Pride month is celebrated each year in the month of June. The original Pride marches were to remember the Stonewall riots which took place in New York in June 1969, triggered by a police raid at the Stonewall bar in Greenwich Village. People in the bar fought back and the disturbance spilled into the street. The aftermath of the riots forged the battle for gay rights and led to groups being formed across the US. Exactly one year later the first gay pride march took place in New York City on June 28 1970. Over time the LQBTQIA+ acronym has evolved to recognise and celebrate more diverse sexual identities and gender expressions.

In honour of Pride month we held a question and answer panel, opening the floor for ZAVAnistas to submit any questions for colleagues who identify under the umbrella term of LQBTIQA+. Our aim was to better understand their experiences and what it means to be part of the LQBTQIA+ community. Keep scrolling to read what was said….

If you’re comfortable, could you talk about the moment when you realised you wereLQBTIQA+? What went through your mind, did you tell anyone straight away? How long did it take for you to come out?

💙

“When I came out to myself at 15 I just whispered the word ‘bisexual’ to myself in my bedroom like a little gay wizard and then I just sort of sat with it for a couple of years, I was afraid of what might change if I told anybody I guess.

Since then my relationship with myself and the community has evolved. But as a queer person you can find yourself coming out all the time, to every person you meet and to whatever extent you feel comfortable in that moment. My mother still thinks of me as a lesbian, my friends as whatever I was when last we spoke, and when men ask me in public toilets, I say I’m a man because it seems the path of least resistance.

Coming out is kind of a trap but at the same time it highlights the moments and the people that make it feel like the easiest thing in the world. It shouldn’t be hard to tell the truth of oneself and we can all work to ensure we make it easier for others to do so.”

🏳️‍🌈

“I was about 9 or 10 when I saw the Disney movie Atlantis: The Lost Empire and instantly felt drawn to Princess Kida… and Milo. Until I reached secondary school, I thought everyone liked everyone the way that I did. My attraction was never limited to a specific gender, just people. Upon reaching dating age and discussing crushes openly in secondary school, the barriers to love and attraction began to form. At the time, being bisexual was the only understood term for liking both girls and boys and I quickly identified with that. But I often wasn’t believed or was told I was seeking attention.

I suppressed my queerness for a long time and told no one. Once as a society we began having open discussions around the nuances of sexuality, gender and gender expression, and how the linear path to love is completely made up and we don’t need to follow it, I began to get reintroduced to myself.

I no longer feel the need to label and classify myself. All I know is that I am attracted to people that I find attractive. Women, non binary people, trans people, men. Love is simply love.”

How has your experience been working at ZAVA as a member of the LGBTQIA+ community?

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“I am inordinately fond of my team and the people with whom I have worked and discussed LQBTIQA+ issues. The support I received from the People Team and ZAVA more broadly during the first stages of my social transition was wonderful.

I’m excited to see more structure around communities within ZAVA because I think that a pillar of a functional community is the ability to self identify as a part of it, to be able to organise and to recognise each other and ask for the kind of changes you expect to see. Working in the healthcare space is fraught with gendered language, with barriers to access of all kinds, and the better we are organised the more likely it is that we can bring about some change in that sphere.”

🏳️‍🌈

“My first impression of ZAVA was how inclusive and diverse the staff are. It feels as though the company prioritises showcasing our various cultures and works hard at maintaining a strong working community. I feel the LGBTQIA+ community is alive and well at ZAVA and you can feel the difference when coming from other companies. The openness amongst the senior leadership team to advance the inclusiveness within the business is also incredibly refreshing.”

LGBTQIA+ is a very broad grouping of people — it’s basically ‘everyone not cis and hetero’. Do you think in future this will split into more specific groups?

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“I think the umbrella term is complicated. Theoretically it unites under its banner all people whose sexual or gender identity or whose sexuality is marginalised, including asexual and intersex people, cis/heterosexual identifying or otherwise. But organising and representation under that banner often fails the community, particularly people at the intersection of marginalised identities and queerness. Most Pride events centre on white, non disabled and to a great extent cis men. They have little to no interest in engaging with people’s access needs, and many people feel they’ve been lumped in with an acronym which represents a kind of community that holds no space for them.

I think currently people are making the kinds of spaces and subsets of community that they need to see. For example FLINTA in Germany (Frauen, Lesben, intersexuelle, nicht-binäre, trans und agender) which holds space for all women but not most men for example. Or events like Black Pride, Trans Pride and Mad Pride in the UK, which are as much radical as they are visible.”

🏳️‍🌈

“I think in a lot of ways the term is already split out as the communities within it have unique experiences and nuances. I do hope one day we will lose the need to define and classify people and just take individuals as they are.

The term is technically meant to distinguish everyone not cis gendered or heterosexual people. However I view it as a community of people who are bonded by a culture, and the movements that aid in the freedom of expressing that culture; regardless of sexual orientation or gender identity and expression.”

💙

Hey! I am someone that identifies as my birth gender and I don’t have many friends that identify as anything other than their birth gender. I’d be really interested to hear about the journey of how you discovered your birth gender was not one that aligns with who you are

🏳️‍🌈

“Hey! Heavens, it all sort of snowballed for me really, I think everyone’s experience is different. Around the first time I think I began to realise that when I don’t have to perform gender to anybody, or rather that when I’m not consistently being perceived as female, I don’t perceive myself as female. I realised that I had no frame of reference to womanhood when I read women’s writing about women. Not that womanhood or women are homogeneous but about a relationship to womanhood I suppose.. I felt adrift I guess. I dated somebody for a short while who’s gender fluid and they helped me put my feelings into context, showed me that if being ‘not a woman’ was all I could be sure of, then that was okay. They were very kind and extremely wise. From then on I’ve been finding and recognising gender euphoria, gender neutrality, generally working out what makes me feel cheerful and hot.”

