Techquity Series: Tackling Breast Cancer Disparities with Digital Health

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[00:01:22] Hello and welcome to the Hit Like a Girl podcast.

[00:01:24] My name is Joy Rios, the show's host, and today we are embarking on an exciting

[00:01:28] journey through our new five part series focused on tech-quity, which is the

[00:01:32] intersection of technology and health equity.

[00:01:36] In this inaugural episode, I am thrilled to welcome Jana Guinan from the Health

[00:01:40] Foundation. Jana is at the forefront of this initiative advocating for

[00:01:44] equitable digital health solutions that cater to the needs of underserved

[00:01:48] populations.

[00:01:50] Jana, thank you for joining us today and help us unpack what tech-quity

[00:01:53] actually is, why it matters and what we can look forward to in this series.

[00:01:58] Thanks, Joy. I'm really happy to be here to kick off this series of five guest

[00:02:02] episodes focused on tech-quity and health care, each of which will feature

[00:02:07] one of our well, feature five winners of the Tech-Quity for Health Case Study

[00:02:11] competition. And just to set the stage.

[00:02:14] So Health Foundation is a nonprofit organization and we're focused on five

[00:02:19] imperatives for sustainable and ethical health care, which are access,

[00:02:23] affordability, equity, inclusion and innovation.

[00:02:27] And technology, when you think about it, complicates all of these variables in

[00:02:31] health care. So about a year ago, the Health Foundation started the Tech-Quity

[00:02:35] for Health Coalition.

[00:02:37] And as a coalition, what we're really trying to do is help the industry

[00:02:40] understand and manage these factors so that we can have greater success and

[00:02:45] consistency in addressing health disparities through digital health.

[00:02:48] I mean, technology can be like the hero or the villain, and it needs to

[00:02:52] be at least a good supporting actor, you know, in the story of health

[00:02:56] equity. And that's why we started the coalition.

[00:02:58] So and then very specifically, the coalition is working on defining best

[00:03:02] practices and recommendations and also looking at metrics that we can use

[00:03:07] for digital health equity again or tech-quity.

[00:03:10] Before I go on, I just want to take a second and give credit and say

[00:03:14] thank you to the organizations that stepped up and supported the coalition

[00:03:18] from the very beginning before it was really anything but an idea.

[00:03:22] So big thanks to the American Medical Association, Amazon Web Services,

[00:03:27] Epistemic, Outcomes for Me, UST, also the National Association of

[00:03:32] Community Health Centers, ResMed, Empirics, VSP, Global Innovation.

[00:03:38] We've had some fantastic support to get off the ground.

[00:03:42] And also I have to just give some credit to our dedicated and

[00:03:48] really experienced group of advisors that are helping to drive this

[00:03:51] initiative, who have just been an incredible and valuable resource.

[00:03:54] And we have a lot of fun as a group, too.

[00:03:56] So thank you to the advisory committee of the coalition.

[00:04:00] And then that brings us to where we are right now.

[00:04:03] The Tech-Quity Coalition just completed its first case study competition

[00:04:07] where last fall we put out a call for cases and we're completely

[00:04:11] thrilled to get about 200 submissions from across the industry.

[00:04:15] It was one of the exciting things about this is not just the number,

[00:04:18] but the huge variety in these case studies.

[00:04:21] So across sectors, settings, technologies, just a great process for us

[00:04:27] to learn and to understand the landscape of Tech-Quity right now.

[00:04:31] And in the end, we awarded 11 projects.

[00:04:33] This was at the end of February at the Vive event.

[00:04:36] We held an award ceremony. It was really, really fun.

[00:04:38] And then just to explain why, like, why did we do this?

[00:04:42] The whole purpose for this competition was to bring visibility

[00:04:45] to the best practices as they stand today, to kind of confirm our understanding

[00:04:50] of Tech-Quity, how health equity can really show up,

[00:04:55] when we're implementing or innovating in digital health.

[00:04:58] And then to look at novel approaches to Tech-Quity and health care.

[00:05:01] And it really did give us some very interesting visibility into the landscape.

[00:05:06] So in each of the five episodes in this series, as I mentioned,

[00:05:10] we will feature one of the winners of the case study awards.

[00:05:14] They'll talk about their projects, the insights, you know, what they've learned.

[00:05:17] And we'll have a guest host, a different guest host for each of the interviews,

[00:05:21] which are one of the coalition advisors.

[00:05:24] And this has been great because we are our winners.

[00:05:27] Actually, there's a sort of a relationship.

[00:05:29] We were able to find an advisor to conduct each one of these interviews

[00:05:32] who is in one way or another kind of connected to or doing work

[00:05:37] in a related area. So great conversations.

[00:05:41] So here's the final thing.

