Category: Mental Health

A Universal Vital Sign for the Brain with Ryan D’Arcy, President and Chief Scientific Officer at HealthTech Connex Inc

A Universal Vital Sign for the Brain with Ryan D'Arcy, President and Chief Scientific Officer at HealthTech Connex Inc

: Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas, great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is slow. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

: Welcome back once again to the Outcomes Rocket podcast where we chat with the day's most successful and inspiring health leaders. Today have the outstanding Dr. Ryan D'arcy. He's the co-founder and Senior Scientist Entrepreneur for HealthTech Connex. He's a trained in Neuroscience and the Medical Imaging. Dr. D'Arcy holds a B.C. Leadership Chair in the Medical Technology and is full professor at Simon Fraser University. He also serves as the Head of Health Sciences and Innovation at Fraser Health, Surrey Memorial Hospital and is widely recognized for founding Innovation Boulevard. Dr. D'Arcy received a BSC with distinction from the University of Victoria along with his Ph.D. degree in Neuroscience. He's done a lot of training and has implemented a lot of the design and technologies in the space of Biomedical Imaging Clusters. So I'm really excited to have him on the podcast today and to hear the insights that they're up to. Sir Ryan, warm welcome my friend.

: Thanks for having me.

: It's a pleasure. So anything in that introduction that I missed that maybe you want to fill in?

: No no. It sounded great.

: Awesome. So what got you into health care,Ryan?

: I've always loved biology and I think I also always loved technology and physics. And then I'd stumbled on the brain and was just fascinated with the brain really towards when I was finishing my undergraduate degree. And from there the rest is sort of history because everything I do is using advance medical technologies to wash the brain in action and help primarily from a neurology neurosurgery standpoint but increasingly broadening out from there.

: Well it's super interesting the work that you've taken on. I'm personally fascinated by neuroscience and am intrigued about the discussion we're about to have. What would you say Ryan is the hot topic that needs to be on every medical leaders agenda today?

: Oh well the hot topic on every medical leaders agenda today I think for me it's not so much about the buzzword of innovation as more about sort of the translation and implementation of innovative lab findings. So I think the hot topic is really the idea that you know medical training really trains sort of a procedure and don't deviate from that procedure.

: Right.

: And when you have a world that is kind of thrusting on with new innovative solutions that are about you know really trying things that might be risky or new or novel or that sort of thing. The hot topic is for us as a society to find ways to embrace that particularly to find ways to allow clinicians to embrace their inner innovator and still of course be completely you know highest quality and safety and patient care, the whole thing. But really that's going to just bring so much advance so much more quickly. And I think that's got to be the hottest topic in my mind.

: I think that's a really interesting point because you know embracing that inner innovators what you call that. And I think a lot of clinicians and physicians want to do this. But to your point Ryan you're just sort of limited to what you could do because of the training. And so it be interesting to hear your insights that how can they do this better? What techniques could they use, what tools can they use to embrace and encourage their inner innovator?

: Well you know it's interesting because there are a lot of forces at work that any any clinician could tell you they feel on a day to day basis that it once you've had an idea of a wait and do something better. It's really challenging to know. Well how exactly would I make that happen. And I think it takes a lot of bravery in an otherwise extremely busy job to find solutions to that issue seeing your practice. You know there's there's an obvious innovation there's this step from identifying it to you know implementing it successfully and in a few patients and scaling it to many is really something that pulls from a training standpoint is counter to the training from the systems administration standpoint historically hasn't been something that you know you might find encouragement in universities and hospitals that are busy delivering services. That's not something that's topped their radar. So I think that what we're seeing is really interesting to watch is forces outside of the hospital system are starting to make that more possible particularly we're seeing shifts in as we are across the world in care being delivered outside of the hospital and more community care-based and much more a shift from a paternalistic model to kind of you know the patients managing their own services and that sort of thing and more kind of shifts in trends that way are actually a good thing for clinicians because it's creating a new circumstance that allows them to just sort of whether the like it or not digital health will be an excellent example have to really tackle some of these innovations. And the last thing particularly if I use the Canadian health care system as an example we just simply can't outspend our way out of the problems we're having in terms of the clinical care delivery in busy hospitals with congestion and that sort of thing. So when you bring the word innovation as a way as a new way to solve problems I think that's really helping us. And it's particularly helping us when we start to entertain the idea of you know learning things quickly in our private sector and then actually allowing them to get tested there and then make their way into our public health care systems. So big forces are I think changing things.

: That's pretty interesting that that theme sort of framed it that way,Ryan. And you know one of the things that I like to think about as it relates to innovation within the healthcare system is that, a good way to start is on the process and workflow innovations that don't necessarily directly aim at patient therapies and things like that. What's your thought process on that? Sort of just scaling from process to patient therapies.

: Oh yeah absolutely. Some of the most innovative things are the things that are the least threatening to the system and the fastest to incorporate right. So I mean with your background working in medical technologies those are what we traditionally think of as innovation and we built tradition...

: Right.

: Thought patterns around. Well then this must apply. But I absolutely agree 1,000% with you that some of the most innovative things we've done that have been rapid and had big outcomes have been shifts in in just process and low hanging fruit that were in the health care system that helped that you know not only the clinicians but also the administrators to understand where we are. This really can be an impactful thing and it can impact service delivery in a positive way. So let's learn more about it and let's try and tackle the more complex things. So I think you know viewing innovation as building a new MRI versus better public health around handwashing for example you know it's a continuum and when you tackle the ones that are more easy and obvious if you start there first it makes it easier to hit the harder ones.

: That's so interesting. So take us down a neuroscience pathway here. How can we take a look at this topic of innovation and neuroscience? What can we use from neuroscience to get better?

: Well that's my favorite area so I'm happy to take it down there. We really focus on being highly translational being highly outcome oriented. And I have a pathology of being very tangible. I only like to get involved in things I know we're going to make an impact positive impact on the person sitting in front of me. And so a couple of examples where that spin have been from on a valuation standpoint there's a huge gap in neurology from being able to do an evaluation and diagnosis at the sort of clinic side things really haven't changed that much. You know neuropsychology is done with paper and pencil testing still it's moving to computers for sure but that's not as quick as one would have hoped. Structural MRI's are still used to diagnose and evaluate you know very very sophisticated changes in brain function and you know disorders and diseases. And that hasn't really changed too much since the 80's. But if you could walk into an advanced imaging lab like mine there's a massive gap chasm between the two, right. So we focus on you were what are some practical ways we can take the super advanced brain imaging that we have in our labs and make impacts on patients that are outcome based implants and one example is a very famous when Canada was involved in Afghanistan as peacekeeper. We had a very famous case with a soldier who was there as a peacekeeper was meeting their platoon was meeting villagers. His name was Captain Trevor Greene and his job was to sit down and say "hey we're Canada how can we help. Can we help you with food water education? How can we help?" And as a sign of respect they would take off their helmet lay down their side arms and a young teenager who was working on behalf of the Taliban came up behind him and varied in axe into the top oh his head.

: Wow.

: And that's a very well-known story it happened 10 years ago actually over 10 years now 12 years ago and we started working with Captain Green because he was making astonishing goals in proving that his outcome was not predetermined wasn't a false hope case. In fact you know he not only recovered phenomenally from a coma and a whole lot of complications at a hospital but ultimately started a goal to recover his brain function to neuroplasticity and return particularly the ability walk and where the axe had struck impacted a lot of his critical areas of his brain for walking. So what we did is we used advanced imaging techniques that exist and were pretty cookie cutter to be honest a technique called functional MRI where we could map the active areas of his brain. Well he was undertaking his own home rehabilitation and we would just take these advanced pictures to show that his brain was rewiring, neuroplasticity was engaged, and he was recovering his function beyond any expectation. That was really fun. Back to your point of process and practical because what happened was we could show a picture and you know that expression a picture is worth a thousand words. Well tissues were made many more I think. And that when the clinicians would see that it was really motivating because they could drive harder to rehab and Captain Greene and his wife would drive harder and try and push further and we could also narrow the treatments so we could be more specific to what functions were trying to help with. And as a consequence of that over the last decade really he's made leaps and bounds into uncharted territory in recovery and he's inspired countless other brain injury survivors with his story and his journey and so much so I think the world knows about the Invictus Games which were recently held in Toronto and he actually opened them with Prince Harry and Derek Hansen and inspired people across the globe with his recovery. Thirdly as an outcome. And I loved that to point this out because his outcome as the hospital system had determined was to put them in a care home and his wife and child would get on with their life. Now he's training to climb to Everest base camp and we're using...

: Amazing.

: Technology to do so. And you know he's since had another child and is basically out there inspiring people to recover from brain injury. So I think that innovation doesn't have to be a new fancy you know high tech MRI although we love those. It can be something as simple as realizing that you can bring the power of something that's in the laboratory in an innovative clinical way to help drive an outcome. And I think that's what it's all about.

: Yeah that's so neat and what a great story I hadn't heard the story of the soldier and it's an amazing what you guys were able to do with some of the techniques and images now available. So walk us through some of the potentially things that haven't gone so well maybe a setback unnecessarily with a patient but maybe something that he tried implementing that maybe didn't work as well as you wanted it to. Something you learned from that.

: Well I approach this with a long game approach so I assume that it's going to be a tough go and that there's going to be it's not going to work out quite as easily as you think. And as General I always if I hit a barrier, I move laterally until I find a way through and just don't give up. So I get you know the innovation across the line and certainly that best example of that would be that when I started my training which I won't tell you how long ago that was. But it was long enough ago that we knew the record brainwaves and that could be used for both potentials to diagnose neurologic conditions so auditory evoked potentials some visual of potentials they're used in a number of different. You know if there's a question about multiple sclerosis or you know if there's a hearing problem versus something more central and that sort of thing. So these were well established clinical tools but yet in our laboratories we had these powerful capabilities to push that farther up the chain and evaluate higher level brain functions cognitive functions and that sort of thing. And I remember when I started my training being told that well those are too unreliable that'll never be in the clinic. And I guess that didn't sit right with me and it turns out that you know in the past over now two decades I've worked to solve that problem and that's come with some setbacks for sure. So the first attempt was really to do research that showed that when we did these cognitive about potentials you could overcome a lot of the problems with neuropsychology that are completely reliant on a subjective behavioral response. And the problem with behavioral response is that if you have a brain injury or brain damage or disease, you decouples your brain function from your behavior. So automatically your behavior is not the best way to go about finding out how somebody is doing inside. And one of the best examples of that is for people to really understand would be something like if somebody was locked in if they have Lou Gehrig's disease it would be an example. Then their brain is perfectly intact and healthy in terms of cognitive function it's just they cannot respond behaviorally and this is a problem that really stymies a lot of evaluation right at the beginning of your critical care decision making process right. Because you can't really tell us when is a function. So our goal was well maybe we'll just use these objective physiological brainwaves and electrify as it were neuropsychology challenged with that was that we made we made a lot of progress in the laboratory but it wouldn't necessarily translate easily into the real world in ways that neuropsychologists could you know switch over what they were doing and you know all sudden record breaking news. Then we moved to the idea. Well we know about the Glasgow Coma Scale and when somebody comes into the hospital Glasgow Coma scale is one of the sort of metrics that are rapidly used to assess the level of functioning. Can we do the same thing as the GCS but replace a subjective and error prone. And just to give a scary statistic that literature shows that it's actually misdiagnosing as high as 43%. So when you landed in E.R. and you get a CS basically a 50/50 chance whether or not the care team knew what that actually meant. So could we just upgrade...

: Pretty low and worth investigating right?

: Yeah, yeah. So we upgrade that with brainwaves, write and record and you know do the same thing where it's it's fast it's easy to communicate and do it at point of care but instead of using these large object brainwaves. And we've done that with patients and we've done it across the country and we created actually a technology version for that and around that time, the epidemic with concussion and increasing concerns with dementia broke out. And one of the setbacks there was that as a deployed sort of unit it's not a very big market size for people who are in let's say vegetative state. So the business world doesn't want to take that as a product because not necessarily a large market to make money out of.

: Right.

: What we focused on was we stood back with saw what's the bigger problem if this concussion is coming up and that's our thing and it occurred to us that actually what's missing is you don't have a simple vital signs or brain function and you can have and look at all the vital signs you have and how important they are and how you know things like cardiac risk factors have been informed by vital signs and how ubiquitous they are and without human goodness we've got to change that. So what we did is we we finally stepped back from that setback to create a framework we actually reverse engineer from bloodpressure and said okay well how did we get blood pressure how can we extract from EEG, a vital sign framework so we could have a simple vital sign for brain. And so for the last five years we've successfully done that and we put it into a point of care completely automated device that...

: Nice.

: Happens in five minutes. And we've used that we use that now routinely and nurse our skin up. To have a unique fingerprint for concussion. We're working in care homes with dementia and a number of other applications just to provide if you can believe it. Finally hopefully we're successful the world will have a simple yardstick for brain function so they can establish a baseline. Find out how a treatment works. I know what's going on. Find out if there's rapid cognitive function deterioration and that's sort of, so that is kind of it started with setbacks but because you know we're tenacious we just stayed at it to try and ultimately refine it to something that hopefully will be very impactful clinically in neurology.

: That is fascinating and great that you guys stayed with it because I mean it sounds like we we are in desperate need for something more accurate and a good baseline and as it relates to the topic of delirium for instance this is an increasingly sadly topic that comes up more and more you know delirium after surgery. How would it help with something like that?

: Yeah.

: If at all.

: Well it does. It's interesting because in neuroscience we're always trained to focus on kind of the condition. Right. So you know you can...

: Right.

: Be a dementia researcher or you know an epilepsy neurologist or what have you and effectively where I really love that technology angles and the medical imaging angles it's cross-cut. So delirium definitely applies because effectively if I have a yardstick that I can take an objective measure quickly of what your brain function is my favorite question to ask is "Do you know how your brain is today? Do you know how was the day before and before that and if you don't...".

: I don't know.

: How are we possibly properly equipped to manage your brain which when you think about it is scary because one in three...

: It is.

: In statistics you know have something go wrong with the brain in their lifetime so you only need three people in a room and one of them will be affected. But it's also scary because we all I mean that's the seat of who we are right that's what makes our money, it's our soul, it's our spirit, it's our consciousness, it's our personality. So if you don't have so much as a baseline of what is going on, when you come out of surgery and there's a question about delirium you have nothing to compare it against. But if you have a brain vital sign you can measure your brain by a sign during surgery you can measure it and if you see an issue can detect it against your baseline and after there's a question you can say with an objective and physiological measure, yeah we actually think there was a change in and that's kind of what we're trying to go at. So it would apply frontally and...

: Interesting.

: Applies to concussion. It will apply across all the conditions rather than just focusing on solving concussion which I think is a silly question because I don't still understand what the answer could possibly be for that question.

: Yeah I think that's super interesting and thanks for expounding on that I was able to wrap my head around the whole topic of you know this vital sign having a baseline comparing it to pre and post events, pre and post procedures. Definitely see the value of having something like this. If the listeners were curious and wanted to learn more by your work and the things that you're researching, where could they find that?

: Well I have a pretty good presence on the web so they would find it through our company health techniques for sure. There's a lot of research articles so we have a lot of scientific articles that are published on this that are and we type. We're really trying to publish in open source articles now so that are accessible so that frontiers in neuroscience has the actual science published behind this as does translational science articles that came out this year. Yeah and other than that I think there's a number of media articles that have been done so I certainly would suggest google would be a friendly start point for that.

: Fascinating. Well there you have listeners. Take a look at Ryan has done some pretty interesting work and just google him, google his work. Check out their website and you'll be able to find more. If we talk about today doesn't necessarily satisfy you fully because the nice thing is that these episodes are 25 to 30 minutes long. The thing that is a lot of people wish is that they were a little bit longer when topics like these come up and they're super interesting so tell us a little bit more about an exciting project or focus that you guys are working on today at the company.

