Improving Cognition as a Method to Improve Outcomes in Brain Injury
Episode 523

Mark Watson, CEO at ABI Wellness

Improving Cognition as a Method to Improve Outcomes in Brain Injury

Mark Watson CEO of ABI Wellness

In this episode, we feature Mark Watson, CEO of ABI Wellness, an evidence-based cognitive rehabilitation program for patients with chronic brain injury to improve higher-order cognitive functioning. Mark shares how his company is helping people with TBI enjoy improved cognitive functions and enjoy independent lifestyles. He also talks about the genesis of ABI Wellness, the reason they chose the B2B path, and his challenges. Mark’s voice rings with sincerity and a real desire to make a difference, so make sure to tune in to learn more!

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Improving Cognition as a Method to Improve Outcomes in Brain Injury

Episode 523

Recommended Book:

The Brain That Changes Itself

Best Way to Contact Mark:

LinkedIn

18334148958

Company Website:

ABI Wellness

Improving Cognition as a Method to Improve Outcomes in Brain Injury with Mark Watson, CEO at ABI Wellness transcript powered by Sonix—easily convert your audio to text with Sonix.

Improving Cognition as a Method to Improve Outcomes in Brain Injury with Mark Watson, CEO at ABI Wellness was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.

Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez here, and today I have the privilege of hosting Mark Watson. He is the CEO of ABI Wellness. Mark’s background as an educator and an athlete positions him to appreciate and explore the brain’s ability to change and recover after brain injury. His experiences with learning difficulties developed his interest in different learning profiles and helping students better understand the nature of their disabilities and their ability to overcome them. Mark has worked in education and cognitive rehabilitation since 2002, having served as a teacher, administrator, executive director and CEO. With a background in human kinetics and educational leadership Mark successfully paired his background and both of these areas into his role at ABI Wellness. What he’s doing is pairing his clinical experience and serving students with learning disabilities with his previous experience as a co-founder and executive director of the Watson Center for Brain Health. Mark has seen firsthand the overwhelmingly positive impact of strengthening specific neurological capacities, what it could have the impact on all aspects of a patient’s life. He’s committed to working with patients so they can lead more fulfilled and independent lives. A frequent speaker on the topic of brain injury rehabilitation, Mark has presented his work to numerous public health agencies B.C. Cancer Agency, the NHL Alumni Association and more. Mark also serves as a member of the Integrated Health Advisory Board at Kwantlen Polytechnic University. What we’re gonna be covering chronic TBI and recovery and what we’re doing to raise standards to produce better outcomes here. And so, Mark, thank you so much for for joining us today.

Mark Watson:
Thanks a lot for having me on. I’m looking forward to our conversation.

Saul Marquez:
Likewise, Mark. So, you know, tons of interesting work being done in today’s field around mental health. You know, that seems to have gotten more light. I’m excited to dive into the topic of chronic traumatic brain injury and in the post acute setting. But before we dive into that, you know, the thing that you guys do so well, talk to us about what inspires your work in health care.

Mark Watson:
Well, I mean, like anything, it really starts with a problem. And Saul, you’ve mentioned there and thanks for the bio. You’ve mentioned my background’s in education. So it started out in working with kids with learning disabilities. And my journey into that started with me being diagnosed with a learning disability in grade one. And kind of as we started to bring this work into working with people with brain injury, what came to our attention was that once someone with a brain injury, whether it’s, you know, a fully acquire meaning more like a stroke or a traumatic event, meaning a TBI, once someone is discharged from acute care, there seems to be a very difficult ability to get access to good integrated rehabilitation care. And this seemed to be consistent everywhere we went. There was a lot of different options for care. And sadly, because of that, it was difficult for people to get access to the kind of care that they could need, especially with cognitive issues, meaning attention, memory, planning and organizing. And so we had continued to see these problems in the school setting and we decided to try to study people with chronic traumatic brain injuries could actually improve their higher order cognitive functions. And when I talk about, you know, being inspired in this work, I have a mentor named Barbara Aerostat Young who created a cognitive rehabilitation program for kids with learning disabilities. And it was her program is quite remarkable. And it was yielding really good outcomes in education. And we were wondering if we could take elements of that program that focused on these higher order cognitive functions and then apply it to really having a significant outcome for those in our community with living a lower quality of life due to brain injury.