💙

“not qualified to answer :)”

As a member of the community already, how can I be a better ally to other marginalised groups within the LGBTQIA+ community. For example, trans or non binary people.

🏳️‍🌈

“Crumbs, I feel you pal, there’s nothing I can say that you won’t already know. Reading books and resources where people have been able to contextualise their own experiences, finding ways to show up for others without taking up space, of course any kind of direct action, either helping out financially or getting your demo on. Trans Pride are actively looking for cis allies to steward the march on Saturday 9th!

Just keep being a hun and calling out your relatives when they start talking about trans women in sports, trans women in bathrooms, trans people in schools. All discussions where trans rights are framed as a debate are dehumanising and ultimately a dog whistle to transmisogyny and violence against trans, non binary and gender non conforming people everywhere on the part of individuals and the state.”

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“I think being a good ally to the trans and non binary community is the same as being a good ally to any community you don’t immediately belong to. Don’t make assumptions, listen, respect their pronouns or terminology (quickly correct yourself if you make a mistake), use inclusive language regardless of who is around, for example “hello everyone” vs “hello ladies and gentlemen”, challenge bigotry and harmful remarks especially within the queer community and admit when you’re wrong and don’t know.”

Is there anything you would like your colleagues to know?

🏳️‍🌈

“Happy pride pals, if anybody would like to go for a coffee and just talk about the gay agenda I would be so delighted, if anybody would like a wingman or a chaperone at a queer event I’m your guy. If I’m talking crap also please tell me, thank you for your time.”

💙

“Fight the urge to assume one’s gender based on how they look and present. I would just gently remind everyone that the pronouns in our signatures help us to know how our colleagues identify and that small effort of using the correct pronoun makes our colleagues feel safe and recognised.”

What do you think is the best part of being LGBTQIA+? :)

🏳️‍🌈

“Queer solidarity, trans kids, queer joy, queer rage, queer sports teams, queer haircuts, romantic friendships, my partner and all my exes.”

💙

“The people. The support you get from those in the queer community is unparalleled. The acceptance and joy of seeing people live their truest lives, makes life endlessly worthwhile.”

Thanks to everyone who submitted their questions, and a very special thank you to everyone who took the time to answer them. ZAVA is a place for everyone. Regardless of gender, sexuality, race, age, or religious beliefs. We hope you feel welcome and accepted here because we are proud to have you.

🏳️‍🌈Happy Pride 🏳️‍🌈

Pride 2022 — Panel Q&A🏳️‍🌈 was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

Thursday 23 June marked International Women in Engineering Day. An international awareness campaign dedicated to enhancing the awareness of women in the engineering and tech space. It also brings attention to the amazing career opportunities available to women in this exciting industry. Engineering and technology are very heavily male dominated industries, with only 11% of the UK engineering and tech workforce being female. International Women in Engineering Day celebrates the remarkable achievements of women engineers all over the world.

We reached out to Hannah, a member of our team to share her experiences of working in the engineering and tech space.

How long have you worked in engineering and tech, and what first sparked your interest in working in the field?

I’ve been working in technology since 2013, so nearly 10 years. Like a lot of product managers, I didn’t necessarily set out to work in product and technology. I started my career in corporate law but Iquickly felt disillusioned, and frankly incredibly bored. I decided to make a career change and my biggest priority was to work for a mission based organisation that was trying to make positive change in the world. I ended up being the second employee of a local food system startup which was my first foray into tech.

In an early stage startup you need to wear multiple hats, so I quickly cut my teeth on marketing, operational and tech basics. I loved diving into each of these worlds and working with colleagues to find the best way to solve various problems you encounter in startup life. Like many product managers, I was doing product work without actually realising it.

I found the role played to my strengths of being naturally curious about how things work and what drives people to do things. I was also able to motivate different groups of people to solve problems and to learn on the job very quickly. I have my legal training to thank for being able to consume lots of information quickly and draw insights, which really helps me in my role today.

What does your role involve?

So many things! The working life of a product manager is so incredibly varied, it’s almost impossible to describe a typical day or week. And trying to succinctly explain what we do to friends and family is always challenging (no mum, I’m not a project manager).

Here’s what my morning today consisted of:

• I’ve been closely monitoring performance following a significant roll out earlier this week alongside colleagues from marketing and data
• I attended my squad’s standup and discussed how we can unblock a story that the engineers have been stuck on
• I refreshed my memory on some user interviews we conducted earlier this month to prepare for a co-design session next week
• I checked in with some junior PMs that I support around some plans for the following week
• I started some market research to help build out a potential future growth opportunity our tribe is developing

I like to borrow Marty Cagan’s description of product — our role is to solve problems in ways that customers love, yet work for the business. So we’re always trying to find the balance between creating value for our users (patients, partners, doctors, internal users) and also business value.

I head up one of ZAVA’s patient facing tribes, our mission is to help guide patients through their first experience. I work closely with my cross functional tribe leads to ensure the tribe is focussed on developing opportunities that get us closer to achieving our tribe goals.

We work together to validate opportunities. Once we’ve made a decision to progress, my job is to assemble all the relevant people together to build something that creates business value but at the same time delights users.

What do you enjoy most about your role/working at ZAVA?

The breadth and variety of work — no day, week or month is the same. The knowledge that our efforts are contributing to helping improve people’s health is a really compelling reason to come to work every day. It’s really satisfying and something we all feel. It’s really motivating to work in a team that is so focused on making people’s lives better.

How do you think we could encourage more women to join the engineering and tech industry?

In all the organisations I’ve worked in, there has been a significant gender imbalance at leadership level. This lack of visibility and representation makes it quite an isolating experience at senior and leadership levels. More importantly, it means there is a vacuum of role models for women earlier in their career. Addressing this underrepresentation could be a really helpful step to encourage more women into tech.