: Well it's certainly our our lead goal and our very exciting project is to bring vital signs to a world wide so that's our our major focus. But we actually work in a district called the Health and Technology District which is embedded with actually not only Canada's busiest hospital in the world but I think it holds the North American record for most emergency visits and a model we work in in an environment that has a high volume hospital and we built an entire technology sector health and technology sector within the campus of that hospital and within that it's just beautiful fusion of bringing together not only your clinicians who are identifying our problems and we're trying to solve them with technology solutions. But you're scientists from our universities and also your business and we have a whole ecosystem of businesses that have our technology solutions that we try to bring right into our clinical environment. So that's probably one of the most exciting things is that we've tried to lead by example with our technologies and brain but also create an ecosystem that allows this to be a sustainable model that people can replicate and utilize. You know join and partner with. And so we spent a lot of time partnering across the United States, with Israel, Europe and as a consequence of that is kind of interesting because what are the answers to your question is when you have the yardstick for brain function and you can objectively measure this one of the cool sort of outcomes is a lot of people come your way with treatment solutions because they want to see if we can measure better whether or not their treatments are working. So we've just entered with a company quite closely named Helios which is a U.S. company that's taking a device called Parnes which accelerates brain plasticity and recovery from brain injury and we've done clinical trials with them and have been working scientifically with them to evaluate this completely non-invasive, nondrug, non-surgical technology, for accelerating recovery for not only concussion but other brain injuries. So it's been really fun because effectively we're really starting to see the most advanced neurotechnologies in the world are making their way to us into this ecosystem and being able to validate them implement them in patients and help them scale up and get across the globe.

: Super exciting yeah. Didn't even dawn on me but that's such a great application of this right. The whole validation piece and all these companies with solutions to brain issues very very exciting and kudos to you and your team for developing the foundation of what's to be in this brain function space.

: Thank you.

: So talk to me Ryan. We're getting close to the end here. We've reviewed a lot about your work the things that are going well. Lessons learned in this in this part of the podcast. We go through the one on one on what it is to be successful and the business of health care and so I've got four questions for you lightning round style followed by a book that you recommend to the listeners. You ready?

: For sure.

: All right. So what is the best way to improve health care outcomes?

: I think by focusing on implementation too much has focused on which is building without focusing on a problem and finding a solution you can successfully implement and see that it works.

: What's the biggest mistake or pitfall to avoid?

: Definitely the biggest if you're coming from a clinical point of view the biggest pitfall to avoid is not being open minded clinicians are overwhelmed. And a lot of times it's too easy to dismiss the aspects of innovation and it takes too much work and finding that extra time to investigate and explore allows you to actually improve outcomes just by being you're embracing or clinical endeavor.

: I love that. What would you say an area of focus of your organization is the number one area of focus?

: Oh you are, you know the term BHAG? Big Hairy Audacious Goal. We want to absolutely end brain disorders and diseases. We want to make them a thing of the past.

: I love it. And what would you say is the way to stay relevant as an organization despite all the change?

: This relates to the book I'm going to suggest you accept a changing world and I just finished a book which is Great by Choice and it analyzed all the companies that succeeded in spite of changing and came up with a couple of key factors. One was that either a company or person who succeeded and thrived in an always changing environment was extremely good at three core things. One was being productively paranoid and always looking for things that could be problems or come up with solutions. The second was being using evidence and being very internally driven. And the third was disciplined and being incredibly disciplined. And then when you combine that with motivation Stage 5 motivation sort of stuff those people can succeed in highly changing times and I think that that applies more so than anything to health care outcomes. I think that recipe and that book are really well it's born out of the business world I would highly recommend it for any health care.

: Amazing, what a great recommendation and a good framework to consider folks who could get all the things that we've been discussing today. The entire interview transcript, notes, and takeaways, and links from the podcast go to outcomesrocket.health/darcy. And as Dr. D'Arcy here and you'll be able to find all that there. Before we conclude Ryan I'd love if you could just share a closing thought and then the best place for the listeners could get in touch with or follow you.

: Oh absolutely so the best place to follow me would be through either health techonics or the health and technology district both of which have websites and are on LinkedIn and Twitter. The terms of my closing thought I would suggest that tackling the brain is really, really rewarding because it's scary and it's on the outer edge. It's complex and it's something that you should be scared. Because if you can make success in something like that it means it's optimistic you can make success. If I can make successful outcomes you know complex brain injury patients. It means that any problem that comes our way in health care, there should be solutions that we can find and it just takes guts and I think that health care innovators are the people that are going to change the way that we deliver our outcomes.

: That's so interesting and I think it's a great challenge for you listeners. So make sure that you keep your mind sharp and stay focused, stay resilient with whatever topic you've decided to tackle within health care. So Ryan it's been such a pleasure to have you on. I'm excited to get this to the listener so that they too could get that inspiration that you are just spreading across your medical facility and all the people's lives that you're touching. So thanks again for spending the time with us.

: Well thanks Saul for inviting me and for having me. This was just delightful.

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Making Digital Delivery For Mental Health Improve Engagement and Outcomes with Ken Cahill, CEO at SilverCloud Health

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. Today I have an outstanding guest for you today. His name is Ken Cahill. He's the CEO at SilverCloud Health. Ken comes from an entrepreneurial background with experience in product and sales strategy, financial and channel management while holding senior roles from a successful career covering H.R., software, e-commerce, telecom to banking, atm solutions. He's extremely passionate about how technology can be used to provide meaningful positive impact on people's lives. He's worked with a number of large multinational organizations such as Gateway, HP and Dell and Europe. The U.S. and India. Ken is super passionate and knowledgeable in this space and he is focused hyperfocus in healthcare now at SliverCloud Health. So it's a pleasure to have you on the podcast Ken. So glad you could make it here to join us.

: Also thank you for the invitation to come on a long time listener for some color.

: Hey. Thank you so much. And so what is it that got you into the medical sector to begin with Ken?

: I think it was accidental in a lot of ways but from my perspective. I met with some of the team behind SilverCloud back in its very early days when it was still a research project and the I'm thawn way with by the team that passed the team that the approach they had taken to a very difficult topic a very difficult situation in terms of what mental health culture has been and the transformation that was beginning to take on in terms of stigmatizing of the Tippoo slowed European reboot from a from kind of what I would refer to. I've often referred to as a highly medicalize family, an interesting cross-section of chronic diseases such as genetic diseases that have passed since my family but my mom was is was a nurse, midwife and a pediatric. So grown up an icon a health care background.

: That's supercool.

: Yeah it is. That being said my wife will often complain how the sympathy levels are quite low for any injury that she sustained compared to the level of sympathy that we would have gotten when we were kids at home due to the fact of the exposure to diesel or sensitized so moving the team. It was very clear the approach they had taken was something quite new. From what I see and you know mental health is such a significant economic and social need for us for improvement. So that was really what got me interested in healthcare and you seeing personal family impacts by mental health I think there's very few people that would be around today that would would have been actively affected by their close family members and can affect their mental health in one way shape or form.

: Yeah I think that's so great. And recently we had our interview with a physician out out west. He has you know he's an Anesthesiology Pain Physician and big approach that he's taken with his pain patients is a mental health approach. So definitely a spillover effect is huge as you and your team look to tackle this space. What is it that makes you guys different?

: I think the team makes us different. I'll be very honest. And you know the approach they've had to what we're tackling the approach that we've had to a small thing but we don't refer to the users on our platform as being patients we would unless we have to for the customers to understand who we're talking about but we will refer to them as clients. And the reason for that is we don't load on to terms of stigma. And also the fact that we need to treat them as being customers of what we offer. So we know they have alternatives. We know that they have alternatives in terms of healthcare in terms of utilization usage all the rest of them we're competing with other parts of their lives in terms of how they can go and watch television they can go on YouTube or Facebook or anything else like that. So as a result of that we need to be cognizant that we think give them an experience that is impactful positive and engaging for them. So that has cut us with the big parts.

: That's awesome. And so you guys are working with a highly specialized team. You're creating some very interesting solutions to tackle this problem or mental health. How would you say and what would you say a hot topic that needs to be an every medical leaders agenda today as it relates to mental health?

: I think fundamentally mental health is the reason that you and I and the listeners got up this morning. That is what it all boils down to. Mental health is the reason why we do or don't do anything ion this life. Everything is behavioral related in some way shape or form. I don't sort of wax lyrical on statistics but the CDC would estimate that one in four of the global population will have a noticable mental health disorder in any given year of their lives. So that's couple things as one of four of the population that is globally. So that's you know pulling out or ruling things around know conditions are there so that in any given year or somebody's life. So as a result of that it's a very very significant. We then even add in issues around chronic disease and the numbers then increase an even more alarming rate. So something else inverted commas as normalized as say diabetes care diabetes you're going to see the prevalence rates there increased around 45 percent of people who have diabetes who also have comorbid challenges around clinical levels of depression, anxiety or stress which is impacting their health care utilization, the medication adherence, their compliance all those kind of key factors which as management or executive level or or other within a health system that's impacting how we deliver care, why we deliver care and all the other elements that are there and then we look at the cost multiplier within reported him from Medicaid for delivery of a patient and he serves me it was around that it was around nine and a half thousand dollars to deliver care to a patient with diabetes in a year. But if you brought in the comorbidity which remember happens almost one and two times what 45 percent of the time in the comorbidity you're looking at that cost multiplier bringing in the cost up to about thirty six thirty seven thousand dollars a year. That's a huge increase. Huge difference in terms that you then include things like cardiovascular disease, oncology all these different elements and I you know I grew up in a kind of family environment that kind of said you know a will is stronger than any medication and was that's not backed in any scientific basis of course not. There is an element to that in terms of the positive approach acceptance and sort of the adherence but also the anxiety of communication with the clinician. You know even something like diabetes looking at things like sexual health impact that can have a family and also things around guilt and shame, things around it. What are the long term impacts of this disease and condition on my life or my parents issues mortality and other things like that. And then also looking at you know for every one person who has a has a chronic disease centre they're typically surrounded by up to six people who are severely affected by that. An example would be our wife with breast cancer and you know that the husband who is severely affected by that or other types of issues like that. So again mental health is such a huge component to unlocking chronic disease. I think it was time in Salt Cellar before that you mental health can have a bigger impact on somebody's health and a more significant impact on somebody's health. And a thousand different sensors. I think that's that's that's very true. So that's the part of what I do and have been doing for the eight years that gets me excited is the impact that we're having of people's lives. We see the impact we see the feedback we thought there was a platform now around 180000 patients since 2012 since we spun out of research. I see some other quality feedback not just constant. And it isn't just that it is about pulling people back from the edge saving people's lives and saving their marriage and all the other elements like that and I kind of mentioned in the intro. Thank you for that. But that's quite different than banking software and hardware software.

: Huge. And you're making some really positive impact in this space Ken, you and your and your team tell us about that platform. Who uses it and what does it do?

: Yes certainly. And so what we have developed sort of spin out from well over a decade of research and that research was coming was bringing together a number of kind of key opinion leaders in search of better experts. And I suppose looking at the big question that was there from the research was looking at the challenges that are there around delivery of digital delivery of mental health and how I suppose effectively there are a number of barriers that limit the level of effectiveness that are there and those barriers are around high levels of client or patient drop rates low levels of client arrangements and limited levels clinical approval. So essentially digital delivery for mental health hadn't worked up to that point and still argue another time still isn't working in terms of those kind of 3 criteria. So that was the overarching question behind. And that's I suppose a research thesis behind Superflat. So what the team did was they developed a platform that was focus on those engagement pieces so core was engagement and all cost and you know how were the key part of measurable change because of measurable change from client perspective. So the team builds a platform which will focused on both the engagement and the outcomes perspective. And we knew that if we could keep them engaged long enough and deliver the right content and supportive tools to them we could help them in a meaningful way the material way. So to an unfairly boil 14 years plus worth of research down we built a platform the team built platform which was the concept of set aside P.S. that was highly applied from us highly social highly interactive highly personalized and highly supportive. So it's kind of for the four pillar elements that the platform is built on. So from a patients perspective from the client's perspective they get access who is online environment that is essentially a digitization of what you would do within face to face therapy or care using text, infographics, audio, quizzes, videos and other typical content that you see to triple effort or live in an online environment accessible on multiple devices like your tablet, your desktop dedicated apps also on a smartwatch device those kind of things that multiple different interaction and touch points with it. And essentially what is designed to do is use core intervention style will be what's called cognitive behavioral therapy and that is really focused on kind of the executive function of the brain how we have you how I or anyone else will we take in information processes and we sort of you know we create an almost outcome or a reaction to it. And often what we can do is we can we can take information in and often we can run more or less of brain with computers and often will do in the wrong way. So catastrophizing or or negative thinking styles or any those kind of elements which can which can kind of spiral down a negative spiral in terms of how we take information in process and then sort of react to it in terms of a physical reactions or how we react to it in greater parts where it lives. So I as as a client will have access to the platform. I could be introduced to it by you know my primary care physician you know see secondary care specialist care like OBGYN,new and expect mothers all the way through to within healthcare organizations to amuse themselves for their own for ease for physician burnout issues and other big issues like that.

: That's fascinating Yeah. And you guys are even helping providers with their physician burnt out disease.

: Yeah well if if we look at it from the perspective of a lot of these large health systems we'll be self-insured. And also these are employee population as well. So it's almost double that a double impact in terms of that population group insofar as they have to pay for the health care costs of that group but also they're getting impacted in positively absenteeism presenteeism issues and challenges as well. If they don't react and also they're going to see a higher level of cost if they don't react in a timely way as well. So as a client I access the platform over typically a kind of six to eight week period of time anywhere from 30 to 40 minutes per week and essentially in doing so learn in kind of about those couples are behavioral techniques to help me to sort of have and build that kind of toolkit in terms of how I how I process the different kind of parts of life. So we've built on the platform a highly engaging platform we've built our programs that 30 programs over 30 programs across mental health like depression anxiety stress all the way through to chronic disease programs. Programs around diabetes, cardiovascular disease, pain management, COPD and those programs are looking at the comorbid psychological stressors and challenges that are there with the chronic disease as well. So the platform itself and integrates within the health system within the electronic health record. It mirrors the care protocols so becomes not a tangent to care because something that's get very integrated and that's one of the key steps that we've done it becomes very integrated within the healthcare delivery. Not a poor cause and oath but a very credible first port of call to you know that's where we've grown. You know we've over 210 organizations using the platform today across five countries and we've overcome all the sort of challenges along the road of how we embed how we connect with you know to borrow a sales force or come expression you know that what they have done around customer success so how do we make the healthcare organization really feel and be successful with using SilverCloud so you know the patient satisfaction scores, the outcomes acceptability, the usability of it. All those elements are all those boxes are being ticked.

: Ah super interesting. Thank you for sharing that Ken. Now can you share with the listeners a time or a setback that you guys had and what you learned in this process?

: I think you don't have multiple setbacks along the route of the majority like Lakewood or any part of any part of life. And I suppose you know there's an expression a mechanic on his or her car a cobbler and his or her shoes so in the sea of mental health company I kind of have to pertainto be whiter than white in terms of my mental health. But yes I think following an entrepreneurial journey it's difficult, it's challenging and you know some of the work that I'm trying to do in the back and the sideline as well is sort of support him a very heavily exposed thing that you're doing here. You're putting yourself out all the time trying to raise funds and having you know 99 percent of all the people you will talk to will reject you or almost reject you in some way shape or form. So it's always always a challenge to part. And I think for you know if I go back to that kind of positive feedback remember we had hired a member of the team and they have agreed and accepted to come on board and that unfortunate decided not to join us. And you know that was after a lengthy recruitment process and it was a shame. One of my colleagues James sent me over some of the quotations some of the quotes some of the feedback from the users of the platform and some of the impact that we were having day in day out and that was kind of enough to kind of say you could push yourself off and off you go. And I'm sure we've had a lot of challenges. Much bigger and much greater than that but that's always a stand out moment. It really made me understand that while we were doing was different was different than what I had done before that this was stepping into people's homes. It was impacting people, their families, their communities, the workplaces and how we were being contacted now by cities, by state and even by countries who were looking to improve the mental health of their own country. Some are looking to provide something that is a safety net a catch in terms that interventional mental health around clinical and an even more severe level of depression or distress. And then all of these large organizations, large bodies of populations and swathes of people who are looking for the positive mental health side. So things around resilience, coping skills, relationships in this sort of fast moving environment and world whereby we're constantly being connected we're also can challenge where our brains are on an awful lot more of the time than they probably were 20 30 40 years ago maybe even 10 years ago. We're seeing a lot more people looking for an ability in a way to compartmentalize why into town and why wind up at the start and at the end of a week.