Saul Marquez:
Well, it’s very interesting work, Mark, and meaningful work. Why do you think that gap exists? You know, why do you think that post acute? There is a huge gap.

Mark Watson:
Well, I think I think we need to look at the mandates of the organizations that are treating this population. So if we look at our typical hospital here in B.C., we were fortunate. I mean, I’m really especially now cognizant of the impact of the acute care system and the outcomes that they’re having.

Saul Marquez:
And BC’s British Columbia, right.

Mark Watson:
Sorry, that’s British Columbia.

Saul Marquez:
Yeah, okay.

Mark Watson:
But it’s the same in the Pacific Northwest and East as well. They’re doing a remarkable job and their mandate is to give them the kind of acute care that they need and they do that. But with many people with brain injury, there’s still a there can be cognitive issues following that brain injury. And what we were seeing is once discharged, those were, for the most part, being left untouched if they were there. So who’s to treat that person, that population. Oftentimes, it can be a clinical counselor. It can be a community support worker. It can be an occupational therapist. But you can see that depending on your resources and your location, there’s not really an optimized or standardized approach to treating this population with a keen eye on outcomes and really capacities.

Saul Marquez:
Yeah, and it’s that that’s the need for a standard. And so, you know, and I guess that’s where you guys come in. Mark, tell us a little bit about how you guys are adding value to the health care ecosystem within this niche.

Mark Watson:
Yeah. I mean, what we initially did was looked at, you know, just the higher order cognitive functions. I shouldn’t say just that’s important. But what we did in surveying and understanding what was out there was that this was an area for improvement. So we got to work and we we did a proof of concept study with the University of British Columbia. Look, the research question was really can post acute or chronic complex, mild TBI. So our concussions aren’t healing after the normal window for recovery. Could that population actually improve higher order cognitive functions by engaging in this kind of program? And initially, many people were saying, well, no, once we’re kind of in that that post acute phase, your window for recovery is kind of gone. And to the credit at UBC, the University of British Columbia, they took on this research question and we found that, yes, people could engage in this kind of program, they could get better. And, you know, typically in outpatient rehab, kind of engagement rates are quite low because of the nature of chronic TBI. And what we found that was really interesting was that our engagement rates and attendance rates were in a high 90 percent, which was really that was a total outlier. We’re talking about Gladwell stuff. And so so that got people really interested. They’re saying, hold on. These people have chronic issues following TBI. And here they are engaging in this outpatient rehab program at a very high level. And not only are we seeing cognitive improvements linked with changes in kind of functional connectivity using EEG, but they’re also self reporting better activities of daily living changes.

Saul Marquez:
The desire is there, right, and people are just showing up.

Mark Watson:
I think people, I think people want the opportunity to get better. Right. And I guess that that that’s one of the things Saul that I really appreciate about, you know, digging into the topic that you do is that’s really what motivates us. You know, we think about the why and the why it’s so closely tied to giving an opportunity in a system space opportunity for this population to help to get themselves better.

Saul Marquez:
You know, it’s so interesting. You know, we we spend so much time and resources making the body better and and for some reason the brain is comes as an afterthought. You know, I mean, I don’t want to say that in a bad way, but, you know, to your point, we need more standards. And and it sounds like you guys are on to something here, Mark. What makes what ABI does different or better than what’s available today?

