Transforming Mental Health Care with Dr. Nick Allen of Ksana Health

Mental health plays a major role in our quality of life, relationships, personal and professional success, and more. Unfortunately, mental health is also something a large percentage of our population struggles with day by day.

In this episode of The Digital Footprint, we sit down with Dr. Nick Allen, Founder and CEO of Ksana Health. Ksana Health is on a mission to transform mental health care through objective measurements and personalized prevention. Utilizing mobile technology, Dr. Allen and his team are looking to move beyond the traditionally subjective "How have you been feeling?" approach to mental health care by gathering objective data on patient behavior.

Ksana Health's digital products, EARS and Vira, leverage remote sensing, objective data capture, centralized dashboards, and AI driven insights to bring new tools and insights into mental health care.

Dr. Allen talks about his experience in academia and research and how it compares to leading a startup. He also shares advice and lessons he's learned along the way.

Guest-at-a-Glance

💡 Name: Dr. Nick Allen

💡 What he does: Dr. Nick Allen is co-founder and CEO of Ksana Health

💡 Company/Project: Ksana Health

💡 Noteworthy: Dr. Nick Allen is a professor at the University of Oregon in clinical psychology and director of clinical training. He's been working primarily in the area of mental health of young people.

💡 Where to find Nick: LinkedIn

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Connect with our cohosts Richard Simms & Carlos Gonzalez on Linkedin

Transcript

E661389B_9 - TT - Digital Footprint - Dr. Nick Allen - Transcript

Richard Simms: [00:00:00] Hello and welcome to The Digital Footprint. I'm Richard Simms. This podcast is brought to you by Tyrannosaurus Tech, an award-winning technology partner dedicated to designing and developing high-impact software products. Very excited to have Dr. Nick Allen, co-founder and CEO of Ksana Health joining me today. Nick,

[00:00:22] welcome to the show. 

[00:00:24] Dr. Nick Allen: [00:00:24] Thanks, Richard. It's great to be here. 

[00:00:26] Richard Simms: [00:00:26] Absolutely. I've been looking forward to this and I've enjoyed getting to know your co-founder, Will Shortt, here in Atlanta over the last year or so. I know you're based out in Oregon. I've been following, you know, the progress with Ksana Health, there's been, you know, a lot of good stuff going on, some exciting announcements recently.

[00:00:45] And, of course I know Will is a little more, you know, has that, that tech and business background, but given your background as a doctor, a professor of psychology, I'm looking forward to, kind of, digging it in, digging into it with you, you know, on the products and, kind of, your, your perspective on this innovative approach to, to mental health.

[00:01:05] Dr. Nick Allen: [00:01:05] Sounds great. 

[00:01:07] Richard Simms: [00:01:07] Cool. So, let's get started. Do you mind first just taking a minute or so to quickly introduce yourself, tell folks a little bit about Ksana Health?

[00:01:17] Dr. Nick Allen: [00:01:17] Absolutely. So, yeah, so I'm a clinical psychologist by training. I, I, I'm originally from Australia as people can probably tell by now if they didn't know already. And, but I, I live in the US, I'm married to an American and I've, yeah, I've been working on, in, primarily in the area of mental health of young people, most of my career.

[00:01:36] So, I've been very interested in adolescents and early adulthood is this, sort of, period of life that's really critical to understand, if you're going to try and understand people's mental health journey across their lifespan. And, the reason for that is that for many people who are going to have a mental health difficulty or challenge in their life, it'll probably emerge in childhood or especially during adolescence.

[00:01:59] And, we see that for a lot of, like, problems like depression, substance use issues, eating disorders, and then later in adolescence and early in adulthood, you see problems like schizophrenia and other problems like that. So, it's really a period of life that we want to understand deeply and know how to help people early so that we can really be preventative if possible.

[00:02:21] So, yes, I've been working on that for my whole career. I'm a professor at the University of Oregon in Clinical Psychology and director of Clinical Training there, and, but also I've done clinical practice, research training, you know, all the things that my profession does. So, yeah. So, around about eight years ago we started getting really interested in digital technology because we were frustrated with some of the limitations of the current mental health care system.

[00:02:50] And I started to get very interested in where the digital technology could help us overcome some of those limitations that we've been wrestling with for a long time. And, it was an interesting time to get involved in digital technology as something that could support mental health because a lot of people, especially parents of young people, worry that the primary thing about digital technologies is that might be harming people's mental health.