: I think that's super fascinating Ken and appreciate you sharing that it's tough I mean when you're in the process of hiring somebody especially a critical role you pour in a lot and that have had that person not respond and not take the role. I'm sure was really tough. I've been through that myself. It's not fun and it's wonderful that we have a team like you do colleagues that are there to remind you of the purpose and you get to remind each other you know. And in a message to the listeners don't forget about why you're doing what you're doing specially in those tough times.

: Yes absolutely. You can kind of become so close on yourself that you forget what you are doing and why you're doing it. And I think often kind of the position that I have maybe it's the personality that I have as well as I can often be too even a kill to not to swing low sweet high in terms of reaction that you have to be a steady ship. And after what happens then is the positive maybe flyby or or cause overpass a little too often in terms of the progress and it's only when you maybe talk to yourself her or even other people who maybe I haven't spoken to in 6 9 months 12 whatever it might be and they kind of are asking for an update or how you guys are doing. And you're gonna able to you know talk about the numbers the impact the outcome. So we're seeing the platform now on average across our and of 180000 users clients or seen seeing about 81 percent. We'll see a clinical improvement.

: That's huge.

: Yeah which is just for me is phenomenal. Now is the be all end all of what we do. And no thank you. And this Congress for the team it's the there's also the humbleness as well. You know we're all will all admit fully the whole team right across the organization. So we know something we don't know everything. No there. And there's that humbleness of continued research so we'd have 20 different research trials running today depress the world here in the U.S. and Europe, the UK and also in the likes of Colombia and Argentina. So there is that acceptance of it's wonderful what you know so far. But don't forget that there is an awful lot more that you need to learn and I know that is terrible but it's often it's often forgotten that it's also celebrate the winds as well.

: That's awesome. Yant can no doubt you know there's so much left for us to learn especially in mental health. Up to this point. What would you say your proudest experience to date is in what you've been doing at SilverCloud?

: I think the proudest has to be the numbers. So we have a couple of large screens in the office with US the UK and Ireland which is one here in Boston and we've had screens up in the office which are essentially a dashboard which will cover things like you know how many users clients have come on and then there's just one very large number which isn't a fun size only one very large number on the screen which is a number of uses that we deliver the platform to the number of clients so far. Just seeing that take over seeing that go when we have every time it's over a sort of milestone number if you will be fifty thousand seventy five or hundreds all the way through to 150000 we try and mark the occasion whether all the team will go out at lunch or even grab a beer. We don't start pause and reflect and kind of on. That's pretty cool. That's pretty you know and that's kind of one of the that's for me is is the kind of that that the single proudest moment that I've ever had has been kind of always around that number showing that impact and then seeing over time the number growing and the pace that the numbers come in. So we all will hit north of 280 thousands clients or patients delivered by March next year. So we're just accelerating off. And you know what are my other colleagues Karen Teralba lines from that interview that she did before you know medical school was that for me and for anyone who has been but I'm very proud by the number that we have in the organization we've probably delivered more care in a shorter period of time than perhaps we could have if we all became trained as charters which is kind of a kind of humbling.

: It really is. Kudos to you guys and folks. A couple notes here from Kenz share other screens and his and his offices in Boston and London and Ireland is that you've got to measure you've got to have optics to know that you're moving in the right direction and to you've got to celebrate those winds when you get to that end point. Celebrate it. Don't just pass it and go to the next one on Thursday. And can you guys do such a great job of that. If he had right now what's an exciting project that you're working on within SilverCloud health that you want to share?

: That's another part of it. It's humbling to see some of the projects working with some of the organizations that are not to be too dramatic but some of the names of organizations that we're working with. I would have killed just two a number of years ago just to get a chance to talk to them who have kind of approached us or are looking to work with on some on some really exciting things around it. Either data or digital delivery or sensor technology or whatever it might be just so much stuff that makes me really excited but in terms of product to talk about I think it's going to sound boring and cliche but for us it's about scaling, it's about process element. It's about making the organization you know the old clichés succession management but it's about making the organization so bigger doesn't it no longer resides in my head or in other members of the team we're in our leadership teams heads or anyone else at that SilverCloud is bigger than all of us. And that for me is something that is very humbling but it has its self living it has its own heartbeat it hasn't some ability and that's part of the culture. So the products that we that we do is around measurement as you mentioned around the measurement of impact that we have across the content we're delivering the platform the clinical delivery and of course the kind of commercial impact that we have with the organization. So that's one of the biggest one the biggest projects that we have is is really continuing that scale as we bring on more and more organizations or more users. Is that kind of automation that sort of scale automation but without losing the touch points that can a feeling of almost sort of boy club service or organizations hopefully will say back to me when you ask them in terms of working with us.

: And it's pretty great and big reason to be excited about. Now we're getting close to the end here ken. This part of the podcasts I've got four questions lightning round style for you followed by a book that you recommend to the listeners. We're going to do a little syllabus 101 on Mental Health with Ken Cahill. So hooray for it. Absolutely. All right. Let's do it. So what's the best way to improve mental health outcomes?

: I think if you can still boil it down what is an outcome. I think the outcomes have to be measurable and you can't argue with numbers. So having a measurable and making sure that it's going the right way.

: What's the biggest mistake or pitfall to avoid?

: I think the biggest pitfall to avoid is taking yourself too seriously and kind of being closed off from what's going on outside?

: It's great message. How do you stay relevant as an organization despite constant change?

: I think the changes you say is constant. I think having that level of humbleness you know you're right every time you put the best effort forward nobody has all the right answers but humbleness are going to ask the end user that the clients the caregiver the health care coordinator kind of be open for that next little spark of genius that might come from a conversation rather than kind of being head down stuck in a box behind the laptop or whatever it might be like giving up and getting out there and trying to evolve.

: Ken, that's such a great message you know I feel like a lot of us as healthcare leaders we could get pretty stuck in our tracks and we could pass by our coffee, or a grocery and we're not going to smell the coffee we get to smell the coffee and be open to those insights.

: Surely.

: That's a really great message. Finally what's the one area of focus that should drive everything in a health care organization?

: I think that's kind. If banks that feeling of treat a patient as a client or a customer a problem for us they have alternatives in terms of care don't think they have over alternatives in terms of usage of distractions and their lives are human and they have human behaviors. So if we were talking about retail, we could look at how can we possibly improve so I think within healthcare I have to say as well.

: Awesome. What book would you recommend to the listeners as part of this syllabus?

: It's less of a mental health book perhaps with elements so a lot of elements of health and mental health illness and possibly a reason the old classic. Richard Francis Losing My Virginity. I think it's just a classic entrepreneur business will struggle get beaten up back at it again and stay in the boxing ring type book that is one that you can kind of pick up read and then read again in six months time and still love it even more every time you do.

: That's awesome. I had not heard of Richard's book. I'll definitely be adding it to my list Ken. Listeners you can go to outcomesrocket.health/silvercloud or you'll be able to find the show notes transcript to our talk as well as a link to Ken's company and all the things that we've discussed can here to the end. We'd love if you could just share a closing thought. And then the best place for the listeners to get more information. Our follow you.

: I think closer to home for me has to be you know borrowing a slogan from from Nike it's just do it. Just keep on doing those terms of innovating terms of helping improve health care and healthcare delivery say in the boxing ring. As long as you can. They've got to be. It's got to be my one. In term of contacts. Always happy to talk to anyone email address is ken.cahill@silvercloudhealth.com and thanks for the opportunity Saul.

: Absolutely can and looking forward to seeing what you guys do here in the next year. Getting that name a 280000. Excited for the things that you guys are doing for patients but clients in the health care space. Thanks again for taking the time to be with us.

: All of us Saul. Thank you.

Hey outcomes rocket friends thanks for tuning in to the podcast once again. As a leader in healthcare you have big ideas great products a story to tell and are looking for ways to improve your reach and scale your business. However there is one tiny problem. Healthcare is tough to navigate and the typical sales cycle is slow. That's why you should consider starting your own podcast as part of your sales and marketing strategy at the outcomes rocket. I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for and the same thing goes. If you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level meaning that the number of people in healthcare listening to podcasts is small but growing rapidly.

I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomes rocket health slash podcast. Check it out today and find a new way to leverage the sales marketing and outcomes of your business. That's outcomes rocket health slash podcast.

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Recommended Book:

Losing My Virginity: How I Survived, Had Fun, and Made a Fortune Doing Business My Way

Best Way to Contact Ken:

LinkedIn: Ken Cahill

E-mail: ken.cahill@silvercloudhealth.com

Mentioned Link:

SilverCloud Health

Episode Sponsor:

Science and Monks Show That Wellness and Mindfulness Contribute to Healthier Living with Charlie Hartwell, Operating Partner, Bridge Builders Collaborative

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the outcomes rocket podcast. Hey, I'm super excited to welcome today's wonderful guest. His name is Charlie Hartwell. He's a change agent, passionate about using his talents to create innovative, sustainable global change. A Harvard Business School graduate, Charlie's helped use his leadership skills in 14 different industries to help build global movements and industries. He's currently the Operating Partner of Bridge Builders Collaborative, a group of highly successful business people who've been the leading investors in the mine training space for the last seven years. He's led teams organizations and brands to incredible results through collaborative and authentic leadership style that utilizes each person's gifts to attain the stated goals. He uses practical wisdom developed through working in many different industries to bring fresh perspectives and models. And now he's operating within healthcare. So I really want to give Charlie a warm welcome to the podcast and have him fill any of the details there in the bio that I may have missed. Charlie, welcome.

: Hey Saul, it's great to be on Outcomes Rocket podcast with you. I don't have anything to fill in from what you said but I look forward to the discussion.

: Awesome. Yeah me too. I'm really glad you carved out some time for us. Now tell me Charlie you've played in a lot of different industries. Why did you decide to get into the medical sector?

: Actually I'm going to credit my wife for getting me into that sector.

: Really.

: Yeah she's been a she's a social scientist has been involved in integrative health care. She's been practicing meditation yoga for 30 years and she got us involved in something called the Mind and Life Institute. Several years ago and then she introduced me to the Mind and Life community. That community really led a lot of the science behind things like mindfulness and other contemplative practices that the science behind all of that kind of coming into the mainstream. So she introduced me that community and through the connections I made there. I met partners. There were three at the outset who were forming the bridge builders collaborative. But that's where I met them was in that community.

: That's pretty cool. And so the Mind and Life Institute sounds pretty interesting. What's the focus there?

: So thirty five years ago to land neuroscientist named Francisco Varella, a Stanford MBA. They may at a mangle and the Dalai Lama got together because the Dalai Lama knew that in order to prove what easterners already knew in their hearts is going to have to prove to Westerners through science. And he actually said you know had he not been the Dalai Lama he would have wanted to be a scientist. So he began to encourage people to do research around in their mind printing practices and you know the early years actually a lot of those scientists put their careers on the line studying crazy things like meditation or math. But then after 30 years 35 years you know another hundreds of studies every year. So the Mind and Life Institute is sort of a community of probably more than 10,000 scientists around the world that are studying contemplative practice and ethics and that's where it's got its start.

: That is fascinating definitely something that that I'm going to check out Charlie and listeners the times are changing. Back then 30 years ago it was crazy it was like sort of hippy dippy thing to do. But I think now the whole wellness part and meditation has become more common place and maybe thanks to Mind and Life Institute and others doing these types of things. And Charlie it's pretty cool that you met your partners there and now you guys are rocking and rolling with your business. Can you tell us about what you think a hot topic that needs to be on every medical leaders agenda and how you guys are tackling it?

: Yeah. So I think that our society has looked at the health care system as a place to go to get solutions that are outside of yourself and what science is proving and what some of the companies that we're involved with are proving that maybe some of the answers are actually inside of yourself and that maybe through changing thoughts and stories and through contemplative practice through different forms of brain training that actually we don't need to look outside of ourselves for medical solutions. There are some things that we can just look inside of ourselves and actually begin to develop skills around mind training that will do things like decrease our stress or help. If we're facing depression symptoms or anxiety or many other types of medical conditions so that I think is something that's still kind of revolutionary to think that some of the answers to our health care problems are inside of ourselves versus outside.

: That's pretty interesting and Charlie you know I think at the beginning you highlighted this difference right. You brought about the idea that in the East people believe it in their heart but over here on the west we need to see it in their research. So a lot of that is maybe coming from this belief here is it intuition what is it that brings about these answers?

: Well that's a good question. I think the first thing that's kind of what I'd say is sort of the gateway to all this is that in the medical system what I hear reported is that 70 percent of doctors visits really are around stress in the world that we live in where we continuously are bombarded by all different phones and the television and our computers and all of these different devices that actually we never get into a place where we can call our minds. So even you know taking 10 minutes a day and learning to sit in a quiet place and even just observe your thoughts can really help people to get into a place where they feel less stress throughout the day. So I think a lot of people think that's pretty hard but it's actually a pretty simple sort of first step to getting to take more control of your own healthcare situation.

: I love it. So you guys are working with a lot of different companies. I think one of the ones that many of the listeners have heard of is news the brain sensing headband but there's also a slew of other ones where you say the common denominator of all the companies that you guys work with is?

: I'd say they all are Mind Training Solutions and they they go about it in different ways. So the companies each have their own unique method of trying to help people to connect more deeply to themselves so they can live happier healthier lives. You know we have everything from sort of behavioral health platforms to sort of knowledge memory platform to what I'd call sort of the Spotify of spirituality or consciousness to a company that's gotten a lot of press recently which is Pear therapeutics. First FDA approved software dealing with and helping with addiction sort of software as drugs Behavioral Health platforms mindfulness apps. I mean I can go through them in more detail but we've invested in 10 different companies in this space over the last seven years and the common denominator is mind train.

: It's really great. And you know I actually I just started reading this book called Thrive by Arianna Huffington. Not sure if you've had a chance to dive into that one but she dives into sort of the idea of this third metric of success. We've driven so much by the first two metrics which is power and money. But the third one is wellness and she covers a lot of things here that you're covering. Have you had a chance to read that one?

: I have the book but I've spent time with Arianna. I just actually wrote a blog post about her commitment to sleep and her new book and the work they're doing at Thrive global. And they've kind of followed and in some ways supported their business since they started because I really appreciate how Arianna has been a champion for this whole space and work with thrive global and kind of coming over from the Post. She's really helping the whole space through her efforts to focus exactly on what you're talking about is to you know really sort of begin to take control of our own wellness.

: I think it's powerful you know. And mine's like yours Charlie and Arianna and I remember I was about four years ago. I was at the exponential medicine meeting. It's a yearly meeting where innovation you know they talk a lot about innovation in health care and that was when I first opened up my eyes to meditation. They asked the room how many people in this room meditate and at that point four years ago I was definitely not I was one of those people that thought it was hippy dippy. I'm surrounded by all these super extremely successful people and I see about 85-90 percent of the hands go up Charlie. And I'm like: What am I missing? You know, I'm like there's something here and not that it was. It's all about like hey, success, success, success. But man like fulfillment. Right. And so I had to dig into it deeper and there was a guy that led a meditation session at that meeting and since then it's become a big part of my day to day.

: Now that's great. So you do it on a daily basis or you do it like every morning or afternoon.

: So typically what I do Charlie is in the mornings or at night whenever I can I don't do both. I do one and I do anywhere between five and ten minutes of meditation.

: OK. That's great.

: Yeah. It's not long but what I tell people is that it's long as you do it for a little bit and you get your mind just to relax and you breathe.

: Yes. Pretty basic. Just focus on your breath. We do it like 27000 times a day or something and we do it without any awareness.

: It's amazing right. And we do it so often without awareness. And you know what. Actually Charlie you know we're putting together a meeting in September and it's called the healthcare thinkathon. And one of the things that I think would be cool is to actually get somebody to kickoff the meeting with a meditation session. Not sure anybody from the companies that you work with maybe interested in but that might be something that would be great to connect with you off line about.

: I'm happy to do that. And you know what I've started doing so in my work I actually love going to conferences and leading panels and Google moderator for panels. Really what I've started doing is that every conference regardless of what the subject is, is asking the audience for permission to take a minute of silence to get into a zone. What I find

: I love that.