Mark Watson:
Initially, our focus, as I noted earlier, was was only looking at the higher order cognitive functions using one of my key mentors program, an element of it. And that was terrific. And we saw really nice outcomes from that. However, as I talk to more people in the space, especially occupational therapists, they’ve been key teachers for me on this road, along with physical medicine doctors called Physiatrist and just general docs and rehab professionals. What they were helping us to understand is that if we wanted to have a really significant impact, we needed to blend the care model and really focus on the B to B model, not just B to C. And in doing that, we had to get to work on the software program to develop a service platform that could actually reliably kind of assess and treat this population in a way that could optimize and standardize interdisciplinary rehab. So that’s actually what we’ve done. And that’s I think the difference that we’re making was that our initial assumption was just looking at cognitive rehab, right. and then blending that, looking at that. But actually, in reality, that could add a further silo in what is already a busy model. So what we had to do was to pivot, which is one of those key words right now to software development and then to blend the care model. Looking at some of the best of evidence based practice that already had good data behind it and blend that into one B2B focused service platform. And that’s what I’m really proud of our team. That’s what we’ve done over the past four years.

Saul Marquez:
Fascinating. So a great pivot and I think a lot of entrepreneurs that get into this space ultimately make that shift. You know that the B2B model. And so you guys have blended software development, cognitive rehab with evidence based approaches that are that are working. Talk to us about how the system has improved outcomes and maybe walk us through an example of how this works and how a typical customer gets engaged with what you offer.

Mark Watson:
Yeah, happy to. So what we found in surveying the market, we did like any. Most people do when we see a problem. We went out and surveyed and tried to understand what the what the space looked like and what we were finding in post acute was a lot of different approaches to treating this population and their symptoms. And you mentioned standards. It didn’t seem to be very well standardized and it didn’t actually seem to be very well optimized either. Some other approaches could probably work really well. And one, I’m not saying that that isn’t true. I’m sure that can be true. But we seem to think that there needed to be more systematization to treating this population. So what we did was we really got to work in doing the programming and then talking with outpatient rehab facility for these and how they come on board with this kind of program is really they need to already be focused in post acute rehab and really bridging the gap between inpatient to outpatient to community, because there’s a lot of gaps there. And we found we can really help with an eye on the provider as well as the patient, a system that can keep those touch points high while keeping costs low. So how it works is, like all of us, we’ve really moved to at-home programming. And really how it works is we partner up with clinics. OK. So it’s kind of like a licensing agreement who already specialized in the space. And really what we want to do is we want to provide provide them the ABI Wellness system of care for them to deploy as they need. OK. So some organizations contact us and say there was one just not that long ago out of Texas who contacted us and said, OK, we work in stroke and chronic stroke. We’ve got an inpatient ward with that outpatient community and we are recognizing that we’re not really even touching cognition. Could we look at that and study that to see what the outcomes could be? The other way that people come on board is we would be in conversations with outpatient rehab clinic. They would train up their staff because most of the programming is more one to one at this time working with this population, which is problematic. And it’s also primarily face to face. I mean, it’s got its advantages. It’s great to have that relationship. However, on the on the business side, it can be harder because OTs, you know, are compensated very well and should be. But the models one to one, well, that’s hard to get access to that care. Our models more six to one. So those ratios are are higher and they can actually optimize that care model for the provider, but also provide the community for the patient.

Saul Marquez:
On the six to one. How much of this is virtual care that you guys are enabling?

Mark Watson:
Well, this is where, you know, I think we we had some good foresight and also some luck is we were we were building this model to be able to eventually be delivered remotely to really access those most in need in remote communities. But at this point, our clinics can take continue to be up and running. And all of this is being delivered from at home and remote right now.

Saul Marquez:
Cool. Very cool. And that that right there in itself. Right. I mean, we talk about outcomes improvement and business model optimization success. And then I mean, to go from one to one to six to one and still deliver an equivalent or better result is is extraordinary.

Mark Watson:
I think so. I mean, I’m so close to it, though. But it’s really it’s really kind of validating to hear that the people in the space that we’re talking with, and especially when we think about the outcomes, because what what has been a constructive criticism of cognitive rehabilitation or cognitive optimization is actually looking at the transfer of those cognitive improvements to activities of daily living or quality of life. And, you know, people are interested. I encourage you to check out our website because we actually have the most recent white paper that we published is actually looking at that transfer. So not just return to work outcomes, which are really, really positive, but also, you know, quality of life and activities of daily living, which, you know, any good, more behavioral to doctor, but any really rational space is going to be looking at those data as well. And that is where, you know, I’m really proud of what were the outcomes that we’re seeing, because people are people are reclaiming some of what they have lost and they’re sustaining those improvements.

