Addressing the Opioid Epidemic with a Mindful Meditation Solution with Dr. Ruben Kalra, Founder, CEO at WellBrain

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 a wonderful treat for you. I’m sitting here with Dr. Ruben Kalra. He is a physician and MBA, is the co-founder and CEO of Wellbrain. It’s a mission driven company addressing the opioid epidemic by providing a proprietary scalable digital health platform that decreases human suffering and optimizes patient function. He’s a Harvard trained medical doctor with double board certifications in anesthesiology and pain medicine Dr. Kalra is a physician and entrepreneur passionate about combining mindful meditation practices which you all know I’m passionate about as well and biofeedback technology to customize a better patient experiences. Now Dr. Kalra also is a partner and current president at pain management consultants. It’s a practice in the San Francisco Bay Area with top trained physicians who take comprehensive approaches toward addressing pain therapies. Dr. Kalra is passionate both for helping patients as well as improving the way that we address the opioid epidemic. And it’s with great pleasure that I welcome him to the podcast. Ruben welcome.

: Thank you. I really appreciate the opportunity to be on your podcast. I’m a fan and I was considered and honored to be invited and share our knowledge and experience at Wellbrain and hopefully share with other leaders and even help more patients out there.

: That’s outstanding Ruben and I really appreciate that. So tell me what is it that got you into the medical sector to begin with?

: Well the young age my dad a research professor at the University of Southern California medical school he’s actually been there I guess almost 50 years. Is the kind and the smartest man that I know and you know, he inspired me to make a positive difference in the lives of others at a young age. And he was a researcher and I always liked the social aspects and being on the front lines and I just remember a young age knowing that it wanted to be a doctor.

: That’s so awesome and shout out to your father for having such a great influence on you. So fast forward now Dr. Kalra, you’ve got a tremendous impact in your community, your leadership as a physician and now entrepreneurship as well. What do you think a hot topic that needs to be on every medical leaders agenda today. What is that and how are you guys approaching it?

Well I think the one buzzword out there is not necessarily a buzzword but fast approaching machine learning and artificial intelligence. I don’t think people realize the positive impact that artificial intelligence is going to have in helping make better decisions and guiding care. At Wellbrain, we’re integrating machine learning and artificial intelligence that help the 100 million patients in the United States living with chronic pain. And I think the beauty of our artificial intelligence is rather than this cookie cutter medicine approach we’re going to be able to unscale to the power one where we’re providing personalized care, using data that and knowledge provide better patient experiences and outcomes.

: That’s really interesting and so I’m always fascinated by companies that are able to take it as a buzzword. Like you said and actually apply it. So Dr. cholerae can you give us an example of how Wellbrain you and your team there are creating results and improving outcomes through this?

: Yes absolutely. I mean I guess one of the good example is just imagine in the doctor’s office, a patient comes in they get handed an iPad which has the Wellbrain platform on there and the patient answers a battery of different psychological questions and then based on the results customized the mindful meditation and chronic pain management program that doesn’t involve opiates to be personalized physical therapy. And as we get more and more patients into our program tens of thousands of patients at this point we’re learning what works and what doesn’t work for patients. The good example that we have a 42 year old female who maybe had Bachelor’s degree also has some anxiety depression and some addiction issues. We’re able to sort of identify that using our program and I can tell you so far with the data that we know we sort of have to approach the anxiety before we get to the addiction. Otherwise we won’t get this patient engaged in the program and this is just based on the data that we’re looking at and what we’re seeing so far with Wellbrain has been pretty impressive with the patients that are using the program. We’re seeing a reduction in possibly emergency room visit, a reduction in opiate use. And most importantly an improvement in pain. And I think it’s only going to get better as we get more patients in the platform and we learn from them,we’ll be able to personalize the management program for each patient.

: That’s super fascinating Ruben. And folks if you’re curious the website as wellbrain.io you’ll be able to take a look at what they’re doing really just kind of taking a look at this problem of chronic pain management. I mean it’s an issue that that is really affecting millions of people in the U.S. and why not take a note from the east and take some of these medication practices and combine it with the science of machine learning and do something about it. Now as I understand Dr. Kalra there’s there’s a Buddhist monk as part of your development team?