: Is that when we do that and when you're asked permission and then people just kind of get more centered on the chair and they are more attentive their backs up straight and going through that minute. However each of them experiences it individually the whole hour changes or an hour and a half because people don't go right back to their phones. They're much more present in the room. The questions get better ,that people are engaged. So I have just started asking permission every time I lead a panel.

: Charlie, I love that man. So I'm going to be going, I have a meeting in Philadelphia in a couple of days and I'll be speaking there. I'm going to take this practice if you give me the green light.

: It's not my green light to give.

: Listen, I'll go and I will. I'm going to give you credit because I think it's such a wonderful way to kick it off and and just to reach Sanner and I love what you said. You know people don't go to their phones because they actually you gave them this gift of pausing.

: Correct. That's what I find. And they're not even aware of it and they're so accustomed to just sitting. If you want to be on your phone that's totally fine. It's cool. Leave the room and go do what you need to do and focus on that but just sit and be focused on two different things you're not giving either one of those things the attention that it deserves.

: Love it man. Now that's so great. And it's a big thing that we do here on the Outcomes Rocket, Charlie. You know we talk best practices and I think this is one that I'm going to take. But also the listeners, hey when's the next time you have a group to address? Take Charlie's practice and share it with the people that you're out to influence, that you're out to share with. And I think it's one that will create a ripple effect of positive in your life and in the life of the people that that you lead here in care and beyond. Charlie in your journey your business journey your life journey, tell us about a setback that you've had and what you learned from that setback that maybe the listeners could get some pearls from.

: So in 1998 I met the first woman who ever skied to the North Pole and the only woman who had skied to both the north and south poles. Her name was Anne Bancroft and she had a vision of being the first woman across the continent of Antarctica. She'd always done it as a non-profit model and spent years paying off debts as she went in and educated. You know some school kids you know through these expeditions and I met her and you know part of my background is as a consumer goods marketer. And when I heard her story and she wanted to go across Antarctica like it was one of the most emotionally professional moments of my career where I knew I wanted to support this through starting a business and marketing and helping people around the world through this metaphor of crossing Antarctica for a five foot four woman pulling 250 pound sleds for 7500 miles. Climbing sea level to 10000 feet you know crevasses and minus 20 degree below weather and she actually did it with a Norwegian woman named Liv Anderson. So the metaphor that I wanted to create was to empower girls and women around the world.

: Yes.

: So I formed the first for profit expedition company in U.S. history to create a global campaign around this expedition and I formed an amazing team and the expeditions launched and the media started covering it and we were you know on CNN 14 times and on David Letterman and on the Today show I mean we got three billion media impressions and when they got back the business side of me said OK so you were called into the expedition. Now let's do something more so I tried to build an education company from what we were doing. The mistake that I made was really not understanding what my calling was which was to make this expedition a very powerful global media campaign. And then I should have just gotten out. Instead I tried to push it to a place that I wanted it to go and we ended up the end of the women wanted to ski together to the north pole which is a very expensive endeavor and we're trying to build an education company and a leadership company. And you couldn't do two things at the same time so we shut the company down and really my experience of learning which was not an easy one as the company was shutting down was really listen to what your calling is and then get out of the way and don't let your ego get involved and I think now that I've done that I know I need to push it here so I don't know. That's probably one of my great learning moments in business.

: Now that's pretty interesting. So how do you tell right. Because it's hard to tell when you're in the moment that you've taken it to where it is. Is it a gut feel? Is it something that you write out your exit strategy that you just commit to? How would you define that, Charlie?

: Well probably different people experience it differently because we're all built a little bit differently. For me if I just would have sat down and sort of said what is effortless and flowing which wasn't building you know the leadership company and really reflecting back on what I was called to do I just didn't take that time and really I never asked myself the question if this is what I had been called to do. So if I would have gone to that place I could have dealt dug into my just intuitive sense and said you know what you did what you were called to do. Now it's time to do the next thing.

: Gotcha. I get that. I get that. Yeah. Just being able to go back to your guiding principles ensuring that it's in line with that and not going beyond.

: Correct. You know and I had I looked at this if I look back at my first healthcare experience it was I started a nonprofit in the slums of Nairobi in Nairobi Kenya in 1988

: That's pretty cool.

: And we built this organization and it became a health care organization. The first maternity wards ever I think in any slum that I know of in Africa had the first ambulance, the first doctors or dentists. We built this organization I think in the last 30 years it is served about 3-4 million people. But in the end there I knew that I was starting something and nine years after I started I turned it completely then my partner that I started with and I turned it completely over to the Kenyans. And I had no responsibilities. I just knew that it was theirs, not mine and they needed to take it where the medicos had actually been successful at doing this before I just let my ego get involved with the other business.

: That's awesome. What a great example and great contrast there, Charlie to another experience that you had that worked more in line with the way that you would have liked the previous one to go and and a great pearl of wisdom that you shared with us. How about the other side of the coin, Charlie? What's one of your proudest health care leadership experiences that you've had to date?

: So for me the work I'm doing in supporting my investment partners and doing this work with bridge builders and supporting the 10 investments that we've made I feel as though maximizing my gifts. I'm passionate about creating impact and building global movements so I'm able to do that. I think that the work that we've done has been sort of provided a bedrock in some senses for a whole new industry that's cropping up that is going to have massive medical implications for the whole planet. And I'm just doing my part in the whole thing you know to co-lead this movement with a lot of other people and I think that we're going to find that there's some revolutions that happen that you know in health care and then the way organizations are run because of the work that the companies that we invest in are doing.

: That's awesome man. Definitely a lot to be proud of there and just centered and listeners, one of the things that you've probably gotten from Charlie at this point if you haven't already is that he's so centered and he's in line with his mission and his why. And it's something that I think is important for all of us to do as leaders in health care and leaders in general just be centered and take some time to understand why it is that you do what you do. And I think it's just so key for us to make sure we keep that at the center. How about an exciting project that you're working on today, Charlie I know you guys have invested in several companies. Anything in particular that sticks out as super exciting out of all the things that you're working on.

: Well since I'm a nonconformist I'm going to answer with a couple of them. So we support a company called happify health which is started by two former mill Israeli military guys whom I absolutely love together built a casual games company. Several years ago they built it. It was like POP3 casual games company in the world they sold it. They ask themselves what the heck did we just get people addicted to. Somebody told them about the science of positive psychology, mindfulness and cognitive behavioral therapy and they didn't believe the science but they started researching it and they then got themselves convinced that that science was worthwhile to pursue. So they started a company called happify which was really to take their skills of building an engagement platform and taking the work of the leaders in those three areas and building a platform that's a customized experience for people which is called Happify so they're building a platform not to get people addicted to technology but really so that they are beginning to prove as an engagement platform that if you come to happify for 14 minutes a day three times a week over an eight week period you can see pretty significant results in multiple conditions and I'll just take one being for people with mild or moderate depression like your depressive symptoms go down. So if you have moderate you might go down to a mild in eight weeks or if you're mild you might get out of your depressive states. And this is to me really exciting because this is just your mind helping you to get out of that state. Another project that I am really excited about which was one of our most recent investments is called Insight Timer. Insight timer's a platform. If you take a look at the meditation apps in the world today. There's no meditation app that has as much meditation done on a daily basis as insight timer.

: Really.

: Million people download it. They have something like 260000 people using it every day a million two a month.

: Why do you think that is?

: Why do you think that it's grown like that. Yeah because what they've done that I'm really intrigued about is they brought the wisdom leaders of the world they have 1900 teachers on their platform so you can go on the platform and just meditate using their timer. They have a great timer but then they have 1900 teachers that have provided content. If you look at all the meditation apps in the world most of them you know you get maybe 10 meditations and then you have to start paying for it on insight timer. You have 9000 free pieces of content and meditation you can use. They're going to monetize through they just launched today, they launched courses by some of the leading experts in the world and you can rent or buy those and you know like Spotify you can get advanced features if you want to pay to 99 or 499 a month. But this content is always going to be free. And it's global and the teachers are teaching in their language. So it's a platform that really can spread globally through teaching locally. And you feel like you're in a community of people because you get on there and you can see everyone in the world that's meditating at the same time. And you can see people in your local area and you can see friends that you make on the platform and so I'm really excited to support that business and I love supporting all of our businesses. But those are two that I'm having a lot of fun with at the moment.

: Super interesting Charlie. Glad you brought those up and listeners if you're curious about the companies that Charlie and his team over at bridge builders collaborative are working on. Check them out. The website is bbcollaborative.com as in bridge builders bbcollaborative.com and you could check out their companies there. I think you'll be very intrigued at the selection that they've made in these very impressive companies. Check them out. That's bbcollaborative.com. Charlie, this has been fun getting close to the end here of our interview. Let's pretend you and I are building a medical leadership course on what it takes to be successful in healthcare business. It's the 101 of Charlie Hartwell. So we've got four questions here for you lightning round style followed by a favorite book that you recommend to the listeners. You ready?

: I think so. Feel like I'm on a game show, right

: And the first question.

: There we go.

: What's the best way to improve health care outcomes?

: Having compassion for patients and encouraging them to look for answers inside of themselves.

: How do you stay relevant as an organization despite constant change?

: If you're always listening to your end users and your customers if you're b2b2c you're going to do just fine. If you listen to what they need and build according to what they need I think you're going to be great.

: What's one area of focus that should drive everything in an organization?

: I just wrote a piece on this in today's world understanding what the mission of the organization is the vision of the organization and holding the leaders of the organization and yourself accountable to living by that mission and vision assuming that you agree with the mission and the vision or else you shouldn't be there. I think that is incredibly important in today's world.

: Think that's a wonderful message. What's the biggest mistake or pitfall to avoid?

: Probably not listening. I'm talking about this from sort of building companies in this space. Absolutely not listening to where the market is.

: Wonderful. Yeah you know I reshared a report that showed that the number one reason startups and companies fail is because there's a lack of market need.

: Yeah they just think they know. I see that over time.

: It's unbelievable man. I mean I see this and I'm just thinking to myself man and then I've been guilty of it and I learned the hard way. And I think a lot of people do. But it's just amazing how easy it is for us to fall in love with our own ideas and Charlie you hit the nail on the head twice one what they have to do is listen to the market and the end user. And the mistake you need to avoid listeners is just listen to the market.

: And I'm going to go different than that.

: Ok.

: I'm going to change my answers.

: Let's change it

: Listening to what the people need not just listening to the market. But what is the need. Because a lot of things if you listen the market you wouldn't necessarily know that something can be created because the market wouldn't tell you that it needs to be created. But if you listen to what the need is of the end user then you can build something really spectacular around that.

: And so how do you differentiate between the market and the end user, the need.

: I think the market is kind of you have to understand how the market works to bring your product and solution then. But if you're listening deeply to the needs of the consumers and then say Okay I understand the needs and that's not being met. So let's create something that and for most people that I work with it's a personal thing that they this is kind of their life's calling. These are the CEOs and start these companies that say you know I think that what I'm really passionate about meets what I'm hearing is an unmet need of consumers today.

: Gotcha. Catch a good distinction, a very good distinction. Wonderful responses here on the syllabus. Charlie what would you say the favorite book that you recommend to the listeners as part of the syllabus is?

: So I recommend that people read a book by a woman named Sharon Salzberg called Real Love. Sharon just came out with this book. She's one of the leading leading wisdom teachers in the world. The book really talks about the importance of self-love. And I bring that up actually as a thing that I think is important for medicine. I know through my own experience that the more that you can come to love yourself, love all parts of yourself actually the healthier and happier you're going to be in your life and the more fulfilled you're going to be. And Sharon is an expert at that and a good friend. So that's my book that I'm recommending.

: Wonderful. What a great recommendation. Listeners don't worry about writing any of this down. You could check out all of the show notes as well as a transcript of our discussion today just go to outcomesrocket.health/bridge that's bridge as in bridge builders collaborative outcomesrocket.health/bridge and you could find all that including links to the book that Charlie recommended I link to Charlie's company and all the companies that he's working with. Charlie, this has been fun. I really appreciate the discussion before we conclude. I'd love if you could just share a closing thought with the listeners and then the best place where they could follow you or reach out to you.

: Yes so I just started a medium blog about three or four months ago. So I do kind of a weekly blog post at Charlie Hartwell on medium just writing my insights into the what's happening in the industry and I guess a closing thought for listeners is that if you just take the time and begin to set the intention around just spending more time connecting to yourself I think you'll be amazed. And when you need it seek outside help along that journey. But in my own experience going down there and having the courage to do that which is hard to do in our society sometimes pays remarkable dividends to creating a better life.

: What a great message Charlie and again this encouragement to our listeners to spend more time with themselves, loving themselves and being more mindful has been really welcomed discussion so I really want to thank you for spending time with us today and looking forward to following you and the things that you're up to.

: Well I'm looking forward to getting a note from you as to how the meditation goes as you leads at the conference.

: Hey you'll definitely hear back. So I appreciate you man.

: All right Saul, thanks.

: Thanks

Thanks for tuning in to the outcomes rocket podcast. If you want the show notes, inspiration, transcripts and everything that we talk about on this episode just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare thinkathon where we could get together to form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference Be one of the 200 that will participate. Looking forward to seeing you there.

Automatically convert audio to text with Sonix

Recommended Book:

Real Love

Best Way to Contact Charlie:

https://medium.com/@charliehartwell

Mentioned Links:

https://bbcollaborative.com/

https://www.thriveglobal.com/

https://happify.com/health/

https://insighttimer.com/

https://www.mindandlife.org/

Episode Sponsor:

Advancing The Science of Sleep Health with Colin Lawlor, CEO at SleepScore Labs

: I welcome you to go to our outcomesrocket.health/reviews where you could rate and review today's guest because he is an outstanding contributor to health care from the great country of Ireland. His name is Colin Lawlor. He's the CEO at SleepScore Labs based in Carlsbad California. They're improving lives and advancing the science of sleep health. They're doing it by taking a look at sleep through the entire continuum from education through recommendations that can involve over-the-counter as well as treatments to help people sleep better and be healthier. What I want to do is open up the microphone to Colin to round out that introduction. Colin welcome to the podcast.

: Thank you very much Saul, delighted to meet you and thanks for the opportunity to speak today.

: Absolutely so Colin. Maybe you want to fill in the blanks there on your background or anything that I may have missed so that the listeners can get to know you better.

: Thank you. I think probably only two things which might might be helpful. The first one is we believe that the sleep health epidemic as it was called by the CDC as recently as 2016 is a global problem and it's one where solutions are available. However for the consumer it's really really hard to understand where to start, where to go for help. What we're aiming to do is to connect the consumer to an understanding of their sleep score which will help them to understand their own sleep and also to connect them to solutions and providers who have proven solutions and by connecting those dots for the first time. We hope to enable a complete solution in the sleep House area and the only other thing to add to that which is important is that we're not trying to do this alone. Sleep is an issue which everybody enjoys every night so that's the whole seven point six billion people on the planet. Three point five billion people have a problem with pretty much every night. So it's a very very big problem. What we're trying to do is to build a partnership starting with a great team of sleep score labs. We're also working with other great companies and great partners in order to consolidate a response which can actually really make a difference.

: Super and tell me a little bit more about what sleep Core Labs does so that we have a good understanding of the solutions and problems you guys solve?

