Theresa Neil
Designing Healthcare That Actually Cares
In this brand new episode of Brave UX, Theresa Neil is reshaping the future of healthcare 🌍, challenging outdated systems 🧠, and championing women’s health innovation when it’s needed most 🚀.
Highlights include:
- Why You Can’t "Move Fast and Break Things" in Healthcare
- On Becoming a Feminist (and Why It Matters)
- Calling Out Oprah’s Menopause Awards
- Lioness: Building a Smart Vibrator for Data
- Fighting Medical Gaslighting with Data
Who is Theresa Neil?
Theresa Neil is the Founder of Guidea, an award-winning, women-owned and led product design firm specialising in strategic medtech and digital health innovation 🌍.
Since 2005, she and her team have partnered with companies like Roche, Johnson & Johnson, WellDoc, and Cigna, designing digital health solutions that have impacted over a billion users worldwide.
In 2022, Theresa launched Femovate, a global femtech incubator supporting early-stage startups with design capital and strategic mentorship. In just two years, Femovate has helped launch 28 products, supported 14 clinical trials, and guided 7 companies through FDA clearance—with startups securing over $100 million in funding 💡.
Beyond founding Guidea and Femovate, Theresa is a strategic advisor and mentor at FemTech Lab and Tech4Eva. She’s also a sought-after speaker and author of two books, Mobile Design Pattern Gallery and Designing Web Interfaces, both published by O’Reilly Media. Her insights on women in tech, UX, and digital health innovation have been shared on global stages ✨.
Theresa’s contributions to UX and femtech have earned her recognition as one of Business Insider’s Top Designers in Technology.
Transcript
- Theresa Neil:
- So the tech world has this mentality of move fast break things. You cannot do that in a highly regulated industry like healthcare, but more importantly, you shouldn't do it because the things you're breaking are humans. It's not just a pushback of being like, oh, we need to make sure that we're doing research and validation with women for your product. It's really kind of changing the mindset too. We're not just going to force our way in and put whatever you want in the market, but we're actually going to take a deep breath and make sure that we're doing adequate research and validation before we ship a solution forward.
- Brendan Jarvis:
- Hello and welcome to another episode of Brave UX. I'm Brendan Jarvis, managing founder of The Space InBetween, the behavior-based UX research partner for enterprise leaders who want an independent perspective to align hearts and minds. You can find out more about me and what we do at thespaceinbetween.co.nz. Here on Brave UX though, it's my job to help you to keep on top of the latest thinking and important issues affecting our field of design. I do that by unpacking the stories, learnings, and expert advice of a diverse range of world-class leaders.
- My guest today is Theresa Neil. Theresa is the founder of Guidea, an award-winning woman-owned and led product design firm specialising in strategic MedTech and digital health innovation. Since 2005, she and her team have worked with companies like Roche, Johnson and Johnson, WellDoc and Cigna, designing digital health solutions that have impacted over a billion users worldwide.
- In 2022, she launched Femovate, a global fem tech incubator, supporting early stage startups with design capital and strategic mentorship. In just two years, fate has helped launch 28 products, supported 14 clinical trials and guided seven companies through FDA clearance with startups securing over $100 million in funding beyond her work.
- As a founder, Theresa is a strategic advisor and mentor at FemTech Lab and Tech4Eva. She's also a sought after speaker and author having written two books, Mobile Design Pattern Gallery, and Designing Web Interfaces, both published by O'Reilly Media.
- Her insights on women in tech UX and digital health innovation have been shared on global stages. It's these contributions to UX and fem tech that have earned her recognition as one of business insiders top designers in technology. And now she's here with me for this conversation on Brave UX. Theresa, a very warm welcome to the show.
- Theresa Neil:
- Oh, thank you so much for having me.
- Brendan Jarvis:
- It's great to have you here, Theresa and I understand that your path to tech started in the kitchen. What's the story there?
- Theresa Neil:
- It did since I was a little girl, I wanted to be a chef and as I got older, I went to work in kitchens and I apprenticed as a chef and ultimately worked as a sous chef in Austin, Texas. And I got married and started my family early, and as I wanted to come back to the kitchen and get back to cooking, the chef told me I should go home and be with my baby. And I believe he actually may have patted me on the butt with that piece of advice too, but to his credit, he suggested I take the laptop with me and to come up with a new way to handle an inventory system for the restaurant. And I knew virtually nothing about computers, but I figured out how to use Excel. I figured out how to write some macros and I built a new pretty low tech inventory system for a restaurant and it saved hours and hours every month that we had previously been doing this manually. And the chef that I worked for took and sold it to a number of other restaurants in Austin, and I attributed that to my, that's my very first UX project was not really coding something but thinking about how to do something better to save time and money.
- Brendan Jarvis:
- Are you still in contact with that chef?
- Theresa Neil:
- I'm not. Maybe I should look him up.
- Brendan Jarvis:
- And I was wondering that behaviour, you mentioned that he might've tapped you on the butt when he gave you that advice. Was that symptomatic of the culture in the kitchen there if you were a woman in that line of work back in that day?
- Theresa Neil:
- Yeah, absolutely. This was in the early nineties, and I'm not saying that that's acceptable at any time period, but it was absolutely part of the kitchen culture. There were very few women working in restaurants then it was before or kind of at the beginning of the food network. So people were starting to get really excited about working professionally in kitchens. But yeah, it was predominantly men,
- Brendan Jarvis:
- Just like the tech world. Yes, just like the tech world and at risk care of speaking about another man that was hopefully more positively influential in your career trajectory so far. And that was a gentleman by the name of Bill Scott. He was one of your early role models and I believe an early influence in your UX journey. Who is Bill and how did he help to shape your approach to enterprise software design?
- Theresa Neil:
- Oh my gosh. And that's somebody who is absolutely worth speaking about. So I made that inventory software and I decided I would go back to school and get a degree at ut, and I went into the business programme, so I guess it was the information sciences in the business school left, and at that time, I think it was right around the bubble burst. So in the late nineties and I ended up taking a job for an airline company called Sabre based out of Dallas, Texas. I wasn't super excited about the job. I was moving from a really fast paced restaurant world into sitting in an actual cubicle heads down programme. I was a Java programmer, heads down programming eight, 10 hours a day. And all of a sudden I was asked to interview my future manager and this man came in, bill Scott, and he brought in a three page, maybe a four page stapled resume that was solid front and back single space type of all the things that he had done in software, both engineering and development.