Saul Marquez:
Fantastic. So so, Mark, there’s you guys are providing a tool to to these caregivers and outpatient facilities. And so these tools are enabling them to provide better care and also run a more efficient business.

Mark Watson:
Exactly. Well said. That’s exactly it. And there’s a keen eye on the efficiency, and that’s who we’re partnering with now. We’re looking at really some some of the bigger providers to help them to understand how they can they can help the markets that they serve. And for some, yes, it’s ABI. It’s ABI focused. But for others, we’re hearing from them. We’re open to hearing for more. It’s really mental health and other chronic health conditions that could benefit from this blended approach.

Saul Marquez:
Well, it’s so, so key. Right, and there has been so much investment in the last five years in mental health that, you know, I really like how your solution, which is grounded in research and really starts off with the physiological thing, then leads into the mental health problem. And so, you know, we are a health community that approaches physical problems. And so. Yeah. Love you how you tackle that from the physical. And now are offering solutions to the mental care as well.

Mark Watson:
Yes. One hundred percent. And the other the other thing that we’d seen in a lot of this is, you know, a lot of a lot of the cares compensatory in nature, meaning, you know, steering around those weaknesses that may become chronic. And we’re not saying we don’t need story strategies. They are important. However, I would challenge that by say, why don’t we look at how we’re sequencing those? So why don’t you focus on increasing capacity first and then later, once we’ve done as much capacity building or reclaiming as possible, then start looking at more competitive strategies.

Saul Marquez:
Yeah. Fascinating. Fascinating, and, you know, if you’re if you’re listening to this, thinking to yourself, there’s something here. There’s there’s an opportunity for me to do better. I think, number one, you’re being honest. And number two, take advantage of this conversation with Mark. The website is ABIwellness.com. ABI is an acquired brain injury ABIwellness.com. Check out what they’re doing. Check out their research and just the improvements that they’re making in this area. Talk to us, Mark, about a setback. What’s something that happened to you or the company that turned to a key learning that that’s really helped you guys deliver what you do today?

Mark Watson:
Well, there’s there’s been many like with with anything where you where you’re driven by vision so hard. But I think Saul, one of the ones that really I think can provide context was a personal setback back when we were starting this exciting work with my mentors know Barbara Arrowsmith Young and Howard Eaton, two huge memories of my life. Just after we were starting to look at this research, I received some very difficult personal news in that I was diagnosed with a rare form of lymphoma at age thirty seven, too young, two young kids at home, an amazing wife. And we were just getting going.

Saul Marquez:
Oh my gosh.

Mark Watson:
And yes, real challenging. And I’m a really optimistic kind of positive type guy. And I couldn’t even spell kind of cancer that I had at that time. Came to learn it later. What this setback taught me, I was so fortunate in terms of the care that I got because I was because of I was quite healthy. Otherwise I was healthy enough to be enrolled in a randomized controlled clinical trial, phase three. And this gave me the opportunity to improve outcomes because the current outcomes for my form were, you know, 50/50. And but this was showing promise in phase one and phase two of a better outcome. And so I went and met with my oncologist and chatted with my amazing wife and family. And we decided to go for it and to trust in the science and in the system. And then the opportunity for a better outcome. And what what I found was, you know, I was in into remission before the end of my treatment, before my my six chemotherapy sessions. And along with that Saul, what I did do was I took technology. You know, I I took the early Fitbit and walked my ten thousand. I meditated every day even while I was in PET scans. I was practicing gratitude and meditation as much as I could be.

Saul Marquez:
Sure.