: Yes. Yes so the Sean Pargo was a former Buddhist monk and yet of all things he approached me and then a couple of years ago and said this was sort of his calling to bring mindful meditation to those folks that might not otherwise be exposed to it. And he also educated me that there were specific meditations that may be more effective for certain medical conditions than others and he helped create a pretty robust platform where we have specific meditations for plotting or knee surgery or specific meditations for migraines and post-traumatic stress disorder. It was sort of terrific having this foundation of Michael meditation which is where we started. And now we’ve sort of moved and realized that mindful meditation’s fantastic but we can continue to customize it and provide patients other validated evidence based modalities that are help for pain such as personalized physical therapy. We just partnered with like routine Behavioral Therapy Service so that we can provide patients with different modalities that are helpful and then like I said in the background use machine learning and artificial intelligence to personalize the recommendations for our patients.

: Super intriguing. And so folks if you’re looking for a different ways to tackle this problem the opiate problem and also the pain chronic pain issue. Something to take a look at. So Dr. Kalra, as far as getting folks on the platform are you guys mainly targeting payers are you mainly targeting providers. Who’s your main audience may Customer?

: Yeah right now we’ve been targeting providers and it’s been sort of figure out who the ideal customers are and providers who are looking for other options have been our initial target. But like anything else everyone’s eager for opiate epidemic solutions so that we have hospitals Kaiser specifically their innovative team be excited about what we’re doing and Evencare to come to us and said well if you can make a difference we’re interested in the end of the day we want to make a great product was helpful and it will not only be in the interest of patients but providers hospitals and even the pairs.

: Very cool. I think it’s a super fascinating approach. Can you give the listeners an example of a time when you had a setback, what you learned from that setback and how it’s made while brain or even yourself stronger because of it?

: Yeah definitely it was early coming out of the gate. I guess a little brief history that we started Wellbrain, we didn’t intend to start the company, it sort to meet a need or practice a few years ago before the epidemic came to fruition and the news we started to see a lot of patients are coming to our offices of pain management where they maybe wanted opioids for the wrong reasons maybe they wanted it for anxiety, history of addiction or insomnia and the child we had at the time as patients didn’t want to see a psychologist or a psychologist and take insurance so we were taking on a lot of risky patients. Incidentally my partner Dr. Longton one of the founders wash it had talked about in meditation neuroscientist that went to India studied the brainwaves the month and came back with the first measurable form of meditation. Why is that important said. Ruben I look at all the data and the data from mindful meditation for pain anxiety depression is phenomenal. It’s way better than anything that we do and so we sort of put two and two together and the genie in office we can do a battery of psychological tests and based on the results give me my meditation in the office and instead of patients complaining about reading about the Kardashians and US Weekly well while Zollverein write at this because essentially the most management tool and over the course of three four months we started page we started seeing patients go wow this is traffic. I’m getting better I’m using less opiates and the mistake that we made is we said OK let’s go to a conference we have something that’s going to be mind blowing. It’s terrific. I went to a conference for pain doctors and pretty much the response at that point this was years ago was actually not that long ago it was “a Dr. Kalra, you’re an idiot” on mindful meditation. But the press conferences are like why do we think this is something fantastic. You know there’s a bias coming from San Francisco and mindful meditate. You know the rest of the world they want it to hear too. So we we sort of took that lesson and like doctors and it’s maybe something unique about our companies what role as well it’s shown the data. So when it did a 200 page study said noted that 60 percent of patients who were offered this platform would want it. So basically we could come back and tell doctors say 6 percent of patients who use this in a bunch of offices of the country would actually want it if you offered it to them and the other cool thing that transpired was while he did this in the medical office that they actually reported reductions in both physical and emotional pain those people were like OK patients only want this but it uses that money you really you’re actually going to maybe get better.

