The future of relationship-based healthcare: Learnings from our first eight weeks operating the Tia Clinic
By Carolyn Witte & Felicity Yost, Tia Founders
Throughout Tia’s trajectory from digital to physical, and from a pure tech company to a tech-enabled clinical services business, there’s been one unifying thread that’s guided our approach throughout: relationships. We believed then and we believe now that women want someone, not something to manage their health. That for women, quality healthcare means a real face and a safe space that makes you feel seen, heard and compassionately cared for — online and offline. And that Tia’s mission and foremost innovation is building a relationship-based care model at a time when “relationships” in healthcare are evermore rare.
Eight weeks since opening our first brick-and-mortar Tia Clinic, we’ve proven that women really, really want a differentiated relationship with the healthcare system, and that they are excited about Tia’s potential to deliver it to them. Despite the influx in demand and pressure to rapidly grow to service more members, we recently made the call to deliberately slow down before scaling up. We continue to believe that changing women’s healthcare is a marathon, and not a sprint, and that unchecked “hockey stick growth” cannot be applied to clinical care delivery when real human lives are at play. Instead, we are taking the approach that growth must be deliberate, thoughtful, and obsessively monitored to ensure care quality is never — not even for a second — sacrificed because of startup “growing pains.”
Clarifying the role of technology
In this explosive era of direct to consumer healthcare companies, we are repeatedly asked — what is Tia? — a technology company, a direct to consumer brand, or a healthcare services business? To this, we say we are not one, but all three — or more accurately, a relationship company above all else.
More tactically, our approach rests on amplifying best-in-class clinical care with innovations in technology and experience design to strengthen — not replace — the canonical patient <> provider relationship. More than an Instagrammable waiting room, or “tech for tech’s sake”, we are laser-focused on interweaving technology and design into the patient and provider experience — not as a “wrapper around,” but in service of clinical care.
In the words of our users, there’s an intangible, emotional quality that results from the interwoven-ness of technology, brand and amazing clinicians all-in-one:
In short, Tia’s model is about a sum greater than its individual parts. Remove the tech, remove the brand, or remove the care, and the whole thing disintegrates.
The necessity for innovation in women’s health
While we believe that every woman should have a deep, loved and trusted 1:1 relationship with her provider, delivering this at scale and at an affordable price-point within the confines of the existing healthcare system is rife with challenges. Specifically, the dominant fee-for-service reimbursement models, women’s health provider shortages, and rapidly changing consumer demands make the historic 1:1 relationship with a provider a utopian concept of the past — increasingly limited to very expensive concierge medicine practices inaccessible to the mass market.
While we know Tia is not yet a universally-accessible solution that works for every woman with any health need across the socioeconomic spectrum, we are committed to building a best-in-class relationship-based care model where women don’t have to “choose” between the trifecta of care quality, convenience and insurance coverage. Instead at the Tia Clinic, women can get evidence-based integrative care in a non “speed dating” environment — for the price of what you pay for Netflix or Spotify each month. To deliver on this promise involves shifting the historic bi-directional patient <> provider relationship to a triangular one, with Tia as the bridge or liaison between a patient and her provider(s):
Productizing this new care model
While Tia started out as the go-to “wing-woman” for women seeking health information before and after the doctor’s office, the move into real world care delivery requires that Tia become the “wing-woman” for providers, too. In the words of Tia’s Chief Medical Officer, Dr. Stephanie McClellan:
“Tia must become both healthcare translator, care navigator and research-obsessed thinker. For patients, Tia should act as ‘your best friend in medical school’ who explains things to you without dumbing things down. And for providers, Tia needs to be their ‘full-time research assistant,’ providing data-driven, evidence-based recommendations that at times, may be non-obvious, but clinically important. To create a meaningful patient <> provider relationship in the context of the pressures intrinsic to the modern medical system, Tia can’t just play one of these roles, Tia needs to excel at all of them.”
From a product perspective, this means building tools that:
#1: Give the patient more control and agency over her healthcare:
#2: Equip providers to spend more time interfacing with patients (and less time interfacing with the EHR)
#3: Facilitate transparency and collaborative care
Why people + tech > tech alone
Patient reviews like these reinforce our belief that the reimagined patient <> provider relationship of the future is at the nexus of technology, design and clinical care.
But, we’ve also learned that we need to make further investments in the underlying service model to support this new paradigm — particularly outside of Tia exam room walls. We know that technology alone can’t cut it as an effective bridge between the patient and provider. Instead, successful solutions involve both people and technology paired together.