[00:05:42] In just a moment, you'll hear from our first guest, Anna Kravitz.

[00:05:46] Anna is the president and the co-founder of Adira,

[00:05:48] which is a digital strategy consultancy.

[00:05:51] So she recently sat down with Andrea Werner,

[00:05:54] who is the chief population health officer at Bellin and Gunderson

[00:05:58] Health Systems and an advisor to the coalition.

[00:06:00] So I'll give you a little bit of background on what they're talking about here.

[00:06:04] So Anna and her team at Adira were challenged by Merck

[00:06:08] to confront the issue of high mortality rates from breast cancer among black women.

[00:06:13] And just I want to share one statistic.

[00:06:16] Black women have among the highest incidence of breast cancer among women in the US

[00:06:21] and women younger than age 50 are twice as likely to die from breast cancer

[00:06:27] as white women. So black women younger than age 50.

[00:06:30] And also, black women have just a higher overall mortality rate

[00:06:34] just at any age from breast cancer.

[00:06:36] So it's a big problem.

[00:06:38] So Merck sought to enhance awareness and encourage earlier

[00:06:43] and proactive health screenings among younger black women.

[00:06:46] Just, you know, that's going after consumer behavior is one way.

[00:06:50] But, you know, patient behavior, just make sure they understand the need

[00:06:52] and that they're able and know the resources to follow up

[00:06:55] and how it pertains to them.

[00:06:57] So what Adira did and their response was to develop NIA.

[00:07:01] And NIA is a digital guide that was created

[00:07:05] to educate and also to really provide like genuine support

[00:07:09] to black women. And it really resonates with them.

[00:07:13] It's you'll hear Anna talk about their success rates,

[00:07:17] like how long people stay and really do the consultations with NIA

[00:07:21] and different measures of success that they use.

[00:07:25] But in any case, this is an initiative that's really a standout example

[00:07:29] of how very thoughtful, targeted and culturally relevant interventions

[00:07:34] can make a significant impact.

[00:07:35] So I'm excited for you all to hear it.

[00:07:38] Wonderful. Thank you so much for all of that setup.

[00:07:40] And I can't wait for our audience to listen in to this conversation.

[00:07:44] So without further ado, let's dive in.

[00:07:47] Hi, my name is Andrea Werner and I'm the chief population

[00:07:50] health officer for Bellin and Gunnarsson Health System.

[00:07:52] And I've also had the privilege of sitting on the Tech

[00:07:55] Woody for Health Coalition for the last couple of years.

[00:07:58] It is a privilege for me to interview today

[00:08:01] Anna from Adira Health to learn about wonderful work

[00:08:05] that she and her team are doing with a solution that is called NIA.

[00:08:11] For me, leading population health, it has become crystal clear

[00:08:14] for the last couple of years that the intersection and interdependency

[00:08:18] between technology and improving the health of our communities is so important.

[00:08:23] And a lot of the health tech companies that we are learning about

[00:08:26] these days are really existing to solve one problem or another

[00:08:31] as it relates to delivering on triple aim or quadruple aim or quintuple aims.

[00:08:36] So when we think about equity results to the communities that we serve.

[00:08:40] So, Anna, maybe you can introduce yourself.

[00:08:42] Tell us a little bit about your story and how you got started with Adira

[00:08:48] and then bring us into learning a little bit about NIA.

[00:08:51] Thank you, Andrea.

[00:08:52] So my name is Anna Kravitz, and I'm a co-founder of a company called Adira.

[00:08:58] Adira is really was born out of the need to help people

[00:09:04] navigate the complexity of our health care.

[00:09:07] There is a lot of information, a lot of education.

[00:09:10] But what we decided to focus on is help people to take health action

[00:09:16] because there is so much information people can drown in.

[00:09:20] So we are a consumer health action company.

[00:09:23] My co-founder and I started this company to really focus on helping people

[00:09:30] navigate the complexity of health care, but specifically help people deal

[00:09:35] with the mountains of information and come to what is absolutely relevant

[00:09:41] for them and can help them lead to the proper health action for themselves.

[00:09:47] So we started about a little over five years ago.

[00:09:50] We build a number of solutions, both for private sector and public sector.

[00:09:57] We build some of the platforms that we own that have not been sponsored

[00:10:02] by anyone and always had health equity in mind because we felt that health

[00:10:08] action has to be achievable for everyone in the country.

[00:10:12] So we're not just a health equity company, but our health action

[00:10:18] is focused on delivering it for everyone.

[00:10:20] So double click, if you will, on NIA and the solution NIA.

[00:10:24] What problem were you trying to solve with NIA?