How much do you think the industry has changed since you joined?

I think there are clearer and more accessible routes into the industry with the emergence of bootcamps and more formal training options. None of this was available when I was starting out. These courses don’t replace practical experience and are definitely not mandatory, but they at least provide people with clearer entry points which I think is a helpful development.

There is also growing awareness and discussion about diversity issues. However, the issue is still endemic, so I would love to see organisations move on from discussion to firm action.

What advice would you give to women entering the field? Anything you wish you had known?

My top tips for anyone thinking about a career in tech are:

Breadth of opportunities:

We’re so lucky to have the chance to join organisations of all shapes and sizes, be able to hop from one industry to another and be in a job that’s guaranteed to constantly evolve alongside technical innovations. I don’t think any other industry provides such flexibility and room from learning and growth.

Don’t strive to know everything:

I wish I had known that you will not have the answer to everything, and actually, it’s not something to aim for. Also, try to not feel intimidated if you lack knowledge in a certain area. With the right mindset you can learn just about anything, at any stage of your career.

Soft skills are a superpower:

In the very early days of my career I thought I would be judged on my technical knowhow. However I quickly recognised how important soft skills were. Particularly in product, you need to be able to work with, motivate and influence stakeholders from across the organisation. Soft skills like communication, negotiation, influencing and finding ways to get things done are product super powers.

Do you think enough is done to help women get into the engineering and tech industry? If not, what would you recommend?

I gave up all my STEM subjects as soon as I could. 20 years later, it’s something I really regret. At school I found them boring, I didn’t find the teaching as inspiring as art subjects and I couldn’t visualise or understand how they could help me in my future career.

I think providing girls and young people with more context and practical information about the multitude of incredibly interesting and inspiring ways STEM skills can be applied would be my top recommendation.

During your career, have you personally experienced a time where you’ve been stereotyped? If yes, what happened and how did you overcome the situation?

Although I wouldn’t call myself technical, my years of experience working closely with engineers means I generally understand enough to get by in most technical discussions.

One thing I have experienced many times is people assuming I won’t understand something, so having ideas or concepts over explained to me — sometimes in a way that feels quite patronising.

If I see this pattern emerging from a team or colleague, my approach is to ask them to continue as they normally would and I will let them know when I don’t understand something.

There is still much to do to support an increase in gender diversity in the tech space and encourage women in the UK to take up opportunities in tech and engineering. Acknowledging the gender disparity in technological roles is one of the first steps employers can take to begin to take charge of creating a more diverse workforce. More initiatives designed to entice women to the industry means the gender imbalance in engineering and tech is shifting. Groups like the Women’s Engineering Society hold sell out annual conferences, use their platform to celebrate the achievements of women in engineering, and encourage aspirational young women to consider careers in tech from an early age.

So, what do you think? Have you ever considered a career in tech?

International Women in Engineering Day 2022 was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

12 months ago, we welcomed Dr Babak Ashrafi as our Clinical Lead for Service Expansion. It was a new role that hadn’t previously existed at ZAVA so we sat down with him to find out his reasons for joining ZAVA and his involvement in the launch of one of our newest services, PrEP.

“Before joining ZAVA I worked as both a salaried GP and as a GP partner. I also spent five years at Nuffield Health. I’d been chopping and changing roles ever since I started to burn out as a partner in my inner city practice, and I still wasn’t happy. So, when I was contacted by ZAVA on LinkedIn I was interested to find out more, especially with regard to how ZAVA is revolutionising Healthcare with technology.

I was given a lot of autonomy and scope to make the role my own and after an initial settling in period, I’ve definitely found my feet. I’m here to help with any improvements that can be made to existing services, and also to lead from a clinical perspective on any new services we want to offer. For the first time in a long time, I am happy at work and really enjoy my job.

One of the biggest projects I worked on last year was the launch of our PrEP service. Pre-exposure prophylaxis (PrEP) is a medication taken to avoid catching HIV and initial study data published a few years ago showed without a doubt that PrEP was highly effective at preventing HIV infection in high risk groups. However, access to the drug in England has been relatively limited with PrEP only available on the NHS for 26,000 people taking part in the NHS IMPACT trial.

There are also other concerns relating to access — if a patient wants or needs PrEP, they’re required to attend an STI clinic in person. The wider LGBTQI community may be historically comfortable with this on the whole, but data shows that other high risk communities who need access to PrEP (e.g. certain heterosexual Black African communities) simply do not engage in the same way. This is where our idea for PrEP came from — understanding the background to this dilemma, and seeing an opportunity which would serve a previously disadvantaged subset of the population. By offering PrEP online to eligible patients we’re able to provide them with medication when and where they need it, with no waiting times, and the ability to talk to our doctors whenever they need.

To kick off the project, I initially spoke with my colleague, Alex, who runs ZAVA’s Pharmacy Operations. We needed to assess whether we (as non-specialists) could prescribe the drug, and whether it was available for us to order. Once we’d gathered this information, we met with the head of markets for Zava UK and decided on a plan of action that would enable us to launch a safe service offering consultation, assessment, prescription and aftercare. At this point, Alex took control of day-to-day project management and when necessary brought the relevant teams and people together. There was a lot of cross company collaboration with Markets, Marketing (including Creative and Content), Pharmacy / Operations, Legal, Clinical, Engineering and UX all involved at some point.

From a Clinical perspective we needed to define the service, decide who we could safely prescribe to and agree inclusion and exclusion criteria. As a digital healthcare provider, our guidelines sometimes have to be more strict, or slightly different, compared with national guidelines but we used BASSH/BHIVA 2018, as well as the drug SPC in order to outline our service. I also took it upon myself to read available guidelines specifically for PrEP and decide on an appropriate patient flow.