[00:03:13] And, of course, my view is that technology is like anything, any technology has risks and benefits. And, what we tried to do over time is understand what the benefits are and how to maximize those and what the risks are and how to minimize those. And so, I really wanted to explore this issue about how we could use it, to overcome all the problems that we have.

[00:03:35] We have problems with access, "How do people get mental health care?" We have problems with the quality of mental health care, we have problems with, you know, making sure it's effective and digital technology has some role there. So, we started doing research with digital devices and digital tools to measure behavior and, and got some grant-funding from the NIH to do that.

[00:03:59] But about two years ago, I really felt that the best way forward to really have impact with this work was to start a company and to use the company as a way to really get it out there and in people's hands and hopefully having a positive impact on people's lives. So, that's when we started Ksana Health.

[00:04:18] Richard Simms: [00:04:18] Very cool. Yeah. And I'm going to, you know, probe further about the specific products you're working on right now. But, you know, in light of that introduction, one trend I've really been happy to see, over the last several years, especially, is the topic of mental health coming more to the forefront of the public dialogue.

[00:04:37] I think everyone from celebrities to, you know, high-profile, very successful business leaders seem to be a lot more comfortable sharing their mental health struggles, which I think is great, you know? And, you being so close to this, obviously, you know, really building your whole career around this, do you think the stigma behind mental health

[00:04:59] is dead? Is it fading? Like, how much further is there to go on that front where, you know, everyone who needs help feel as comfortable and hopefully has resources.

[00:05:10] Dr. Nick Allen: [00:05:10] Sadly, I think we've got a long way to go. I, I,  I do agree with you that I think the level of public discussion about mental health and the stigma associated with mental health has improved dramatically over the last, I don't know, pick any period of time, 20 years, 50 years, you know. The, the public understanding of mental health has improved, the level of stigma and shame around mental health issues has reduced. People understand that mental health problems are tradable, that you can recover,

[00:05:41] you can throw thrive, even though you might be dealing with issues like that. So, that's really positive. I think the thing though, that we also have to take into account, is that while this has been happening, we haven't seen a corresponding reduction in the burden of mental health problems in the community.

[00:06:01] So, if you look at the epidemiological data, you know, the data about how many people are experiencing mental health problems and, you know,  the community and how long they're lasting that has to be a way out, that really hasn't changed over that same period. So, while I absolutely embrace the improvements that we've had in the areas of stigma and public awareness, we've also got to recognize that that hasn't translated yet into reductions in mental health difficulties in the community. Yeah, mental health is a tough problem. It's a tough one to solve, but we have seen dramatic reductions in lots of medical conditions over this period, particularly infectious diseases, obviously it improved, but things to do with obstetric practice, you know, dramatically improved over this period.

[00:06:50] There's a number of areas where we're making very significant advances, and even in some areas of cancer and other major diseases like that. So, those of us in the mental health field, we're still wanting to find our way to really have that kind of impact, you know, to see those, the, the, the community impact of those problems reduce over time and that's something we're not seeing yet, so that's why we've still got challenges. 

[00:07:14] Richard Simms: [00:07:14] For sure. Yeah. That makes, makes a lot of sense. And, you know, I think that's a testament to, I'm sure, what, what drives you in your mission day-to-day with, you know, Ksana Health and with being a professor and, and researching all of these, these things. So, very cool. Going back to the products,

[00:07:30] my, my high-level understanding is, you all have two products, Ears and Vira, and they serve, you know, they're somewhat similar, but they serve different purposes, different markets. Can you tell us a little bit more about them and you know, which came first? How did they evolve? I'd love to get some insight there.

[00:07:50] Dr. Nick Allen: [00:07:50] Sure. So, so both of those products are based on a core technology platform and the core platform is really, uses a method that we call "mobile sensing." So, it's basically using people's personal smartphone to collect data on their patterns of behavior and use those data to actually understand, you know, what, what, what their daily life experience is like and how they're functioning now.

[00:08:17] There's, there's some exciting things about that, and there are also some very serious caveats. So, let me, sort of, talk about both of those. The exciting thing about it is that, you know, there's all these sayings like, "You measure what you treasure," or, "You can measure, You can only manage what you can measure,"

[00:08:35] and we've been really, really terrible at measuring behavior. And the reason for that is because the main way we measure behavior right now is, we give people, we ask people questions about what they think, about what they are doing. And, that's important data. I'm not against that kind of data, but it never tells you the whole story.