[00:10:27] So when we looked at the issues that exist in breast cancer, it's a complex

[00:10:36] topic for a lot of people to navigate, but specifically there was a much

[00:10:43] higher kind of barrier to overcome for younger black women.

[00:10:47] I don't know if everybody knows, but for younger black women ages 25 to 45.

[00:10:54] So it's in this pre-guideline phase for a regular screening, such as mammogram.

[00:11:02] That population tends to have very poor outcomes.

[00:11:06] They're more likely to get aggressive forms of breast cancer called TNBC.

[00:11:14] They're almost like three times more likely to get that aggressive form of breast cancer.

[00:11:20] In addition to that, because they get it at the younger age, oftentimes when

[00:11:25] they turn to the doctor, what they hear is you're too young to have breast cancer.

[00:11:31] The normal screening doesn't work very well because they have denser breast tissue.

[00:11:39] So because they are not being heard for their issues, the outcome is they tend

[00:11:46] to be screened later, diagnosed later.

[00:11:50] And ultimately younger black women in that age group end up with a 41% higher

[00:11:59] mortality rate from breast cancer than white women of the same age group.

[00:12:05] So what we wanted to focus on is to help the younger black women to understand

[00:12:12] signs, symptoms and the risks of breast cancer for that, their population.

[00:12:17] And be able to advocate for themselves and start taking more active role in

[00:12:24] their breast health, things like self-exams, regular clinical checkups with our doctor.

[00:12:32] So when something starts changing, they can catch it earlier.

[00:12:36] So the Techquity for Health Coalition has really been focused on thinking

[00:12:40] about technology that can equally distribute access to services, provide

[00:12:47] tools that are engaging and empowering to all populations.

[00:12:53] And one of the things that I've loved about NIA and one of the

[00:12:57] reasons why I scored NIA high in the radiance as a reviewer of these

[00:13:02] cases is the fact that you co-designed the solution with people who have

[00:13:08] lived experience, experts who came from the community.

[00:13:11] Can you tell us a little bit more about that Anna?

[00:13:13] Like who did you partner with?

[00:13:15] Absolutely.

[00:13:16] It takes a village to tackle difficult problems.

[00:13:19] First of all, I wanted to mention and acknowledge that the sponsor

[00:13:24] for Project NIA is Merck from Suricall Company.

[00:13:28] So they provided sponsorship and thought leadership around the subject matter.

[00:13:34] Our expertise is health action.

[00:13:36] Our expertise is not breast health necessarily, this clinical domain.

[00:13:41] But to make sure it's clinically relevant, what we have done is brought in

[00:13:47] black women's health imperative to really bring that voice of the community.

[00:13:52] So we worked with them to really zero in on that population.

[00:13:58] They helped us organize several focus groups and moderate those focus groups.

[00:14:03] Actually, the moderator herself is a black woman who is breast cancer

[00:14:08] survivor, so it really helped to bring that relationship and with the

[00:14:14] women that were part of the focus group and make sure that they felt

[00:14:19] comfortable to speak up about their experience.

[00:14:22] We also worked with black women's health imperative to really set the

[00:14:28] direction for the visual design, both for the look and feel, the palette,

[00:14:35] the tone of the conversation, design of the avatar for the experience was

[00:14:41] very important for us, making sure it's someone people will find relatable.

[00:14:46] But at the same time, they can connect with that avatar that they're having

[00:14:52] conversation with and Nia is the name of the avatar and hence the name for

[00:14:58] the project, Project Nia.

[00:15:00] So we knew that we got the design right.

[00:15:02] One of the reviewers from the community saw it and said, oh, Nia

[00:15:08] looks like a cousin who made it.

[00:15:10] Right?

[00:15:11] So it's like a cousin.

[00:15:12] Someone is from my community I can relate to.

[00:15:16] But at the same time, I can look up to them so I can take their advice.

[00:15:21] In addition to bringing the cultural expertise, sourcing it from the

[00:15:26] community, we engaged with the clinical expert from the community as well.

[00:15:31] So the clinician with whom we developed the algorithm for the digital

[00:15:36] conversation, Dr.

[00:15:38] Christy Johnson is herself a black female clinician who practices in

[00:15:43] Philadelphia and sees the population.

[00:15:46] So we bring it both from the clinical and then the cultural, and we try to

[00:15:52] immerse herself as much as possible with the representatives of the

[00:15:56] community we're trying to reach.

[00:15:58] I have to tell you that I experienced Nia and it was a really interesting

[00:16:03] experience.

[00:16:03] So I went out there and I found her in the Bellen region within our

[00:16:08] enterprise.

[00:16:09] We have a promise that we talk about and it's I will know you.

[00:16:12] I will show you respect.

[00:16:14] I will go with you on your journey and I'm here to help you.

