Interview: How Women's Health Clinic Tia Is Enabling Relationship-Driven Care In A Fragmented Space
Tia's founder explains how the women's health platform aims to fix a broken model by setting new standards of care, focusing on holistic and personalized attention as well as greater accessibility
Despite advancements in many sectors, and disruption in nearly every retail or service category, women's healthcare remains a pain point for many consumers, especially in the U.S. To compensate for female patients feeling like care is fragmented, or that their complaints are not listened to, startups like Tia are taking a Silicon Valley-inspired approach to developing a better women's health system.
Tia began as an app, where women could track health and menstrual cycle information in order to better support visits to their existing doctors. Earlier this year, the company expanded to brick and mortar, with a membership-based New York City clinic. With a colorful and less clinical feel, the space is designed to invite its patients to feel better in uncomfortable situations and with sharing sensitive information. Working within the existing insurance system, Tia faces many of the same constraints and operational challenges as a traditional medical office. However, it remains committed to creating a better experience for all patients, with a needs specific to women.
PSFK spoke to Tia founder Carolyn Witte about the evolution of women's health and how approaching the healthcare space as an outsider gives her a unique, patient-first perspective.
PSFK: What are some of the gaps that currently exist for consumers in the healthcare space?
Carolyn: As a founder who doesn't have a healthcare background and who's not a doctor, we're taking a new approach to the space, from the patient's perspective. We've been listening to and learning from patients, provider and people working in the healthcare system more broadly about the challenges and opportunities in the space.
I dove into the startup space after going through my own frustrating series of women's healthcare issues. In my early 20s specifically, I dealt with a three‑year long PCOS diagnosis process. It got me very fed up with healthcare not being designed for women, and being fragmented, very focused on treating illness, instead of supporting wellness. It wasn't personalized, lacking the soul and any emotional intelligence at all.
Women feel alone, confused, not heard, not seen and ultimately, not healthy. These are systemic issues that affect patients and providers. We need to fix both of those to build a new better model for women's care.
Look at the state of women's healthcare. Women's health is getting worse instead of better with respect to almost every metric that matters. Maternal mortality is going up, and not down. The U.S. has one of the highest maternal mortality rates in the developing world, which is shocking and horrifying. A crisis that needs to be addressed. Endocrine disorders, like PCOS, and autoimmune disorders are at higher rates than ever. Women are diagnosed with anxiety and depression at three times the rate of men. There's a ton of research coming out about how all too often their pain is ignored or trivialized by the healthcare system.
Women are on waitlists to get a pap smear, even in a place like New York City. Access to basic reproductive healthcare, birth control, abortion, STD testing, you name it, is difficult.
Then you look on the provider's side, and it's also getting worse. There's a massive OBGYN shortage in this country. OBGYN has the highest burnout rate in all of medicine, with the average OBGYN retiring at the age of 40. How are we supposed to address these issues in women's health when there are not even enough providers who want to work on the front lines of care? Doctor burnout rate and mental health issues amongst providers of all types is a serious issue in the spotlight.
We believe wholeheartedly that to build a better model requires deep systemic change in the healthcare system. It requires enormous compassion and empathy for patients and for providers, and pairing those patient wants with provider needs. Those are some of the themes that underlie what we do at Tia.
Where did you decide to start with Tia?
With all of the challenges I just listed, it can be intimidating to figure out where to start. How could any one person, company, set of doctors, you name it, solve all these issues? What we've really homed in on is our superpower and an opportunity that we think we're uniquely suited to address in the market.
At a time when women's healthcare is becoming more fragmented than ever and more commoditized, there's a rise of what I'd call point solutions, whether they're birth control delivery companies, one‑off telehealth products or new diagnostic packs. All of these things are wonderful from an innovation perspective, but a lot of them aren't connecting the dots between. What Tia aims to do is connect those dots. Listening is our superpower in building our relationship‑driven care model.
As we think about everything we've built, from our women's health advisor app to now the first brick-and-mortar Tia Clinic, we think about what makes us different. We really innovating on what we want to set as a standard, a norm for what women's care should be.