- I sat down and started talking with him and he was just a natural teacher and he explained to me what usability was, what design was, how that goes hand in hand with engineering. He had worked on some of the very earliest computer games for Apple and had that as part of his resume, just an absolutely amazing energetic, enthusiastic teacher. And once he came and became my manager, we actually ended up building out the first UX team at Sabre, kind of at the early days of people starting to call what we were doing, UX. And yeah, I stayed with him for the next four years and we wrote a book together for O'Reilly, so fantastic mentor in that space. And I think one of the coolest things about him was he had the engineering mindset. He was a fantastic engineer and a design mindset, and he understood the value of talking to people, the buyers, the end users, everybody in between, and really blending all those things together. And it's so unusual to see unusual, really strong technical engineer, a really strong design thinker, and a really strong business leader all combined into one person. So I feel really fortunate that we cross paths and I had him as a mentor
- Brendan Jarvis:
- And listening to you describe those various aspects of Bill's capabilities, it seems like you too share some of that DNA if you like, you have that engineering background, you also have the design background, but you also went back to school, I believe, and did an MBA as well. So you, you've got the business background and hence you've also gone on to found and run Guidea for almost 20 years now. So that's clearly come strongly through. But if I can just take you back to perhaps it's your time at Sabre and you were working on a airline kiosk. It might've been your first usability or design project, but what can you tell me about that time there working on that project and how, if at all, it influenced your decision to continue to pursue the more design aspect of technology as opposed to engineering?
- Theresa Neil:
- Well, I really wish you hadn't called this out because now everybody in the world is going to hate me for designing those terrible kiosks that you get stuck at in the airport.
- Brendan Jarvis:
- Sorry about that.
- Theresa Neil:
- But at the time, it was actually really interesting because we had a mandate from a specific airline that we needed to create a check-in experience at the kiosk that took people, I don't remember anymore, but let's say 50 seconds or less. So nobody, the intent was for nobody to be standing at that kiosk for more than a minute. And so we needed to optimise the screen layout to work, to be touch friendly and for people to be able to get out all the different cards and various things they needed to check in and then move on. So that one was really cool in that we set up in the development lab that I worked in, which I remember it being very, very cold, I guess there was a bunch of servers in it, but we set up actual kiosks and when we would code it and roll out an iteration of the code, we'd have other people from the company line up in front of the kiosk and come in and we would time it and test to see if we actually were getting this done in 50 seconds or less. So we were doing rapid iterative testing evaluation in real time with real code to get to that solution really quickly. I wish in fact the airlines still had that mandate for a minute or less because it seems like they've added in 7,000 questions to check out now.
- Brendan Jarvis:
- Well, maybe we need to bring you back to one of the major airlines so you can go back in time and help people get through that system more efficiently. It certainly, it's great to hear about the lab and how you were running that. And I wonder, did the lab have any windows? You mentioned it was cold, but did it have any windows?
- Theresa Neil:
- No, it did not have any windows. And I remember that it was cold because at that time period, this well predated smartphones. And so I don't know if anybody was really doing much touch friendly interfaces, tablet style interfaces, but the screens at that time wouldn't pick up your touch if your hands were cold. And so I remember wearing jackets and sometimes wearing mittens to get warm enough to be able to test the code that we were making.
- Brendan Jarvis:
- That's too funny. That's too funny. Hey, tell me, fast forwarding a few years now, tell me about gia. So you founded the company in 2005, it's now 2025, so it's coming up if not already 20 years. What motivated you to start GIA and how has your vision or perhaps the company evolved over the time that it's been running?
- Theresa Neil:
- So I never planned on starting a company. When I left Sabre, I realised I was just going to consult. I realised that I had a really unique differentiator from many people that were in the field. At that point, people were still working as web designers and calling themselves web designers, really focusing on marketing, advertising, beautiful brand work. And what I had leaving Sabre and they allowed me to take with me was this huge portfolio, 2030 products of enterprise software built on Web 2.0 and nobody else had anything like that. This was the very beginning of Ajax and actually be able to have software and a browser to do complex tasks. Previously, people were still installing local software on their computer in order to run any type of programme had any complexity. And so I was like, oh, I have a differentiator here. And I was able to through just good luck and referrals, end up with quite a few web two oh projects at the very beginning of that era of helping companies build out software and complex domains.
- Over the next couple of years, bill and I published a book together with O'Reilly and I started getting even more referrals, and then I started getting more and more complex domains that were starting to exceed my, let's say comprehension. So I got one in finite element simulation and I was like, is okay, interesting. Well, ultimately they were designing software for let's say car engineers or people who are building industrial engineers who are building phones. So they could run simulations to see at what point will the phone break, will it break at three feet, four feet, six feet, eight feet, and for cars at what point of impact it's going to crumple or not. This was tools to run simulations for the industrial engineers to know how to optimise and refine the design for the product so they could withstand dropping or cracks or crashes or what have you.
- But yeah, definitely at one point I was like, oh, we're past my understanding of this domain. I can't remember the next one. I think it was like something maybe in network security and another one and genetics and astrophysics. I was like, I could really benefit from having some domain experts working with me as consultants. They didn't necessarily have to be great at UX as long as they had the domain turned out they were also really good UX designers. So I invited people to come work with me on different projects and I don't know, five, six years past I looked up and none of those people had ever left. We had plenty of work, so we made a company and brought people in full time and it was completely organic. There was never a business plan, a strategy, annual goals, any of those things. It just organically grew through referrals and more experts wanting to join and be part of the group that I created.
- Brendan Jarvis:
- And Guidea is a woman owned and woman led company. Was that a conscious decision from the start or was that also something that evolved organically?