[00:16:16] And I honestly felt like that's what Nia was doing with me all the way

[00:16:21] along.

[00:16:21] What was so interesting is that she would ask me questions and I had

[00:16:26] to be honest with her about an opportunity I have to improve with

[00:16:30] self breast exams.

[00:16:32] And it was so awesome because she did not feel bad about it.

[00:16:36] She framed it in a way where, well, great, but you could do

[00:16:41] better if you did this.

[00:16:42] She was instructional.

[00:16:44] I felt like she displayed empathy and it was so fascinating.

[00:16:48] And she kept telling me that at the end of the experience, I would walk

[00:16:51] away with a personalized report that I could take with me on my own

[00:16:56] health journey.

[00:16:57] And I thought that that was so fascinating and all along I could tell

[00:17:02] that she was designed in a way to meet people where they're at, not

[00:17:06] only culturally, but as unique individuals as we engage with her.

[00:17:11] And one of the outcomes that I'm really fascinated with with the Nia

[00:17:16] solution is the amount of time that people are willing to engage

[00:17:20] with her.

[00:17:20] So, Ana, my understanding, a really impressive outcome measure for

[00:17:24] Nia is that 66% of women who engage with her, engage with her

[00:17:30] longer than four minutes and 25% of people who engage with Nia

[00:17:35] engage with her longer than eight minutes.

[00:17:37] For me, I found myself spending a lot of time with her, partly because

[00:17:41] I was a curious healthcare professional, but also because Nia was challenging

[00:17:45] me to be a better steward of my own health.

[00:17:48] And it was fascinating.

[00:17:49] But I think that that's an outcome measure that is truly impressive.

[00:17:53] What other outcome measures or measures of success would you highlight

[00:17:58] for us that you're proud of with Nia?

[00:17:59] There are actually a few things.

[00:18:01] One, I would say is just targeting, making sure that we get to the right

[00:18:07] people because how many young women that are otherwise healthy may not

[00:18:15] realize that they have this higher risk factor for breast cancer would

[00:18:21] want to click on and add and talk about breast health.

[00:18:25] So making sure we're able to reach and engage young black women was something

[00:18:32] that we were not sure initially we'll be able to achieve, but because we have

[00:18:37] this kind of continuous loop between our outreach campaign and data coming

[00:18:43] from that and the data coming from the experience, we were able to get

[00:18:50] very, very tight targeting and about like 60% of women that come through

[00:19:00] the experience are black women, actually young women who ages 25 to 44,

[00:19:09] basically sub 45, and we have another pretty good number of women in that

[00:19:16] 18 to 24 age group.

[00:19:20] We, our experience is not under 18 so we politely exit people that come

[00:19:26] that are under 18 but that like think about that number of women in that

[00:19:31] younger age that are curious about that topic and starting to think

[00:19:36] about it early so we definitely got our age targeting down and then

[00:19:43] race also were close to 80% with getting right race targeted and one of

[00:19:51] the things is we definitely are not excluding anyone else but young black

[00:19:58] women first type of solution.

[00:20:00] It's mainly for them, but we have somewhere 16 to 17% of combined

[00:20:08] white and Hispanic coming to the solution and they still get a

[00:20:12] meaningful experience, but they're not the primary audience.

[00:20:15] So definitely getting the targeting right.

[00:20:17] Something that was pins and needles for us in the beginning, making sure

[00:20:22] that if we're trying to help this population, we're able to reach them.

[00:20:26] The second thing is the completion rate.

[00:20:30] We talked about how long women engage, but we also have this

[00:20:34] benchmark for us, how many women who started the experience

[00:20:39] actually complete that.

[00:20:41] And there we are at somewhere for the life of the program.

[00:20:46] We launched late last summer.

[00:20:48] We somewhere around 16, 17%, but we are continuing improving.

[00:20:53] So we're higher, but like the blended completion rate, which is

[00:20:57] three times industry average.

[00:20:59] And again, going back to the example I mentioned from the New York

[00:21:04] State WIC program and that program is called Project Wanda.

[00:21:10] One day sister of Mia there, there was a concern if we're able to meet

[00:21:16] the industry standard of about five to 7%, but we were able there to be

[00:21:22] that and be somewhere around 15, 16%.

[00:21:25] So here we're doing as much of not better.

[00:21:28] It's so fascinating to me.

[00:21:30] I mean, in population health, we think a lot about really

[00:21:33] solving those last mile problems.

[00:21:36] What do we really need to do to reach everybody, to drive outcomes and impact?

[00:21:41] And what just struck me is that you're leveraging technology in the

[00:21:46] spirit of equity and you're doing it by myth busting.

[00:21:50] Like you're creating a credible avatar, a credible experience, and you're

[00:21:56] busting the myth for these young black women and you're giving them the

[00:22:00] facts and you're equipping them with tools and information.

