of Product, BCG Digital Ventures, and Susan Schriver, Managing Director and Partner, BCG
As momentum builds to address the gender health gap, few people may realize that it wasn’t until 1993 that clinical research was required to include women. This surprising fact helps explain why, across hundreds of diseases, women are diagnosed on average four years later than men and are more likely to have their symptoms dismissed by doctors, experience adverse drug reactions, and die of heart attacks.
When it comes to FemTech, only 3% of the more than 2,700 US digital health deals since 2011 have focused on women’s health — despite the fact that women make 80% of healthcare decisions in the United States and spend 29% more per capita on healthcare than men do.
Bearing in mind these sobering realities — and the promise of technology and cultural change to create a more equitable future in healthcare and beyond — BCG Digital Ventures (BCGDV) recently inaugurated a quarterly panel series called InnovateHer. Because BCGDV works at the intersection of corporates and startups, we proudly feature both startup founders and corporate leaders in our panels.
For our first panel on the topic of reimagining women’s health, we brought together FemTech leaders Priyanka Jain, Founder and CEO of Evvy, the first-ever at-home vaginal microbiome test; Alyssa Atkins, Founder and CEO of Lilia, an egg-freezing concierge service; Bruno Van Tuykom, Founder and CEO of Twentyeight Health, a company focused on making birth control more affordable and accessible; and Colby Holtshouse, US Maternal Health Business Unit Lead at Organon, a leading women’s health–focused pharmaceutical company. The panel was hosted by Vicky Zhou, Healthcare Partner and Director at BCGDV, and Sam Juraschka, Product Director at BCGDV.
The wide-ranging discussion kicked off with an overview of some of the largest gaps in the women’s health space today before progressing to the innovative solutions these companies — and others in the market — are creating to improve the state of equitable healthcare for women. Here are some of the major gaps we see in women’s health today, as well as the opportunities to address them.
Despite technological progress, medical care still tends to treat issues rather than prevent them
For a variety of reasons — from cost of treatment to access — medical care still trends toward being reactive. Not only is a reactive approach more expensive overall, but it also leads to suboptimal outcomes in the long run — and this is having a disproportionate effect on women.
For example, medical research is passive when it comes to taking into account female-specific biomarkers. The composition of the vaginal microbiome — measuring and tracking the unique signals that women’s bodies are constantly giving off that could be playing a role in broader female health outcomes — may be responsible for the most common conditions affecting women, such as recurrent UTIs, bacterial vaginosis, yeast infections, fertility and IVF issues, preterm birth, cervical cancer progression, and much more, yet this information is not being utilized to provide more precise care. Health startups are beginning to focus more on discovering and leveraging the vaginal microbiome, but in general, many of the biomarkers that doctors use to define whether someone is healthy or sick are still based on middle-aged, midsize white men.
Fertility is another example of how proactive medicine has the ability to empower female patients. One of the ways to begin measuring fertility is to determine ovarian reserve through blood tests and vaginal ultrasounds. This tells patients how many eggs they have as well as how they compare to others in their age group. These are very important indicators of a patient’s ability to become pregnant or when they might enter menopause. This testing has the potential to empower women to take control of their reproductive futures by better planning their fertility.
Despite progress in many areas of women’s medicine (e.g., breast cancer survival), significant gaps remain in maternal care
Recent numbers from the CDC reveal that the US maternal mortality rate rose from 20.1 to 23.8 deaths per 100,000 live births between 2019 and 2020, with rates for non-Hispanic Black women (55.3 deaths per 100,000 live births) significantly higher than for non-Hispanic White and Hispanic women.
Few devices exist to mitigate preterm labor, postpartum hemorrhaging, and other complications, and not enough pharmacological innovation is being done in those areas.
When a baby is born prior to full term, every day it spends in the NICU instead of with its mother has a profound effect on its development. Detecting and diagnosing women at risk of preterm labor, and then controlling contractions once labor begins to help prolong time in the womb, can be very beneficial to the health of the newborn.
Additionally, for 60 to 90 days after birth, women should receive better monitoring and treatment for postpartum depression and hemorrhaging. Postpartum hemorrhaging, in particular, can happen as late as 12 weeks after birth and causes blood pressure to plummet, depriving the brain and other organs and potentially leading to death. Prior to recent advancements, it had been almost 20 years since a device to treat postpartum hemorrhaging had been developed.
Lack of access to care is preventing girls and women from ensuring their own health
Half of Americans in their 20s don’t have primary care physicians, and many don’t invest in follow-ups or have the ability to pay for basic sexual health services. In some places, the nearest OB-GYN is several hours away, adding a physical burden to the economic ones.
Historically, barriers to knowledge and care have disproportionately impacted underserved and underrepresented people: Black women and communities, Indigenous and other communities of color, low-income people, and immigrants.
So, what can be done? Our InnovateHer panelists presented a few solutions — both technological and societal — for consideration.
Asynchronous telemedicine is coming into its own
New platforms are coming onto the market enabling patients to transmit information to a doctor who can review and respond electronically. Video-based — or synchronous — medicine was vital during COVID, but there’s much more to engaging healthcare than just video visits.
Additionally, many patients lack sufficient broadband internet for video telehealth or live in households where privacy is impossible. Thus the ability to message with a doctor and provide medical information in order to receive answers, home tests, and prescriptions securely and confidentially is becoming more available to women in various living situations, including in underserved communities.
New technologies are making egg freezing more viable
While egg freezing is often spoken about in the context of career, a great deal of women are leveraging the technology to optimize and expand their reproductive window.
Startups that are making egg freezing easier to access and more affordable are helping, but it’s still a price that often women must pay until more employers, insurance companies, and governments subsidize the procedure.
Businesses are thinking about equitable distribution of women’s healthcare across all income levels
In the United States, one FDA-cleared device can be used across many hospitals and locales. But delivery systems behave differently in lower-resource settings like “safety net” hospitals, where there are significantly greater challenges with budgets and resourcing.
The same is true in lower-income countries. Startups and traditional companies are more motivated now to completely reimagine the device itself; for example, in places where there is no reliable source of power or where syringes are not readily available. They’re also approaching training and education differently and working to justify investments in expensive technologies like those that treat postpartum hemorrhaging by explaining the risky trade-off of not intervening early.
In addition, startups — and even companies that are reliant on traditional revenue models — are starting to bypass longtime gatekeepers of information and care like hospitals, employers, and insurance companies. They’re forming consumer partnerships, working with social impact funds, and marketing their innovations directly to the people who need them most — enabling women to take control of their own health and to manage their treatment options for themselves.
Check out the panel in full below:
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