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Saul Marquez:
Hey everybody! Saul Marquez here with the HLTH Matters podcast. I want to welcome you back to this amazing series. Make sure you’re hitting the subscribe button to make sure you don’t miss any of these amazing interviews we’re doing with some of the most innovative and impressive leaders in healthcare. Today, straight from the Las Vegas show floor, I’m joined by two amazing healthcare leaders. First, I want to introduce you to Brad Kittredge, he’s the co-founder and chief executive officer of Brightside Health. He has spent over a decade pioneering evidence-based and consumer-driven healthcare solutions, including building the product teams at 23andMe and Lantern. Inspired by the challenges of a close family member with lifelong depression, Brad’s mission is to ensure that everyone has access to life-changing mental healthcare with measurably better outcomes. He holds MPH, MBA, and psychology degrees from the University of California, Berkeley, and I’m excited to have him here with us. I also am joined by Dr. Mimi Winsberg, she’s Brightside Health’s co-founder and chief medical officer, a Stanford-trained psychiatrist with over 25 years of clinical experience. She has profound expertise in the application of digital tools and therapeutics that impact behavioral health. Mimi leads and oversees Brightside’s psychiatry and therapy clinical programs with a focus on optimizing engagement and outcomes in individuals with mental health conditions across a range of severity. Prior to Brightside, Mimi applied her clinical skills and leadership roles at Ginger and Lyra, as well as serving as the onsite psychiatrist at Facebook Wellness Center. Mimi also holds a BA in neuroscience from Harvard College and is on the Leadership Council of Brainstorm, the Stanford Laboratory on brain health innovation and entrepreneurship. Obviously, we’re going to be talking about the topic of mental health, and I’m so excited to be joined by two amazing collaborators and innovators in the space, and so with that intro, I want to welcome both of you to the podcast. Thanks for joining me.
Brad Kittredge:
So glad to be here.
Mimi Winsberg:
So great.
Saul Marquez:
Now, I’m very curious always about what makes the leaders in our industry tick, so I’d love to learn from you. What is it that inspires your work in healthcare?
Mimi Winsberg:
Well, I’ve been a psychiatrist for almost 30 years now, and so I’ve gotten to see how psychiatrists practiced over the years. And I was really motivated to be able to deliver the kind of quality care that I can do individually at scale. And when I met Brad, he had the genius to be able to translate a lot of the product ideas, a lot of the ideas I had about how to treat patients into a tech product that we could use to scale our services.
Saul Marquez:
That’s great.
Brad Kittredge:
Yeah, and I came from the very opposite end of the spectrum as Mimi and my start in digital health was as a frustrated patient where when I had to use the healthcare system for the first time, I had a really hard time finding the care that I needed, navigating the care system, getting my own data. And I felt really frustrated and empowered and inspired to try to make it better for myself and for everybody else in that situation. Also, like so many people, we have depression in our family and just about every family that I’ve met has someone they love affected by mental health challenges, and the combination of those two forces meant that I just couldn’t sit back and not try to do something to make it better.
Saul Marquez:
That’s great, Brad and Mimi, thank you guys for your why. I always love starting with that. And here at HLTH, we’re covering a lot of things on mental health, on health equity, on the things that we need to shape the future of healthcare so we get the healthcare that everybody deserves. What do you guys think the current gaps in mental healthcare are, the actual model of mental health, and how can virtual care help fill those gaps?
Brad Kittredge:
Yeah, the most obvious gap for mental healthcare that so many people experience every day is access. If you’re somebody looking for outpatient psychiatry and you go to your local health system, you’ve got a wait of at least six months in most places, and obviously, we’re talking about a condition that requires treatment now when people are really struggling. so access is just a huge issue that we all understand and experience and feel in a really visceral way. The lesser known and lesser talked about challenge and gap is in quality, and that for a long time mental healthcare has been sort of shoehorned into primary care, where you’ve got busy practitioners managing a lot of complexity, but not having the ability to really focus in and understand and meet the needs of people with mental health challenges. And so this fundamental mismatch and a lot of structural challenges in the delivery system are downstream of that near-term access pain point, but a really important part of ultimately what we need to remake to deliver much better mental healthcare to everybody.