[00:22:04] A report, a guide to do the right thing.

[00:22:08] And normally these women may not have access to these types of resources

[00:22:13] and information, and you're creating a new narrative for the right thing

[00:22:17] to do with for breast cancer and young black women.

[00:22:20] It's really awesome.

[00:22:22] That's really awesome.

[00:22:23] Thank you.

[00:22:24] We definitely, we want to give them agency.

[00:22:27] We want them to be able to come, first of all, understand and take in that

[00:22:35] this problem exists, give them knowledge, give them tools and give them resources

[00:22:42] to have the better conversation with a doctor.

[00:22:45] We're not there of course to replace the doctor, but we want to make sure

[00:22:50] when they go for those checkups, they come informed and being able to

[00:22:56] advocate for themselves.

[00:22:57] Because as I said, we heard the stories of women getting a long windy road

[00:23:04] towards diagnosis, feeling something is off with them and not being heard

[00:23:10] for a few times when they voiced their complaints or sometimes even

[00:23:14] themselves not realizing that if I'm feeling something is off, it's

[00:23:19] important to go and get checked.

[00:23:21] But you would know that something is off if you know what the signs

[00:23:25] and symptoms are and what are your risk factors?

[00:23:30] I love the thought of giving agency in that that's exactly what you're doing.

[00:23:34] Knowledge is power, having someone support you, giving you information

[00:23:39] so that you can take charge of your health.

[00:23:40] I absolutely love that.

[00:23:42] I'm curious, what was your biggest surprise in all of this?

[00:23:46] Good, bad?

[00:23:47] What was the biggest surprise or biggest learning that maybe didn't expect?

[00:23:51] Yeah, that's a good question.

[00:23:53] The biggest surprise, we were a little bit again, speaking of myth busting,

[00:24:00] right?

[00:24:01] There is this notion that there is a complete mistrust of pharma industry

[00:24:08] among patients, among the population.

[00:24:11] So we were not sure if our statistics of engagement and completion would be

[00:24:18] on par with our other solutions.

[00:24:21] We've built solutions for travel health, for contraception, for, as I said,

[00:24:27] this women infant children program.

[00:24:30] And we had very good engagement, but this time it was very clearly stated

[00:24:35] that it's sponsored by pharmaceutical company.

[00:24:39] And guess what?

[00:24:41] We meet the same levels of engagement and in some cases even had better

[00:24:50] performance.

[00:24:51] And that speaks to, it doesn't matter who sponsor it.

[00:24:55] If you do it right, if you show through your solution, that you're

[00:25:03] speaking authentically, you truly care about them, you treat their time

[00:25:09] with respect and you treat them with respect and you don't talk down

[00:25:16] to people, you don't judge them and you give them something useful and

[00:25:21] relevant at the end.

[00:25:23] People will listen, people will work with you, people will take your

[00:25:27] advice and the information.

[00:25:30] So I think one example again, going back to the solution that we have

[00:25:36] done for New York state, for Wanda, when we were testing and that one was

[00:25:42] the person participating in the research or kind of giving feedback on

[00:25:47] the solution was a man taking care of the nephew and needed some support

[00:25:54] with nutrition.

[00:25:55] So went through our experience called Wanda, came to the end of it

[00:26:00] and said, Oh, that was simple.

[00:26:03] I got everything.

[00:26:04] It was quick.

[00:26:05] And you know what?

[00:26:06] It didn't make me think less of myself, right?

[00:26:09] Because a lot of time, even in the sense of efficiency or getting to the

[00:26:16] point of things, people feel like they're being talked down or it's

[00:26:21] some sort of going through the process type of experience.

[00:26:26] And it's hard for people to talk to another human at the time when they

[00:26:30] are vulnerable, they're not sure of themselves that meant the world to us.

[00:26:35] Right?

[00:26:36] It's those little comments, little remarks.

[00:26:41] And we spend a lot of time making sure we get the voice, right?

[00:26:45] The tone, right?

[00:26:47] Of that conversation because each of our solutions has its own, a

[00:26:53] little bit of the personality, a little bit of fun, making a joke.

[00:26:58] We hear there and depending on the topic, obviously we keep it within

[00:27:04] of what it is, but things don't need to be boring.

[00:27:08] Right?

[00:27:09] Even when you talk about serious topics.

[00:27:11] Absolutely.

[00:27:13] The TechWiddy for Health Coalition, we talk a lot about technology and the

[00:27:17] role in preventing further advancement of health disparities and closing the

[00:27:23] gap on disparities and solutions like the ones that you're describing,

[00:27:28] where you do the research and you do the hard work and you get to know

[00:27:35] through voice and through data, each unique population that you're

[00:27:39] serving just is so powerful.