- Theresa Neil:
- It evolved organically, and I've tried to be conscientious about it over the years because we all, I believe as humans feel comfortable with folks like us. So not only were we women owned, women led, we were all women of about the same age too. So I have unconscious bias just like any other human was probably ending up having teammates come and work with me that had similar age, similar experience, similar backgrounds, but we also ended up with a lot of organisations and individuals referring their female designers to us saying, oh, you're looking for a change in your career. Did you know Theresa has the idea? Why don't you go apply with 'em? And so it was kind of a byproduct of both probably that unconscious bias plus that referral and of all these different really talented women that were looking for flexibility in their day. So because we've always been a remote company, we were able to offer that flexibility that many of us as parents, not just women need for dropping kids off, picking kids up, taking kids to appointments and not really basically recreating that cubicle,
- Brendan Jarvis:
- That flexibility is a really important thing to provide. And perhaps this next one might seem, perhaps it's a little direct, so tell me if it is, would you consider yourself a feminist?
- Theresa Neil:
- I don't actually think so. I have to admit, before we created our women's health incubator in 2022 that I really had not given a whole lot of thought to it, which may be a little bit embarrassing to admit, but I had not gone through my career in restaurants or in technology really thinking about advocating for women's rights or really that there was much difference between the genders in the workplace. I am very much a heads down problem solver. I'm very focused on the thing that I'm working on to the point of I've lost track of time and really anything else. So I hadn't really thought about it until I got into women's health. And I think over the past two and a half years I've become a feminist because of the experiences I've had in moving from technology into women's healthcare and seeing the, I know we're supposed to call it bias, but the extreme sexism that female founders experience trying to raise funds for their women's health companies. And I think that's really actually now brought out the feminist in me where I want some equality and I want to make sure that founders and employees and teammates and everybody, they each have a stake at the table and are able to bring their skills to bear and aren't kept out of let's say the workplace or in investment opportunities or in fundraising opportunities just because of their gender.
- Brendan Jarvis:
- And perhaps this will highlight that sexism that you've touched on there. And I definitely want to come back to and speak specifically with you about the raising of capital, particularly for fem tech. But about a week ago you posted on LinkedIn and gave Oprah the queen of all media a really hard time. What did Oprah, and perhaps it's more Oprah's team, but what did Oprah do to deserve that?
- Theresa Neil:
- So I noticed that Oprah's team had put out a menopause awards. It's a little cute little o for Oprah Awards article or post about all of these amazing new advances in menopause, and I was very excited to see this. I don't follow Oprah and I haven't seen her show in a very long time, but I have a lot of regard for the woman. I was like, oh, this is great, because one thing that women need is education about their bodies. So we don't receive it in school. Our doctors and gynaecologists don't receive enough education. There's just a full lack of education. It's like, oh, great. Oprah's putting awareness on this. And I started looking through the list and no shade on any of the products that are in the list. There are certainly some really good things in there, probably a lot of really good inventions.
- There's supplements, there's beauty care products, and I got down to the tech section and I work and breathe and live fem tech. So I'm like, oh, what are we going to see here? There are so many amazing scientists and researchers and founders pouring their heart and souls into figuring out how to improve women's health span. And I look in the text section and there's too many fans like oscillating fans, like a fan that you put on your desk to cool you down. And I'm just dumbstruck by this. I really wish Oprah's team had had the time and knew where to look to see where all of these new inventions are incurring in EmTech. Now, menopause is something that happens to all women and you might say, well, you can't prevent it and you can't fix it. It's just something women have to go through. A lot of people aren't comfortable talking about it, which I think is a combination of it's a woman specific issue, but also it makes us realise we're all getting old and we'll eventually die.
- So I think there's two things that make people uncomfortable talking about it. That's just another condition, like any other health condition. And you could say, well, it happens to everyone. You can't prevent it. But there are actually researchers right now looking at preserving ovarian longevity. They found that when I believe this is correct, I'm not actually a clinician myself, but women are the only mammal whose ovaries or any body part just stops working. Why do they stop working? Let's look into that. Can we preserve how long they work? Because ovaries provide important hormones to women's bodies like oestrogen, and these are things that protect us from cardiovascular disease. They protect us from early death, they protect us from dementia. There's all this research going on in this space, and there's all this tech happening in this space for at-home testing kits, telehealth platforms that can provide HRT and other services.
- There's a really cool product out there that is great for all genders. It's called O Osteo Boost. It's very well designed. It's almost like a belt that goes around the hips and it has vibration and you use it while walking. I hope I'm explaining this correctly or at least good enough. It stimulates the impact that you would need to increase bone density. So as all of us age, I'm thinking probably like after sixties or so, we started to have a decline in bone density. And it's not like we're really going to go out there and do super high impact trail running to rebuild that bone density. And this device can do it for you, wearing it a couple of times a week while you go for your regular walk. There's another one out there, the super cool stability scale. A lady who used to work for NASA came up with it.
- And so if you get on the scale, it can predict within a year whether you'll fall. And if you think about the biggest causes of death and people in the US having to live in nursing homes, it's because of falls and fractures. If you have a scale that can predict you're going to fall within a year, you could go get physical therapy and regain your stability. And if you're also using boost and building up your bone density, if you fall, maybe you won't break that hip. So there's all these things out there, and I'm like two oscillating fans, are you kidding me? So I don't know, it was a gut reaction.
- Brendan Jarvis:
- You mentioned menopause and you mentioned a few things in there, right? Obviously menopause was the focus of the awards there, and you got a couple of fans, which is given what you've just explained, if they just looked maybe a little bit deeper, they would've found some truly phenomenal and deeply interesting innovations that are happening in this space. But yet you get fans, and I can't help but wonder topics like menopause and menstruation and many other aspects of women's health, regardless of whether the women make up half the population on the planet, these are still considered rather taboo topics, and not just for men, but for everyone, even women blush when these topics are brought up, how is this cultural discomfort, which seems like a cultural discomfort with discussing just things that are part of life for a significant proportion of the population. How is this shaping the system? Define the system how you will, but perhaps the health system or perhaps just the conversation around that system as well and these issues, how is this discomfort shaping that and reinforcing, perhaps I'm leading the question here, but how might it be contributing to the status quo that women experienced today?