Mark Watson:
And understanding the mindset that I needed to be and try to be in for recovery. And throughout the six, this setback. Yes, it was terrible. It was scary. Were my colleagues allowed me to continue to work on this ABI Wellness while in in this treatment. And what I learned out of that was really challenge the standard of care. I got the most remarkable care. I’m so fortunate, so fortunate like many are. But what I continue to learn throughout this process and after it was that get your research question type, understand that there is there is an issue that needs to be solved and chase those outcomes. And we all understand that brain injury and neurological disorders are causing huge problems in people’s lives. Their causing huge problems on society with the long term cost of care. But there are solutions out there as well. For me, I’m just a debt of gratitude to all the doctors who helped me out. But sadly, that is not what I’m seeing in brain injury. The level of care is nowhere near the level of care that I received. And we want to try to change that. We want to make it. We want to help people get themselves better. We want to help organizations apply a system based theory, system based program that really helps to produce predictable outcomes.

Saul Marquez:
Well, I think it’s outstanding and what what an amazing story, Mark. I mean, gosh, I mean, I feel you there. You know, I’m I’m you know, and I feel you because gosh I mean, I’m I’m you know, I’m thirty six and I have my son and I just put myself kind of in your shoes and I felt the pain and…And you made it man. Congratulations first though.

Mark Watson:
Thanks. I mean, it’s it’s great. You know, it was it was a great thing. But you know what? I’m still there, you know, and I’m still cognizant of that. And and that’s part of what motivates our team. Our vision is to help the ultimately these people. But actually more these organizations to have a more predictable pathway to partner with us, to say here’s a way that’s working. Here’s a way we can optimize. Come along with us.

Saul Marquez:
Totally. Yeah. And we all know that variability and are in our care delivery is a problem. When you have the opportunity to tackle something and remove variability and produce standardized delivery of care, it take advantage of it. Your story is inspiring, Mark and you know, I’m thrilled to share it here with the community. So what was what was what is your tight research question? Because I love the idea, first of all. Right. There in the tip here for all of us to take away is get your research question tight and chase those outcomes. I love that. That’s my that’s my mark quote for the day. What was yours and I just wanna hear that.

Mark Watson:
So the initial question was, can a behavioral cognitive rehabilitation program improve cognition for people with chronic TBI?

Saul Marquez:
Mm hmm.

Mark Watson:
Because while we are seeing is sure everybody struggles with this population. That may be partly also a baseline issue, because in these complex mild concussion cases, roughly between 80, 86 percent are going to get better. I still challenge those data a little bit, too. But what about those other. What about that? You know, 14 to 20 percent? What about that? What do we do about that? And do you you know, I also used to play football in university and I’ve seen many concussions in my day. And what do you do? Is it some special limitless type supplement that’s going to do it? Is it is it biofeedback? Is it all just going to go away? I don’t think so. And that the bigger thought I had was, well, what do you then do? So let’s say you’ve had all of these issues, these cognitive or these concussion or these TBI type issues. And, you know, you’re a year out, but you still have symptoms. What do you do? What’s the plan? Do you just advocate? Do you do like many great not for profits are doing and advocate that these concussion issues are a problem. Do you have counseling sessions which are super helpful? What do you do? And what we wondered was, OK, could you dose that rehabilitation dose specific to these cognitive issues? Pair that assessment with good treatment. And then look at the outcomes. And that’s what we did. And yes, we saw cognitive changes.

Saul Marquez:
Well, I think it’s great. And the opportunity to to tackle this is extraordinary for all of us. The costs to people’s lives, to families, to society is too great to just ignore. What are you most excited about, Mark?

Mark Watson:
The opportunity to transform a system of care and to be a part of that, to be a small part of that, to partner with really, really smart institutions. I’ve been fortunate. I’ve met some real leaders in in kind of we have met over the past few years. And I’m humbled that I’m able to communicate with them about what we’re doing and about how it could help to have a more mature, a more sophisticated model to treat this population. Because remember, in the back of my mind. Thirty seven year old Mark says, thank God somebody asked that question. So and so that motivates me personally. But our organizations is ultra motivated by the outcomes that we see. You know, I hear from former clients frequently and, you know, they feel so fortunate that they were able to be a part of this and. But sadly, you know, most aren’t able to get access to this kind of care and work. And that’s what we’re excited about. We’re excited to help to make that happen so that people can transform their own lives.

