“Treat the person, not the disease.”
by Emily Melton, Threshold Ventures
A person-centric approach to providing healthcare is a consistent investment theme of mine. Livongo, Wellframe, and Elation Health, three Threshold investments, are great examples of companies making their mark by focusing on patient needs. When I first met with Carolyn Witte and Felicity Yost, the co-founders of Tia, I was impressed with their vision, but even more so when they helped me understand the importance of fixing how we care for half of the population. Fundamentally, you can not treat me as a person without explicitly recognizing my unique experience as a woman. Carolyn and Felicity are delivering a distinctly new model focused on caring for women in a modern healthcare system. Walking into the Tia Clinic in NYC, I saw and felt firsthand how a FEMALE-CENTRIC approach could transform healthcare. It was one of the rare times where I was impressed both as a consumer and healthcare investor. As true with the best consumer entrepreneurial ventures, Tia has built what I wanted without even knowing it was possible.
My first visit reminded me of how I felt when I first went to Starbucks and Lululemon. There is a unique atmosphere that made me feel both empowered and put me at ease. Sitting in the exam room, it was also clear that no shortcuts were made on the clinical process.
Tia has created the perfect marriage between technology and the physical experience of delivering care — the providers were there to talk to me, and technology provided the context and enhanced the interaction.
Why Women’s Healthcare?
First, women are good for business. Women control more than 80% of US healthcare dollars and are the most frequent consumers of healthcare. We are great customers!
Second, women are different from men (sadly this still needs to be said). One size fits most has been a consistent trend in the standardization of healthcare systems, designed largely by men. Not only do we have different reproductive parts, but the complexity of women’s hormones, metabolism, and gene regulation means that we experience diseases and treatments differently than men. For example, women face a higher incidence of illnesses such as breast cancer, osteoporosis, and auto-immune disease. Also, diabetes, CVD, and depression do not present in women as they do with men. The leading cause of death for women is heart disease, however, women EXPERIENCE different symptoms than men. For many women, a heart attack feels like indigestion vs a chest pain. And because of that very reason, many primary-care physicians and cardiologists struggle to recognize heart disease in women, and women are more likely to die from heart attacks than men.
While the biological distinction has long been understood, how that manifests in diseases and treatments is nascent. In 1977, the FDA issued guidelines banning women of childbearing age from clinical research studies. A decade later, these policies were reviewed and guidelines were updated to be more inclusive of women, but in 2020, clinical trials for women are still vastly under-represented. Women’s body size, hormones, and body fat can impact the way drugs are metabolized and several drugs have been recalled after being found to cause harmful side effects specifically in women. When my doctor is writing a prescription for me, it is reasonable to expect that being a woman has been taken into account both for the medication and the dosage. But sadly, this is frequently not the case.
Tia’s approach recognizes that women’s health is more than gynecology and has created a unique model that combines primary care, gynecology, nutrition, mental health, and evidence-based modalities into an integrated practice.
Women’s bodies are complex biological systems and from a first-principles perspective, Tia has built the system to comprehensively and uniquely address women’s health needs.
Tia Humanizes the Delivery of Care Via Technology
Tia’s model is predicated on building a deep and meaningful relationship between the patient and Tia’s providers. Tia wants every woman to be heard and known, and not treated as a cog in a healthcare machine. The company has an NPS score of 95 — enviable for even the best consumer brand and unheard of in healthcare services.
The Tia experience embraces technology from the beginning, not as a bolt-on or efficiency ploy, but rather a tool to enhance human relationships and provide both more convenient AND higher quality care. Tia aims to meet every woman at the place where they need care, and their technology enables both the patient and the provider to enter into an interaction with the right data and context so the time is spent on the personal interaction instead of paperwork.
There has been a recent explosion in telehealth solutions on the back of the continued adoption of technology by large health systems. Many are positive, but some solutions further abstract the patient and provider. A person is more than a chart or a statistic in a population health model. Tia’s technology stack has been designed to break down these barriers and enable Tia’s providers to focus on the vital relationship between patients and healthcare providers.
Women’s Health in a COVID and a Post-COVID World
I committed to the Tia investment prior to the COVID outbreak in the US and our investment closed just as NYC, home of Tia’s first clinic, began its shelter-in-place.
The current extent of the COVID tragedy is not fully known, both in terms of human life and the toll on the current healthcare system. I do believe that this unique event will accelerate a focus on new health solutions that are not dependent on monolithic systems. Also, with a heightened awareness around health, consumers will demand personalized care models.
Even with COVID, my belief in Tia’s long term prospects remain undeterred, but what has surprised me is how much the community has relied on Tia during this time for all of their healthcare needs — beyond what we conventionally think of as “women’s health.” Tia rose to the occasion to deliver comprehensive “healthcare for women,” launching Tia Virtual Care to provide Covid screenings, antibody testing, and monitor patients remotely — keeping them out of NYC’s inundated emergency rooms. By listening to their patient’s needs, the company successfully rolled out a behavioral health program that is now at capacity and will be expanded with further offerings.
While the world is uncertain today, I know Tia will continue to redefine women’s healthcare and meet the needs of their patients in this new environment with their unique flare.
To read more about Tia’s experience evolving their business and service model in response to Covid-19, read this letter from the Tia founders.