[00:08:57] So, the first thing about these kinds of data is that they're what we call "objective." They, they're actually, they give you a measure of behavior that is not just the person's opinion about what they do. And, we know that's important because there's lots of areas where if we have an objective measure and a subjective measure, we know that they don't always correlate very highly and sometimes they don't correlate at all.

[00:09:17] So, for example, sleep. If you ask someone, " How, how, how's your your sleep?" They'll give you an answer, "I sleep badly. I sleep well." If you measure their sleep objectively either with a wrist-wearable, like a Apple watch or Fitbit, or with a, or with a, you know, if you put them in a sleep lab and you stick electrodes on their head and you measure their brain waves, you often find that those things don't correlate very highly. You can also see in substance use, you know, if you ask people about are they using substances and then you have a urine screen that tells you objectively whether they're doing that. Once again, it's not the whole picture. And, the same can be true for many other things. Condom use is another example where people have looked at objective measures of whether people are using condoms for safe sex, and they're asking them and you often get a different answer.

[00:10:04] So, the point is, in the mental health area, we've only had the subjective data. We almost entirely run the whole system on asking people, "How are you doing?" And, that's an important question. I don't want people to stop asking that question, but we don't have the objective data. So, having this method for collecting objective data is very important.

[00:10:28] And then, the second thing is we can continuously collect it across time, so that means that we can, sort of, get this sense of what are the patterns or the changes that are occurring within a person, so you can compare the person to their own baseline, not to some other theoretical average that, that maybe they should be compared to. 

[00:10:48] Richard Simms: [00:10:48] Right.

[00:10:48] Dr. Nick Allen: [00:10:48] So these, these are very exciting in our field, you know? The idea that you could measure behavior in this new way, and because you're using this smartphone, this supercomputer that everyone's got in their pocket and that they're using all day, and you're asking people to just use it as they would normally use it,

[00:11:03] it's, it's a, it's, it's also a very feasible and scalable method of measuring these things. So, so that's, that's the good side. The downside, and we may want to dig into this in some more detail, Richard, is that, is that, obviously, there are very significant privacy and security issues collecting these kinds of data. And so, what we're trying to do is work out a way of collecting those data that is, makes, provides the best value for those data to the person themselves and to the people who are helping them with their health care, but also gives them the highest level of privacy and security so that we're not selling it for ads and doing that thing. I think people's experience of collecting digital data has been so, so profoundly influenced by their experience of social media and other big tech companies who are essentially trying to target them with ads, but they tend to assume any use of digital data is going to have the same goal. And so, I think we've got some work to do there to explain to people that it is actually their data and someone who can give that data back to you in a useful way is actually empowering you, which is very different from someone who's collecting it from you in a sneaky way, without telling you what they're doing, and then using it to manipulate you to buy something that maybe you didn't want. 

[00:12:18] Richard Simms: [00:12:18] Right. Right. Well, that's all super interesting. I definitely, of course, understand what you're saying as far as the objective measurement. So, I can just imagine scenarios where, you know, if I'm meeting with a therapist, you know, every other week or something, and you know, I come in and I say, "Well, I'm feeling great right now,"

[00:12:40] and they look back and they see that actually I self-reported three days in a row, the week before, that I was feeling really down. They can see, I didn't get exercise those days, you know, they can see I didn't sleep well, of course, I assume they can more readily identify patterns in the behavior that the individual might not recognize,

[00:12:59] like, "Hey, it looks like when you go to bed at this time each night and when you exercise and when you spend at least a half an hour outdoors, you report much better mental health." Right? So, and, and that makes total sense, and I, I think that's very cool. Actually, Richard, that's a good segue for me to try and answer the question you actually asked last time, rather than the one I went off on intangibly.

[00:13:22] That's all right.

[00:13:23] Dr. Nick Allen: [00:13:23] So, I can, I can briefly relate the two products to that, to those scenarios you just said. So, so our product called "Ears" is, Ears stands for Effortless Assessment Research System,

[00:13:36] and, and basically that's a tool that researchers use who are interested in human behavior. And so, we've had that product in market for about 18 months now, maybe a bit longer. And, we've had a lot of success with people wanting to use that because it is such an exciting new way to look at human behavior,

[00:13:53] and to try to understand the problems that people are trying to address in their research with human behavior. So, that's the Ears tool, sold mainly to university-based researchers and hospital-based researchers who are looking at health and human behavior. And then, the second tool, the second product, sorry, is called Vira, and that's, that's our healthcare product.