: So sleep score Labs is at its heart it's about helping the consumer to understand their own sleep and that requires measurements. So you think about it, we understand our diet we understand or exercise on the diet and exercise were enabled by the introduction of new ways of understanding it. So for example we had the harmonization of food labeling 30 plus years ago where every food product is now labeled. Even in restaurants you can see the calorie content, the fat content, the salt content. So we get to measure what we eat and that helps us to make good decisions in relation to what we eat. That in turn enables services so syncs Weight Watchers Jenny Craig all the way through today to map my fitness on all of those services use the very same idea which is to manage a problem. It's natural for us. So for measurement of our nutrition the problem has been solved and the market has changed substantially since that was enabled same things been happening an exercise that ticked off those heart rate monitoring. Ad now it's also a step counting. But at the end of the day most people know that the more steps you do the better it is for your health. The more active you are the better it is. And so these technologies essentially helps to spur services products which make life better in terms of exercise. When you think about those two things there is a very difference between those two things and the other key pillar of health which is sleep because I remember everything I ate yesterday I can recall it pretty accurately and I can do that probably for three or four days pretty accurately. Same with exercise. So can you. So can most people. However when it comes to my sleep I cannot recall it because I'm actually unconscious during the process so it's actually really difficult for me to recall it and the more I try to concentrate on things like oh how many times that I wake up and how long do I wake up for the more I concentrate on those things the more difficult it is for me to sleep well so the sleep part of the three pillars of health has been completely misunderstood because we don't understand that ourselves because we can't. So therefore we need a way to measure it which is subjective and which can help us to understand what is actually happening during our sleep. So we start the whole process with a sleep score technology so we have a number of technologies. The first of which we have brought to market as a non contact sensing technology and that basically sits beside the bed. It uses high frequency radio waves low power to measure movement. And with that we can understand whether you were awake or asleep and what quality of sleep you're achieving all throughout the night for you. And with, that you can understand your sleep but we don't think that that's enough. We think that it's also really critical that we use that technology to measure all of the interventions that people are currently using everything, mattresses, pillows, pills, all the way through to interventions for snoring etc. and figure out which ones actually work for whom and which ones don't. So essentially at the heart of what we're doing it's about measurement first helping you to understand your sleep but also using that measurement to finally begin to figure out what works and what doesn't work for him.

: Super interesting Colin and listeners one of the things that we got to think about as healthcare leaders is how much sleep we're getting, the quality of that and I love Colin's example here bringing out an analogy between what happened in the diet industry with food measuring it. We've got to be able to measure sleep as well. So I love the progress that's being made by Colin and his team and I'm excited to dive in a little bit deeper. Can you tell us a little bit about what needs to be and every medical leaders agenda today?

: Absolutely. Well I think certainly I would argue sleep but then your listeners would expect me to say that.

: Right.

: So I will say to everybody listening for your own health, for the health of your family, for the health of your teams, for performance please think about sleep please Measure, please get your sleep score. And please begin to think about what you can do. But out a bigger picture level, I think there are some parallels between the journey that we've experienced in sleep so far and health care overall. And I'd like to call up maybe two parts or two issues which I think are probably relevant to everybody. The first one is I'm calling it the difference between the consumer and the patient. So in the medical sector we tend to talk about patients and that's great because we have patients so we have to provide services to those patients. But the very definition of the word patient limits our understanding of that person and we focus on the specific illness and the specific interventions and those very very tight things around that. In truth, every patient is for the most part, also a consumer. They live lives. They go on vacations. They work sometimes. They are active, they have families they participate in communities and so forth. So my point is that only understanding the patient means only understanding a small part of their lives. And if you only focus on that it's really difficult to help consumers or patients make the changes that they need to make to ensure that the therapies that we in the medical sector are connecting them to are actually effective. So I'm guessing what I'm trying to say is that we have to begin to look at the people we serve in a much broader richer way than the simple term patient implies.

: It's an interesting thought. Absolutely. Why look at it so siloed.

: Right. Right. Under siloing is in many ways a challenge because we see across health care today, the challenge very often is not just a both appropriate diagnosis and not just about connecting the patients to the appropriate therapy but in lots of areas of health care we're struggling with lack of compliance. So as a result the interventions that we spend all this time an effort to connect the patients who don't work. And at the end of the day, that I believe is significantly influenced by the fact that we don't understand them as well as we should and we don't deliver the supports that we need to deliver in the way that we should. And that's illustrated for example by some of the great work that's been done by ResMed for example which is a founding partner and joint venture partner and Sleepscore Labs, ResMed is global leader in sleep apnea therapy and sleep apnea therapy involves a person wearing a Sipah mask and being connected to a machine every night while they sleep. So Doc is a compliance challenge in itself. However most patients feel so much better the next day that they actually put up with that and they get used to that and they get so much strong benefits from that that they continue to be compliant. But there were some who struggled and Resmed spent a lot of time and effort redesigning the entire flow from beginning to end and in connecting the patient or consumer to improved data and services and insights and that has radically transformed our compliance. So by looking at the patient not only as a patient in the very narrow sense but looking at the more holistically, ResMed for example has led the way in very substantially changing points in its sector. That's the kind of thinking we need to apply everywhere in healthcare because it's not just a specific issue in isolation in its own silo. We've got to look at the person and their lives on the challenges and the things that motivate them and connect all of those dots if we really want to make a difference.

: Yeah you know Colin, that's a great call out. This is a really interesting distinction that I think we need to keep in mind is if you make that slight adjustment in considering the patient as a consumer, all of a sudden the walls of limitation that you restrict yourself with perhaps subconsciously on on what you can do for this patient. They get knocked down and ResMed did. And you know Colin team are doing. Your imagination can go beyond the typical to create solutions that actually make an impact on these patients. Super interesting discussion here, Colin. Can you give us an example of how you guys have improved outcomes through the things that you're working on?

: Sure absolutely. So one of the products we developed and which is now in the market is the sleep score Max and that started life as a very sophisticated advanced technology which accurately measure a sleep outside of the sleep lab. So the benefit of that is you place it beside your bed. The consumer doesn't need to wear anything and therefore the measurements itself doesn't influence the thing we're trying to measure which is really critical when it comes to sleep. You don't want some same stop to some part of your body waking you up in the middle of the night that's not a good idea.

: Picturing that column like, you know I'm thinking okay, how am I going to, you have something attached to you kind of like when you do in a sleep lab in a hospital. It affects the psychology of the sleep. Now this is a device that sits on your bedside. You could do it at home?

: Yes you can do it at home. It's designed for use of home but we've done a lot of the research in hospitals and it's a essentially a I think about the principle that a bat uses. So it's a radio frequency technology, a very low power radio wave is a middle man bounces off the surface of your body and it turns to the device. So we send one of those waves out 16 times per second on the clock.

: And you have to be in the room by yourself right. You can't be there with your significant other.

: Absolutely not. We designed this particular technology so that we can zero in on the person we want to measure..

: Is that right? That's pretty cool. Okay, alright.

: So in situations where they work which is about 75 percent of situation people sleeping together you can see very very clearly with very high acuity the sleep of the person that we actually want to monitor and with that, we have built a whole series of devices which we give based on the specific circumstances which we form. So in addition to the sleep quality we also collect information on the room environment, the temperature of the light levels the background noise levels because they all influence sleep, right. We also collect some information from the user about their lifestyle so caffeine consumption, alcohol consumption, stress, exercise, those kinds of things.

: And these are manual manual inputs?

: Yes some are manual. Some are connected for example to health kits so we collect data from a variety of sources to make it as easy as possible for the customer. And our goal is to use that data to then understand well what seems to be the significant issue around sleep for this particular person and based on the issue we find we don't have a whole series of curated advice which is all based on a review of approximately 600 clinical papers in the space and we have as a result literally millions of variations of advice which are customized and personalized and given to the person that needs them based on the data.

: Very cool.

: What that's delivered in some of our early studies is a significant improvement in sleep duration and sleep quality particularly for people who have poor sleep at the beginning. So we've seen for example that approximately 50% of users improve their sleep duration after a few weeks by as much as 45 minutes per night.

: Nice.

: Now to put that into context, there are some studies which show that the impact for example of using prescription sleeping pills long term improves sleep duration by as little as eight to 13 minutes. So I think what we're finding is..

: Not very impactful.

: Not as impactful as we would all hope. We all know that these interventions are not really designed for long term use. What we do know that there are lots of people who are using them for the long term. So you know really again the issue here is trying to understand. In truth the consumer, their sleep their sleep environment the actual truth behind that at a level which the consumer can't recall any discussion with their doctor and even if they could recall, the doctor would struggle to have the time necessary to listen them, to really try to interpret all of that.

: Super fascinating and very intrigued Colin. So this is something that any consumer can pick up so they can go to your site and purchase one?

: Yes. You go right ahead to sleepscore.com. And there you can purchase the device. You can also purchase it from our partners at Pottery Farm at Westown. Put sleepscore.com and inside there you find all the information about how the technology works. And I was going to say one thing which I think is important. It takes a team of experts to make this happen. I mentioned this in the beginning in terms of partnership. So within the organization, we have a tremendous team of people who are really passionate about making a difference to sleep health and they includes sleep experts and researchers. We also partner with lots of people outside the company. So our advisory board is made up of some of the best leaders in sleep health around the world and in addition to that, ResMed, which is a significant investor in this joint venture is probably the biggest single investor in the research around the world. So we're really trying to take advantage through this broader team of the latest knowledge and the latest information in science and bringing that to the consumer and vice versa as we collect more and more data. So we now have about 4 million nights of sleep data broken down 30 seconds by 30 seconds there all night long with all of that data.

: Pile of data.

: Yeah exactly. So we're using that data already to begin to advance the science and that's what we hope to do.

: That's so awesome Colin and super intriguing right. So listeners, we have an opportunity for you to really take your sleep to the next level. If you are serious about your performance whether it be business, whether it be athletic, whether it be just family quality of life. Sleep is key. So measure it to improve it. Check out that link. We're going to provide it here in the show notes for you to check out Colin's devices here, things that you could do at the home. And just like we've talked about in the past about mental health. Right. This is one of the key areas sleep, mental health. They are not being measured the way they should be and with folks like Colin, making waves here in the space to allow us to do the measurements required, we're going to be able to get better sleep better mental health. So really love this. Colin, Can you share with us a time when you made a mistake or failed and what happened?

: There's quite a few of those I have to admit there are quite a few. So I'm afraid I graduated originally from Trinity College in Dublin but then for the rest of my life I really have graduated from the school Knox. All joking aside there. You know when I try to reflect on that question I think probably the one most relevant for this discussion and it was a time when we at the early stage of the development of this technology, we partnered with another company to bring a consumer sleep monitoring solutions to the markets and we bring it to the market. However it felt really in commercial terms. And what did we learn from that is the question you've asked think we learned two things. The first one was nobody really is interested in monitoring per se. It's really about why you're monitoring and what you can do with that and people are interested in improving their sleep. They're not really interested in the measurements step although it's a critical necessary step, it's not the outcome it's not the benefit. So I think we learned very clearly that bringing a monitoring solution to the market is absolutely not going to work in many many other companies abroad. Various monitors and trackers to the market and we can all see what's happening. It is not really a huge degree of interest. What is interesting is how do we improve my sleep. How do I improve my health, how do I improve my life and that requires something way more than a monitor, surely an accurate starting point is essential and monitoring is essential. But it isn't enough in itself. That was one to learning in the second. Learning which I think is probably resonates to lots of the people who are listening today. Partnering is not easy and it's essential because increasingly we really reach out and we want to make a difference to a large number of people. There are very few companies in the world that can do that alone. So partnering is essential. However it's not easy. So what that means is depending on the relationship you have with your partner. If it isn't close enough if it isn't strategically aligned enough then it's going to be really hard to make your way through the various challenges which occur in partnering because you're not necessarily 100 percent aligned. And as things don't work out, how you respond is influenced by your alignment so I think the two lessons for me are when you're partnering with somebody, spend the time off front to make sure that you really deeply are strategically aligned if you're tied to something very very important because it's not going to work out exactly as you expect and you need to be strategically aligned if you're going to see your way through that. The second issue is monitoring per se is not enough even though it's important step.

: Wow Colin, you walked us through some very valuable experiences and you're right, you know in health care we can't do it alone and we definitely have to partner. You've offered some really sound advice so listeners you may want to rewind and relisten to that. So I definitely will be Colin and then the other part 2 is is how we position our technologies. You know folks people don't want to know how the airplane works and what gadgets are used to keep you on track. They want to be on the island experience paradise. Just like with the technology that Colin had he he had this technology that was monitoring people it was cool, it was savvy but people don't care about that. They care about the quality of their sleep. So as we develop product as healthcare leaders, it's important that we focus on the island rather than the airplane. So what a wonderful point that you shared there with us Colin. And one that that healthcare entrepreneurs and business executives should be keeping up the top of their mind. Really appreciate you sharing that.

: Cheers some. My pleasure.

: So tell me you took us to the learnings. Tell us about one of the proudest moments you've had in the healthcare business?

: I think almost anything that I did at ResMed is definitely proud. That company just published its latest quarterly results if you haven't looked. Take a look. It's amazing. So they now have aboat 14 million patients that they support true sleep in one way or another every night.

: Amazing.

: approximately four plus million of those patients are connected. So every breath is now monitored, every night it's the largest connected infrastructure in the world and they use the data to help the patients or the consumer to understand their own sleep and to motivate them. For people who are experiencing issues they have a whole bunch of services which are nodes are never true. Consumer friendly applications. I think that's the direction of the future. So any of my time would ResMed was proud from beginning to end. Proudest I think is the work we're doing at the moment. Right now it's still in progress and over the next couple of months more and more of that will unfold. But certainly it's a really amazing space to be working on. What we truly believe we're trying to do is to make a difference to people's lives and in so doing, if we can just simply move the needle for a large number of people by as little as 10 or 20 minutes every night we can make a huge difference to how they feel, how they perform, their relationships long term. So their long term health because we absolutely know and the data's mounting all the time. Doctors have direct correlation between sleep deprivation and pretty much every major chronic disease. So we believe passionately that we can move the needle a tiny bit for a large number of people we can make an enormous difference where we're proud of that but we're not too proud because we have to get it out into the market fully and make sure it's working fully before we can take a breath and take some credits.

: That is so awesome. Colin and you know I'll tell you what. We had our first son about 15 months ago.

: Congratulations.

: Thank you. It's been a blessing and it's also tough right. Because when they're growing up this sleep thing. And you know since he came. We've been definitely more focused on sleep how to get it how to help him get it. Because if he gets that we get it right?

: Right, absolutely.

: So we've been diving deep into this column and sort of the room and the sound, noise machines and temperature and all these things. So what you're saying is really resonating with me as I'm sure it's resonating with a lot of folks listening. I'm so intrigued with this. I think the vision that you and your team have is a highly impactful and inspiring one so kudos to you for this mission that you have in your hands. I think that you're definitely going to make a big impact. So congrats to you and your team.

: Thanks Saul. And if you could see me on Irish fair skin and blushing and also it's not it's not just you like you said it's not me. It's a team. We are on a mission. There's no doubt about that. What is a team. It takes a team to make anything like this happen. And hopefully we can make that difference in the points you make about your son and are so so key because what you teach your son about sleep now is going to impact him positively for the rest of his life. We know that sleep habits and habits are learned young. We also know that in childhood many many issues for example. And this is one of the great things we get talked to lots of people in lots of spaces where sleep intersects it intersects with almost everything. One of the great leaders doing research for example in A.D.H.D has told me that in almost 50 percent of children being diagnosed with A.D.H.D today do not have A.D.H.D. They have poor lifestyle.

: Wow.

: For example number that's a big number right?

50%, 5 0?

5 0 percent. So that's five zero percent.

Even if it's anything close to that number what that means is we got a whole bunch of kids who are actually being medicated for an illness they don't have and the medication causes sleep problems and those sleep problems exacerbate the underlying behavioral problems and so there is a absolutely a relationship between all these things. You know what we hope to do over time is to make more and more data available to help more and more people to understand what's going on and over time that will eventually help. So when you're thinking about your own son and his growing up I think you're spot on. Think about his sleep house. If you can help him with that, he will be happier. He'll perform better. He'll have less problems as he grows up and for the long term to be healthier.

: That is so fascinating. You know Colin I'm definitely going to have to pick up one of these things. Now take a look at sleepscore.com and you'll see the device it's it's actually quite aesthetically pleasing and very very reasonable price sleepscore.com. Definitely will be picking one of these up great great message here. Tell us about an exciting project this is an exciting project to begin with but is there is there a slice within what you're doing now. That's very very exciting that you want to share with us.