Saul Marquez:
Now, that’s wonderful. And so, you know, there’s a lot of people listening. What’s the call to action for them, Mark? Well, yeah. What do you want them to do? I mean, say you presented the the great solution that you guys provide. What’s the call to action?

Mark Watson:
Hey, if you work in the cognitive rehab space, in the medical space and want to learn more about transforming outcomes from a cognitive but also interdisciplinary lens, give us a call. We’re interested to partner up with other organizations. You know, right now. And, you know, we’re interested to understand what you’re currently doing and how we might be able to further standardize and optimize it. So, yeah.

Saul Marquez:
So what’s the number or Web site or where it where should they reach out?

Mark Watson:
Well, what they should do is just go to our website www.ABIwellness.com or you can give us a call. I mean, if it’s international, you can call us toll free at 18334148958 or you can e-mail us at info at abiwellness.com. We’d love to hear from you.

Saul Marquez:
Love it. Mark, we’ll definitely include that in the show notes. So, listeners, if you’re wanting to respond right away, just, you know, you’ll have a way, different ways to contact Mark and his team in the shownotes of the episode. Go to outcomesrocket.health and type in ABI wellness. You’ll see everything there, including a full transcript of our discussion with with Mark today. Mark. You know, I’m always curious what smart people like you are reading. So what book would you recommend?

Mark Watson:
I don’t know how smart I am, but thank you. I’ve got very good mentors..

Saul Marquez:
You’re the average of your five closest peers.

Mark Watson:
Well, absolutely. And this voice always tried to surround myself with people who helped to make me better. So same here. You know, one of the great books that really opened up my mind to this work is called The Brain That Changes Itself by Dr. Norman. Dr. Norman Doidge, chapter two of that book is on one of my biggest mentors, Barbara Arrowsmith Young. But it really it really shows, you know, what can be possible in terms of the brain and its capacity for positive change.

Saul Marquez:
The brain that changes itself.

Mark Watson:
Yes. By Dr. Norman Doidge. Very good book. I’ve got a lot of books on the go right now probably like you, I also love Collin’s Good to Great as well as a staple.

Saul Marquez:
Aweome great recommendations there, Mark. And one that I will definitely be reading. And chapter two, I guess you’ve made a couple mentions of your mentor, Barbara Arrowsmith Young. And so maybe another person that we should look up and learn a bit.

Mark Watson:
She’s amazing, as well as Howard Eaton, who is really specialized in that and really, you know, improvement of systems. And he’s a part of AbI wellness on this as well.

Saul Marquez:
Love it. Fantastic. Well, Mark, thank you. Before we close out our chat today, you all already provided the best way to contact you. But but what would you you leave us with a losing thought.

Mark Watson:
You know what I challenge our team to do and myself to do as much as possible is be clear on what you stand for personally. And then once once you’re there, which can be hard, then then challenge your organization to live to who you are and what you are as a team. And this is a whole starts with why Simon Sinek stuff, which I love and, you know, understand who you are, what you’re trying to do. Understand what your core values are. Be very clear on what you’re trying to do as an organization and be tenacious and go for it. Because without that level of innovation, things don’t change. And the status quo in my work. Isn’t quite doing what it could do. Well, we’re committed to that and completely and that’s what I would leave you with, is that if you work in an organization that’s looking to do something exciting, that can actually change outcomes and get clear on what you stand for, what you’re going to do. If it does fit with our space. Contact us. We want to hear from you. We can maybe help you achieve that. You can do it right? That’s the thing. You can actually do it. Starts with one step.

Saul Marquez:
It’s such a great call, Mark. And and folks take action. And you know where we believe it’s possible. And abiwellness.com is is a tool in your arsenal that that could help you take your business, your care for your patients to the next level. So, Mark, such a privilege to to have you here on the podcast today and and definitely looking forward to staying in touch.

Mark Watson:
Sounds good. Keep up the good work.

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