[00:27:41] I think it's just incredibly powerful.

[00:27:44] And you're working with communities and populations who have had to

[00:27:48] struggle in the past and giving support right from the very beginning

[00:27:54] with the solution based on research.

[00:27:57] And again, through collective voice and experience, I think is just one of

[00:28:02] the most powerful things in the space of TechWiddy.

[00:28:05] That's one of the reasons why you won the award that you did.

[00:28:08] Congratulations again on that one.

[00:28:09] Thank you.

[00:28:10] What do you look forward to next?

[00:28:13] Like what is your next horizon with Adira and with this

[00:28:16] great work that you're doing?

[00:28:17] There are a few things we're currently working on a few other solutions.

[00:28:23] Some of them are in oncology space as well.

[00:28:27] I cannot talk about the specifics yet, but once they launch, I'm sure

[00:28:33] we'll want the world to know.

[00:28:35] But you know, we're also looking to build solutions that are more

[00:28:43] open for broader collaboration and participation from the ecosystem.

[00:28:49] Because I think it's really important to, especially for those complex

[00:28:54] problems for various organizations, whether it's public sector, private

[00:28:58] sector, academia, to be able to come together and leverage what was done

[00:29:05] by others and add on to their solutions.

[00:29:08] So think about having, we now have this great tool that provides

[00:29:15] education and then personalized curated summary of resources for women.

[00:29:22] Wouldn't it be wonderful to have other organizations that want to close

[00:29:27] the last mile of actually finding the doctor, setting up an appointment

[00:29:33] if someone doesn't have a doctor or really...

[00:29:37] So one of the things we always include in our solutions is social

[00:29:41] determinants of health, assessment of what gets in the way of you getting

[00:29:46] care that you want, that you need.

[00:29:49] Everything from transportation, childcare, work and so on.

[00:29:55] There's so many organizations that provide those services.

[00:29:59] So being able to at the end of it, to connect into all of that.

[00:30:05] So we don't just give like a summary guide with the resources at

[00:30:10] the end, but we provide integration and we've done that for our health

[00:30:15] and travel, a platform at the end if a person is interested in after

[00:30:19] we help them understand food and water safety, vaccines they need for

[00:30:24] the travel destination they're going to.

[00:30:27] They want to, we help them schedule an appointment for

[00:30:30] pre-travel health consultation.

[00:30:33] But that's the platform that we own ourselves and there is no

[00:30:38] constraints of what can be sponsored by different sponsor.

[00:30:43] So we really would like to do more of those solutions that

[00:30:49] multiple parties can participate in.

[00:30:51] So we're thinking of applying for some grants so we can build those

[00:30:56] more solutions that are open for collaboration and participation

[00:31:02] for everyone who is interested.

[00:31:04] Partnerships, I think are one of the most powerful things in those of us

[00:31:10] and who are part of organizations and individuals who care about

[00:31:14] advancing health equity.

[00:31:16] How do you approach partnerships or what are your thoughts on partnerships?

[00:31:21] We partner as much as possible.

[00:31:25] One thing or one guiding principles for us in ADHERA is not to build

[00:31:32] anything that already exists in the market.

[00:31:35] And also strong recognition that we're not experts in everything.

[00:31:42] So we are a self-funded bootstrapped company and from the beginning,

[00:31:48] we decided that technology wise there's so many technical

[00:31:54] platforms in the market.

[00:31:56] We'll find the right ones.

[00:31:57] We'll partner with them.

[00:31:58] We'll leverage it.

[00:32:00] And what we will focus on is what I have seen as a tremendous gap in the

[00:32:10] health IT innovation across the board is coming up with really good use cases

[00:32:17] for various technology, defining your problem while bringing the data that

[00:32:23] has the evidence that it's a problem and having those statistics because

[00:32:28] that helps you define a good solution that you can also measure.

[00:32:33] Are you making a dent by your solution in solving that problem?

[00:32:37] Number two, executing it with as much care, creativity, fidelity,

[00:32:45] cultural intentionality, focus on excellent user experience,

[00:32:51] beautiful design, good, good content.

[00:32:56] That's another piece is a great execution of the solution to problem,

[00:33:01] to the use case that is well defined.

[00:33:04] And then last but not least is operating it well because oftentimes

[00:33:09] wonderful things are built and then they put out there and if they don't

[00:33:16] get continuous care and feeding and looking at the data and feeding,

[00:33:21] what you learn from the data back into improving your solution or maybe

[00:33:27] modifying it to be a better solution and using this data to identify

[00:33:34] opportunities for other unmet needs and maybe either expanding your

[00:33:40] solution or building new solution.