- Theresa Neil:
- It's a key part of it. So I have to admit, before we started this women's health programme, I am not sure I would've even been comfortable bringing up menopause on a podcast. It just happens that the past 10 podcasts I've been on have been women's health. So I'm very comfortable talking about everything now. And I was like, oh, wait a second. Is that even appropriate for UX? I'm like, yeah, we're humans. These are our bodies. It's things all women go through. But how are everybody's level of comfort or discomfort in talking about the human body and the human body ageing, and specifically women's bodies being taboo is a huge problem. And that actually kind of ties back to one of the things I was talking about, about the sexism I've experienced working in women's health after 25 years of being in tech and not really encountering very much of that issue at all.
- So when I speak to a colleague now about running women's health programme and we're peers, maybe we're both, we both have a development background, maybe we're both designers, maybe we're both business owners, when I mentioned that I have a women's health incubator, if it's a male, they will more often than not offer to introduce me to their wife or girlfriend. And this is perplexing to me at first. I have the benefit of the doubt of thinking, oh, are they in healthcare? Are they in med tech? Are they an investor in this space? No, I'm like, that's a really unfortunate way to handle the introduction of the topic I've brought up in assuming that I would like to have more female friends because what I'm talking about is an industry that's projected to have a trillion dollar market revenue in 2030. This is a huge opportunity for design, development, innovation.
- It's transformational. We're not looking at a disruptor here because there's really nothing to disrupt. There's not very many products out there for women at all as evidenced by two fans for menopause. Clearly there's a huge gap of opportunity for actually supporting women through this, I guess almost 50% of their lifetime. And so it's been a very interesting experience to see how people respond to even my work in women's health and then watching how venture capitalists and other potential investors respond to pitches for women's health products, even if the founders a male is also really eyeopening. I've sat through pitches where VCs have said, yes, that'll save women's lives, but it's not really enough for us to care about a million women a year is not really enough for us to care about. And so hearing these things is really disappointing. As a human, it's confusing as well.
- But then if you start thinking about shifting the narrative and moving people out of being uncomfortable about women's bodies and longevity and start moving it to presenting things in a way that are about business value, then all of a sudden I think we can be back on an even playing field. So it's not that I'm ever going to stop saying the word menopause or postpartum haemorrhage, but in the future when we talk about a lifesaving device for postpartum haemorrhage, we're not going to play on or assume that people are going to be moved by this idea of saving women's lives. And instead, we say, women who experience postpartum haemorrhage have generally incurred 400% higher expenses in the hospital than women who don't. And so this is a business problem. Now, whether or not you're squeamish about blood, we can look at that and be like 400% higher. Well, clearly that's an opportunity for a solution that would drive down that cost and provide better quality of care. So I guess that's my solution is don't stop talking about it, but also frame things from a business perspective, especially when we're talking to investors because what they need to hear,
- Brendan Jarvis:
- Just to give some context to people that are listening, the million women that die annually, you mentioned earlier, is directly related to, I believe, postpartum haemorrhage that you also mentioned. And it's curious perhaps, but perhaps understandable also why that huge human cost just doesn't seem to register in the hearts and minds of investors. And you've quite rightly pointed out that framing things from that financial return perspective seems to get their attention. And I suppose they're just being true to type A, if not a little heartless. It's certainly something also that I've experienced, not personally, but my wife experienced that after the birth of our second child. And if you are squeamish with blood, that's certainly a situation that'll make you, so you mentioned that one founder that you observed who went in with that sort of pulling on the heartstrings, using the mortality rate, if you like, of women who have experienced that haemorrhage not working. Were you there for the time where she went back and re-pitched the business to another set of investors?
- Theresa Neil:
- I was not, but I do know that they are definitely making steps forward in their funding. So I would hope that we, and they've received quite a few grants, so I would hope that we actually have something on the market potentially in 2026 that women will be able to wear in the hospital and it'll do proactive detection of postpartum haemorrhage. And you're right. Thank you for clarifying. It's 1 million women a year, around 1 million women a year die of postpartum haemorrhage, but 14 million are impacted. So probably like myself, your wife, other women, it's a very traumatic experience and costly, even if you don't die from it. And it takes time away from you bonding with your baby, which again sounds like another kind of warm, touchy, fuzzy feeling thing that we shouldn't be like, does anybody really care about that? But when you start at actual evidence for newborns having that early contact, there's lots of beneficial health outcomes. So yeah, everything's just got to be phrased I think in terms of how is this creating better health outcomes, not so that we feel good about it, but so that we lower cost with better preventative care.
- Brendan Jarvis:
- The statistics behind funding of fem tech are atrocious, and they are that female tech founders more broadly only receive 2% of VC investment. And women's health is, I suppose, a category of investment only receives 4% of the investment that goes into digital health. Do you have any near term hope that this is changing?
- Theresa Neil:
- Well, I want to just say something because every time I talk to folks and I'm like, female investors only receive 2% of VC funding, usually people ask me, well, there can't be that many female founders. Is it just proportional? And I'm like, no, there's more than 2% of all tech founders are women. So just to clear that up in case anybody's thinking, well, it is absolutely disproportionate there. I don't remember what it is. A much larger number than 2% of founders in tech are women. Women are definitely getting the short shift on that. Do I have any hope of it changing? I don't know. I like to think of myself as an optimistic person, but at a certain point of we have, let's see, 64 companies in our incubator. Some of these companies have multiple founders. So we're talking about 80, 90 founders. I had been watching these folks bang their head up against this wall for two and a half years.
- And while I would like to remain optimistic that things will change, I don't know if the fem tech world should hold out for VCs. It doesn't seem like many of the solutions in fem tech are really properly or super well aligned with VCs. So let's take medical devices. Medical devices take many years to get through regulatory approval way more than the five years that a VC may want. And they cost millions and millions of dollars to take through pre-human trials, clinical trials, all of these different trials. And there's a lot of risk at each stage. So I'm not sure we should all hold out hope for VCs to be the investment saviour for women's health, women's health. I think we need to be looking at alternate sources of investment. And so with the last administration, there was the Jill Biden put in, I think it was a hundred million dollars into women's health and then expanded that, and that supported an ARPA H Women's Health Innovation sprint.
