The Pause Patient Research view Memo Resume

Sandra M.46 · seven years of records · six health systems

Name stays with Sandra

tirzepatide 7.5 mg

Inject once weekly on Thursdays. Her third GLP-1 agent in seven years.

Week
31
A1C
6.4
Next visit
Nov 3

    Paused for gallbladder surgery. Daily check-ins until her next dose.

    Sandra's relapse surfaced in a note on day 21. Her check-in catches it on day 4.

    A concept for Novellia. One check-in serves her care team today. With her consent, it crosses the line as deidentified, prospective evidence.

    Based on the patient example in Novellia's GLP-1 registry post, July 23, 2026. Sandra here is synthetic.

    Research bin

    No names, no dates of birth. Thin rule: patient reported. Heavy rule: clinician confirmed.

      Signal by check-in
      Not yet
      Signal by clinical note
      Day 21

      What a sponsor sees on the other side of the seam

      Same events, no identifiers. This is the view a Precision sponsor would work in. Every number here is synthetic and only illustrates the idea.

      The bin: 1,812 GLP-1 initiators

        Signal lag after a pause

        Days from pause to the first sign of trouble, by where it showed up. One dot per synthetic pause.

        Strip plot of days to first signal. Check-ins cluster around day 4. Clinical notes cluster around day 20.
        Show as table

        Crossing the seam

        Live. Log Sandra's check-in above and watch it land here.

          Persistence by comorbidity burden

          Share still on therapy by week. Novellia reports persistence holds steady across comorbidity burden. Curves here are synthetic.

          Two step curves, high and low comorbidity, that stay close together over 52 weeks.
          Show as table

          Why patients stop

          Share of synthetic discontinuations by reason.

          Horizontal bars of discontinuation reasons. Pause not restarted is the one The Pause targets.
          Show as table

          The memo

          Folded like the insert in the box. Hypotheses built from Novellia's public material, not a read on its roadmap.

          The bet

          GLP-1 patients pause. Surgery, shortages, coverage gaps, side effects. Today a pause is a hole in the record.

          I'd make it the moment Novellia shows up.

          The hypothesis: patients with a pause plan check in more, restart sooner, and flag trouble weeks before a note does. Every one of those check-ins is a prospective ePRO a Precision sponsor wants.

          One patient action. Two kinds of value. That's the whole company in one feature.

          The first 90 days

          Days 1 to 30
          Listen. Sit with 20 registry patients who paused this year. Sit with five HEOR and RWE buyers. Learn the pause from both sides of the seam.
          Days 31 to 60
          Ship the smallest version. Detect the procedure from the record. One question a day. One share button.
          Days 61 to 90
          Measure, then decide. Keep it, change it or kill it. In writing.

          What I'd measure

          • Pause day check-in rate. Do patients answer?
          • Days to restart. Does it help them?
          • Days from first signal to a clinician. Does it help their care team?
          • Consent rate on pause check-ins. Do they trust us with it?
          • Sponsor pull. Will two sponsors pay for pause ePROs in a Precision cohort?

          What I would not build

          • No weight goals, streaks or badges around eating. Wrong incentive for this population.
          • No AI diagnosis. The app flags. Clinicians decide.
          • No separate GLP-1 app. It lives inside Novellia, on the record patients already trust.
          • No selling the signal before patients feel the value of logging it.

          Who's proposing it

          I'm Phil Morehead. HCA handed my team an idea for patient intake. I took it live in 36 hospitals across the US and UK, got the flow wrong first, and fixed it. Then I built NTT Data's first product org. Today I'm cofounder and CPO of NutrAssist, a consumer health app.

          Novellia built something rare: product and engineering thinking together. I'd come to grow that, not replace it.

          Read my resume LinkedIn