: Love that. What a great story. Ruben and thank you for sharing it. You guys didn’t let that stop you. You developed the clinical data to support and then you brought it back and now it’s starting to get some traction. So kudos to you and your team for getting that going.

: Thanks Saul, I appreciate that.

: And I think that’s a lesson for everybody listening to take a lot from. So you could have your product but when you’re playing in this healthcare space you really have to have your evidence based results out there. And the U.S. is one thing,if you’re looking to go beyond they do it differently in other countries and then it’s the payment model making sure you have that payment model in place and finally the logistics to be able to support the manufacturer, production and distribution of it. And Dr. Kalra is really highlighting the importance of this clinical piece. So again just talking to Dr. Ruben Kalra from Wellbrain. Check them out at wellbrain.io. Fascinating approach to chronic pain. So taking a look at the other side of the coin, Ruben, tell us about one of the most exciting and successful moments you’ve had in medicine today?

: That’s a tough one. I mean I definitely enjoy getting patients better. One in a one on a daily basis. But with wellbrain and digital health I think there’s an ability to scale that to a much larger audience and it’s a proud moment. Sometimes they know. Several years ago before Wellbrain our group was approached by this entity top acquires and Sensing that working for a big medical group and most of the other doctors sold and we said no. And I think one of it was just trying to maybe let a lot of money and label but there’s something to be said about controlling your own destiny and control your own time rather being an employee. And with that decision it enabled us to have her own schedule and essentially enable Wellbrain to come into fruition wouldn’t have that would have happened otherwise just because we were able to scale her own we decided on time schedules and focus on something that was going to be much much bigger than our own practice and the patients that we helped.

: You know that’s so fascinating and yeah there’s been a huge wave of I mean I think we’re on the on the end of it now because the majority of physician practices have been acquired and so kudos to you and your team. Dr. Kalra for holding strong and now having a huge impact because of it.

: Thank you, I appreciate. You ever heard of a dying breed like Prabal. But we hope so. We hope there will always be a room for private practice doctors.

: You said like travel agency cozI love it. Oh man. So while brain is obviously an exciting project within Wellbrain itself, Ruben, what would you say. An exciting focus area or project that’s going on right now?

: I think one of the most exciting things we’re we’re doing right now is we actually just recently acquired another digital health company soon to be announced probably as we called Nevoked.

: And what does it called?

: Nevoked, N E V O K E D.

: OK, Nevoked.

: And it’s a company that uses big data and behavioral phenotyping to basically help patients with postpartum depression. Postpartum depression underdiagnosed and that only affects families children mothers. And what’s unique about the company is not only another a vertical force and we know the company and the management team for a long long time. We always talk about working together but we are sad about the technology that they’re going to bring to us for the chronic pain which is not only with Wellbrain we’re getting a valuable objective data through surveys and questionnaires and patient profile but we’re also with Nevoked and to be able to not only help manage patients but manage patients at the right time because with behavioral phenotyping, we will know a patient let’s say through their phones. Have they been on the phone the entire night looking up the web or and not sleeping today. Do we need to send them insomnia medication to get them better. Then I left their house in 3 days. Maybe they needed to for a wellness check to make sure they’re not profoundly depressed. And I think we’re excited about the future of not only artificial intelligence but helping deliver the right care at the right time and acquisition of Nevoked will not only help patients with chronic pain but really be able to soon enough cases of postpartum depression with a nicely intergrated product.

: That’s fascinating. Dr. Kalra, what percentage of what you do then within these companies and it’s pretty exciting. You know the acquisition of this firm. What percentage of it is mental health including your workout Wellbrain.

: I would say almost 100 percent mental health. What’s interesting about chronic pain is almost 60 percent of chronic pain, 6 percent of patients with chronic pain have some degree of anxiety or depression or what we would define as a mental health condition and too often it’s challenging to figure out the chicken or egg which one came first. The pain came first or the anxiety and a lot of time it’s a self-fulfilling prophecy the patient hurt, they can’t move, then they start getting aches about moving then they get depressed because they can’t do what they like or muscles get because they’re not exercising. And it fuels this cycle that sometimes can spiral into addiction and overdose. Definitely, everything I do is focus on mental health.

