Brian Fleming Brian Fleming

Twine Health (acquired by Fitbit) mobile and web platform for patient engagement & health coaching

Update: acquired by Fitbit February 2018

Head of Product

Twine is a mobile and web platform focused on connecting patients with their healthcare. Twine works with organizations providing health coaching and primary care to self-insured employers and consumers. The Twine platform and coaching model results in unparalleled patient activation, behavior change and outcomes across all conditions. Provider sites using Twine have seen patient populations get 91% to reach target blood pressure, 95% weekly active users, and 100 net promoter score.

Patient Mobile App

One of the core principles of the Twine experience was a connection between patients and their care team. The patient profile was the first opportunity for a patient to express the motivation behind their journey to better care.

The core of Twine was the patient today page. This page captured all the health actions the patient needed to complete for the day. The real time data on completion rate and vital levels was available to the patient's care team in the clinician app.

Each vital measurement and health action completion rate was available in historical trend charts so the patient could watch their progress and learn how their actions directly related to their outcomes.

Real time messaging between the patient and their care team was essential to limiting in office visits as well as to nurture the relationship between the patient and those providing guidance and support.

The patient care team has bidirectional real time access to all the patient data so they are informed and can help make the best decisions

Clinician Tablet App

The clinician dashboard shows all the patients assigned to each coach. Powerful sorting and filtering allows the coach to find the right patient at the right time for an intervention. Easy access to vitals, adherence levels, and messaging are all one tap away.

Each patient has a plan. The plan is broken down into the adherence actions and vital levels the patient will track. The patient and the coach co-create the plan together. On the patient plan overview screen the latest readings and adherence levels and trends are available to the coach.

From any point in the app when viewing a patient record, the coach can open the conversation with the patient to send an intervention at the right time. No need to wait for a phone call or office visit.

Tracking the history of action adherence as well as metric readings is important for the coach to understand if the plan is being effective and to know if the patient has had a lapse in adherence. This real time data is available to both the coach and the patient. There are no hidden charts or notes in Twine that the patient cannot access.

Part of the patient profile, a survey to find out where the patient is in their journey is important to structure the most effective plan. The survey can be updated at any time, with the history of responses automatically tracked.

Population level reporting is available to coaches and organizations to keep an eye on the overall effectiveness of their interventions and teams

A comprehensive library of best practice and coaching guidance was hand crafted by Twine content experts to deliver the model of care backed by research.

My Role

As Twine’s first hire, the company started as a collection of research papers, clinical trial prototypes and sketches. After absorbing the research, and in collaboration with the CEO, I planned, documented, and help build the first feature set to productize the offering.

As owner of the road map, my main responsibility is to spec, design and prioritize all feature and enhancements to the software platform. I work closely with the customer success team to process feedback from the field and ensure we are responding to customer needs. I contribute directly to the engineering team to not only monitory quality and accuracy of feature development, but also as the primary presentation layer engineer by authoring CSS, html, iconography and animations.

I formed a multidisciplinary internal product team whose mission is to coordinate the definition of the Twine experience, assemble it, and deliver it to the users, while being a resource to facilitate connections between the Twine teams. The team consists of health care content experts, designers and engineering resources.

The product team owns new customer training as well as setup and maintenance of internal tools for Finance (Chargebee) Marketing (HubSpot) Customer success (Zendesk) and engineering (Zenhub).

Twine Health was built with the goal of putting people back at the center of their care, helping them take ownership of their health actions and outcomes with the continuous support of both clinicians and loved ones. I am proud of my contributions to both the product vision and the eventual acquisition by FitBit.

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