Logging biomarkers in the Virta mobile app
Virta Patient Health Journeys
Building a cross-disciplinary empathy practice

What is Virta?
Virta allows patients with Type 2 Diabetes to reverse their chronic illness through dietary changes, health coaching, and continuous remote care.
User Listening Fortnightly
When I first started at Virta I was asked to take over a meeting that had an unclear focus.
Feedback channels:
sustainability survey
mobile app satisfaction survey
rolling NPS
ad hoc NPS
health coach satisfaction
Focus of meeting:
customer service meeting
create call assignments for negative feedback coming in through the above channels
Cross-Disciplinary Involvement
Product Managers
VP Product
VP Operations
VP UX
Operations Manager (Manager of all the Coach Managers)
Data Science
Designers on the patient side
Lead Coach
Saw an opportunity to build cognitive empathy:
Rather than call patients and start solutioning with them, I suggested we conduct 45-minute listening call following Practical Empathy methodologies
The meeting could turn into a place for us to share what we hear and capture patterns along the way
To build cognitive empathy we must uncover the following:
inner reasoning
reactions
guiding principles
philosophies
common ability blockers
past experiences and how those shape their current values
the inner thoughts of someone trying to adhere to something antithetical to what we have learned as healthy all our lives
Goals:
conduct the listening work
share individual stories across the company
create thinking style segments
form a mental model diagram and an opportunity map

Canal Barge patient screenshotted from Virta website
A Note On Problem Space Work
The Jobs to be Done Playbook (Jim Kalbach)
Practical Empathy (Indi Young)
Virta patients came from many different backgrounds. Most were offered Virta as an employee benefit. We were lucky to be able to recruit many different people:
Barge operators
Truck drivers
Casino workers
Tribal nations
Tech workers
Retirees
Veterans
Direct patients - the only patients paying out of pocket
2. Direct Patients
3. Patients that Did Not Apply
Veterans Health Administration
Our goal was to understand the needs of Veterans that had stopped logging biomarkers and/or delayed dietary change start date. While this behavior was seen across the patient base, this group over-indexed on these two issues.
What has been going through your mind since you signed up for the Virta treatment?
What has been going through your mind since you stopped logging?

Example note-taking sheet. These notes were from a patient who delayed dietary change start date.
Templates and Training for Listening Calls So All Disciplines Can Get Involved
Templates created for email contact, calendar updates, script
Note-taking template helped team members capture thoughts at end of the session
Reflect on calls after completed to share patterns and improve listening practice
Findings from VA Patients
Inner Reasoning
Needed help from friend in order to wrap my mind around it before setting a start date
Reaction
Feel frustrated due to lack of clarity on the treatment
Guiding Principle
Always get second opinions (e.g. from family, friends or VA community)
Impact:
Gained support across the organization for VHA patient community group
Improved enrollment advisor communication and messaging when communicating with VA patients
Direct Patients
Direct patients are both customers and patients. They are the buyer and the user. They are our hardest customers and our largest potential for revenue. - VP Operations
Goals
Direct patients pay out of pocket ($250)
Health Coaches wanted to better understand how to serve their toughest patients
Team
myself
3 health coaches
Inaugural Health Journeys Monthly
Each team member shared on 1-2 patients including verbatim audio clips
No health coach conducted listening sessions with their own patients
This was the first "patient voice" that was not entirely focused on positivity and life changes

"Who wants to drink an avocado smoothie?"
We Brought Insights Beyond Outcomes
Inner Reasoning
Thinking that the food available to me to eat was not appetizing at all
Knowing that I can't stick with it unless I have someone cheering me on
Reactions
Felt frustrated when my provider told me to change to a different medication level without explaining why
Felt annoyed when I had to wait 24 hours for a response
Guiding Principle
Organic first
Be a daredevil
Impact
Do better to build trust by learning how to capture those moments asynchronously

Worksheet for brainstorming connection and trust along the patient journey
Painting a View of Trust
Wanting to know more about how trust is built over time, we kicked off a learning plan for understanding the patient and provider trust relationships.
We included:
Direct patients
T2D on medication
T2D no medication
Looking Beyond the Current Patient
The next Health Journeys Monthly focus was planned for understanding those who never applied. Despite having access to Virta for free, they did not enroll.

Continuous Glucose Monitor (CGM)
Uncovering Finger Pricking Fears During Enrollment
Discussion with the EA:
What happens when someone has a fear of finger pricking?
How do you end up finding out?
What do you do?
Do you ask why?
Did you know some of our patients are using CGMs anyway and they love it?
Impact on service touchpoint: Adjust to putting a positive spin on CGMs, ask about reasons for fears on enrollment call to address anything that may not be true
Future Listening Work in the Health and Wellness Space
What went through your mind...
...the last time you tried to get help for chronic pain?
...the last time you tried to change a behavior?
...the last time you considered a medical option to treat a health condition?
... the last time you considered a new health benefit for your employees?