- There were a couple of other, or there's plenty of actual grants, the women's health research space. I noticed that Melinda Gates has a new $500 million fund that is specifically around women's health. And it might be these funds and these social impact funds and grants that are going to move women's health forward because the biggest gap in women's health moving forward right now is the lack of research. And I just can't see, and when I say lack of research to clear this up, for anybody who's new to this, who's listening, all of the trials on medicines and devices, healthcare devices for people were all tested on men up until the nineties. So it's only been in the last 30 years that clinical trials have included women. And then I'm hoping I get the data right on this too, but at that point, when women were included in trials, I think they had to be women who were not of reproductive age because this kind of makes sense.
- You're like, I don't want to run clinical trials on women who are maybe trying to conceive or actively pregnant, but that's a large group of women that's like everyone from what, 12 to that menopause age. So I'm not sure how much that's changed at this point, but we do have this huge gap of data around women's health. And I can't see VCs being maybe, or certainly not the majority of 'em being really interested in paying for that research. That seems to me like a social impact and government funds are going to have to step in and universities academia are going to have to step in and fill that research funding gap so that innovation can really move forward.
- Brendan Jarvis:
- And you've observed that many researchers and innovators in fem tech have cited that core problem of not having enough data available as slowing down, and perhaps as you've alluded to, making it less attractive to outside investment to put into these potential innovations. Because I suppose it increases the risk, right? If you don't have that body of evidence or data to draw upon to inform some conclusions, that makes it more challenging. But I also, I wanted to ask you about a story that you've previously shared, and that's about the lioness smart vibrator. Oh yeah, this is great. Yeah, there were challenges that they faced getting market access and to assist with adoption. What is the story there? What were those challenges and how did the company innovate and get around that sort of absence of data?
- Theresa Neil:
- So I have not personally had the opportunity to work with this founder, but I read a couple stories online, and I hope I'm paraphrasing them correctly, but it sounded as if the founder of Lioness, which is, it's a vibrator. It's in the sexual health space, sexual health and wellness space. It sounded as if they ran into some challenges being able to bring this smart device to events like CES or Mobile World Congress where everybody else can bring their devices and display 'em and people can learn about 'em. And it's a great marketing move as well as an opportunity to be acknowledged and recognised as a leader in technology. And because this was a smart device in the sexual health space, it sounded as if they weren't allowed. What the lioness vibrator does is it collects female orgasm information, and they have, I believe, created the largest repository of this information ever.
- And you could be like, so maybe that's interesting. But the founder's premise is, well, but if we've never collected it before, we don't know if it's valuable or invaluable or not. So if a man were to go into see his gp, a general practitioner healthcare provider, and say that he was having erectile dysfunction issue, one of the first things the provider would typically test for is to make sure that his heart was okay, because that is actually a symptom of cardiovascular issues, or could be, I'm not diagnosing anybody out there, but it could be a symptom of that. And so the doctor will check, we don't even know what information women's sexual health could provide for other things like cardiovascular disease, early and early signs of dementia. Who knows? Because the data's never been collected. So they've built a great data bot based and repository of that information. And then it sounds like now they do have access and are being acknowledged as an actual tech company with a real value now that they have that data set. So happy ending on that.
- Brendan Jarvis:
- I want to come back to where we were a little earlier because I don't think we addressed it specifically. Why is there this huge discomfort with anything to do with female genitalia or female health? Why is this such a thing?
- Theresa Neil:
- Americans are prudish? I dunno, maybe, I dunno, we're brought up that way. Maybe women have just been oversexualized and I don't know. I do know you had asked a question earlier about what's the impact of so many of these topics being completely taboo? And there's a real financial impact to this in that many of the companies that we work with and many more in the EmTech space actually cannot advertise their products on social media or on billboards or in commercials because we can't talk about breast, even if we're talking about breastfeeding now, we can show 'em in a beer ad, but when we're talking about breast exams for early detection of breast cancer, they're censored. And it kind of blows my mind. I am from Texas and anytime I live in California now, but anytime I'm back in Texas and I'm driving around, there's billboards up billboards on the side of the highway where my kids can see them about erectile dysfunction. And I think if we have that there and I get to explain that to my young children, then I think we could certainly have up a board that shows a woman breastfeeding or talks about early detection of cancer and we just shouldn't have this double standard on it. But it is directly impacting many, many, many of these fem tech companies because they cannot put ads for their products, even when they dump everything down and use all the euphemisms, they can't put the ads on the social media channels.
- Brendan Jarvis:
- And that further impacts the attractiveness and the likelihood of success of those innovations finding product market fit, so to speak. And thinking about this, and obviously I'm not from the US so I come at this from a completely uninformed perspective, but I gather that in the US a women's healthcare access depends quite heavily on factors like insurance, their particular employer and also the state and federal laws that may be applicable where they are. How are corporate and political forces limiting women's healthcare choices?
- Theresa Neil:
- That's a heavy question to ask with the new administration. I think the answer is it remains to be seen. I'm sure you've seen plenty of new stories lately on so many of these different departments being dismantled, the impact that that's going to have for generations, the money, the grants that are being revoked in the research space for everything, not just women's health, anything that touches on anything with equality or even says the word women in it. So I think it remains to be seen how this is going to play out. It from my perspective, looks pretty scary. I can't imagine that rolling back access to health data and rolling back access to healthcare is going to do anything positive for our country and the women in it.
- Brendan Jarvis:
- And yet, this is interesting because when you think of America, it's the poster child for modern capitalism. And if there's anything that an administration, any administration and the corporate culture should understand, that would be the power of the dollar. And from what I gather from things that you've shared previously, women drive the majority of healthcare spending in the US by quite a margin. Yet you still see what we've been talking about here, which is this substantial underinvestment in EmTech and in women's health research. So what do you suspect is, and I know this isn't necessarily your, you're not an academic in this area as such, but I'm curious, what do you suspect is the source of that disconnect between women's economic power in this particular space and the actual amount of choice or healthcare innovation that's happening for women to access?
