all posts, eczema, women's health

policy and innovation around skin

blur brainstorming business close up
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A long while back I came across this article called From IUDS to IVT – Designing for Women’s Health on medium a while back, by Emilie Lasseron. In a nutshell, she talks about the new innovations in women’s health and how it is important for creators in this realm to be mindful of their audience. Naturally I tried to pattern match this to blend into the eczema realm as well, to combine my two interests/where I’m at in life now.

Lasseron’s big 5 bullet points were to “design:

  • for passive engagement”, which was where she explained how we have a culture where we don’t really think about fertility until we start trying. I hadn’t really contemplated this concept before, but it’s so true. I would bet not many of us know if we are fertile until the point at which we try to conceive or have gotten pregnant (or unless one has had a specific procedure or sustained an injury/trauma that makes it impossible to get pregnant). It’s interesting to think about not knowing this huge aspect of our lives, especially as many women do one day want to be able to have children. At the same time, money constraints aside, how would we be able to check fertility? It seems as though even today, many women can’t know if they are fertile or not, and we see many women who try to get pregnant or go through processes like IVF and may not have success.  Our assessment of infertility is mostly “you tried and didn’t get pregnant”. But how do we know that it wasn’t just the wrong time of their menstrual cycle, or that maybe they were too stressed or some other physiological impact wasn’t the reason it didn’t work out?
  • for myths, not just the facts”, in which she explained that we have to meet people where they are at, even if that means from a perspective that may be incorrect or grounded in myths. This too was an interesting point. It makes sense because if a woman goes to see a doctor and the doctor’s first reaction is to dismiss everything the woman says because it’s not grounded in science or whatever the reason, the woman is most likely going to feel like she’s being made to feel stupid and not want to see the doctor again, rather than be open to what the doctor is saying.
  • for the conversation women want to have with their doctor”, in which she described creating tools to help women feel comfortable getting their questions out to doctors and to help them reclaim their agency. This is so important. Doctors inheriting have such a power dynamic relationship with their patients because patients come to them asking for help, and doctors use their advanced knowledge to help solve the problem. The issue is that this often results in patients completely deferring to what a doctor says without speaking up when something doesn’t feel right, or they aren’t being heard. This can be tragic, and has been one of the issues believed to be impacting the maternal mortality rates today.
  • with as few assumptions as possible”, in which she talks about not assuming women know everything about their bodies (most of us don’t), and uses the example of a period tracker app that expected you to know your cycle length before you could sign-up. I never personally know how long my cycle is as it fluctuates a lot so I probably wouldn’t use this app.
  • with side effects in mind”, in which she talks about making products that allow women to talk about/understand other side effects, an example being an app that tells you you may be more constipated during the luteal phase of your period. This would be awesome especially if it included things like “if you have X symptoms, you may be deficient in Y nutrients/vitamins and should talk to you doctor”, or things like that.

And now, how it all relates to eczema. “Design:

  • for passive engagement“. This is similar to what we see with eczema where we don’t think much about our skin until it goes nuts. It is not until the symptoms start to take over and disrupt our way of life that we feel compelled to address it.
  • for myths, not just the facts“. This is huge for eczema. From dispelling the idea that we have contracted some contagion, to explaining that no, coconut will not cure the skin, there are so many “old wives’ tales” and other myths to slog through that when talking to someone new to having eczema, it’s important to be able to calmly and concisely explain the basics and why some of the commonly heard remedies may be wholly ineffective.
  • for the conversation women want to have with their doctor“. Fear avoidance doesn’t just extend to using topical steroids. I know many people, myself included, who have to think long and hard before we are willing to try working with a doctor again. We already feel terrible about their skin, and having a doctor that reduces all our problems to a need to use corticosteroids again, or some other quick fix response is so detrimental. It is so important that we can feel able to openly talk with our dermatologist and not feel judged or scrutinized for our choices, where we are coming from in our educational journey, etc.
  • with as few assumptions as possible“. We need to stop assuming people will know exactly what they were eating, thinking, doing, how they felt, etc when their flares get worse. Eczema spreads its influence in most sectors of life, some without us realizing it is happening, and so creating apps that want really specific times and information before we can use it, or limit us to certain responses are a problem. This is like if there was an app made for eczema and it keeps requiring the patient to know exactly when the flare started, what we ate that day, how long we slept, did we encounter any new allergens, etc. It is hard to track all of these little life factors, especially if we didn’t think we were going to flare, or we are new to having to deal with severe eczema.
  • with side effects in mind“. In thinking about making apps for people to track their eczema symptoms this would be the equivalent of an app that gets you to talk about various symptoms and co-morbidities of eczema like the oozing or the flaking or the infections, the isolation or depression, etc, so that it would be easier to identify:
    • one, what stage of a flare the person is in, and
    • two, what is most common, and therefore important to address (like increasing rates of depression).

All in all it was a fairly quick read and highlighted a lot of the innovation that is and needs to continue to happen within women’s health (and could be extrapolated to what innovation needs to happen in the eczema world too) to allow for better healthcare and treatment.

Speaking of innovation, I entirely missed hearing about this event: Make The Breast Pump Not Suck, a hackathon that happened in Boston April 27th-29th last year. It was hosted to try to address not just pump technology itself, but policies around maternity leave, breastfeeding spaces at workplaces, what barriers to breastfeeding exist, how to build community engagement, and getting stories from different women about their experiences.

There were also community innovators mentioned who are doing awesome things in the field of women’s and maternity health (see here), including one in Boston called the Neighborhood Birth Clinic! The group is trying to open a free standing birth clinic in Dorchester. The event also highlighted different independent innovators like Melissa Hanna who created Mahmee, a secure platform that lets providers coordinate healthcare of both the prenatal and postpartum stages.

My dream is that there will be hackathons and the like for innovations with eczema too, besides just the Eczema Expo. And also that more and more awesome and innovated technology examples will be created to improve the women’s health community as well (especially with care for mothers of color!).

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