[00:33:43] It's no good for anyone, right?

[00:33:45] Everything needs care and feeding.

[00:33:47] You plant a beautiful garden if you don't weed it.

[00:33:50] It's going to go bad on you quickly.

[00:33:53] And because of that philosophy, wherever possible, we bring the right expertise.

[00:34:00] We're experts in defining the problems while building great consumer

[00:34:05] health action solutions, but we're not clinical experts in any

[00:34:11] particular clinical space.

[00:34:13] As I said, we've done solutions, everything from nutrition to cancer,

[00:34:17] to contraception, to travel health, you name it.

[00:34:21] For those we bring the right clinical expertise and we typically work with

[00:34:27] people who are not just KOLs and focused on just like a high level

[00:34:32] thought leadership, we want people that actually work closely with the

[00:34:36] patients because our solution is patient facing and we see our solutions as

[00:34:42] almost like an extension of that clinical capacity into the form of

[00:34:47] digital conversation.

[00:34:48] So we can take 80% of the common topics or ways that this problem framed

[00:34:56] and exists in people and digitize that.

[00:34:59] So we bring in clinical partners, we bring cultural partners,

[00:35:04] depending on what it is.

[00:35:07] We work with outreach partners that have maybe footprint in the

[00:35:11] community or oftentimes when we do it for sponsors, they often have

[00:35:18] agency already doing digital outreach, but we engage with them in a

[00:35:23] completely different way that they've ever worked with anyone else.

[00:35:28] Any other digital solution, we have weekly meetings with them.

[00:35:33] We compare notes of what we're seeing in terms of the traffic that

[00:35:38] comes from that outreach, how they're behaving.

[00:35:41] We're moderately giving them that feedback.

[00:35:45] They refine their campaigns, their messaging, their targeting.

[00:35:49] We were able to make tremendous improvement from the initial start of

[00:35:56] those campaigns to how well they're performing ultimately when we get

[00:36:00] into a steady state.

[00:36:02] So we partner a lot.

[00:36:03] And I love that you mentioned humility as the key to being a good

[00:36:08] partner. And I love that you gave a strong nod to quality improvement.

[00:36:13] I always say life and work is one big PDSA, one big quality improvement

[00:36:17] project. So when you think of the solutions that you have at Adira,

[00:36:21] do you have a standard scorecard for all your solutions that you use

[00:36:26] and metrics that you look at across the different solutions?

[00:36:30] And do you have a common way of reporting those out to stakeholders

[00:36:33] and then improvement methodology that you use or how do you go about

[00:36:37] formally integrating that into your work?

[00:36:40] Yeah, because we're very clear about what we do.

[00:36:43] We know the problem we're solving and it's data-backed and we know

[00:36:48] what health action we're looking to affect.

[00:36:53] Basically, between that, that sets the framework.

[00:36:57] So people, we know who we're targeting.

[00:36:59] So the first thing we always focused on, are we getting the right

[00:37:03] people who this solution is for?

[00:37:06] Because if we're not, we are spraying and praying.

[00:37:09] We are very specific about who are we after?

[00:37:13] And because we know what we're trying basically for them to

[00:37:18] complete that experience, driving that to that point that

[00:37:22] we consider like a completer, there are certain milestones

[00:37:27] on the way to that. So every solution we have, we built,

[00:37:31] has what we call funnel.

[00:37:34] Right? For people that come and then what happens with them,

[00:37:37] like where are we losing them?

[00:37:39] And we monitor that and we adjust our solution both from

[00:37:45] starting from getting quality input in people who are actually

[00:37:49] this is for and then delivering the right experience to them.

[00:37:53] So this is why we always very clear, like what we report on

[00:37:58] is our targeting on point, is our completion on point.

[00:38:03] Are people engaging long enough to comprehend the information?

[00:38:07] And of course, with every solution we ask for rating.

[00:38:11] So going back to Project NIA, I would say as last time I looked

[00:38:16] about 84% gave a five-star rating and the five-star

[00:38:22] and four-star combined was 93%.

[00:38:26] So congratulations.

[00:38:27] Thank you. Thank you.

[00:38:28] So imagine talking about not the most exciting topic of

[00:38:32] breast health for four plus minutes and then after that,

[00:38:36] giving five-star rating is extremely humbling for us

[00:38:41] when we are grateful.

[00:38:42] Congratulations on that.

[00:38:44] What are you curious about in terms of the next evolution

[00:38:48] of NIA? Do you see NIA evolving into doing even more

[00:38:53] in this space or do you see NIA serving her purpose?

[00:38:57] So one thing I would imagine NIA staying there for as long

[00:39:02] as she is useful, because there is always that next young

[00:39:06] generation coming in that need to be informed,

[00:39:10] educated and activated to be serious about managing their breast health.