: There sure is. All right now we have been with our customers help. We have been measuring the impact of interventions on sleep. So we have approximately so far 40 thousand users approximately four million nights of sleep data and those users have very kindly shared with us things like what mattress they use, what pillows they use, what interventions they use and that's given us a really clear baseline for sleep quality mattress type, mattress brand and so forth all these things we're learning. Now what we've then been doing is we've been partnering with a large number of companies who offer solutions for all sorts of sleep issues from snoring through to basic comforts. And we've been measuring those solutions so our customers volunteered to be part of a small pilot study where we measure essentially the before and after impact of a given solution. So what that's helping us to do is to learn about what actually helps to improve sleep or in some cases disimprove sleep. And I think that's probably one of the most exciting things because right now the consumer spends about 60 billion dollars on all sorts of stuff to improve their state. Now the problem is we believe that probably half of it doesn't work. The other half of it is maybe purchase swipe the wrong people because of course we don't understand their sleep so we have found in our data set that we ask our users when they sign up what do they think their major sleep issue is and they tell us and then we measure their sleep in objective terms for a week or two. And what we discover is almost 85 percent of people doesn't issue wrong. In other words they weren't really clear as to what their real issue was and that kind of just goes to the very point of talking from we talked about which is people are unconscious for the process of sleep. So they find it impossible to objectively measure them track it. And therefore it's really hard for them to understand what exactly is their issue. So they just know they're sleepy they just know they're tired they just know they're not at their best. Some think it's just aging. It's not survey sleep changes with age but it doesn't have to be that we are all you know slower and more tired more miserable as we age. We can still have a great sleep health but people don't understand where to start because they don't solve the problem. And I think if we can really uncover how these interventions work or don't work we can then connect consumers to the appropriate solution which bypasses all the trial and error that currently goes on and unfortunately during that trial and error process for many consumers they give up because they've tried 4 5 6 interventions and they don't work or they feel they don't work and they give up and that's what we want to try and deal with. It's this kind of nihilism which is coming from trying to make something better failing and then not knowing what to do next.

: Super fascinating Colin so I really have enjoyed this discussion. It's been so much fun especially because sleep is so important for all of us. I think the listeners definitely are getting a lot here as well. Let's pretend you and I are building a medical leadership course on what it takes to be successful in sleep and it's 101 of Colin Lawlor. So I'm going to ask you four questions followed by your favorite book that you recommend to the listeners. You ready?

: I'm all set. Thanks Saul.

: All righty. What's the best way to improve sleep. Health care outcomes?

: Well I think the first thing is to be aware of it and then start with the inputs. So learn about it objectively measure it and start from there because you can only improve an outcome if you know what you're measuring.

: Totally. What's the biggest mistake or pitfall to avoid?

: I think the biggest mistake is to avoid a very narrow focus and instead to more broadly connect with the consumers to understand what's truly going on, it's really hard to deliver an outcome if you misdiagnose the issue and it's really easy to misdiagnose the issue. If you don't have enough information.

: Beautiful how do you stay relevant as an organization despite constant change?

: I think that's a really simple one you've got a push to change yourself so if you're not leading you're following. So you've got a leash. And so if you're not a driver of the change yourselves you're going to struggle.

: Love that. What's one area of focus that should drive everything in an organization?

: I personally think it's the mission and it's down to Why are we doing this. What difference are we trying to make. And in our case it's about trying to make a real difference to the quality of people's sleep. We if know we can do that. We can reduce accidents improves proves our mood, reduce long term chronic diseases and that's a very powerful take. So our focus is really being clear on the mission. Why do we. Why are we trying to do this.

: What's your all time favorite book column that you recommend to the listeners?

So you give me a perfect segue. It's actually Start With Why by Simon Sinek. So if you've not read the book you at least go and watch his TedTalk, it's awesome. We'll start with why I think it's so inspiring. The book itself opens with the statements which kind of traps you and then then he delivers a really big surprise. This all happens on the first page and from then on he captivates you. The issue at the very heart of it is why are we doing this. That's what matters. If we can't understand why, then what we do and how we do it we can figure out what it's all about the motivation. If we can stay singularly focused on the mission we can make a difference in that space. I think that's what drives success for companies. We'll see. That's certainly at the heart of what we're trying to do.

: Beautiful. Listeners, don't worry about writing any of this down the entire transcript that we've discussed will be available along with the show notes and links to the things that we've discussed just go to outcomesrocket.health/sleepscore and you'll be able to find all of that there. Before we conclude Colin. I'd love if he could just share a closing thought and then the best place for the listeners could get in touch or follow you.

: I think at the end of the day for me it's about whatever you do whether you measure your sleep or you don't measure your sleep or at least think about it, sleep is not for wimps sleep is actually the latest newest performance enhancing drug which is actually good for us to find us. You'll find us at sleepscore.com and you'll also find me at LinkedIn Colin Lawlor C O L I N L A W L O R. We'd be delighted to connect with anybody that can help on the mission or if we can help you in research.

: Outstanding. Thank you so much for your time. This has been a brilliant episode and we have you to thank for that. Appreciate it. Looking forward to staying in touch.

: Thank you Saul take care.

Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.

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Human Excellence, Neuroscience and The Platypus Institute with David Bach, Founder and President at Platypus Institute

Human Excellence, Neuroscience and The Platypus Institute with David Bach, Founder and President: Platypus Institute

: I really thank you for tuning in and I welcome you to go to outcomesrocket.health/reviews you rate and review. Today's podcast because we had a magnificent guest. He has done so much in health care by starting many different companies. He's a physician. He was a physician, frontline for some time. His particular expertise is in Applied Neuroscience and he's doing some pretty interesting work currently at the Platypus Institute. But let me tell you a little bit about the special guest. His name is Dr. David Bach. He's a Harvard trained neuroscientist and he's the founder of the Platypus Institute,a New York City based research and training institution focused on the question of how neuroscience can be practically applied to radically enhance cognitive functioning and the human experience. He's got much success to discuss. But right now his core focus is this and what I love about David is that he's a physician that's very focused on wellness. He's got a wonderful story that we're going to dive into as well as his work at the Platypus Institute. Lots to cover here. But what I want to do is open up the microphone to David to fill in any of the gaps in that introduction that I missed. Welcome to the podcast.

: Thank you so much. It's a pleasure to be here.

: And the other thing that I want to mention is that David also has a podcast which by the way if you wanna excel what you do in your life, it's called Neuronfire podcast. He interviews world's leading neuroscientists and elite performers that I think you'll find very intriguing. We'll leave you a link to that below. But David tell us about your story. Tell us about you?

: Well first of all thank you very much for the kind introduction. I kind of have. Two stories that ran in parallel that got me to the point where I wanted to start the Platypus Pnstitute so I guess you'd call it the external story is a pretty traditional I guess physician executive route so I went to Harvard College. I went to Harvard Medical School. I practiced medicine. I did science a lot of work in cancer research left and then went into business was a venture capitalist and then started a bunch of companies. And so that's the kind of resume story the parallel track though is an internal journey. I've been on in the last 15 years and this is probably what's most relevant that guided me to start the path of this institute. So around 15 years ago I hit a low point in my life. So that's the point when I had just started my first company I had left academia. And the bottom line is it was really not going well you know as I told you I had a history of you know at least from other people's perspective success but at this point I just couldn't make the company go anywhere we were doing okay on a revenue perspective but the problem was our expenses were a lot higher than the revenues and break it out. And I was working like 15 or 16 hours a day and just chronically exhausted I and I was just drinking coffee like by the gallon. And not only that I hit a point in my life where for the first time in my life my body started to give out on me. And I just didn't know what to do and there was one morning it's 6:00 AM I'm looking at myself in a bathroom mirror and I said to myself I said, OK David, enough, you know something needs to change.

: Yes.

: And it was just this bizarre thing and I had this thought as I was looking at myself and I said wait a second David you're a trained scientist. What if you approach this problem this moment from a scientific perspective saw that that was the moment that basically changed my life and began my journey into what I now do. Because from that point you see I started to look at myself differently I looked at myself objectively the way a scientist would look at a lab rat. And so I mean this is a bit of a strange story but the first thing I did as I started to do what any scientist would do so I started to collect data about myself. So I collected my brainwave data and I looked at my heart rate and I looked at my thoughts and my posture and my breathing you know what was I looking for it was I was looking for patterns you know something that I could scientifically measure that correlate with you know how much my life sucked right and you know and ask those patterns started to emerge. The next thing I did is I started to do experiments on myself to say OK can you change these things.

: Yes.

: And you know as I'm sure you can imagine through that process I learned a whole lot about myself and you know I obviously went down a bunch of rabbit hole. But what I can report to you is this the guy talking to you today is an unrecognizably different man than you would have met 15 years ago. So for example I turned around my health and I'm sure you know you can measure your body's biological age or just to measure of how old your body is based on your blood chemistry and not your chronology. Right. And what I could tell you is my biological age today is four years younger than it was 10 years ago when I stop. I know it's crazy. I you know if you do that math correctly 15 years from now I'm going to be eight. I'm kidding.

: I was going to say.

: But it's really beautiful and you know I turned around my cognitive function. I became happy. And in fact I turned around my business as a result of that you know by stretching myself mentally by stretching myself physically. I became a different guy who was then able to find his way toward taking this company. We grew it up to a hundred and thirty five million dollars in sales and significant profitability and then I did that with a couple other companies. So I I'm kind of like the hair club for men guys I'm the first customer of a scientific approach to rewiring and it had a very powerful impact.

: That's such an interesting story.

: I know it's bizarre but.

: And The one thing that I do is I know you want to continue David but I do want to highlight listeners in the light of all the things that we do like David. We all have an internal and external story right. In a lot of times we're so focused on that external story. As healthcare leaders how could we improve this. How could we reshape that. How can we help patients feel better. How can we improve the finances at the expense of our internal story. And so I love that David shared this very personal story about himself and the transition. I think every one of us can identify with him and the things that he went to David continue please.

: Actually I am just building on what you just said. I guess what I will tell you is the discovery I made through this process and probably a dozen years ago and this was really the discovery that changed my life is you know speaking about this internal story is that you and I, we've got unconscious patterns right that is. Yes hatters that we have no conscious awareness about and those patterns have a huge impact on how we show up in life. You know that's things like how we hold our body how we breathe our automatic reaction to stimuli and the like. And what I discovered is because those unconscious patterns have such a profound impact on how we show up in life, we characterize measure and change those patterns. Our life can get better quite profoundly without any additional effort. And that's really that's really the insight that drove me personally and I think the insight that is is driving our work at Platypus.

: Super insightful and definitely want to dive into this and folks just want to highlight that David the three companies that he founded they all grew to be more than 100 million dollar enterprises venture capital. Now there's no doubt what he's doing produces not only internal but external results and impacts society in a very positive way. I'd love to dive into what you do at the Platypus Institute David. But first why platypus?

: So I don't know if you know anything about the platypus it's indigenous to Australia but what I love about that animal is it's made up of multiple component parts that don't normally go together and so it's got a duck feel about an Otter Tail and that's a mammal but it lays eggs and that's waterborne and that's got a poisonous Spore and the list goes on and so

: Australian animal right?

: Amalgam of multiple things that don't fit together and so when we named platypus we liked it as a metaphor because we see ourselves as doing something similar where we're kind of neither fish or fowl were glomming together a bunch of unconnected pieces to create what we think is a new and exciting opportunity. But the other thing about it is you know we're a scientific organisation and people like us we have this tendency sometimes to take ourselves a bit too seriously and so we kind of like it because it's whimsical and it's it's just really hard to look someone in the eye and say I worked at the Platypus Institute, seriously?

: Yeah right.

: It's like you know now that I've been through this whole entrepreneurial journey a bunch of times it's really important to me that we have fun. So you know I was telling you earlier we have a little stuffed platypus and every time we have company retreats we put the platypus up there in a leadership role so that we know kind of who we work for, you know.

: Amazing.

: It's fun, it's really fun. You know I have to tell you. I know you listen to the podcast with Andy Walsh. Yes. To prepare for this fascinating. And he's a really cool guy and when I started this I didn't think I would be able to get him because he didn't know me and I just cold called the guy and they said I'm starting this thing called the Platypus Institute. And he told and he's from Australia and he.

: Wow cool.

: And he took the call is because anyone who names themselves after an Australian animal is going to be.

: I love it. And folks, Andy, he's in charge of all the amazing things that happen with Red Bull athletes and as David astutely put it in that episode. He teaches them how to fly and I'll provide a link to that episode something that you should definitely take a listen to. That's super interesting and congrats on getting him on the podcast.

: It was phenomenal. I was so proud of him because I think I think he went a whole three minutes without swearing which for him was an accounting record.

: That's awesome. So let's dive a little bit deeper David into the platypus Institute. What is it that you guys do. Why should the listeners be intrigued?

: It'll take me a few minutes to answer that question. So let me start with what we do at a high level give you an example and then talk about what I think the implications are which is pretty big. So what we do for a living as you said in the introduction is we try to translate neuroscience research into practical applications to upgrade human performance and to upgrade the human experience. You know it's funny. Back when I started my first company I was at a conference in Silicon Valley and it was talking about the future of technology and I'll never forget there was this Silicon Valley investor a very famous accomplished guy who got up there and he said I predict that ten years from now mobile technology is going to be pervasive. It's going to effectively replace the computer. People are not only going to look at e-mails but they're going to be searching on the Internet they're going to use that to connect with each other not only through telephone calls and it's going to become a new mode of communicating. And I remember sitting in the audience just rolling my eyes and saying this will never happen. And even if it does one thing I'll tell you for sure is I'm not going to be one of those guys carrying a device like that around. You know. Of course now. Everything I do is through my iPhone. Right.

: That's some foresight.

: So I. It was amazing. Why is it that he and everybody you worked with knew that was going to happen while I I mean I ran a kind of a health care tech company that I had no idea. And the answer is he was in the middle of the science and he saw what was happening about it. He saw the implications, he saw the impact on consumers. And so for him it was blindingly obvious that this would soon become pervasive. Now the reason I tell you that story is that's where I am today with Applied Neuroscience. The fact of the matter is 10 years from now what I do is going to wind up being pervasive worldwide. That is people will be using neuro technology in a way that they are fundamentally rewiring and upgrading their brains and it's going to be pervasive like the internet and mobile phones simply because it is so incredibly powerful and it's a really kind of exciting place to be. So let me go back and tell you practically speaking what I'm talking about and I'll just tell you a case study about this. So I would imagine you might have you've heard of the notion of neuroplasticity?

: Yes.

: Right. So the history is when I went to medical school we were taught the adult brain is fixed right? That essentially after your kid your brain takes on a certain shape and then it just doesn't change. Now since that time neuroscience researchers have demonstrated that that conclusion is just completely wrong. Our brain is continually rewiring itself in response to stimuli. And so what it looks like today is very different than what it may look like a year from now or even a month from now and that rewiring happens throughout the lifetime so you can see that even in very elderly people. About 10 years ago neuroscientist started to ask the question well OK if the brain can be rewired can we do stuff to it to induce that rewiring that is to kind of make it go from point A to Point B? And so they said what can we do things like accelerating learning speeds where you're trying to learn a new language or you're trying to learn a new skill? Can you speed up the process and speed? Can you reduce cognitive decline that comes with aging and they started building a series of technologies in order to do that. So I'll give you the classic experiment which was done. And this is probably a dozen years ago. It was done out of DARPA which is the defense agency research program that does all the sort of secret stuff, they're the ones who did the original work for the Internet and so on. This was done by the chief science officer at Platypus Amy Cruz. And what she did and it was a pretty revolutionary study back then and she asked the question is there a difference in the brains of experts and novices and she studied a bunch of tasks and the one that was the most important to the military was shooting, and a shooting a gun. So she took a bunch of elite snipers. She put sensors on their head and on her chest and so on. And she looked up what happened when they took a perfect shot. And then she took a control group of people who didn't really know how to hold a gun. These were people who were just come into the military who were being taught and what she discovered and it was a big discovery is that there is a signature brain pattern associated with the lead shooting. That is you take the perfect shot your brain always looks the same. And that way your brain looks is radically different from the brain of somebody who's never shot. So it's a trained state. Yes. That comes through practice. She asked the second question which was even more exciting and she said, "OK now that I know what an expert brain looks like could I do something with technology to accelerate the process for people learning how to become expert snipers?" So she built what's called a neuro feedback paradigm and what she did is she just put a headset on somebody measured whether they were in the zone or not and then gave them feedback saying you're in the zone, you're not in the zone, you're in the zone you're not in the zone. And she did it in a whole bunch of ways she did it with haptic feedback where it would buzz on their body. She gave them visual feedback and what she found is she could radically accelerate the process for people to become experts snipers basically with an hour of training. She could get them 85 percent of the way there. And not only that she.

: Impressive.