It's about maximizing patient‑provider time, collaborative decision making and a space that makes women feel heard. It's a community to support clients, leveraging best-in-class innovations and clinical research, instead of just technologies available in the space, in the context of a relationship‑driven care model.
What do you think of the direct‑to‑consumer brands emerging within the healthcare space? What are they getting right, and what could they improve upon?
The rise of direct‑to‑consumer solutions instead of patient‑centered models puts the control and onus back on patients to dictate their care. A lot of these require a new business model, service models outside of the existing ones, like insurance‑based reimbursement structures, in order to enable them to happen.
In Silicon Valley, they say, “Move fast and break things.” I say, in healthcare, we move fast and shake things up. For us, that means figuring out how we innovate on certain things while working in the context of existing payment models, chiefly insurance-based reimbursements, which is the basis of the vast majority of our service offering at Tia.
It's a hybrid model. On the one hand at the far end of the stake, you see pure cash‑pay models that are like, “Screw insurance. Put some pretty packaging on a generic drug and just sell it directly to consumers.” Then you see on the other end of the spectrum players who are working within the confines of the existing system. Tia is somewhere in the middle, and we're trying to figure out how to make healthcare something people want to engage in and not something to avoid.
Can patients get care if they are not part of the Tia network?
Yes. We do take both women who are uninsured and women who are out of network. We function like any gynecologist who is out of network. Customers pay cash, and they can submit claims to their insurance provider for reimbursement. We help them through that.
How has the idea of treating the whole patient influenced the evolution of your business model? Why was it important to start from that baseline?
It is connected to the technology piece in the way we have these rapid feedback loops from our online products to online care that inform our service offerings. For example, you see women ask questions in our Tia app, everything from, “Hey, Tia. I missed my birth control pill,” to, “Why do I have pelvic pain?” to, “Can you recommend an organic tampon to me?” to various things they track on our app, from their period to headaches to anxiety.
If you have problems with your ovaries, you go to a gynecologist. If you have a thyroid issue, you go to an endocrinologist. But what about things that don't neatly fit into those boxes, where do patients go? What about those things that probably are related, but no one's connected the dots? We wanted to offer women a place to go where they are treated as a whole.
We're trying to put together Issues that are all too often treated in silos. We're connecting the dots between them and thinking about how we can build a care model that helps women see the connections. We talk a lot about body literacy and giving providers more tools and more data points to make connections.
It's our challenge to figure out what, from a care quality perspective, we can feasibly deliver in the confines of a one-stop-shop without ever sacrificing on quality.
The marriage of the traditional Western medical approach with a more holistic approach like acupuncture is interesting. Why was it important to bring elements of wellness into healthcare?
Two reasons. One, women told us they wanted it, so we listened. The second goes back to care philosophy and a belief in a growing body of evidence to support non-pharmacological interventions, like acupuncture and nutrition and lifestyle changes, in support of your overall health and wellbeing.
It is important to include those interventions and schools of thought in our practice and not have wellness be the afterthought. We're about not just treating sickness but supporting wellness at Tia.
Can you explain how the app personalizes the patient experience?
The way that Tia technology personalizes the experience from the get‑go is we ask patients what they want to talk about when they book an appointment at the clinic. For the initial well‑woman exam, patients can choose everything from cycle irregularities to mood swings to recurrent UTIs, pain during sex, you name it, a whole host of issues. Then we personalize their health record or intake in the context of that issue.
You don't get a clipboard at the doctor's office or a bunch of paperwork. You fill out your entire health record digitally on your phone beforehand, including this personalized intake. All of that information is shared with your provider ahead of time.
Tia helps flag, so to speak, important components of that health record for you or for your provider so they know what to focus on. When you show up at the Tia clinic and you walk in the exam room, the provider is prepped already on your health record. That appointment time is focused on conversation versus data collection. All that data is visualized so you and your provider can look at it in tandem.
What are some of the core digital services that you offer to the patient as they're sharing this information with you?
Our hallmark feature today that's live at the Tia clinic is something we called Cycle‑Connected Care. We have a tracking feature, encompassing everything from stress to your period to anxiety to pain with sex, in the Tia app.