Additionally, I was also guided by the content of an internal talk I had organised by an HIV consultant from Chelsea & Westminster Hospital. At this session, and a few afterwards, I formulated and discussed my ideas about the patient flow for Zava’s PrEP service; first to a handful of clinical colleagues, then to the rest of the project team. I used this feedback to write a document detailing the service proposal. Once the team and I were happy, I completed the clinical guidelines and outlined the questions that had to be incorporated into our asynchronous clinical questionnaire to ensure patient safety.

As an example, PrEP should only be taken by people who are HIV negative and at high risk of contracting HIV, either through not wearing a condom or sharing needles. This is because it’s possible to develop resistance to HIV medication if PrEP is taken by someone who is HIV positive. National and International guidelines for PrEP also highly recommend regular (3 monthly) STI testing as routine. It’s especially important to test for hepatitis B and C at the start since the drugs in PrEP are antivirals which may affect future treatment options for patients that are Hep B or C positive. Another vital check that needs to be completed before a patient starts PrEP medication is a kidney function test. The drugs that make up PrEP tablets are processed in the body and disposed of in urine by the kidneys. If a patient’s kidneys aren’t functioning correctly, the drugs can build up in the body to unsafe levels. This in turn can further damage the kidneys.

As a result, we request all patients get a mandatory HIV and kidney blood test up to four weeks before starting PrEP medication and also recommend a full STI screen. Our clinical team will not approve the order and prescribe the drug without making sure the tests will be done.

Here’s an outline of ZAVA’s recommended/necessary testing before and during PrEP therapy — all of which is outlined clearly to patients on our website and within the order process and questionnaire:

1. Up to 4 weeks before starting PrEP: HIV test and kidney test (necessary), full STI screen (recommended)
2. Every 3 months: HIV test (necessary), STI screen (recommended)
3. Every 6 months: kidney test (if at high risk of kidney problems)
4. Every 12 months: kidney test (if at low risk of kidney problems)

Once the structure of the service was agreed, the next step was to ensure our clinical and customer support teams were adequately trained so that they could safely support patients. The training for our doctors consisted of three core elements, an interactive face-to-face session with an HIV consultant, self-directed learning using the European AIDS Clinical Society online training modules / familiarisation with ZAVA’s approved PrEP guidelines and a review of applied cases”

ZAVA’s PrEP service launched in November 2019 and over the last 7 months we have supported a number of patients in accessing medication that has protected them from HIV infection. It’s a service we are proud to be able to offer to patients and one we know makes a positive and significant difference to their everyday lives.

For more information about our PrEP service please visit: https://www.zavamed.com/uk/prep.html

Launching PrEP was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

I started working for ZAVA in August 2019 after having worked in the NHS since I graduated in 2006. The reason for my move to the world of online prescribing was simple, I had reached burnout. After struggling to come to terms with the fact that being a GP was not exactly what I had expected, I tried to avoid my disappointment by locumming, followed by taking a year out to learn aesthetics and do a diploma in dermatology. I then set up a business, working part-time in general practice and part-time in the aesthetics industry.

After a few years I still felt dissatisfied, overly tired with running my own business and unfulfilled, so returned full-time to general practice. My previous feelings of dissatisfaction still remained and I reflected extensively on the root cause. I soon identified it to be a feeling of isolation due to the lack of team support, a frustration with the ever present hurdles within the NHS, and irritability in the inability to change a system that wasn’t benefiting the patients that were obviously most in need. This coupled with the increase in patient expectation led to me seeking other arenas to work in, but those which incorporated the medical qualifications I had worked so hard to achieve.

I met up with a friend who told me he had recently got a job at a ZAVA, an online patient consultation service providing advice, assessments, lab testing and private prescriptions, that followed guidelines strictly to ensure patient safety. I applied and shortly after commenced work in an environment that I had only ever previously dreamed of working in.

At ZAVA, I walk into a friendly office full of people from all around the world and different walks of life. They vary in their professions, but all have the same goal of providing excellent patient care — offering a service that’s accessible, dependable and a fraction of today’s cost.

When I reach my desk I am surrounded by happy faces offering food, and coffee (we have an in-house barista) and most importantly these medics offer support. Whenever I need help I just turn to the person next to me and ask.

Not only is working at ZAVA, fun and a supportive environment, the work itself is interesting and filled with opportunities to implement changes to better patient care. Working with people from different professions also means there’s a breadth of experience to be had, whether it be in medical editing, or working alongside the marketing team.

The role of a clinician at ZAVA is a complex one. We start the day logging into an inbox which contains a multitude of consultation requests, including those for assessments, lab tests, advice and medication requests (not unlike EPS requests in general practice) All processes are safe-guarded so that all contraindications show up as red flags that have to be manually overridden if it is justified to do so. If anything seems ambiguous or unclear, the patient is messaged via their confidential patient account and they are sent an email advising them to log in to receive and respond as required.

We consult with patients throughout the day but ensure time is spent reviewing and discussing any relevant changes to recent guidelines. This means our services remain safe, and enables us to continue our professional development.

Soon after starting at ZAVA I applied in-house to be a clinical content editor and as a result on Fridays I work as part of the marketing team, editing copy on the website, proof-reading and writing short medical related pieces for magazines and newspapers. A life-long dream for a secret creative like myself.

Since starting I have journeyed through a sea of feelings, starting from guilt of leaving the NHS, to fear of the unknown and now considerable joy and contentment in the job I do, something I never thought I would have.

Life after burnout: Falling back in love with medicine was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

At ZAVA we’re building healthcare that is accessible, dependable and a fraction of today’s cost. In order to build a service that matches this mission we rely on our team of five UX Researchers to help us understand our patient’s needs and motivations.

In this article, our UX Research team provide a deeper insight into why their work is so important to helping us achieve our mission as well as detailing some of the approaches they use when conducting research.