[00:14:14] And, that's much earlier in the development cycle. We're just doing some piloting now with that. But it's, but it's got the, exactly the goal  you articulated, which is to use these data in healthcare to say to the person themselves, "Hey, here's some interesting feedback about your patterns of behavior and particularly how do these correlate with your own mental health." Sleep is a great example.

[00:14:36] People, the research tells us very clearly that sleep influences people's mental health, quite powerfully. But very often individual people don't notice that pattern in their own lives. So, you're in a crappy mood one day, and, you know, you're arguing with your partner or getting annoyed with your work colleagues or whatever it is.

[00:14:56] And sometimes it takes a while for the penny to drop that, "Actually, I had a really bad night's sleep last night. I'm tired. This is why I'm experiencing it." But very often people don't make that connection, and so this is a way of helping people to see these patterns because that's actionable information and they can, sort of say, "Okay, well, gee, this sleep thing really seems to be important for my wellbeing.

[00:15:16] Maybe I should pay some attention to it and value that a little bit more in my health care." 

[00:15:23] Richard Simms: [00:15:23] Yeah, absolutely. Well, very exciting. That makes a lot of sense. So, changing gears a little bit, one question I had for you, you all started the business in 2019, so COVID hit pretty early in your startup journey. You know, I think, kind of, everyone understands that affected people's mental health tremendously globally.

[00:15:46] How did it affect things specifically with Ksana Health in your journey to, kinda, have that huge shift early in 2020?

[00:15:56] Dr. Nick Allen: [00:15:56] Well, you know, it goes without saying that the COVID pandemic has been enormously difficult and stressful experience for all around the world, and so, you know, and obviously has resulted in enormous death as well as stress, illness, it's exacerbated inequality, you know? Since a lot of negative effects are there,

[00:16:22] and the reason I need to really emphasize that is to say that, however, as it turns out, some solutions were well suited to the times and, and in, and in many ways our solution was, it wasn't designed for such an event, how could we have known, you know, but, but, but it was well suited to the time. So, for example, if you are a researcher doing research on human behavior, typically you would get your research participants to come into the lab and you do things with them.

[00:16:53] Well, the fact is our solution was a solution where you could do some very detailed data collection with people remotely. And so, that was, that was, that was, that helped to solve a problem that the pandemic presented. And then, the other, and of course, on the other side, one of the massive effects of the pandemic in turn that will probably be ongoing is this effect on how we expect to receive health care. And, you know, in some ways the pandemic, despite all those terrible effects has, kind of, taught us some things. For example, you know, it wasn't uncommon before the pandemic, if I was asked to, that I would get on a plane and fly all the way from Oregon to Washington, DC to go to a 4-hour meeting,

[00:17:39] and then I would, you know, some government agency or something like that, and then get on a plane and fly back. And now, that just sounds completely insane. You know, like, I think our perspective on how you need to do that kind of work has completely changed. And, the idea that one would, you know, get, you know, use all those resources, and time and so forth, to be at a meeting that you could do in a different way has changed.

[00:18:02] And, I think that's also true with healthcare. I think, you know, we had this assumption that healthcare was something where you had to go and see the doctor, you know, you had to be in the room with someone, and that's absolutely true for many aspects of healthcare, but mental health care, in particular, is one where, you know, it doesn't involve a physical exam, usually, it's  largely informational.

[00:18:22] And so, the idea of offering it to people virtually, suddenly, all the people who may have said to themselves, "Nah, not going to try that, it's, I'm not a techie person," you know, whatever, they had do it. And suddenly, we found, "Well, it's not, you know, it has some downsides, but it also has a pretty big upsides. You don't have to drive across the city to a hospital, you don't have to find a parking spot, you don't have to wait in the waiting room. You can, kind of, click in and have your appointment and then be back doing something else straight away." So that's, that's also been, been a positive for us because our solution is very, matches that, kind of, virtual health care delivery approach. So, you know, I'm sure after the pandemic, there'll be a big shift back to in-person health care, but, but a certain proportion of it will stay virtual, I'm certain of that. And, and that will be probably to the benefit of people's access, and reducing some inequalities in access to that kind of health care.