: Experts and she could make them better snipers just by teaching them what they're like when they get a perfect shot so that they got much more consistent at it. This was a big deal. And so then you know that was the beginning. And since that point in laboratory settings. So people have done things like doubling the brain's processing speed, tripling learning speed for a many many things like language learning quadrupling memory dramatically reducing cognitive decline. And we're just beginning. And it's not all neurofeedback. There's a lot of techniques. But the bottom line is what we're doing is we're measuring what an optimal brain looks like and then using technology to induce rewiring to get the brain to that state. And the end result is we are now building I guess you'd call it the capability to rewire the human brain, to bring it up to levels of performance and experience that no one has ever conceived of. And that's actually just the beginning. We're also doing things where we're learning to connect brains to other brains connect brains to computers connect brains to the Internet of Things. So it's a very exciting world where in essence 20 years from now probably 10-20 years from now the experience of being human is going to be fundamentally altered because of neuroscience and neurotechnology what we're calling neuro performance technology.

: Super fascinating David and there's no doubt that through the process you're definitely improving outcomes for the people that are there doing these things. You mentioned I read on your site that you're working in some examples include like peak performance athletes, elite Wall Street traders. You're helping them take their games to the next level. How is it that you're doing it right. I'm sure that audiences still left with the question of how what mechanisms are used?

: So let's just talk about those two examples. So in athletics let's take basketball for example. I would give you two examples in basketball where neuroscience directly impacts people and by the way this is true in every athletic endeavor but it's different by sport. And so I'll give you the most obvious one. Think about free throw shooting.

: Yes.

: In NBA, you see some people who have free throw percentages in the low 90s, 91, 92, 93%. But you've got other really good basketball players who shoot 65 70 75 percent The same exact technology that was used to train snipers can be used to train free throws. It's exactly the same thing you get into a zone. You can teach yourself to get there. And through neuroscience, you can rewire people's brains so that you can you know I think pretty consistently take someone who's shooting 70 percent and get them into the low 80s. And if you think about the economic impact for a player or a team that's huge. That's actually a small example. Here's another one remember I told you you can accelerate the processing speed of a brain. Yes. It's the same thing as this processing speed of a computer. And there's different processing speeds. You process visual stuff and you process auditory stuff. But let's talk about visual stuff. If I take the worst NBA player out there, there are visual processing speed is about eight times as fast as mine. So when we test them they can see stuff. I can't even begin to see it's crazy

: Really?

: But I'll also tell you is the processing speed for the best people in the NBA is 32 times as fast as mine. Right. So there's a threefold difference. And then if you build a correlation analysis and you say what does that processing speed correlate in anything it turns out it correlates immensely with a number of points they score per minute is specifically assists and steals. So your ability to play in the NBA and generate assistance steals, number of assistance steals per minute is directly tied to the visual process and speed because you're just trying to anticipate where the ball is faster than someone else. Amazing. And so it's a right. I mean it sounds silly but athletes all know that mental capacity has a huge impact on performance. We can measure that. And so the fact is we know now here is a metric you know the same as body fat or heart rate that you can measure which is tied to performance and we can somewhere between 50 and 100 percent improvement in visual processing speed for any athlete and that translates directly into points. And so you can imagine if you're a professional athlete, you can't afford to not do this and what you're seeing is it's just starting to work its way in. But the best football players in the basket basketball players are now spending a bunch of their time during neurocognitive training because just like weightlifting are just like running. It's training their brain to allow them to be happy.

: Yeah and you know one of the things to David thanks for walking us through that and if we take a look at the you know this is the athletic side of things and we take a look at for example in your in your analysis here you got the physical part but then you also have the neuro scientific part. The same is true when going to your primary care doctor on a yearly basis you go, you get a checkup. Why not go and get a mental health checkup. I think it's just as important and this should become more routine.

: Yeah I think our belief is that ten years from now there are going to be probably five years from now, there'll be a set of brain vital signs which are standard in most medical offices. Right now, this stuff is still kind of laboratory based but there is I can't even tell you how much venture capital money is getting poured into this. And I think it's essentially inevitable that there is going to be very affordable rapid testing where most people are going to just have seven or eight key metrics about their brain measured.

: That's exciting. I always had a sense.

: I was actually just on the phone yesterday. I don't want to give his name because I don't know if he wants it but with you know let's say one of the most famous scientists in in neuroscience and he was talking about exactly that and we're very confident that that's going to be affordable. And when you look at research, what you will see is there's actually tremendous consumer appetite to have these brain Vital Signs measured. And so yeah, I think it's pretty much an inevitability that that that's evolving and that's why I'm saying this neuroscience is going to wind up being pervasive because once you can measure how your brain does, you're going to want to do it the same as if you're wearing a Fitbit and you're tracking your steps or you're tracking your heart rate.

: Absolutely. Well I didn't mean to disrupt your train of thought here you were going to dive into the. The other example of Wall Street.

: You want to go into that? Ok.

: Yeah.

: Now let me say you're asking me for specific examples but we could go through a bunch of them and I actually want to tell you about one more.

: Sure.

: Because it's just because it's so fun, I'm about to record a podcast about it. I'll tell you about the finance one quickly and then I'll then I'll save it for last. Well first of all when I talk about finance, I'm talking about Wall Street traders these are the people who work at the large hedge funds what are called portfolio managers and they are the ones sitting in front of a series of computer monitors making buy and sell decisions where every one of these decisions is worth you know a million dollars, 5 million dollars, 20 million dollars or so. Right.

: Right.

: So neuroscientists have done research where they've put sensors on these traders and asked the question, "Is there something I can measure about the brain that correlates with the profitability of an individual trade?" Right. Remember the sniper saying, "OK your brain looks like this, when you hit a shot it looks like that when you when you miss it". So it turns out that same thing appears to be true with portfolio managers that you can use neuroscience we believe to predict whether a trade is going to be profitable or not before the trade estimate. And it's really cool and appears to be really reproducible. And I'll walk you through the science it's actually very simple. It turns out that the key predictor of profitability for an individual trade is the amount of stress that's in the person's system. Now you may know when your nervous system is in a fight or flight mode right when you're really kind of stressed out. What happens is you have a lot of blood flow going to your muscles, you're pulling blood away from your brain and the part of your brain that is primarily deprived of blood and fuel is the frontal part what's called the prefrontal cortex where you do your executive thinking. So if a wall street trader gets into that fight or flight mode and they are lizard brain takes over that lizard brain which is really useful if you're in the woods getting attacked by an animal turns out to be very counterproductive.

: Right.

: And so in that scenario, you can actually use neuroscience to monitor your neurocognitive state and make sure you're in the zone when you're making trading decisions and it can also be used by the people who run the hedge funds to track how their individual traders are doing. And you know in Wall Street where it's all about trying to find an edge in where it's all about using cutting edge technology. This is a very hot area right there so.

: Fascinating.

: That's my second example but I want to tell you the third one that's here. So it turns out that another application area for what we do is in the world of sex. Have you ever heard of these people who have these like eight hour long tantric orgasms. You know like stag.

: And you know what I actually haven't heard of the eight hours long huh.

: Well it's apocryphal. Anyway I'm interviewing I think in a week some tantric practitioners. But it turns out, there's people who've spent decades learning how to experience ecstasy better than kind of your average person and appears. There's a measurable brain state associated with. So we believe we should be able to use neuroscience to train people to get there more quickly. Now, unlike Wall Street or sports I actually haven't done any market research confirming that there is a market appetite for it but we have this hypothesis that there may be a market opportunity in that arena as well.

: Fascinating.

: Yeah, it's very cool.

: Your covering all areas David. And listeners, it's fascinating to think about this right. We've got to start thinking outside of the box and I really am intrigued and I'm sure that you are too with what David and his team are doing to make our experience here as humans that much better. David what would you say right now is one of the most exciting focused areas that you're working on?

: I think the thing which is the most exciting is the fact that today we are at a point in history where this is science which is no longer going to be only in the laboratory, it's going to be able to make an impact on individuals. And the most gratifying thing for me is when I see it having an impact on people, when I see them reducing their stress. Becoming more happy, becoming more of who they are capable of being. It's just wonderful and I feel, I feel really fortunate to I think probably the only time in my life to be part of a new industry emerging. It's just a really cool thing so I think that's how I'll answer your question.

: Now that's really great David and you know from the perspective of frontline physicians right we're sort of in a kind of a crisis let's call it what it is. Where you know physicians are committing suicide. There's burnout and I'm sure there's people listening to this thinking what is it that we could do with the Platypus Institute to help our frontline physicians. How would you answer that?

: First of all let me say you could answer that question on two levels. There's a question about how applied neuroscience will effect healthcare itself. But I think you're really asking personally if I'm a doctor. How will neuroscience have an impact on the internet. I think the answer is burnout is a neurocognitive state right the same as being in the zone or having an orgasm it's it's just a thing that your brain does automatically. And right now it's a very challenging time to be a doctor. But you can rewire your brain so that you don't go to burnout so that in the face of a stress sore, you know something triggering you your body moves into a place of relaxation and ease rather than this fight or flight reaction that I was telling you about Wall Street. And so the alternative to that fight or flight reaction is this thing that we call the flow state where you actually relax where your your brain actually calms itself down you get more of what are called alpha and theta waves which are kind of associated with meditation. And in that case, your body is healthier but your productivity is actually higher than it is when you're operating from stress. And so I think what Applied Neuroscience or neuro performance technology will offer specific to that burnout issue is a way of rewiring the brain so you just don't go there. It just has an automatic behavior pattern. Your unconscious reaction to stress will be to relax rather than to tense up and it's going to make a huge difference on you know of health of people who learn that and productivity.

: That's super fascinating.

: It's very cool.

: Yeah, if you've got questions about this, if you're curious I definitely recommend that you check out David's website. It's platypus.org, that's P L A T Y P U S dot org. Super fascinating work that's happening there and so David this has been a really fun discussion. I think what you've done is created curiosity in this realm of neuroscience and applied neuroscience and what it could do for us as health leaders and individuals. I'd love if you could just give us a closing thought and the best place for the listeners to get in touch?

: You know I hate to say this because it sounds egocentric but I do think my story is relevant. The insight that our brains can be rewired I think is a really profound one. And so I think if I'm going to leave someone with a closing thought it would be this, "if you start paying attention to your automatic and unconscious behaviors with the understanding that those are neural patterns that can be changed. The process of becoming aware and trying to change them can have a very profound impact on your life" and that's what I would say and in terms of getting in touch with us as you said the website url is platypus.org. My email address is david@platypys.org. And I get a lot of e-mails but if you're right I will absolutely right back and you know the podcast we do. It's great. Not just you know not because of me but I get really cool guests and I have the opportunity to do interview. You know the world's best neuroscientists and Tantric Sex experts. So you know I feel like podcasts would be a privilege to have to listen to ours.

: And now definitely a testament to that folks. The neuro fire podcast is fascinating. They're talking about big data. They're talking about hacking consciousness. Some really fascinating episodes and the guests that David brings on are just wonderful so.

: And they're so cool.

: They're so cool right?

: I know. I think you feel how lucky I am.

: Hey, and I feel the same way here you know at the outcomes rocket. We're just having folks like you David. It's just a privilege. And so folks check that out. All the things that we discussed. You're going to be able to find links to David's podcast neuro fire. You're going to be able to find the Platypus Institute website as well as a transcript of what we just discussed. Just go to outcomesrocket.health/platypus. That's P L A T Y P U S. Really excited to have you check that out. And David, I just want to give you a big thanks my friend. I'm looking forward to staying in touch.

: Thank you so much.

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THE NEURONFIRE PODCAST

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Addressing the Challenge of Mental and Behavioral Health in The U.S. with Christiana DelloRusso, Partner at Providence Ventures

Welcome to the outcomes Rockit podcast where we inspire collaborative thinking, improved outcomes, and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

: Welcome back once again to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to welcome you to go to outcomesrockethealth/reviews to rate and review our podcast today because we have an amazing guest. Her name is Christiana DelloRusso. She's partner at Providence Ventures, Board Member of N-of-One, Board Observer at Omada health, has a really broad and deep appreciation and influence in the health digital space and I've just feel so lucky to be able to have her here on the podcast with us today. So what I want to do is welcome you Christiana to the podcast and then let you fill in the gaps of that introduction. Welcome.

: Thank you. Thank you. I'm really thrilled to be here. So thanks for having me. The only thing I'll call out is that Providence Ventures is a strategic venture fund in essentially the strategic venture arm of Providence St. Joseph Health which is a large, complex, integrated health system on the west coast and one thing I always like to draw people's attention to is that where a Catholic nonprofit. But if you think about the founding story of Providence St. Joseph hoealth. I joined in 2014 we were still Providence Health and Services. We've since merged with St. Joseph health, hence the new name, but the founding story is fascinating and so inspiring in that this now 23 billion dollar health system with what in seven states was actually started by five nuns.

: Amazing

: Who came out of the US from Montreal on horseback in the mid eighteen hundred.

: Wow.

: And they pacifically came out to this region to care for the poor and serve indigenous and pioneer communities that were settling out here. They had no money. They had very few resources and they just, they came. They answered a call and they persevered through these unimaginable challenges. If you think about it they were the ultimate scrappy startup and five women to boot

: I love it.

: And you know we're still here today. Over 160 years later so I love this story. I think it's so incredibly inspiring when we when we look at healthcare today we're like, oh gosh it's such a mess. There's overwhelming challenges that are so complex and you just think back to those women who you know again on horses with nothing like OK we're going to open a hospital. I love that story and I just I wanted to relay it and honor the bigger and broader organization that I work for.

: I'm so glad that you did Christiana because it is really an inspiring story and it just a testament to you gotta give a go giver, not a go getter. And these nuns did it and now they've led the way we're standing on their shoulders. What got you interested in health care, Christiana?

: So I mean my my past into being really inside of healthcare has been somewhat circuitous and pretty opportunistic and I actually started out as an academic research scientist who I was I was at the bench. I was working with the DNA, and cells and protein and animal models of disease like cancer and muscular dystrophy. And even though I was working on treatments for these diseases in the lab, a constant nag of myself was that my work was really far from the patient. And you know we always wrote at the end of every publication and everything you put into a journal at the very end that this research will contribute to a cure for this disease. And I was very impatient. I still am. I had a hard time believing it myself and I really just felt so far away from the patients who were actually suffering from that disease. At the same time in academic research you really have to focus on particular problem or one particular area to be successful because it takes complete and total attention and passion for that problem and while I really enjoy going deep in particular areas and learning as much as I can about an area I really at the same time liked learning about a lot of new things and kind of pulling my head up from the hole in the ground and looking around. Yeah, there's stuff over there and there's stuff over there. Little like a square where it's like oh, there's a new idea and there's a new idea. And so at the same time as I was feeling far away from the patient and continuing to learn new things and go into new areas of research I also felt like I couldn't really commit to that type of a career from my lifetime. And so I figured out how to kind of navigate out of academic research which isn't easy because you're not really taught how to do that when you're doing graduate work or postgraduate work. And so I navigate and I worked in a number of different companies in a number of different startups in biotech in Medtech, really supporting them on some grant program. I was essentially learning about the business side of science and that was really really fascinating. And what I also learned while I was doing that was I thought I was far away from the patient I really had no idea how long it takes to get something from the lab to something that's an actual treatment. So that was very, very eye opening for me. It also opened my eyes to the possibilities. There are so many possibilities out there in terms of different careers. And so I did that more and more and learned a lot. And when the opportunity came to get inside of a health care organization I figured you know this is probably one of the closest places I could get to being closer to the patients so I couldn't really refuse that opportunity.

: That's awesome. Thanks for sharing your story. The epiphanies that you had along the way and now going on four years here with Providence after all this time you know from the bench to the company to the provider what would you say today Christianna is a hot topic that every health leader needs to be focused on?