This is a tool we built that's about bringing more transparency and collaborative decision‑making around self‑supported data as a way to diagnose certain issues, manage outcomes and improvements over time, and share data between the patient and providers seamlessly. That's one thing we're excited about.
What prompted the decision to create a physical clinic in New York?
We found in the early days of the Tia app when we were essentially a pre‑post clinical tool, that women were bringing Tia with them to the doctor's office, specifically to gynecologist's office, and messaging us in a care context.
We were their wingwoman for healthcare or a translator there to guide them through that experience. This was not by design. Women were hacking our products in many ways for use cases outside of our original intent.
This was shocking to us, to see women messaging us in the waiting room asking us, “What is the copay,” or in an exam room saying, “What IUD should I get?”
It's trust. It's also the fact that we're just listening. We were there, ready to listen when other people weren't. It sounds so simple, but it's true. That was the light‑bulb moment, the company moment when we realized that our patients want their whole care experience to be more like Tia.
In pursuit of the relationship‑driven care model, we decided to make a bet on real‑world care. Care building in process and evolution will always be changing, always be evolving. We hope it can raise the bar for what women's care could be and should be for all women, not just Tia patients.
We're constantly iterating and listening to our patients and providers' feedback on what they want from care. Proving that we can deliver better care to women is our north‑star aspiration.
Can you tell us about the design and the services offered in the space?
It's a 3,000 square‑foot clinic. In many ways, it's the anti‑doctor's doctor's office, the female oasis. We spent a lot of time thinking through the patient‑user journey. What doesn't work about the gynecologist? Why do women want to avoid it at all costs?
How do you make this a place people want to go to, not just when something is wrong but to proactively check in on their health? We partnered with the LAB at Rockwell Group to have amazing architecture and experience design.
It's not just about the couch or the waiting room but every touchpoint. I call them shoulder‑drop moments or exhale moments when consumers walk in, that make them feel that, “I am safe here. I can bring my whole self here. I don't need to leave part of my health history at home. I can advocate for myself in a care context.”
I'm especially proud of the exam room. For obvious reasons, it's the most important room in the whole space. At the Tia Clinic, we re‑imagine making women physically, emotionally and mentally more comfortable, and able to advocate for themselves. We designed the space and built some amazing pieces of furniture that hides those things like speculums, all the doctor stuff. We also built the space around maximizing eye contact and personalization.
We built a second part of our platform called TNV that is an iPad app on a TV screen that visualizes patients' health record, and allows them to design their care plan in cooperation with their provider. It's the quintessential example of what we're trying to do at Tia, blending experience, design, and the best‑in‑class clinical care and technology, all together, in a super tiny space to deliver the new patient‑provider interaction.
Your space also includes some retail and lifestyle elements. Why was it important to include that in the space?
We want Tia to be a place patients go to not just once a year, but to proactively check in on their health. We view health as an everyday thing, not a once‑a‑year thing, so we built a space to support that. Building out more spaces beyond the exam room was important, so we included what we call the living room and a retail space that sells non‑pharmacological products that our care team often recommends, all backed by science.
We're also innovating on the wellness model through a community‑based program. We'll host special panels and events, everything from bringing in clinical researchers around a given subject matter to discuss the latest research on a particular topic to more socio‑cultural discussions around sexuality, for instance.
We're really about holding conversations, cultivating connections between women. It's about building programming that supports the lifestyle‑based interventions that are key to foundations of health that tend to be difficult to master in a 20‑minute exam.
Women want highly personalized care from their provider, from a doctor, and they also want to connect with other women. We want to support all of those things in our care model.
What can we look forward to in the coming years as Tia continues to develop?
The key focus is how to scale that to all women, perhaps countrywide or even the world one day. We're not trying to build a boutique care model for a few women in New York City, but really innovate on the patient‑provider relationship, prove out how technology can help to reinstill that relationship and be a broker, not to be a replacement for care. We want to prove that community is powerful when it comes to making women healthier, happier and more informed about their health.
I'd say that's the thing that I'm most excited about: continuing to hear from women around the country and the world, what they want from healthcare and helping Tia be a platform that can help bring those wants and address those needs. My hope is for it to be a byproduct of a crowdsourced, bottom‑up care model that accounts for the diversity of women's experiences.