Why do we do research?

We conduct research because we simply cannot build a service without understanding our patients: needs, motivations struggles and pain points. We need to know who they are and why they might want to use our service. Armed with this knowledge, the product teams can ensure that patients are at the forefront of all product decisions. And in turn this means we offer a service that is usable and valuable.

Another reason for doing research is to discover new opportunities — how can we help even more patients? What new services could be launched? Which conditions should we look to treat?

Research is also about testing our designs not just asking questions. Even the best design has to be tested to make sure that it actually matches patient needs. We ask existing and potential patients to review all new designs and services to make sure they’re easy to understand and don’t cause friction.

Cultural nuances between locales

Behaviours change per country so it’s important we understand patients in all our markets. We treat patients across the UK, France, Germany and Ireland and need to be mindful that one solution might not work in the same way for all of these.

Conducting research across markets allows us to create services that meet patients needs regardless of the different cultural approaches to medicine. This could be the actual medication we provide, the manner in which patients expect conditions to be handled or simply how medical content is translated into different languages. As an example, previous research has shown that German patients scrutinise healthcare information they are presented with more heavily than patients in the UK and therefore additional information needs to be provided to German patients.

How is Research Conducted at ZAVA?

Research at ZAVA goes right through the business from initial strategy to product and marketing. Ultimately, we believe in collaboration. Each of our researchers are assigned to work with one / two cross-functional product or business teams, working alongside doctors, customer support, marketing (including content and SEO), data, engineering, product and growth. The researchers are fully integrated into these teams, attending stand-ups, co-creation sessions, workshops etc. They provide insights at every stage of the journey, identifying research questions and creating research plans to answer questions and build a more patient focused product.

Discovery and Testing

We mentioned before that research is not just about finding out information but testing our assumptions and designs. Research at ZAVA is primarily split between discovery research and user testing. Discovery research allows us to dig deeper, in a qualitative way, to really understand patients and potential patient pain points. The findings of discovery research help product teams and designers to create products, which are truly designed around patient problems and behaviours.

Within product development, user testing is carried out throughout the process. We are strong believers in iterative research. We adopt a listen, learn, build ethos — testing and learning as we go to fine-tune our products and ensure an optimised, clear, consistent and intuitive patient journey

Approaching patients regarding uncomfortable subjects

A lot of research we do at ZAVA is around health conditions that people might be embarrassed to discuss (e.g erectile dysfunction, contraceptive pill, mental health), so we need to make sure people feel at ease in any research situation.

The initial stage to a successful patient interview is being upfront about what we will be discussing. Respondents are asked several questions when they are screened for research to ensure that they meet certain criteria, one of these questions may refer to a health condition. Following this question we will ask them to confirm that they will be happy to discuss that condition in an interview.

Where possible we also give people the choice of talking to a man or women, or if only one sex is available to conduct the interview, we will ask them if they are comfortable talking to that person. We only want to interview people who are happy to talk, we don’t want anyone to feel uncomfortable.

Confidentiality is key

Within the interview, we firstly confirm that everything they say to us is confidential, and although shared with the team, will be kept totally anonymous. It’s important to make them feel at ease, so we start by asking a bit about them as a person — their family, what they do for a living and move into talking about broader health conditions.

The interview will gradually focus in on the sensitive area we are looking to explore. As we ask questions around this area, we just let them talk — sometimes people find it’s the one opportunity they have to really open up, and they will talk very openly. Although it is important to keep on topic, it’s also important to let them talk and continue to feel at ease. If at any point we feel they are uncomfortable we double check that they are fine to continue — if not, we either finish the interview, or move on to another topic.

How do we protect research participant data?

Part of conducting safe interviews is also about ensuring the protection of patient data in all user research projects we conduct.

During our research, we are likely to capture personally identifiable data (e.g. age, gender, video image, audio) and medical data (e.g. health conditions, medical history, medications taken). Therefore, we take appropriate safeguards to keep patient data secure.

Recruitment of participants through to data storage

Ensuring patients that we take data security seriously starts at the earliest stage of participant recruitment. All participants are required to provide informed consent before they take part in a research interview, and confirm that they understand the purpose of the research. We also tell participants what purposes their data will be used for (e.g. to help improve the ZAVA website or service), and who it will be shared with.

For in-depth interviews or usability testing, we like to record the research. This is so we can refer back to any findings or observations, and share footage with other project team members. We tell participants upfront if any recordings will be taken (e.g. voice, video) and because we use a third-party tool to record interviews we have to be explicit about its usage, providing participants with access to the tool’s privacy policy.

Storage of data is a hugely important part of keeping patients safe and we have to ensure that we comply with GDPR. Therefore patients are made aware of how their data is stored and can also ask for it to be withdrawn at any point. However the most important point is that we never link data that can be used to identify a participant to the data we use for the research projects.

How does our research help Zava as a business?

We ensure that ZAVA’s product and service offerings are usable and provide value. And that patient needs are at the forefront of all product decisions. Ultimately we work to ensure that we support the company in meeting the first two values of our mission — providing accessible and dependable healthcare.

Understanding patients to make healthcare more accessible was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

I organised and facilitated a design sprint to collaboratively redesign the homepage experience of the ZAVA website. This case study highlights the process and outputs of the Design Sprint, as well as giving some insights into the results of various methods of testing and analysis.

But first, some context…

ZAVA is one of the largest digital healthcare players in Europe. We are attempting to break down barriers to health and enabling people to do more of what matters to them by building healthcare that’s accessible, dependable, and at a fraction of today’s cost.

We were previously known as DrEd, and operate in several countries across Europe, most notably in the UK and Germany.

Also, the captain’s hat is a team tradition; we wear the captain’s hat whenever one of us facilitates a meeting. I don’t casually wear captain’s hats…

Why we Sprinted

A homepage has many roles. Those roles will vary depending on context.