: Yeah I say you know there are so many and a lot of your guests have brought up so many. I would say one that I in particular have a specific interest in that I think is just it's a massive societal problem that we all should be thinking about as citizens of this country and this world is mental illness and behavioral health. It is a huge massive complex challenge and it really is different from the challenges of physical health. You know you break a leg. You go in and you get it fixed and you're out. Mental behavioral health issues - they're just much more challenging the reason why they're challenging. They're not easily solved whether it be not enough providers who can help these folks. Not enough providers who will take insurance who take cash payment. Fair enough. They're quite happy doing that. Their schedules are full. Why take reimbursement when it's a pain in the neck to lots of forms and everything to this that follows behavioral health that keeps people from getting help. To the fact that it's a disease that sometimes you don't even know what you're feeling and what you're believing is actually a disease or something that is biological versus something that you're causing. We just don't understand the brain frankly that well right now we're learning a lot every single day. But it's such such a complex problem. And I think you know we have an investment in Lira health which is a company in the Bay Area that's doing great things and really trying to serve up a ten times better employee assistance program. So that's a way for people to potentially get better behavior health and as an organization where we've launched the well-being trust which is a separate non-profit focused on community groups and organizations that really deliver a lot of these services out in the communities. And I think one thing health care leaders need to figure out and we're doing this as well as seniors who are the partners we need to engage with because hospitals are probably not the best place to deliver care for the mentally ill but who can and how do we better connect with them and how do we support each other moving forward I think some of the biggest challenges we're facing in society.

: Yeah Christiana I think you're bringing up a really great topic and one that I think is like you said oftentimes either avoided or just stigmatize and definitely a space that we need to be spending more time in I mean from your perspective what can be done. I mean what is the future if we do it right, look like in five to 10 years?

: Yeeah I think you know we'll try to figure out a think of the one of the biggest challenges specially for start up companies is really figuring out the business model of who's going to pay for this type of care and what are the right economics to make this work. It's just a really really vexing and challenging problem I think that we know. We also know a lot about good, evidence based care. It's just really hard to deliver with the right economics that makes sense for folks so I think again much like bigger, broader health care figuring out where the stakeholders should be aligned what's going to motivate people to provide better care and how do we support the families and the friends of people out in the community who are suffering because so much can be done by people that we know. But we need to support them as well not just the patient because it really is the community effort. So that's also an area focus. And it's not, I think we also have to accept that technology will definitely add so much and help a lot but it's not the magic bullet we really have to figure out how to leverage technology to empower the humans to help us solve this problem.

: That's such a great call out, Christiana. And you know when we look at this so many times entrepreneur wars or large companies will try to just throw technology on top of a broken process or on top of broken system and it just doesn't work. That's right.

: Exactly.

: So what would you say right now you guys are doing that has improved outcomes. Maybe a company that you guys have partnered with or a project that you guys have started there at Providence Ventures.

: First I'll talk high level first about our approach, which I think is unique in healthcare venture. I mean we're not we're not new in healthcare venture that we're not the first. There's a lot of organizations out there that do this and there's different models for how it's done. And I would say you know our real goal as a venture is to invest in companies with whom we're going to be really close partners with. And the idea behind that is that we can invest the capital. But look if you look at there's a lot of capital out there which maybe isn't a good thing right now for the environment. There's there's an awful lot out there and you know we also have incredible scale. We have amazing assets to bring to bear as a just that massive health care organization that has footprint again across much of the Western United State. We have a ton of experts within our system and we really have a lot that we can add and to help a company be successful. So really what will try to do is both but we also need to drive returns to know that we don't want to forget that. So what we do is not we are a strategic venture fund but I would say that we are not a pure strategic fund and the three things that we do to try to check the box before we make an investment are: number one, we really try to look at the business as a stand alone entity and say you know if we are a financial investor would this be a smart bet. Can the company on its own show us that it's really a venture class business and it's something that we would invest in whether we have that resources or not. Second is what problem is that companies solving that helps us as a big health system is it one of our you know big hairy audacious problems that we have as a health system or is it kind of more in a smaller area or a nation and not that that's bad it's just something that you know with the scale that we have. We want to go solve the problems together.

: Yes.

: So we look specifically at what the company is doing and what it intends to do and how that's going to help us and what's the impact on us as a health system. And then third is what's the strategic value we can add to that company with the assets that we have which might be helping to risk a product in the earlier stages it might be testing out that platform and proving that there's real ROI behind it and it might be that you know if it's in one of our regions or one of our hospitals and we're really really excited and compelled by it how do we bring it to the rest of the system which is not is easy if you think that you might be in one hospital in a big system and it's just going to easily scale and deploy across the rest of the system and that is not true. So you know we really try to help those companies scale and so we're really looking for that win win win and the you know the theory is that if we're able to help the company the risk can get better and really make sure that its product is really fulfilling the needs of health care. You know we're not fully capacitated a system, we're a messy complex idea which is pretty reflective of the rest of healthcare across the country. And we also believe that most of health care is still delivered regionally so we want these companies to go out and sell the other houses straight. We don't want them we don't want to hold them close in our own. So we want to make sure they're scaling not just within Providence but across the rest of the healthcare ecosystem. So if we can line up those three things and it is not easy to do. But that's a lot of what we try to do during diligence so that when we do make an investment we are ready we say okay we've got our internal champions we got folks who you know said they were excited about this and compelled and they're actually going to put their heads and do some work on it. We figure that that's the right thing to do to make these investments work and actually return funds back to the system.

: Thank you so much for walking us through that process, Christiana. Can you share of a more recent company and one of the things that you guys are doing with them?

: Yeah I would say you know a couple of great examples one that we invest in a couple of years ago but that has been on the radar for a long time as Omada health. So they are a company and interestingly how they came to us was through our H.R. department. So they serve employers and health plans and they're really a digital therapeutic company that is all about prevention of chronic disease. And so they've digitized clinically proven programs that will hopefully prevent people from getting things like diabetes or obesity related chronic disease. And so they came to us in to our H.R. department that was really interested in finding something better for its employees. I mean health care employees actually largely are are sometimes in a worst case in terms of rates of for diabetes and obesity related chronic disease though actually piloted with Omada for about a year. And we as a venture team was it was early in our formation and we were able to kind of watch that relationship and watch the company get to know the management team and the timing was just great in that by the time we completed the pilot the HR team was really excited about finding a bigger deal and scaling it out to the rest of its employees and the company was raising it seriously. And so we made an investment. We came in alongside Norwest and some other strategics and you know overall it's the program's been delivered to almost 5000 of our employees who have collectively lost almost thirty five thousand pounds over three years and reduce their risk of diabetes by almost 40 percent. So they're doing great things. And you know sometimes we we always think about our patients but we don't want to forget about the people who are delivering care and their health and well-being is just as important as our patients because for them to be as healthy as they can and happy as they can in doing their work it's only going to make for a better health system overall.

Yeah, what a powerful example and actually Kristanna we had Lucía Savage from Omada on the podcast. She told us a lot about what they're up to and I think it's super cool to hear that you guys were involved with them early on.

: Yes. No they're great we really really enjoy working with them and they're doing really really important work. And I will tell you that you know nobody will ever say that prevention is easy. It is very very challenging. So they are tackling just a huge massive problem in society.

: Now that's for sure. Thank you for sharing that. And so you've been through a lot. Christianna folks Cristián is modest she's got her Ph.D. in Physiology. She's a brain in molecular and Cellular Biology. She's done a lot of really cool things you don't get there without hitting any roadblocks, Christiana so maybe I love to hear you could just share with the listeners a setback or failure that you had and what you learned from it?

: Yeah sure. So I go back actually to my graduate work and publishing your work is the most important thing in academic science. And so the culmination of my thesis work I was working on a gene therapy for Duchenne muscular dystrophy and this work was in my ear in mouse models and we had done some studies in older mice really trying to show that you could take older my suit already had muscle deterioration and go backwards and actually improve muscle function. So we did some studies. And you have a certain number of mice did a controlled environment and you know we did show some positive results and we got the papers accepted the DNA after the proceedings of the National Academies and it was all very exciting and the title of the paper was reversal of muscular dystrophy and MDX mice and as a graduate student you know you're ending you're getting close to actually earning that Ph.D. and then the article came out and the press got a hold of it which is not surprising. And I was working in the lab and the phone started ringing and the people who were calling me were parents of kids with muscular dystrophy.

: Oh my gosh.

: And I had no answers and I was kind of floored. And I thought wow wow. Like these people are holding out for anything and this is what really again kind of hit home and reminded me that what I'm doing is it's important. It's critically important what Donna's needs research labs but it's so far. And I have to tell them that. And so that is really incredibly eye opening and was hard because it happened at least five times that day. And so it reminded me I think you know it's just the huge learning is no matter what you're doing don't forget the patient from the other end. Right. I mean it's always always always have to think about that and be prepared for that because those are the people who really are in need and are going to be looking for answers.

: What a great story and a great message. Christiana how about the other side of the coin. You know that's one of the tough times. How about one of your proudest medical leadership experiences to date.

: Yeah you know I... in medical leadership. But again it goes back to just stuff that it is it's more simple but it has really, really long impact and especially when we talk about things like prevention. So you know one of the things in my bio is that I started and ran and sold a women's health business. And so what that actually was was a franchise business for new moms with their babies in strollers come into exercise class. And I did this while I was a postdoc at Children's Hospital in Boston and ran this side business and really this is out of necessity for my own sanity. I'd always been an athlete and I thought I had two very young girls and I thought how in the heck am I going to exercise. So this was a way for me to bring them with me. That's awesome. And so I ran these exercise classes for the new moms and they came together and one day we were outside and it was just a really neat day. And at the end of the class all the kids get out in there runs around and you see kids and they start doing push ups and sit up right next to Mom. And it just hit me that you know this is generational impact right? These are kids really looking up to their moms and saying hey we're in a group we have friends with us. You know we're doing something active. And this is important to mom, she needs this and it's fine right. And you know it just it really really hit me that I can be here and doing deals worth millions and millions of dollars. And that's important but you know I always go back to those moments of thinking I'm never going to be able to measure that in terms of our lives or dollars saved with those families down the road. I have to believe that that it really does have a lasting impact.

: Now that's another great example, Christiana. And I just kind of pictured those kids next to their moms and here you are you know in the middle of a Ph.D. program and meeting to find a way to just work out.

: So yeah, it's necessity.

: And I love that you did what you did because you know you not only did it for yourself but you identified that this is something that other women struggled with and you put something together. And I love the words that used generational impact with the kids doing push up next to their moms jumping jacks and what a great way to impact health.

: Yeah it was really really fun. I'll never forget that it was so different from what I would normally do and I have to call other franchis is called Stirling's tried sitting come up with the idea but it was a great opportunity because went into a franchise you know the marketing and everything is easy so the business side of it was actually fairly easy and running classes had been easy to me given my background coaching but it just, it really does have lasting lasting impact they think in and you know for women at a time when it's it can be very very isolating and really difficult. And so you know I would say that that group was not only working out and helping their health but they were getting advice from each other and supporting each other. And it was just an incredible resource for women in this place.

: I love it. And listeners you know take this example but don't just stop at Cristiána's example. Think beyond and the basic principle here is that just when you think you're alone with the challenge that you have at hand, look beyond and start a group, start a community because what'll happen is you'll find that there are a lot of people with the same challenge and you create an opportunity to form a community like Christiana did.

: Absolutely.

: Christiana tell us a little bit about an exciting project or focus that you're working on today.

: Yeah I say you know I come back to the work that Providence is doing in mental and behavioral health. There's a lot of effort internally focused on providing infrastructure for providers to share best practices to learn from each other because they think in a huge health system like ours it's probably no surprise that there's many many pockets of beryllium and to share those in scale those is really hard. You're talking about a population that's incredibly hard to reach and incredibly challenging to work with and see more positive outcomes. So being a part of this internal effort and really really trying to help folks figure out you know what are their biggest need. And then what are the technologies that will enable them to do a better job here. So I would say I'm watching this effort and I'm sitting right next to it and in it and I'm learning so much about this. And that's what I think I love about this job as well is that you know when you're making investments you'll often be calling folks and trying to do deals and figure out is Is it real is it really a problem but to be within the health system and just have this kind of access to the real challenges that people are trying to solve right now. It's incredible learning. And so to be able to be learning real time how people are trying to solve this problem and then to be proactively able to say, OK well if there's a technology or solution out there in the market that we can bring to bear that can actually help solve that problem then we can be a great partner to folks within the health system. So I'm just I'm really excited about the learning because it just never stop especially in this space where there are such big challenges.

: That's brilliant. Let's pretend a Christiana you and I are building a medical leadership course on what it takes to be successful in medicine. It's the 101 of Christiana DelloRusso. So we're going to build a syllabus with a four question lightning round followed by a book and a podcast that you recommend to the listeners. You ready?

: Ok.

: All right. What's the best way to improve health outcomes?

: Dig deeper with intention to address the cause not just the symptoms. I'd say it's another way of saying look for the social determinants of disease.

: Beautifully said. What is the biggest mistake or pitfall to avoid?

: Not listening.

: I love how short that was too.

: You said it was lightning.

: I love it. That was beautiful.

: Lightning round okay.

: How do you stay relevant as a health organization despite constant change?

: To getting outside of our box and continuously learning.

: What is one area of focus should drive everything in a health organization?

: Do excellent work.

: And what would you say. Christianna is your favorite book and a podcast that you recommend to the listeners.

: Let's see, favorite book. I would say I don't these days. I'm a morning person and so any attempt to read anything at night. I usually get two or three sentences so I can't say that I have read anything of depth any time recently but one that I continues to remind me of some of the most important stuff in life is Atul Gawande's Being mortal. I think everyone in health care should read it. Everyone side of health care should read it because if you talk about where we spend most of our healthcare dollars towards the end of life and the satisfaction of people at the end of life which is not very high I would say that is an outcome that individuals and families have the power to really change just by having some difficult conversation. Now I say that like it's easy right just by having..

: That's all you gotta do.

: But I think his book is so moving and personal it really helps to kind of kick off. What could those conversations be about. And it's just done. It's done so well and it's beautifully written and I still think about it all the time. So I think that people should definitely do that.

: A great recommendation. And how about the podcast.

: I really like Kara Swisher's podcast. What's the name of it. Recode is I think it's recode decode. I just love how she doesn't care. She just asks really hard, important questions.

: That's awesome.

: And so I think she does a fantastic job, she's super entertaining and she really just you know she she gets the truth out there which I think is important.

: And what does she focus on. What would you say the show is mainly focused on?

: Yeah I'd say a lot of you know big tech, high tech Silicon Valley but she's had a couple of really great influential female VCs who've talked about some of the issues facing the venture industry and the treatment of women. And so she's really gone deep with a few folks there that I have found to be very very helpful and inspiring and needed at this time.

: Beautiful. Listeners, take this syllabus learn from and practice it put it into action. You could find everything on outcomesrocket.health/Christiana and you'll be able to get all the show notes as well as links to the books and podcasts and everything else that she mentioned here on our podcast. So Christiana, before we conclude, I'd love if you could just share a closing thought as well as the best place where the listeners could get a hold of you or follow you.

: Yeah sure. So I would say my closing thought again I come back to this big massive complex messy health system that I work in and I'm so fortunate and grateful and humbled every day by the people in our system who delivered direct patient care. So they're out on the hospital floor as they're in the clinics. There are skilled nursing facilities and just they have so many amazing stories. And again this is what brings me closer to the patient and reminds me that everything that I diesel will hopefully, ultimately, positively impact those people and I think healthcare to a great extent. Technology has done in its interim form and we know it takes many many years but especially in healthcare technology has done a great disservice to these folks given its legacy infrastructure and its the lack of ability to change and upgrade and it's largely in some places taking the humanity out of health care. And what I'm hoping for is that we can really technology can be such a great enabler and if we can by investing in companies and helping them be successful if we can leverage technology and create this beautiful irony of putting the human back into health care and restoring the humanity to it. That's what I think is ultimately what we're trying to accomplish.

: Awesome. And what would you say the best place the listeners could get ahold of you is?

: You know our Web site is providenceventures.org We have our portfolio my contact info is on there but that helps give a little bit more background about the fund and what we're doing.

: Outstanding. Christiana, this has been awesome. Really appreciate all the words of wisdom and ideas that you've shared and also the amazing storytelling that you do so it always makes for a very dynamic episode. A big thanks to you and we look forward to staying in touch.

: Thank you, Saul. I really appreciate you having me on. And it's a great thing that you're doing so thanks for what you do.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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Recommended Book and Podcast:

Being Mortal

Recode podcast

Best Way to Contact Christiana:

Linkedin - Christina DelloRusso

Mentioned Link:

http://www.providenceventures.org/

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