[00:19:18] So, so yes, it was a challenge, but, but also there was some of the things that we've been learning during the pandemic. Our solutions have, have, have fitted well with those new, new learnings, so, I think. 

[00:19:32] Richard Simms: [00:19:32] Yeah, absolutely. And, I think a lot of what you spoke to is, you know, we, kind of, have to look for some of the silver lining coming out of all of this, at least for those of us who feel like we're on the tail end of it. And yeah, that, that's been my takeaway, is a lot of these, what I believe are very positive trends, have been

[00:19:52] accelerated a lot, and we've, we've seen that, you know, across, across a lot of the folks we work with and folks in the startup community. And yeah, similar to what you've described, you know, we, we know great people building great products that unexpectedly, you know, that the whole situation accelerated their progress and, that's, that's great.

[00:20:13] So, let's be real here, startups are variable. Although you have, you know, the deep scientific and psychological experience, startup world is a little different, and I think this is, kind of, a new experience for you, right? So, what, what would you say have been the biggest challenges so far?

[00:20:41] Dr. Nick Allen: [00:20:41] There's, yeah, I mean, it's been an interesting experience because I, you know, have previously held one of the most secure and predictable jobs that anyone could have, which is a tenured academic position, right?

[00:20:54] You, you know, you're very hard to get rid of, once you've got that job, and, and, you know, and, and, you know, but I always felt that that was, that that should be a platform you use to, to leverage it, to do things that maybe other people can't do, you know? And, and so, I was very happy being a college professor, you know, I loved it. I still do, you know, like I love teaching, I love research, I love seeing patients, that's always wanted to do, so I was very happy. But, you know, the thing that was really frustrating me was that I, you know, we would generate this knowledge,

[00:21:29] you know, we do the research and we do all the right things, you know, we do the studies and get the funding and then we'd publish it in good journals. And then, it would be like, "Who wants it?" You know, how, how can we get, you know, we couldn't give it away, obviously, you know, because it was like, we didn't own the rails,

[00:21:45] you know, we didn't own the method of implementation. And, that's where I just started to feel like a startup was the right way, particularly because there's a strong technology ankle to what we're doing. It was the right way to, sort of, not just generate the knowledge, but deliver it to people and get it to heavy impact.

[00:22:02] And so, so yeah, so, so it's, it's been an exciting journey and I think that the part of it that's been great is that there's a lot of things about running a startup that are like running a research lab, you know, you have to, kind of, be nimble, you have to learn quickly, you have to be agile, you have to, you have to get funding,

[00:22:20] you have to, kind of, convince people that you're worth investing in. You know, all these sorts of things are very similar across those skillsets. But it has this, kind of, very existential feeling to it, you know, like, that, you know, like, "This thing could die at any point," you know, and, and that, that, and you desperately wanted to not die. You know, like I said, there's that, that, that aspect of the startup is both thrilling and also terrifying at the same time. And, it does, and it does take away that safety net that I, kind of, got used to, having this thing  like, you know, "Even if I screw everything up royally, I'm still going to have a job,"

[00:22:55] and, and that's not true when you have a startup, you know, like, if you screw up royally, you probably are not going to have a company anymore, and you're not going to achieve that mission that you have in mind. And, that's, like I say, it's both the invigorating, it's been exciting and fun, but it's also, yeah, it's a bit scary and, I bounce,

[00:23:15] I, I'm totally glad I've done it, but yeah. So, some of the challenge, one of the challenges has been, I think the challenges have been like, yeah, not today, and they're the same ones that everyone has, just hustling to keep the whole thing alive. You have to do, yeah, you have to do a lot of hustling, and by that I mean, like, just meeting with people and bringing them in, you know, we've, we've, we've just been through a round of fundraising and that, and that was something that was new to me as a specific process,

[00:23:43] but of course I've had to raise funds for research before, so I, kind of, know the, the, that you have to be persistent and that you have to get, you'll get more "No's" than you get "Yes's," like, that's, that part of it all I was, kind of, used to. 'Cause you fail a lot in research, you know? So, you get used to that sort of fail, but persist, kind of, thing.

[00:23:59] But yeah, it was, it was, it was hard, but you know, you just have to persist and then you meet the right people and, and, you know, that's really the key. You meet the right people who believe in what you're doing and who are part of your, of your mind meld, and then, then it's very exciting.