[00:39:15] But in general, what we try to do is what kind of like,

[00:39:21] why do we create experiences that we create?

[00:39:24] Right.

[00:39:24] Those are digital conversational experiences that somewhere

[00:39:30] three to five minutes long.

[00:39:32] We call those experiences micro moments.

[00:39:36] So that's what we try to create for people because we realize

[00:39:40] everyone has their busy life.

[00:39:43] They have million things that they're responsible for.

[00:39:46] Oftentimes health is not a priority for people until

[00:39:51] it's there's something acute.

[00:39:53] So somewhere along the journey from being healthy to having

[00:39:58] been diagnosed and dealing with the diagnosis and so on,

[00:40:02] there are always those moments like we call them sliding doors

[00:40:06] where you can fall off the wagon and don't give yourself

[00:40:10] the right attention, the right care.

[00:40:12] It could be by just not knowing and doing nothing or knowing

[00:40:17] and thinking that it's the problem is insurmountable or you have

[00:40:22] other things or whatever gets in the way of you either doing

[00:40:27] the wrong thing or doing nothing.

[00:40:29] And what we want to do is create the right experience,

[00:40:34] the build those micro moments for people to do the reality

[00:40:38] check, do the education, give them tools to that health action.

[00:40:43] So they stay on the right course so they can have the best

[00:40:48] health trajectory for themselves.

[00:40:50] So what we want to do is with Nia or her sisters is to make sure

[00:40:57] that we cover all continuum.

[00:40:59] So if you think about Nia, she's in this population screening phase,

[00:41:04] but there are also people who are in this like symptomatic

[00:41:09] pre diagnosis going through diagnosis.

[00:41:11] There's so many people that get stuck and they get something

[00:41:16] abnormal and don't necessarily take it all the way through or take

[00:41:20] too long to get fully diagnosed so they can get treatment and then so on.

[00:41:26] So definitely we want to build more along that continuum of disease

[00:41:33] progression, but also think about like all the other things that branch out.

[00:41:40] So I love micro moments and TechWidi has such a huge opportunity because we know

[00:41:48] 80% of our health and wellbeing has nothing to do with clinical care.

[00:41:53] 20% has to do with being inside walls of a defined healthcare situation or

[00:42:00] experience.

[00:42:01] Micro moments empower a unique kind of access, levering technology

[00:42:06] that's available to everyone.

[00:42:09] And so I just love that concept of micro moments because people have the ability

[00:42:13] to access information that can empower them on their terms, when they want it,

[00:42:18] where they feel safe, when they have time and when they can act.

[00:42:24] And then they can revisit it.

[00:42:25] So TechWidi and Access walk hand in hand together and your solutions that

[00:42:30] you're describing Nia, Wanda are just great examples of that.

[00:42:35] Such great examples of that.

[00:42:37] You're giving Access an agency.

[00:42:39] It's so, it's just brilliant.

[00:42:40] Thank you.

[00:42:41] That's Access an agency with respect without judgment.

[00:42:47] That's what we're shooting for.

[00:42:49] Well, Ana, I would just like to express my gratitude to you, to the

[00:42:52] Black Women's Health Imperative, to Merck, to Adira for giving the

[00:42:57] communities that we serve collectively the opportunity to engage.

[00:43:02] The fact that vulnerable young Black women have a resource to go to, invite

[00:43:09] and engage and empower them in leading their healthiest lives is spectacular.

[00:43:13] So on behalf of Bellin & Gunnarsson Health System, whom I am employed by

[00:43:19] and loyal to and proud of, and on behalf of the TechWidi for Health

[00:43:23] Coalition and Hit Like A Girl, I just want to say thank you and keep going.

[00:43:28] And I look forward to hearing in a few months and years.

[00:43:32] What Adira is up to next.

[00:43:34] So take care and thank you so much.

[00:43:35] Thank you, Andrea.

[00:43:36] And thank you, TechWidi Coalition.

[00:43:40] Thanks for joining us as we've explored this winning TechWidi case study.

[00:43:44] To learn more about the amazing work being recognized by the

[00:43:47] TechWidi for Health Coalition and see all the incredible winners we

[00:43:51] featured throughout this series, head over to the dedicated TechWidi

[00:43:54] landing page on the Hit Like A Girl website.

[00:43:57] You'll find it linked in the show notes.

[00:43:59] Before you go, remember to like, follow and subscribe to the Hit Like

[00:44:02] A Girl podcast wherever you listen.

[00:44:04] And if you've enjoyed this episode, please share it with a friend who

[00:44:07] might be interested in digital health equity.

[00:44:10] All right.

[00:44:10] Thanks.

[00:44:11] See you soon.