: So fascinating and and I think listeners were getting to the point where we’ve got to make this realization and they feel like you know Dr. Kalra here and his and his team have made that connection. But I think as as a whole in health care, we’ve got a beginning incorporating the mental health piece with the physical health piece in a way that’s impactful and it’s super exciting Ruben to see that you and your team are doing that.

: Thank you, I appreciate that Saul.

: So getting to the end here what would you say. Right now we’re going to build a leadership course. OK. And so it’s called the 101 of Dr. Rubin Kalra on how to treat chronic pain and mental health to improve outcomes so I’ve got four questions for you lightning round style followed by a book that you recommend to the listeners. You ready?

: Yes.

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

: I’m a specialist so this will be surprising coming from a specialist a specialist doctors say but is being proactive and preventive rather than reactive. Digital Health and artificial intelligence is going to help prevent problems before they become problems and at least enable unable to manage them better?

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

: Making sure key stakeholders are involved in the decision making process when you’re bringing a product to market. This was important at Wellbrain where we felt engaged in positions was important in eliciting positive change on the part of patients.

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

: And the tough one but being adaptive and iterative and always keeping your eyes on the ground and what’s coming next. I think having a noble organization such as at Wellbrain where our offices are essentially below a pain practice so we can actually rapidly go upstairs, deployed product get feedback continually get feedback from the customer and continue trying try to develop in a positive way.

: Outstanding, and what is one area that should drive everything in a health organization?

: I think the mission every company has a different mission for Wellbrain, We, our mission is pretty simple. We’re to protect on the obesity epidemic by trying to provide physicians and patients with everything that isn’t obese to get them better. And by having this focus attracted just a plethora of phenomenal people to come to the Wellbrain team who are not only focused on delivering a great product but actually making a positive change in the community.

: Love that. What book do you recommend to the listeners?

: My wife give me a hard one part time when we were surfing at Costa Rica and I brought along a survival in Auschwitz by Primo Levi and she said that was a pretty hard read for being a shore of Costa Rica. I tell you. It’s the story of a survivor of the Holocaust. All my time at Auschwitz. And while it’s appalling it is a testament to the power of the human spirit and our ability to overcome. And as a founder and entrepreneur, we are heartily tested and this book you know, I just referred to HealthSpring restrength during challenging times.

: Wonderful recommendation. I haven’t read that one but I’ll add it to the list Ruben. I had a chance to read Viktor Frankel’s Man’s search for Meaning and boy.

: It’s terrific book.

Oh my gosh. Yeah I mean talk about giving you strength when you need it most. Just inspirational. I Appreciate that recommendation. Hadn’t heard about it before. Listeners, if you’re in this entrepreneurial space or also as a provider looking to tackle huge challenges. Take this book make a note of it and read it. You could find all the show notes as well as a transcript of our discussion go to outcomesrocket.health/wellbrain, that’s well, W E L L, brain, B R A I N. This has been a ton of fun, Ruben, I appreciate the opportunity to connect with you if you can just leave us with a closing thought and then the best place where the listeners could collaborate with you?

: Oh awesome, sure. Her life is a gift enjoy it maybe as a clinician I’ve seen a lot of my debt a lot of debt during my time but burnout is real especially for founders. As I told my patients you take good care of yourself before you can take good care of others. So both are high for go surfing and smell the roses don’t travel. If you’re looking for a rational reason to do that evidence basis since I’m a doctor. Studies have shown by taking vacations shut out your phone, it’ll actually make you more productive and a ton of fun.

: I love it. I love the evidence base there at the end and the encouragement. What would you say the best place for the listeners to reach out to you or collaborate with you, email address?

: Yeah,sure. They can email me anytime. It’s just my my first initial rkalra@wellbrain.io.

: Outstanding.. Again, just want to thank you Rubin for spending time with us this has been insightful and really excited to see where where your company takes the space in the future.

: Thanks I’ll look forward to listening more of your podcast.

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.

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