- Theresa Neil:
- I feel like it has to come down to the bias, the taboo, the sexism, and it's just a really, really slow change. So I think about this a lot because I'm not necessarily at the end of my career, but I am 25 years in. It's not like I'm planning out my next 25 years of pioneering in women's health. I like to think that a lot of us who have gotten into women's health actively pushing innovation forward on the tech side, there's been people pioneering in women's health for a long time, but on the tech side, I feel like we're paving the way for the next generation to really crack this open and get past a lot of the, I don't know if it's cultural or around specific to people's age, education level, I don't know. Or education, not education level. I'm sorry, that's a really hard question to answer, but I do hope the work that we're doing right now is paving the way for more progress with the next generation.
- Brendan Jarvis:
- You've spoken about before the, it's almost like a grassroots response by some woman thanks to fem tech innovations, increasingly bringing self-track data and things like at-home test results to their medical consultations. What is it that you think is driving that shift and how is it changing the dynamic between patient and doctor?
- Theresa Neil:
- Yeah, this is a really interesting one. We coined this spike tracking, and so not all women who are tracking their symptoms are doing it out of spite, obviously. But I kept hearing, and my colleagues at Guidea kept hearing these stories of women and experiencing this themselves, tracking symptoms on their phone using maybe a menstruation app like a clue or flow or something like that, or any other healthcare app where they could track symptoms and logging all this information so that when they went into their provider, they would not be ignored, dismissed. Many times we're told, we're overreacting. Can you imagine going into the doctor? You're like, I have back pain. And he's like, you're overreacting. You're like, no, it's a legit symptom. It's in my lower back. It feels like it's burning. And to just be dismissed or told that, oh, well that's a normal symptom of a better example would be joint pain.
- That's a normal symptom of menopause. It just is. That's not how you talk to somebody who presents symptoms to you. You should look at 'em, analyse 'em, and then make hopefully a decent recommendation or order test or whatever. So what we're seeing or what I'm seeing is that women are starting to take their health into their own hands, and that involves lots of different things other than just tracking symptoms on an app to prove to their doctor that they were experiencing these symptoms. It's in the form of home testing kits. So women, and then I'm sure too, in many cases, become desperate to find a solution to the symptoms that are really, really impacting their life. They've gone to the doctor, maybe they've tried a couple of things, it doesn't seem to be working. Maybe I was misdiagnosed. Maybe there's something else out there. Maybe I have some type of allergy or intolerance or whatever.
- And so people are resorting to these at-home testing kits in the face of that, this industry of at-home testing kits has grown up. And I think this is actually super beneficial to women because now from their own homes, if they have the means, they can order kits and find out about their hormone levels or their blood glucose levels or their endocrine health, all of these different pieces. Now, there's a little bit of a challenge that is inherent in that, is that if you had a physician who wasn't listening to you to begin with, when you bring them at home test kit results, they're probably still not going to listen to you. What we need are more physicians, and there are plenty of great ones out there. We need more that are comfortable listening to self-report symptoms from women, acknowledging them, providing additional education, and then acting upon the symptoms that are shared.
- But I am really actually happy to see how much women have embraced and this idea of education and empowerment and at-home testing and symptom tracking, because we need that knowledge, we need that information. None of us as humans should just implicitly trust that a doctor is going to tell us the right thing right off the bat. They're human too. So we need to be involved in our healthcare and we need to have some baseline understanding of our bodies. I know we call it spite tracking, which sounds a little harsh, but for some women that's because they've had these really gaslighting experiences with their physician. But really it's more about empowering women to learn more about their health and about their bodies, that they can be a good advocate in working with a healthcare provider.
- Brendan Jarvis:
- And I dunno if there's any specific advances in this field, I have to admit, it's not something clearly I'm personally affected by, but I know at least three women who have endometriosis and at least one of them who I know very well has shared just how frustrating it had been to get the diagnosis of that. So I can imagine having your own self collected body of evidence to support something, perhaps something like that, to have a conversation with a physician who's open to having that presented to them and discussed may make it easier for women to achieve better health outcomes. And maybe this is a crass analogy, but I can't help but thinking about how, for example, the internet enabled us to have much stronger shading positions with say, car salesman. When we go in to look at a car on the lot, it's no longer just about what you can garner from the conversation with the person that's there to make a dollar from you. It's something that you can bring to the conversation. You already know all about the car, what it's priced at on various different car yards, lots more power in the relationship in a way that was healthier for the consumer, if you like, or for the patient in this case of that service.
- Theresa Neil:
- I totally agree, and I feel like the term empower is probably overused in women's health, but that is exactly what we're talking about here, is it's arming women with education, which gives them power to then be a better advocate for themselves. And since women are the primary caregivers, we can be a better advocate for our kids, our ageing parents, our spouse, anybody else. So it is really about empowering, and I think that analogy is a really good one because I think it really shifted the same thing for car buying, but also for booking travel. I think when our parents were probably younger, they had to book travel through travel agents. I was trying to imagine what that would've even been like. Did you call somebody on a phone and ask to book a flight? I've kind of baffled even trying to imagine it, but the advent of Expedia and all the other sites where you can just go book your own travel, it gave some level of transparency and people really flocked to that, and they really flocked to learning about the car buying process and getting a good deal and choosing the thing that was best for them, and maybe choosing a vehicle that is really high on safety and good gas mileage.
- And so the more you learn, the more you can identify what your priorities and your boundaries are in any of these situations, and then be a good advocate for yourself and your family. So I think it's a great analogy.
- Brendan Jarvis:
- Thinking about what you've been talking about there, which is I suppose the user, if you like. And then thinking about something you said earlier, which was the reluctance of some of your clients, and you weren't naming names, but just this reluctance you've experienced at times of some of your EmTech clients with their receptiveness to the user experience research that you'd done into the prospective market or the people that would be using the software and or device that they were considering creating, just not wanting to hear it, not wanting to really understand what it's like from that person's perspective and how that product might fit into their life or otherwise. How do you handle situations like that where a client is reluctant to actually hear what that woman's perspective is?
- Theresa Neil:
- It's a really good question. I will admit that many of the founders that we work with in our fate programme are female founders. It's like over 80%. The male founders that we work with, many of them have a lived experience as well through a loved one. So they are already empathetic in both pioneering a solution and hearing feedback from more women. I don't through our fem of eight programme run into any people who are reluctant to hear about women's actual needs for these products. I have through clients that we've had in the idea, I have run into plenty of companies, and it could be any gender founders who are coming from the tech world and they're moving into healthcare. So the tech world has this mentality of move fast break things. You cannot do that in a highly regulated industry like healthcare, but more importantly, you shouldn't do it because the things you're breaking are humans.