For a homepage within healthcare, we know that there is a particular significance on comprehension and trust of the service.

As healthcare undergoes a digital revolution, we must be able to coherently explain our service — who we are, what we do and why our offering is safe. The way our patients interact with our doctors differs significantly from the offline experience they’re familiar with, and if we can’t convince them to trust our service then there’s little chance of them becoming a patient.

We decided to tackle this challenge with a redesign of the homepage.

The importance of the project along with a desire to move quickly led us to the decision to run the project as a Design Sprint.

The Structure of the Sprint

Rather than adopt a traditional Design Sprint structure, I decided to use the updated Design Sprint 2.0 approach.

What is the Design Sprint 2.0?
Design Sprint 2.0 is simply the most up-to-date, semi-official version of the Sprint, as of May 2018. One of the biggest differences between the original Design Sprint and the Design Sprint 2.0 is that 2.0 is optimised to work not just in startups, but also in large organisations that don’t necessarily have time to commit an entire week to the full process.
- Reference

There were two reasons behind this decision;

1. We already had a brief and area of focus so I didn’t want to spend too much time on the journey maps. Instead, I wanted to put greater emphasis on expert interviews.
2. Not everyone is needed for the entire Sprint, so I wanted to limit the effect on everyone’s day-to-day work.

We used a time timer throughout the first day to create a sense of urgency within the room and improve confidence in the process.

The Problem and The Solutions

The first day was split in half; the morning was for understanding the problem and gaining as much context as possible, the afternoon was for ideation and solutions.

The Morning

Firstly, I spent a small amount of time explaining what a Design Sprint was, why we were doing it, and what we were hoping to get out of it. This naturally led us into discussing and agreeing on the project goal:

To create an outstanding homepage experience

As I previously mentioned, we wanted to put much more emphasis on expert interviews during this Sprint. We spent two hours interviewing four experts, one each from UX, Research, Marketing, and SEO. Whilst the interviews were taking place, I asked everyone in the room to write How Might We statements on Post-it notes based on the expert’s responses. This allowed us to affinity map everyones Post-its in order to create key themes for the Sprint.

The key themes for the Sprint were kept as How Might We’s;

How might we…

• build trust
• show how ZAVA works / what ZAVA does
• show who ZAVA is through brand personality and achievements & profile
• create a bangin’ first impression
• demonstrate the value of being doctor-led
• adapt to multiple user journeys

The Afternoon

Straight after lunch we went into Lightning Demos, where we all shared our opinions of outstanding homepage experiences, both on competitor and non competitor websites. Whilst the Lightning Demos were taking place, I would sketch out interesting features from the homepages onto a whiteboard for reference later.

We then did 4-part sketching , which is comprised of boot up note taking, ideation, crazy 8’s, and then solution sketching.

Once solution sketching was finished, I placed all of the ideas up on the wall. Solutions were kept anonymous whilst I presented the ideas to the group. Everyone was then given unlimited dot stickers and was encouraged to vote as much as they wanted on individual features of each idea.

At the end of the first day, we had a selection of dot-vote heat maps which helped us identify the features we felt were doing the best job at solving the previously defined key themes.

Co-designing

The next day, I worked with another designer to co-design hi-fidelity UI based on the highest voted features from the previous days Solution Sketches.

We designed in Sketch, and used Abstract so we could work individually, then periodically merge ideas back into a master file. We also used Principle for prototyping any examples of motion that were required.

Testing

We ran several tests in order to give us the best chance of having strong and contextual insights. We also aimed to gather a mix of qualitative and quantitative data.

A/B Test

We tested the new design in Optimizely against the original base design with the measurement of success being a 6% expected uplift in users starting the assessment journey. It is common practice in our squad to perform our A/B tests on mobile only as the large majority of our traffic is on mobile. This means that a developer will only need to create a mobile version in Optimizely which saves time and effort.

Heat maps

We ran heat map tests using HotJar on both the new design and the base design to gather insight into where people are tapping on the homepage, how far they are scrolling, and how that behaviour differs between the variations in design.

Service comprehension test

We also ran two service comprehension tests (one in the UK, and one in Germany) in the form of a survey on Helio, where we tested three variations of copy which attempts to coherently explain what ZAVA is and what ZAVA does.

During this test, we also asked the participants to comment on the look and feel of the new design in order to gain some qualitative feedback which could be used for a design iteration in the future.

The Results

A/B Test

Overall, there was no statistically significant change in primary or secondary metrics, but we did have several interesting learnings from the A/B test.

The base design (blue) had higher peaks and lower troughs than the variation (green), so the new design was converting more consistently throughout the week.

We had highlighted a few more of our breadth products, but slightly lost the emphasis from one of our core products, which highlighted itself as one of the biggest areas for improvement in the next iteration.

Heat maps

Through the HotJar heat maps, we saw a significant increase in engagement in the number of taps on the new design. We also saw some changes in user behaviour between the base and variation design.

We also saw that users were seeing much more of our new homepage design compared to the base design, the assumption of this being that users could be learning more about the service. Below you can see the scrolling heat maps;

Service comprehension tests

We found some strong themes in the comprehension tests with winning variations of copy appearing in both locales (UK and Germany).

We also had some strong themes in the feedback on the look and feel of the new design which will be used to help steer the next co-design session.

What’s next?

The outcomes of these tests have given us clear direction for the next iteration of the design. We will be specifically focusing on regaining sales for our affected core product whilst maintaining the positive exposure gained for other products, and looking at how to implement the improved look and feel updates based on the visual design feedback.

We’re hiring!

We’re building an incredible UX team at ZAVA, so apply below and join the team!

