The front desk at Tia L.A. in the city's Silverlake neighborhood. // Photo by Monica Wang

Through design that responds to the specific needs of women, Tia L.A. is part of a new breed of women’s health care.

By Joann Plockova

Like health care itself, health care spaces have typically been designed in a one-size-fits-all model. But as new standards of care are making their way onto the marketplace, so too are spaces that support them—and ultimately their users.

For women, doctor's offices and other health  care spaces often aren’t large enough to accommodate pregnant bellies, exam rooms are unequipped with places for diaper bags and other belongings, and clinics are without thoughtful design details that help calm nerves, among other oversights.

“Traditionally, [designing healthcare spaces for women] hasn’t been thought about differently than standard health care spaces,” says Alda Ly, founder and principal of New York-based Alda Ly Architecture (ALA). “Aside from the actual equipment, we’re treated the same.”

Ly and her team, an all-female, certified minority and woman-owned business, were called on to design the inaugural Los Angeles location, along with several other clinics across the country, for Tia, a women-centric health care platform that aims to transform the paradigm of women’s modern health care.

“Women’s health care is fragmented and disconnected. We are treated like separate body parts,” says Carolyn Witte, Tia co-founder and CEO. “But science and medicine tells us that all of all these things are connected, and women need to be treated as full people. That’s why at Tia we offer an integrated and connected approach.” Founded in 2017, the membership-based service combines primary care, gynecological care, mental health and evidenced-based wellness into an integrated care experience delivered virtually and in-person at lower costs than patients are typically charged.

“Tia is a brand really leading this change. And, the more successful Tia is, that means it's going to be more accessible for all women,” says Ly. “Eventually, if everybody picks up on this, it's only going to make things better universally.”

With a mission “to enable every female to achieve optimal health, as defined by herself,” Tia, which opened its first physical space in New York in 2019 and with the support of a $24.3M Series A funding (one of the largest of its kind led by a female CEO in 2020), has an ambitious rollout plan of multiple clinics across the country. The company's goal is to improve health equity for women.

“While Los Angeles is known as an epicenter of wellness,” says Witte, “health care is a different story.” For women in Los Angeles, the average wait time for an appointment with a primary care doctor is 42 days. Severe shortages in OB/GYN care are worse – the city ranks number two in the nation. The pandemic has only exacerbated this problem, Witte says. “Compared to the same time last year, gynecologic wellness and screenings have plummeted by 86%, and contraception visits have gone down over 60%.”

An exam room at Tia L.A. // Photo by Monica Wang

Located on Sunset Boulevard in Silver Lake, Tia L.A. was designed to address these issues through a warm, welcoming environment that’s a distant departure from the cold, sterile, often intimidating spaces that typically define the health care experience. “We were kind of turning that on its head, and saying how can we make something sanitary, clean and safe but more inviting,” says Marissa Feddema, ALA’s director of architecture.  “[More like a] hospitality space, [or] even like a coffee shop, those places you want to stay and sink into.” ALA designed a space that empowers women to understand their own health, one that’s communal and collaborative, fluid and flexible and informed by the specific needs of the community it’s designed to serve.

“It’s successful because it responds to their specific community and mission,” says Feddema, “And it’s unlike traditional health care spaces.”

Designed to be accessible for all ages and prioritize the person not just the patient, Tia L.A. sits on the second floor of a curvaceous building with wide windows designed by Neil M. Denari Architects. A textured exterior side wall greets Tia members with a colorful mural by local artist Ashley Lukashevsky. As is standard practice for Tia, they turned to the community (via their online platform, Instagram and word of mouth) to help decide which artist to commission. The open, inviting atmosphere continues inside where the bright uplifting color palette—an extension of the brands—includes another mural by a female artist that frames the backdrop of the wood-clad reception. The fluid, easy-to-navigate 3,000-square-foot space has a clear through line to the waiting area, which is connected to a spacious outdoor balcony with a variety of plants, part of ALA’s incorporation of biophilic design, and views of the Hollywood Hills.