- And so it's not just a pushback of being like, oh, you, we need to make sure that we're doing research and validation with women for your product. It's really changing the mindset too. We're not just going to force our way in and put whatever you want in the market, but we're actually going to take a deep breath and make sure that we're doing adequate research and validation before we ship a solution forward. But I do have an example of one company that I was working with where it was a hormone replacement therapy company, and the whole experience felt very, very masculine, and they wanted to update it to work better for women, but the questions that were in the onboarding questionnaire were really invasive, and there was no context around 'em. So a lot of times in healthcare, especially, you go online, maybe you're getting one of those home health kits or you're doing an online screening, these questions will be invasive.
- They're asking about your medical history, potentially your sexual history, but how you frame those questions is really important. And the order in which you put these questions, how you design that experience is really important. So you have to do an onboarding experience that first builds trust and credibility around the scientifically proven solution that you're supposedly going to be offering. And they need to be really thoughtful about how you design that questionnaire so that the questions aren't feeling like they're coming out of the blue. And so if we're asking women to share their menopause symptoms, some of these are things that most women, me included, aren't super comfortable just saying out loud or saying, yeah, who's reading this? Who am I talking to right now? Who's going to be looking at this information? And then in this HRT programme, just kind of out of the blue, one of the questions was like, how many abortions have you had?
- And I'm like, whoa, whoa, whoa, whoa, whoa. We don't just drop that question on people. Now, there's lots of things with HRT where that's hormone replacement therapy. The providers do need to know about medical history because you've had, I think it's like blood clots or some of these other conditions. HRT in a certain format should probably not be delivered to you. Please. Again, everybody refer to your own physician for the actual medical recommendation on this. So there are some sensitive questions that need to be asked, but when you're dropping something that heavy on somebody, there needs to be context. So are we just asking that because we want to collect that data? The marketing team wants to know, or did that question just slip in there out of ignorance and we don't even actually need it? But when I brought this back to the team and I told 'em, I was like, Hey, we need to go through these questions and find out what's absolutely critical to have in the assessment. Do we need all 40 of these? Some of 'em are really invasive. What bearing does that have on the diagnosis or the screening? And I was like, can you go back to the physicians and find out what do they have to know before that first meeting? And they're like, we're not going to ask the physicians. I mean, they're physicians if they're asking, it's super important. And I was like, but nobody's going to complete this form because they're really invasive. And they're like, how dare you tell us how to craft a form?
- I'm like, well, you hired me to tell you how to craft a form for one thing. And then second, we done 2000 hours of research with women. I can tell you where they're going to drop off here. But it was kind of this mentality of the physician's always, right? How dare we ask anything? I wasn't saying the questions were wrong. I was just saying, look, if you're going to be asking about a sensitive topic frame, why on the screen you're asking if we need to know about number of abortions, it's because this and this, which will impact your treatment. Then the woman can go, oh, okay, then yeah, I'll answer it. Otherwise people are just going to lie. So it was a very interesting dynamic of how do you create a really great solution for women when you have this mentality of we can't even go back to the physicians and have a collaborative conversation on what's required versus optional. And then we had a team that wasn't really willing to liaise behind, but between the patient experience and what the providers needed.
- Brendan Jarvis:
- Well, it sounded like you couldn't in that circumstance.
- Theresa Neil:
- Yeah, we were pretty much stuck.
- Brendan Jarvis:
- Yeah. Yeah. I mean, it's a great example of where design can play quite a meaningful role in that onboarding experience. Clearly there's the context that you spoke to. Why are we asking certain things? There might be some sort of foreshadowing of some of those more sensitive areas like questions around abortion. And also you pointed out really good thing, which is do we actually need to be capturing all of this data? And I understand from the perspective of healthcare, there's often quite a lot of regulation in terms of how data is stored and perhaps the things that need to be collected for certain treatments. It sounds like it often doesn't guide the design of those experiences in such a way that the emotional wellbeing of the patient or the prospective patient is considered when those questions or other aspects of personal information are being asked for.
- Theresa Neil:
- Yeah, I think that's a holdover from the healthcare industry is not patient centric regardless of technology, regardless of what gender, it's not patient centric. You're there, you're going to fill in this form. We don't care how long it takes. You answer all this stuff. Yeah, I know you did it two weeks ago. When you're here, fill it in. Again, it's not really optimised for the patient. Really. Patient-centric research and care has really just emerged in the service design field probably in the last decade and a half or so. So it's not necessarily about tech founders pushing this or being insensitive to patients. It's kind of a byproduct of healthcare. But when I talk with physicians about this and bring up, Hey, what if we presented information like this? Typically they're very open to it. We have a great client in the UK who has an at-home testing kit for screening for HPV.
- So if you can screen for HPV, you can find cervical cancer earlier, maybe even overt it. And so they've created this nice test, and I was talking with him about something we learned in our research that in designing mobile solutions, because a lot of these test kits, the reports delivered through a mobile interface that people with mobility issues may not be able to access their results. And so if you think about the beauty of the at-home screening kit is that people are not having to drive into a physician's office or drive into a lab. It means we can reach more people with mobility issues. And it would be a shame for them to not even be able to access their results because just think cerebral palsy or even rheumatoid arthritis things where people just don't have the, it's not easy for them to use the mobile interface to get the information.
- And I was telling 'em, I was like, Hey, this is a super easy fix in the kit. You allow the customer, the user or the patient to specify do they want to receive their results by phone, by email, in the app, right? All different ways. And he's like, oh yeah. And if they pick phone, we'll just call 'em with the results. And I thought, can you imagine being at work or in the middle of caring for an ageing parent or taking your daughter out for her birthday and getting a phone call with the results to your cervical cancer screening? Like, ooh. And I was like, Hey, what if they can opt in, your results are ready, and then they have the autonomy to make the call at a time that's appropriate for them. And he was like, that's a brilliant idea. But because he is been in healthcare, that's not really the way healthcare operates. Healthcare is like, Hey, we're busy, right? This is on our time, not on your time. And so just kind of that shift changes it up, right? In thinking about the patient experience of just having autonomy to call and get the information when you have time to call when you're in a state to process it. And if it's bad news, you're maybe in a physical location or with people that you can really take the time and process this information. I don't know, with dignity.
