A Feasibility Pilot

Objective
The primary objective of this feasibility pilot was to assess the implementation of the Dama Health (DH) birth control platform at a Women’s Health Clinic in Philadelphia,PA. The pilot sought to evaluate the platform’s technical performance, impact on patient care, provider efficiency, and its integration into clinical workflows. The platform was tested by medical providers providing contraception care at the clinic —an OB-GYN, PCP, nurse practitioner (NP)—with a focus on how effectively it could enhance contraceptive counseling and streamline decision-making processes for both patients and providers.

Implementation Overview
The DH platform achieved over 99% uptime during the pilot period, ensuring reliable access for both providers and patients. To facilitate smooth adoption, in-person training was provided to both clinic providers and administrative staff. This training ensured that all personnel were equipped to use the platform effectively, minimizing disruption to existing workflows.

Key Findings

Patient Participation
Throughout the pilot, 201 patients completed the DH platform’s contraceptive assessment, contributing to a 40.5% final invite sign-up rate, indicating significant interest in the platform's assessment. The average time for patients to complete the assessment was around 15 minutes, with the majority of time spent on the “lifestyles and goals” section, where patients are asked about their personal preferences. This indicates patients taking the time to think through what’s important to them, preparing them for the visit and their desire for personalized birth control recommendations.

Clinical Insights
The platform provided substantial clinical value by identifying patient health concerns before appointments. Approximately 20% of patients were flagged as potential candidates for further investigation, including symptoms of potential underlying conditions like polycystic ovary syndrome (PCOS), endometriosis and concerns related to breast lumps, and risk factors for sexually transmitted infections (STIs). 

Additionally, 31% of patients left additional free text comments for their providers, fostering more meaningful appointment discussions. In these comments, patients often talked about using birth control for medical reasons, such as managing painful or heavy periods, some patients expressed anxiety about changing their birth control method or removing their IUD.

The platform also successfully flagged relevant drug interactions, such as with weight loss medications. Medical comorbidities such as higher body mass indexes (BMI), dysmenorrhea, vaginitis, PCOS, oligomenorrhea, and hypertension were highlighted on several reports and factored into Dama’s recommendations, following the latest US MEC guidelines to ensure safety and allowing providers to make individualized recommendations.

As part of the assessment, patients get an opportunity to list their previous experiences and satisfaction with birth control options and brands, and any side effects they may have experienced. This is then factored into their recommendations and summarized for providers. In our sample >200 patients, we were already able to notice patterns and population insights shining the light on people’s experiences with birth control. Common side effects that were mentioned included irregular bleeding, acne, weight gain, mental health issues, headaches, breast tenderness and fatigue. Some patients reported being dissatisfied or extremely unhappy with certain methods, often due to severe side effects while some reported being satisfied despite experiencing some side effects. A few patients expressed dissatisfaction with multiple methods before finding one that worked for them. This analysis highlights the diverse experiences of patients with various birth control methods, emphasizing the importance of individualized care in contraceptive counseling and management.

System Functionality
From a technical perspective, the platform functioned well in this low-fidelity clinical flow that replicated an EMR-integrated flow.The DH platform’s report generation and transmission processes were highly reliable, with over 99% of faxed reports successfully delivered to the clinic. Additionally, more than 85% of the reports were successfully uploaded by the admin team into patients' electronic medical records (EMR) via e-fax integration. The creation of user accounts and the overall report flow worked as intended, confirming the platform's stability and promise of better integration into existing clinical systems.

Patient and Provider Feedback
Patient feedback was positive. Satisfaction scores reached 5/5, and the platform achieved a Net Promoter Score (NPS) of 100. Surveyed patients indicated that the DH platform helped them feel better prepared for their appointments, with 62% stating that it empowered them to make informed decisions about their birth control options.

Providers also recognized the platform's value in streamlining the contraceptive counseling process. By reviewing patients’ lifestyle factors and goals before the visit, providers were able to offer more focused guidance, improving the overall quality and efficiency of appointments. The pilot revealed strong interest from providers in a fully integrated EMR version of the DH platform, which could further enhance the patient-provider experience. One provider said “The report reminded me that BMI is a risk factor for DVT”, highlighting how Dama’s reports offer clinical decision support, while another provider summarized their experience with Dama by saying: “it helped patients to have time to think about what birth control matches their lifestyles before coming in so they already had more information and had a better idea of what they wanted to discuss”. 

Conclusion
The pilot demonstrated the feasibility of deploying the Dama Health platform in a clinical setting, particularly through its e-fax to EMR integration. The platform proved to be a stable, reliable tool that offered valuable insights into patient health and preferences, ultimately improving contraceptive care. Both patients and providers reported good satisfaction, with the the platform enhancing pre-visit preparation and streamlining the counseling process. The results suggest that wider implementation of the DH platform, particularly with full EMR integration, could further optimize clinic workflows and patient outcomes.

By Fiona Kennedy