UI/UX Designer

or check out the other open roles here:

Zava

Redesigning the homepage for one of Europe’s largest digital healthcare companies was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

It’s not unusual for engineering departments to find themselves deeply invested in old technology, all too aware that there are beautiful, shinier, newer frameworks or languages out there. Technologies that could make impossible or hard things — possible and manageable.

This scenario is usually solved by a complete rewrite. A start-over in an entirely different framework, language and technology stack. While this can solve the problem, it requires a lot of effort, can lead to delays in development work and have unpredictable ETAs. Moreover, this situation can repeat itself with rewrites required every 5–6 years when new front-end technologies appear.

This was something we wanted to avoid at ZAVA. We wanted to find an approach that would enable us to continuously and discreetly switch from one tech stack to another. Something that made it easier to predict when new technology would be implemented and remove the usual risk associated with implementing and investing in something new.

Why did we start looking for a new front-end framework?

ZAVA is growing fast, and to support this growth, our engineering team needs to develop new applications, scale them for multiple brands and implement experiments and new features as efficiently as possible.

However, at the end of 2018, almost all of our front-end was powered by Angular.js including customer-facing and internal applications as well as lots of supplementary tools and components. It wasn’t possible to make necessary changes at the speed required because our apps used outdated approaches and accumulated problems like:

• Big bundle sizes, no code splitting was used
• No shared components were used between apps. Only CSS styles were shared
• Code wasn’t modularised enough. Global objects were being referenced everywhere

As a framework, Angular.js is no longer supported for development. Its creators have abandoned it, no new libraries are being created, and the job market of Angular.js developers is slowly shrinking. It was clear we needed to try something new.

The review process — which framework should we use?

Whether to migrate to the new Angular framework (which is entirely different) or choose framework like React wasn’t clear at all. At that point of time React was an established option, that seemed like the go-to solution to all our problems, but we decided to consider all the available options.

To organise our migration to new technology we created a forum for front-end devs from independent teams — the “next-web” guild. Everyone was asked to propose a framework of their choice. The main candidates were:

• Angular
• React.js
• Vue.js

Angular

Angular is an entirely new framework, and we knew that we wouldn’t be able to reuse anything we’d already written in Angular.js. During the decision meeting, Angular was discarded straight away as it relies on TypeScript and RxJS library. RxJS, for example, forces you to think in reactive programming paradigm and structure your app accordingly, while React and Vue.js are less opinionated in how to handle asynchronous logic.

No one in the team was comfortable with TypeScript of RxJS library, so it seemed too risky to invest not only in a new framework but also into these new technologies as well.

React.js

React has a very strong set of advantages:

• Major internet companies support it: Facebook, Airbnb, Netflix.
• Rich ecosystem of open-source libraries, discussions, courses.
• Multiple libraries exist for the same problem — for example for state management Redux, Mobx, Unstated. You can pick up the most appropriate for your problem.

But on the other side of the coin there were some disadvantages:

• Fast turnover of libraries, it’s harder to keep up with the fast pace of changes (state management, routing libraries).
• Often React libraries try to be super generic so that they can be used both for web and native development, react-router v3 was good for web, but react-router 4 was focused on both web and native platforms, so at first, it had a lot of things missing for the web.
• Has a steeper learning curve, developers have to understand new concepts of functional programming, such as higher-order components.

React has its specific use cases, it is especially well-suited for making apps, but it shouldn’t be used for everything, for example, for static pages.

Vue.js

The positives for Vue.js are as follows:

• Focused mostly on solving problems arising in the web.
• Easy to get started.
• Has default libraries for main problems which are supported by core contributors: vue-router, vuex for state management, vue-server-renderer, vue-cli.
• More natural understanding by backend developers who had limited exposure to front-end before, because Vue uses plain templates.
• It’s opinionated in a good sense. It has ready patterns for solving many problems, fewer choices to make.
• It is aligned with the web-components standard.

Still, Vue is younger technology than React, and it has its downsides:

• Less choice of open source libraries, fewer people that have experience in Vue.
• Fewer companies are using Vue, though this seems to be changing — for example, Apple and Netflix have recently started using Vue.
• Not so many examples of large applications written with Vue, with the notable exception of Gitlab. For Gitlab transition to Vue went quite well and supported their scale.

The Decision

To make our final decision, we had an open vote for developers, which helped everyone to align. We identified two main aspects of how we can differentiate between Vue and React:

JSX vs. HTML templates. React implies using JSX to write templates and while it’s also possible with Vue, it’s more idiomatic to use HTML templates in Vue. So we had a choice between using HTML and JSX templates.

Opinionated vs non-opinionated framework. This choice has a great impact on the codebase. Choosing a less opinionated solution provides lots of freedom and flexibility to architect your app. However it comes with a cost — teams need to spend more time on investigations and in numerous meetings to align and agree on the approach. In contrast, with an opinionated solution, a lot of decisions are already made by the framework authors so aligning the team requires way less effort.

We voted on which approach our team members preferred:

Final voting was about choosing between Vue and React:

Vue won voting with a slight advantage. After the voting, no one questioned the outcome because the decision was owned by the team.

First steps

After we chose Vue, we started to build solid foundations for our new front-end tech stack. The first step was the configuration of Verdaccio — the registry for storing private node packages. Next, we analysed the leading solutions for displaying the shared component and were choosing between Storybook and vue-styleguidist. We built proof-of-concept style guides with both solutions, and we chose Storybook as it has a more flexible configuration and better community support.

However, initial development progress stalled for a while, as we didn’t have a clear migration path for big applications. The situation would remain like this until we figured out how to write apps in Vue whilst still delivering value to the business:

• Using Micro Frontends — an approach with splitting frontend application into smaller and independent “micro” applications. It’s great for migrating old apps incrementally.
• Creating new apps completely in Vue — this was easier if the app was completely independent of old apps.

