Case Study: Mosaic Bridges
Building bridges between community expertise and clinical practice through education, tools, and shared language.
Partners
UCSD SOM, Casa de Mosaic
My Role
Founder & Lead Study Designer
Challenge | Autistic adults are too often treated like children in healthcare, leaving providers without the tools to deliver age-appropriate, responsive care.
Healthcare was not designed with autistic adults in mind. While pediatric settings often provide structured support for communication and medical anxiety, these resources drop off dramatically in adulthood. The consequences are significant: autistic people experience 2.37× higher all-cause mortality than non-autistic people, alongside persistent barriers to accessing quality care.
Communication is a major part of this gap. 59% of autistic adults report difficulty communicating during medical consultations frequently or all the time, compared with 12% of non-autistic adults. Yet many autism resources remain designed for pediatric settings, leaving adult care providers without practical guidance for adapting communication, environments, and care.
As both a medical student and former academic support specialist for students with autism, I saw a critical disconnect: other fields had developed practical ways to support autistic adults, yet these approaches rarely translated into adult healthcare. Providers lacked both awareness of these strategies and accessible tools to put them into practice. The opportunity was not simply to create more education, but to bridge this gap by translating existing knowledge into practical tools for adult healthcare.
Casa de Mosaic | Our community partner supporting autistic adults in San Diego.
Approach | Rather than designing from healthcare’s assumptions, I looked to the adaptations already happening within the community. What was already working, and what could healthcare learn from it?
When approaching the community for co-design, I explored established methods, including generative co-design and participatory design. But many of these approaches relied on quickly building rapport, verbal participation, and comfort with unfamiliar facilitators, assumptions that did not reflect the social needs or experiences of medical trauma within our community.
Traditional research can also become extractive, particularly when communities are repeatedly asked to share their experiences without seeing how that knowledge creates change. I wanted our role to be different: not to extract expertise, but to create a bridge for it. Our team would serve as a conduit, translating lived expertise into practical tools and language the medical system could hear and act on.
Transforming the Traditional Double Diamond Structure
Design | I translated lived experience into tools that could work in real healthcare settings.
I led the design of Mosaic Bridges’ patient- and provider-facing resources, translating what we learned from autistic adults, caregivers, support workers, and healthcare providers into practical tools for adult healthcare. Rather than designing a single solution, we mapped where communication breaks down across the healthcare experience and designed resources to support both patients and providers at those points.
Our co-design process showed that accessibility could not depend on one communication style or level of support. We developed multimodal resources—including medical social stories and priming tools, accommodation aids, and provider education—and considered how each could fit into existing clinical and community systems. Prototypes were repeatedly brought back to community members for feedback, allowing the tools and their implementation to evolve alongside what we learned.
“What are the barriers for them and their families to receive care and what is the most adequate way that we can provide that care? I wish that in the future something like this is implemented.”
— Medical Student, UCSD
“This experience truly made me realize how extremely difficult it is to get even basic care for my son.”
— Parent & community partner
“The way you interact is very individualized. And I think the first piece of it is understanding what [someone’s] abilities and needs and learning styles might be.”
— Medical Provider, UCSD
Implement | We are bringing Mosaic Bridges into real-world care.
With our resources co-designed, the next step is getting them into the hands of patients and providers. We are actively pursuing grant funding to develop a free digital toolkit that can be shared across San Diego and integrated into existing healthcare settings.
We are also beginning implementation through UCSD residency programs, where providers will learn how to use the resources and translate patient-identified needs into accommodations in practice. As we expand, we will evaluate both sides of the bridge: whether patients find the tools accessible and useful, and whether providers show increased confidence and ability to provide accommodating care.
These findings, along with continued community feedback, will guide future iterations of the resources and help us understand what works outside of the co-design setting.
The goal is to make what works for the community easier for healthcare systems to understand and use.