Saul Marquez:
Yeah, thank you for that. The amount of time that it takes to get to a clinician is really unacceptable and so we really need better options.
Mimi Winsberg:
I think two other points to make about gaps in care right now are those with high-severity symptoms, so maybe experiencing suicidal ideation, and those with comorbid medical conditions. So on the suicidal ideation front, what we see happening to patients who are on this higher severity is, they’re treated like a hot potato and nobody wants to treat them, they’re bounced around. They might end up in an emergency department where, the emergency department is really not equipped to address their symptoms. And if they felt bad before they were admitted to the ED, they’re going to feel even worse being held there in a nonpsychiatric bed as somebody looking for a bed for them. So we really wanted to fill that gap in intermediate care for the higher-severity patients. I think those with chronic medical conditions, you know, we know there’s so many chronic medical conditions that can be treated with lifestyle effectively, things like high blood pressure and diabetes, but if you’re depressed or suffering from a mental health condition, it’s really hard to take the steps to initiate those lifestyle changes. And so by tackling the primary mental health condition, you know, hopefully, we can move the needle on some folks who are struggling with chronic health conditions as well.
Saul Marquez:
Yeah, that’s great. It sounds like you guys are really thinking about and acting on the full continuum of care, and so virtual care is key. Historically, care for severe and acute cases of mental health conditions, including suicide ideation, was limited to in-person providers. Is it safe to deliver for severe acute cases remotely?
Mimi Winsberg:
Well, the answer is that really you can take some steps to make it safe. So not necessarily safe across the board if you don’t put the right measures in place. What we’ve done at Brightside is we’ve taken an evidence-based model, which is the CAMS model, a collaborative assessment and management of suicidality, and we’ve digitized that and we’ve combined it with a lot of the fancy bells and whistles that are part of our standard care platform, and that is to say, remote patient monitoring, visits that can happen on demand rather than just in a scheduled basis. The patient is interacting with the platform so that the provider knows what’s happening for them in real-time and can have a sense of what’s happening in between appointments, as well as using these very evidence-based tools that we’ve digitized to monitor suicidal symptoms. And so that and also looking at natural language processing in text messages and asynchronous messages that patients may be sending their provider, all of these things can make the treatment of these patients much, much safer, and that’s what we have set out to do. We’ve also published research showing that we can reduce suicidal ideation in our current patients with our standard model of care, so we feel confident in tackling this harder space.
Saul Marquez:
That’s great, and it’s encouraging to hear that we could fix the scalability problem and the access problem with a platform like yours.
Mimi Winsberg:
Yeah, I mean, we’re launching now the first-of-its-kind national program called Crisis Care, and it’s specifically designed for patients who are experiencing active suicidal ideation. We’re really excited to partner with health plans and health systems around this program in treating this higher-severity group of patients.
Saul Marquez:
Amazing, congratulations on that. That’s definitely exciting.
Brad Kittredge:
Thank you, I mean, it’s a huge need, of course, for anybody that’s affected by a suicide or a suicide attempt. We know that about 50,000 people take their own lives in the US every year now, but for each of those people, that does, a huge number, over 200 actually seriously consider suicide. So you’ve got 13 million Americans on average in a given year in this real crisis zone that need timely, effective help.
Saul Marquez:
Wow.
Mimi Winsberg:
What we found in our platform is that about 50% of our patients are experiencing suicidal ideation when they come in for intake. So we know that this is a population that needs help.
Saul Marquez:
Wow, well, you guys are doing great work. Thank you, it’s much needed. The pandemic only highlighted it even more, and I’m glad it’s in focus and I’m glad somebody’s working on it. So kudos to Brightside, you guys, and your team. What does it take and what do you have to do as a company to bring this type of care to the market?