For micro front-ends, we chose two approaches:

• Use single-spa to migrate current applications gradually. Single-spa library provides utilities to initialise and destroy app automatically depending on the active URL. Another great thing is that it allows the sharing of dependencies between micro-frontend apps.
• Writing widget apps with Vue so that we can use it anywhere. We have just two files: script and style files which we can embed whenever we need to show the widget. In the future, we would want to make web components out of the widget to isolate its styles and make it more robust.

We can show how we use both of these approaches in our Assessment application. The primary purpose of our Assessment app is to obtain information regarding a patient’s medical condition, including all details that allow us to fulfil the order safely. It consists of these sections:

• Questionnaire to make a diagnosis for a patient
• Product selection
• Login and registration
• Delivery
• Payment

This is how it looks (displaying a questionnaire section):

Our general approach is to use single-spa library to split the Assessment application into independent micro apps and migrate them independently. Single-spa provides a handful of utilities for loading/destroying new apps depending on the active URL. It also allows sharing dependencies between them.

However, in some cases, we need more flexibility, so we decided to extract the Questionnaires section into a widget. This way we can reuse it in any context (e.g. an app for a user account, static pages), just by loading script and style files from the CDN. On top of that we have the additional benefit of being able to deploy widget independently from all applications where it’s located.

This hybrid approach looks like this:

We’re already using single-spa in other customer-facing applications, and it’s greatly simplified our migration process.

We’ve also switched from WebDriverIO to Cypress for end-to-end testing for the widget and started testing widget in different contexts: standalone widget, widget inside other applications.

What we’ve learned so far?

• vue-cli is excellent for scaffolding projects, keeping build process up to date and in sync between projects.
• It’s hard to organise work on shared components if you have cross-functional independent teams.
• White-labelling is particularly hard, as there are varying degrees of customisation you can provide. Narrowing down the requirements helped to get the ball rolling.
• With Vue and Jest testing became way easier that with Angular.js

Looking back at the last nine months, we can say that the crucial part in migrating to a new tech stack is organising it incrementally. This makes it easier to convince stakeholders and to implement step-by-step migration without disrupting business processes.

As the next steps we’re planning to:

• Join efforts of independent teams to merge multiple components implementations in the shared library
• Add visual regression testing of shared components
• Adopt standard tools — tracking, A/B testing for use with Vue apps
• Start using server-side rendering of Vue components

This will allow us to easily scale ZAVA for multiple brands, have a consistent design and implementation and quickly experiment with ideas.

Thanks to Ramón García, Gemma Goode and Mati Shomrat for help and reviewing this post, Michele Stara for wonderful cover image and everyone from ZAVA Engineering team for ideas.

Zava’s journey to Vue.js was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.

Product Management is a hugely desirable role and given its positioning in the tech world, more and more people are looking at this as a potential career. After all, a Product Manager has access to all corners of a business, working with Developers, Designers, Marketeers, CTO’s and CEO’s. In this position, you can influence business direction, speak to users / customers, drive forward new features and clearly see the impact of your ideas.

With the increase in popularity has come an increase in competition. Whether you’re an experienced candidate in the tech world looking for a career change or someone on the hunt for their first product job, it has become a challenge to get a foot on the Product Management ladder.

Our brilliant team of Product Managers here at ZAVA have come from all walks of life, they’ve been Analysts, Marketing Execs and Entrepreneurs and they’ve worked at organisations like Zalando, Paypal and booking.com.

In this article, our Product team have given some advice and tips on what to think about if you are looking for your first or next Product Management role.

There isn’t one path to Product Management

There really isn’t one ‘right’ job to do before entering Product Management. However there are a few well-trodden paths into the role — and some useful knowledge and skills you could develop before doing it.

A pre-product role would benefit you if it helped you acquire knowledge of UX, Engineering and Business/Finance alongside soft skills like teamwork, collaboration, communication and stakeholder management.

Commonly someone working closely with an existing Product team learns so much that it’s a relatively small step to switch into the Product Management role within that company.

Product Management is a balancing act between ideas, people and actually getting things done

Product Management is a hugely multi-faceted role but getting your house in order is really important. Prioritisation is crucial so spend more time thinking about what’s really necessary and how to get the best results rather than trying to do everything! And, create a team environment where everyone can collaborate and thrive — an important part of a Product Manager’s role is helping other people to be successful.

Identifying your skill set will help you decide if it is a good career path for you

Product Management spans a huge mixture of hard and soft skills but to be a great Product Manager you should understand your user, be able to spot opportunity and (as already mentioned) know how to prioritise.

Having vision and knowing how to successfully communicate your vision to the whole team and wider business is also important.

Keep honing your craft

The best Product Managers love learning and accept that to be successful you need to be open to learning new skills, methods and approaches. The best way to do this is to be well-read and top of our team’s recommended reading list for a new Product Manager is; Inspired (which offers a really great look into the life of a PM) and Delivering Happiness. But they also recommend Cracking the PM Interview for great advice in securing your next role.

Make sure you understand a company’s structure before joining

Different companies will all have a really different approach to Product Management and also hugely different company values so make sure these values align with your own.

Use job interviews to check for compatibility; ask questions about an open & learning culture and whether there’s room for personal and career development. Make sure you understand how collaborative the team is — are the developers co-located or remote? Does the company use data well, do they run experiments before building products / features?

Product Managers have a big impact on the business and should work closely with the management and leadership team. It’s a good idea to understand the personality and management style of the business leaders as this could be a warning flag or selling point for the role.

Finally our team all agreed that an environment that is outcome driven vs output driven is really important. Product Managers do a lot of hard work that might come to nothing if theories are disproven or business vision changes so ensure you are joining an environment which focuses on the great work you do and its impact not on how busy you are.

Starting out in Product Management was originally published in ZAVA on Medium, where people are continuing the conversation by highlighting and responding to this story.