As a patient-first company who believes that transparency is the foundation of trust, here are the chief points of feedback we’ve heard from our members the past eight weeks, and the ways we are working to address these wants and needs before releasing new memberships:
#1: “I want more appointment times that work with my schedule!”
While non-traditional doctor’s office hours optimized for the working woman have always been part of our care promise, we opened with limited availability for early morning, evening and weekend gynecology appointments, which booked up far more quickly than we anticipated.
To address the demand for these hours, and the higher-than-expected utilization we’ve seen amongst our patient population, we have hired two additional women’s health nurse practitioners to our Care Team to support an expanded schedule. Starting this week, the Tia Clinic has:
- “Pre-Work” morning appointments starting at 7:40AM Monday — Friday
- “Post-Work” evening appointments ‘till 8PM Mondays, Tuesdays & Thursdays
- Saturday gynecology appointments 9AM — 3PM once a month starting May 11th (and acupuncture every Saturday!)
- Designated same and next day appointments for time-sensitive issues (such as UTIs or strep throat) that are released 24 hours ahead of time
As we further expand our Care Team with an additional MD hire over the coming weeks, we will continue to expand our appointment availability, upholding our commitment to convenience and accessibility without compromising care quality or overloading our providers.
#2: “I love the experience I get at the Tia Clinic, but want that personalized care to extend before and after my visit.”
To date, we’ve struggled to ensure patients get the timely communication they desire, while also allowing our providers to stay focused on patient care in our exam rooms. To address this, we’re making significant changes to both our staffing model and supporting tech products to improve patient communications pre and post Tia appointments:
Specifically, we are introducing:
- Care Coordinators — a dedicated human face assigned to members when they join to help them navigate every touch point of Tia Care. From questions about scheduling and billing, to referrals and labs, this person will act as our members’ “personal concierge” to streamline all communications between a patient and her provider team at Tia. We believe the addition of Care Coordinators will facilitate higher touch communications, faster response times, and enable continuity of care — without overburdening our providers.
- Chat with the Care Team — and in a few weeks, we are launching a private, secure inbox for ALL communications with the Tia Clinic. These past few weeks, we’ve seen that administrative questions (“I need to reschedule my appointment”) can quickly become clinical (“Do I need an ultrasound?”), and clinical questions can quickly become administrative. We are streamlining communications with a single inbox, staffed by each member’s personal Care Coordinator.
- A single front door to the digital Tia Care experience — from text messages to the app to the Tia Clinic Home on web, we know it can be confusing to know where to go for information from Tia. To solve for this, we are introducing a single doorway to all-things Tia Clinic where members can book appointments, edit their health record, find pre-appointment reminders (and soon, chat with the Care Team, too!) — accessible from our iPhone app or our website. We will continue to use text message as a notification and reminder system to ensure members don’t miss a beat.
#3: “There are so many different services at Tia from workshops to events to different types of gynecology and wellness appointments. But, what’s right for me?”
Today, orientation is commonplace in college, the workplace, conferences, you name it. We would never think about bringing on a new employee without “onboarding” he or she to our company’s values, processes, and workflows. Yet, in healthcare — one of the most complicated, but important systems we interact with — we leave patients to figure things out on their own, and all-too-often, not until a crisis strikes.
To address this, we are introducing a program, free for all Tia members, called “Well-Woman Orientation” — quite literally, an orientation to the Tia Clinic, our care philosophy, Care Team, and service offering.
Starting Wednesday, May 8th, Tia members can sign up for a 90 minute Well-Woman Orientation, during which they will meet our Care Team and other members, set individualized health goals, and design a plan to achieve them with the support of Tia and our community.
While the past eight weeks have reinforced that women want, need and deserve better care, we are dually humbled and evermore motivated by the challenge inherent to delivering that experience — first and foremost to our current members, and slowly and sustainably, to future members in NYC and around the country. As founders, we are excited by the sheer excitement we’ve seen women express about engaging in their health in a new way. Most importantly though, we are keenly aware of the responsibility that comes along with that.
To us, the answer to translating an ambitious vision into action lies in the most sacred part of any relationship: listening. To our members current and future — we pledge to always listen faster than we move, and evolve our interwoven web of technology, design and clinical operations with the utmost intention. This, we believe, is our ultimate mission.
This post is part two of a series of Letters from the Tia Founders that aim to give transparency into our insights, process, and learnings building a new model of women’s healthcare. We believe in sharing not just what, but why and how we do what we do. Please share any feedback, ideas, or questions directly to email@example.com.