- Brendan Jarvis:
- And you are talking about the service design, the broader design of that experience. I suppose it's not just the product, it's also how you actually getting informed of the outcome of your experience with the product. It's much deeper than just that digital interface and what that's like. And I understand that a lot of your work through Guidea and Fem Tech has involved collaboration with industrial designers because there's often a physical product involved. What would you say are some of the things that have been key to the most successful collaborations that you've had with those industrial designers?
- Theresa Neil:
- I'm really glad you brought that up. If I were to go back and do it all over again, I think I would've majored in industrial design potentially instead of software. I think it's absolutely the coolest field. We have a super talented designer on our team. His name is nine, like the number nine, and he is the key reason we've had success in this space at all. He's just got a brilliant, brilliant brain for thinking through how the digital and physical work well together. I guess if I was to share one takeaway of how to make sure your MedSec device or your wearable or any type of connected device in the healthcare space is going to be successful is that you can start with the industrial design and then follow with the software design, or you can start with the software and follow with the physical.
- Usually people start with the physical because it takes longer to come up with those prototypes and test those prototypes and get 'em through the process, but you have to reserve collaboration time between the designers where they're actively working together and being able to make compromises. So it could be something as simple as the brand team has come up with this beautiful colour purple for the brand and they want all of the lights on the physical product to be shades of purple so it matches the brand. But on the software side of things, we have requirements to be able to, that we have to communicate errors and issues and we can't just use shades of purple to do that, right? We need to be able to show a critical issue. And so at least in the US and probably in many other countries, red would normally be the colour for that.
- And when we place that on the physical device is going to be important. We know for accessibility, you can't just change the colour. We've got to have what iconography or label or placement to also indicate issues. And so if a company comes to us and the physical product design is a hundred percent baked and there's no flexibility to change it to work well with the digital component we're creating, it's probably not going to work. We just have to have that back and forth. And same thing, the digital team always has to be flexible to the changes that are coming through on the physical side. So we might have a beautiful design ready and it turns out that on the physical device, we can only have three LED lights instead of the six that we need it. Well, we're going to have to all figure something else out. So just leaving that extra time for iteration, that extra time for testing the physical and the digital together with our end users from both unboxing, onboarding, first time use, subsequent use, leaving sufficient time to iterate and update those, both of those digital and physical products to ultimately come up with a really, really great cohesive solution is key.
- Brendan Jarvis:
- Speaking of time and extra time, we don't have any of that today. So I have one final question for you and that is, Theresa, you've worked with hundreds of founders and perhaps patients alike in this fem tech and innovation space that you've entered into. Is there one story that's stayed with you that perfectly encapsulates why EmTech matters?
- Theresa Neil:
- I have to tell you, I think it's the combination of the stories. When we launched the call for applications for Femme eight, I knew that we'd have to create a completely new network in order to attract these applicants. We had a great network of folks in tech we've been working with for 15 or more years, but I knew we needed to branch out even farther. The call for applications was really successful. We had something like a hundred founders the first year, and we spoke with each and every founder. It was the most exciting and interesting month of my entire career learning about all of these different elements of health span and women's health and women's lives and all the opportunities that are out there and all the ways that the system has failed us. And the director of fate, Karen would tell me after each college, she's like, I know you love them and you want 'em in the programme, but we can only pick two or three companies.
- And so we are 25 calls in. And I'm like, I want 'em all. And then we're 50 calls in. I'm like, but I want 'em all. And she's like, you can't have all of these. And we ultimately ended up picking 30 companies because, not because I have no willpower, but because so many of these teams needed support and they just weren't getting support from other places. And it was those combined stories. I think Kelsey at Armour Medical, the one with the postpartum haemorrhage detection is the one that tipped me over from realising that I thought we were going to run this itty-bitty programme where we supported two or three startups to, this was probably going to change my life, was hearing her story. She was one of the last applicants that we spoke to. And hearing her story about women dying of basically bleeding to death and there not being a solution. And I was like, oh my gosh. Well, we have to do something. And I think that was it. It was the combined stories just building and building and building on each other that made me realise this was where we needed to put our time, or at least I need to put my time and energy moving forward. So I don't think anyone encapsulates all of it. I think it's the group. I think it's all of the people in this space that are on a mission to improve healthcare for not just women, but for everyone.
- Brendan Jarvis:
- That's a great place for us to bring things down to a close. Theresa, this has been a fascinating deep dive into fem tech and what you've been doing in that space. Thank you for so generously sharing your stories and insights with me today.
- Theresa Neil:
- Yeah, what a fantastic conversation. Thank you so much for having me.
- Brendan Jarvis:
- Oh, my pleasure, my pleasure. And Theresa, if people want to connect with you to learn more about FEM eight in the things that you're doing for fem tech, what's the best way for them to do that?
- Theresa Neil:
- The best way is through LinkedIn. You can just look up fate or you can look up my name Theresa Neal, and I'm right there on LinkedIn and you can reach out to me. I'm pretty active on the platform.
- Brendan Jarvis:
- Great. Thanks Theresa. And to everyone who's tuned in, it's been great having you here with us as well. Everything that we've covered will be in the show notes, including where you can find Theresa and Femovate and all the things that she's been contributing to this fem tech space.
- If you've enjoyed the show and you want to hear more great conversations like this with world-class leaders in UX research, product management and design, don't forget to leave a review. Subscribe to the podcast also so it turns up every two weeks in your feed and tell someone else about the show if you feel that they would get value from these conversations at depth.
- If you want to reach out to me, you can find me on LinkedIn, just search for Brendan Jarvis. There's also a link to my profile at the bottom of the show notes, or you can head on over to my website, which is thespaceinbetween.co.nz. That's thespaceinbetween.co.nz. And until next time, keep being brave.