ALA has made a name for itself turning traditional models on their heads. “We started the firm designing for users that are typically underrepresented,” says Ly, “or just not considered traditionally.” After designing several locations for The Wing, a co-working space for women, ALA made its debut in the health care space with two clinics for Parsley Health, which aims to take a whole body approach to care, followed by the flagship Washington D.C.-based clinic for Liv by Advantia Health, a new model of convenient, comprehensive health care for women.

To support Tia’s integrated care model in Los Angeles, different areas of care are not siloed, but rather connected on a fluid path that makes collaboration between a patient’s collective care team easy and helps to put patients at ease.

“It feels like one big comprehensive hospitality space that really addresses all those different pieces of the health care journey," says Feddema. Followed by three wellness rooms, where procedures like acupuncture can be used during more intensive procedures like IUD insertions to help manage anxiety or pain, the four exam rooms are themed with a corresponding color palette. “Instead of doctors just telling you, here's what's wrong with you, they want to show you, and to empower women to understand their health."

With the feel of a boutique dressing room, exam rooms include a patient nook with a curvy mirror and warm, flattering light; a place for patients to put their belongings; a robe-like dressing gown and a plush chair. “They don't just feel like they're like plopped into this room and sitting on an exam bed,” says Feddema. “We really wanted to design in those little details that put the patient experience at the forefront of the design.” This includes a tiny window in between the light-filled lab and a restroom near the exam rooms so patients can discreetly hand off urine samples as opposed to having to walk down the hall with them. A lacatation room was a informed by Ly’s own experience being a new mom. “After my first baby was born, I went to my first follow-up and I had to pump right away and they didn't have a mother's room, “ says Ly. “And they put me into an exam room that wasn't being used, and so I had to draw the curtain. There were people knocking on the door asking if anybody was in there. And I'm pumping. It was the worst experience.”

Many of the design decisions were informed by stories shared at the start of the design process about the project team’s personal health care experiences

“We like to say that we're really designing this for ourselves,” says Ly. “We’re designing a space that we would want to be in. And that appeals to us, because we are part of the target user base.”

Outdoor patio at Tia L.A. // Photo by Monica Wang

The team also worked closely with providers to ask questions about their specific needs. This led to colorful break rooms with plenty of light and places to store their belongings and phone booths, where, in addition to providing virtual care, doctors can have a place to close the door.

“I think that was part of why they chose [to work with] us,” says Feddema. “They just wanted people that they could relate to but also people that actually came in not saying, ‘we know exactly what the space is going to look like,’ but instead, our team really came in ready to just listen. And then together, we problem solved.”

Tia uses its own app and website not only to provide virtual care and education, but also to directly connect to the local community, ask questions and respond to  specific needs. Services at each clinic are prioritized according to feedback.

“By having technology and being able to reach out to all the membership in the community to say, ‘what do you need’, that is incredibly powerful, “ says Ly.  “You get direct feedback, and you can respond right away, and pivot immediately for the next location. That's a game changer.”

One of the keys to creating a more accessible health care space was taking it beyond mere health care. “The way that we're looking at all of the Tia locations is that they are community hubs. They're built out to serve a local population of women, “says Ly. “As we’ve said before, it's [like] a community center that happens to have all these health and wellness services. We think that is a huge part of how to support women locally.”

Located on the opposite end of the clinic as the balcony, a flexible classroom can be used for everything from nutrition classes to group therapy to meditation to support groups for members with chronic issues. “The classrooms are always going to be placed in locations that are connected to the street and feel connected to the community,” says Ly.  “They really see their community and these classroom spaces as an anchor and something that says this is what Tia is about: everyone is welcome.”

Tia’s next expansion plans include Phoenix and San Francisco by the end of 2022.

As designers, we just need to continue asking those questions; continue listening and asking providers and pateints, 'What do you actually need? What do you want?', because health care is changing constantly. Care for women especially is changing: awareness of mental health, contraceptive care," says Feddema. To design spaces that support health equity, designers need to be flexible to those changes and more fluid in their approach. First and foremost, they need to design spaces that are responsive to the user--both provider and patient alike. "I think that could really help," Feddema says.

Joann Plockova is a design writer based in Prague.

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