Brad Kittredge:
Yeah, you know, there are a lot of steps to be able to deliver high severity, high complexity, high acuity, mental healthcare, and to do it with high confidence. And I think, as we’ve looked at this market develop and it’s been a very busy part of the market with a lot of investment and innovation over the past few years, I think the notable paradigm for me is that we’re a healthcare company using technology and data and novel ways, not a technology company trying to do healthcare. And what that means really is a commitment to meeting and exceeding all of the standards of the healthcare industry and all the checks and balances that are there. So it’s things like partnering and working with payers inside the payer ecosystem and meeting all the standards there, achieving things like high trust certification that Brightside has done, having a continuous quality improvement and management system, doing proactive regulatory compliance, all the things that are standards in healthcare that are not necessarily the norm outside of it, and so meeting that quality bar and those things are there for a reason is really critical. Otherwise, it’s about publishing data, right? So the norm, the way you actually demonstrate your impact in healthcare is through peer review, and it’s a high bar and it’s that for a reason, because it’s a way to make sure that companies are actually delivering against their claims, and it’s what the healthcare system looks to make sure that there are those checks and balances and that quality control.
Saul Marquez:
Love that, got the controls in place, the clinical evidence to prove efficacy. You guys are off to the races here.
Brad Kittredge:
That’s right, you know, we’ve been really proud and fortunate to partner with national payers like Cigna, Aetna, and Optum, as well as a lot of the regional Blues plans, because we’re seeing them really lean into behavioral health and go through a period of renewed investment where they really see and understand the inherent interconnection between behavioral and medical side of the business. They see the value and the importance of providing those great services to their employer customers, but also really recognizing and intervening and supporting their members at every step of that care continuum, especially when they’re escalating and need that timely and effective care.
Saul Marquez:
That’s great.
Mimi Winsberg:
And I think from the point of view of health systems, we’re seeing that they’re now willing to partner with virtual partners as well. We know that virtual care has become on par with brick-and-mortar institutions, particularly in the mental health space, where a physical exam may not be required at the time of the visit.
Brad Kittredge:
That’s right, it’s a great opportunity, a great new phase that we’re entering where our health system partners and friends who are struggling with capacity, challenges, and demand that will exceed the providers that they have in network, have in the past felt like they didn’t have really trustworthy or high-quality resources to be able to support them and to help them manage both the triage and the overflow of what’s necessary there. And now I think they see that there are companies that are rising to that quality bar who are leaning into collaboration and care coordination and data sharing in the way they need and can work together to really solve those problems in a compelling way.
Mimi Winsberg:
The data sharing piece I think, is super critical to underscore, that we can give that granular data that we collect back to the primary care provider to show what the patient’s progress has been and what kind of outstanding outcomes we’re achieving.
Saul Marquez:
That’s fantastic. You know, you guys are ingrained, a trusted platform, and so I appreciate hearing some of these success stories that you’ve had. How do virtual care providers like Brightside fit into the larger healthcare ecosystem?
Brad Kittredge:
Yeah, you know, as I mentioned, it starts with making sure that you can use your benefit to pay for care, right? So in mental healthcare, for quite a while, there have been a lot of people willing to pay cash for care because they had long waits or limited access through their benefit. Certainly, that’s not what anybody wants. If you have health insurance, you want to be able to use that to get timely and high-quality mental healthcare. So being seamless with your benefit that you can use with Brightside, the same way that you would with any in-person provider, is really critical part. And then again, working with other providers as part of that healthcare ecosystem, knowing that many people start their journey with their primary care provider, where they may have a relationship or where they may have other conditions that they’re managing and being able to collaborate for referral pathways for data sharing and for patient management across that life cycle is really important part of fitting together.
Saul Marquez:
So has it improved the benefit side of this? Have you seen it improve?
Brad Kittredge:
Yeah, we’ve seen our payer partners just doing great work here, really leaning into making sure that their members have the right options and the right availability of services and really doubling down on quality understanding who’s doing measurement-based care, who’s got great data, who’s publishing, who’s meeting all the standards in the high bar that they have, so that they can be confident that they’re putting the right service options in front of their members.
Saul Marquez:
That’s fantastic. So this has been really great, and the theme of hybrid models has been present across all of our conversations, in-person, brick-and-mortar, virtual, can you talk to us a little bit about the difference between both?
Mimi Winsberg:
So, you know, obviously in mental health, as I previously mentioned, in the absence of a physical exam, we can deliver just as good, if not better quality care over telemedicine. But one of the things that allows us to make it better than what you might provide in an in-person care is that we don’t just put a provider and a patient behind a video screen. We have a lot of other features in the platform that are enabling tracking of symptoms, remote patient monitoring, scheduling visits on demand when needed, and connecting the provider and the patient through messaging and other features. So what this allows us to do is to treat a potentially higher severity group of patients with more consistency and more follow-up in between visits and not be just relegated to the one visit every two weeks model that you’ll see in traditional care.
Saul Marquez:
Yeah, Mimi, it’s really great to hear you say that because we’re done with the episodes of care. It’s the entire journey, it’s stitching it all together, and it sounds like your platform really allows for that.
Mimi Winsberg:
Exactly.
Brad Kittredge:
That’s right, you know, the convention in anti-depressant prescribing for a long time has been, try this and come back in six weeks or eight weeks and tell me how you’re feeling. And we know that so much can happen just in that six or eight weeks, multiple initiate medication, and when they’re still at their high levels of severity, their symptoms, and oftentimes patients feel like they’re kind of stuck, where if you want to schedule an appointment and get back in, often it’s 21 days for an appointment, you don’t have resources you can reach out to in real-time. And so in addition to the clinical benefits and alignment of the model, I mean, we talked about is just a better patient experience to knowing that your provider is there, that you can message them, that you can get a response in 24 hours, that you can ask for a video follow-up when you need it and get it within 24 to 48 hours. And so having that different type of relationship between a patient and provider throughout the entire course of care actually aligns not only with the clinical outcomes, but with really great patient engagement so that we can get more people, more adhere to their treatment programs, and better outcomes.
Mimi Winsberg:
It’s this notion of a closed-loop feedback system, and if you think about how people learn best, it’s through feedback.
Saul Marquez:
Yes.
Mimi Winsberg:
They don’t learn in a vacuum. And so we’ve created that closed-loop feedback where a patient can log in to their platform, see their own progress, connect with their provider, connect with their doctor, and know that they’re on the right journey.
Saul Marquez:
That’s fantastic, it sounds like a seamless way to ensure that patients get the quality care that they need, clinicians have the confidence to know that the care being delivered is effective, and as a payer, you’re happy too, because you’re paying for delivery that works.
Mimi Winsberg:
Well, you have the data to back up what you’re paying for.
Brad Kittredge:
That’s right, you know, we’ve been in an era for many decades now where payers have been paying for billions of dollars of mental healthcare with very little idea whether it’s actually working or not and having a measurable clinical or financial impact. And what’s really exciting is now we’re entering a new era where we’re bringing that rigor, that outcome measurement, and that commitment to stand behind those outcomes in a way that can really change that equation, change the way that payers think about mental healthcare delivery, access to that care, rigor behind that care that’s going to drive, I think, a continued investment cycle so that everybody can get that timely and high-quality care.
Saul Marquez:
That’s fantastic. Well, I want to thank you both for spending time with us today here at the event. Congratulations on the recent announcements and the work that you guys are doing to continue expanding the platform to the people that need it. What closing thoughts would you leave the listeners with today?
Mimi Winsberg:
I would say that, people, if they are looking for care right now, please log on to Brightside.com, where you can learn about our services, you can learn about the kinds of services we provide. That’s therapy, psychiatry, a combination of the two, and our newest launch, which is Crisis Care to address those patients that are having more active suicidal thinking. So I would say think about our program as an option in your care plan.
Saul Marquez:
That’s fantastic.
Brad Kittredge:
And the only thing I would add to that is, so many people out there are struggling, so many people are doing so quietly as well, and so we just encourage everybody to check in with the people they love. Don’t be afraid to ask hard questions. Don’t be afraid to probe in and make sure someone feels supported, knows what resources and options they have, and just take care of yourselves and each other.
Saul Marquez:
That’s great, really appreciate the message there, guys, and thank you both for what you’re doing, it’s making an impact on healthcare, but also our world. Folks, make sure you check out the show notes for all the links to stay in touch with Brightside, as well as these two amazing health leaders. I want to thank you both and thanks for tuning in.
Mimi Winsberg:
Thanks for having us.
Brad Kittredge:
Take care.
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