[00:24:19] Richard Simms: [00:24:19] Yeah. Yeah. That, that all makes sense. And, I think, I don't know that that mix of excitement and fear ever goes away, so, you know, even when you all are 300 employees, it might just be that much more scary and exciting, so you just got to enjoy the ride. So, one 

[00:24:35] Dr. Nick Allen: [00:24:35] question. 

[00:24:36] Well, I was reading, I was reading the, I've read recently, it's a bit of a classic, the Ben Horowitz book called, "The Hard Thing About Hard Things," you might have seen it or read it. Great, there's a great quote in there, I think from Mac and Darius, and that says, like, "The thing about the startup is that you only have two emotions, which are elation and despair, and lack of sleep enhances them both,"

[00:24:57] so. 

[00:24:57] Richard Simms: [00:24:57] Yeah. 

[00:24:58] Dr. Nick Allen: [00:24:58] I thought, I thought that was a very apropos quote, anyway. 

[00:25:02] Richard Simms: [00:25:02] Well, at least you have the know-how to self-diagnosis if the lack of sleep is a factor there. So one, one question I have for you. You know, my, my assumption is, and I may be wrong here, but that you probably have a lot of tech experience in, like, the research space, right? But I'm assuming that you didn't have a lot of experience in mobile development or building out, kind of, more of a platform like this.

[00:25:31] So, what's, what's been the hardest part there, and, you know, do you, kind of, remove yourself from some of those tech-implementation details and you are much more focused on, you know, the, the expertise and the value product brings, or have you had to, kind of, learn some on the technology front? How's that experience been for you?

[00:25:55] Dr. Nick Allen: [00:25:55] Yeah.

[00:25:55] So, you know, I'd been, despite the fact that I'm a psychologist and people think of that as a, kind of, a so-called soft science, I've actually been on the technical and computational side of that most of my career. So, you know, I've done quite a bit of research in, in neuroimaging, which is a highly, you know, quite a technical area.

[00:26:13] You know, my PhD studies, I did on, on, you know, physiological measurement of brain waves and, and, and other things like that. So, you know, and that's a long time ago now, and so I, you know, I had to really, like, program my own analysis tools and, literally, solder together my own lab equipment, so I, I'm a relatively geeky kind of psychologist.

[00:26:36] And so I, I, but, you know, but the great thing is you've got to be a lifelong learner, and learning is exciting. That's what's nice about academic life. So, having so, so I, you know, I've got some good general knowledge, but, but you're right, in terms of mobile development, you know, we started out, you know, with, I started out with one mobile developer and then we got a second one and we started to employ data scientists,

[00:26:58] and, you know, I sort of, I know enough about what each one of them do, to perhaps not be totally incompetent as a manager, but clearly each one of these people has matched greater depth of knowledge than I do, and then what they do and, you know, we're building up that team. But, you know, I think the area that has been, I was really trying to be a product person before I even knew what that was,

[00:27:21] like, you know, didn't even know that was a thing. And then, and then I discovered, you know, so I thought it was all about get the technology right, pull the data, have really good quality data. And, but this, but the big challenge in technology, as I'm sure you know is, "Is anyone going to use it?" And so, this whole expertise of UX and product and things like that was, that's been the part that I've had to probably learn most about.

[00:27:45] And so now, you know, with our funding, where we're increasingly able to bring in people who have that real expertise in that area, who are not fake as, like me, and so, I, you know, it's been nice to, to be able to bring professionals in, either as consultants or as, or as members of our staff who really know about that.

[00:28:03] But that's probably been where I've had the most learning to do. But, but the cool thing, once again, is there's a lot of psychology in it.  Psycho, psychology is a great training ground, you know, because it's all about human behavior and how people think and behave. And, and you know, if you're trying to work out how do you design a product that people will actually use, then it's essentially a psychological problem. 

[00:28:24] Richard Simms: [00:28:24] Yeah, absolutely, and that makes total sense. User experience, in general, is fascinating. We do a lot of that type of work and in a very healthy way, we do a lot of, kind of, educating folks on the importance there because, you know, naturally folks have a big idea, you know, they want to jump right into building something, but we are, are, big, big, big advocates for design first.

[00:28:48] No focus on making it pretty, you know, "How does this whole ecosystem work? Who are the stakeholders? What are their pain points?" Yeah, I think particularly for, you know, Vira, where that sounds like it could be more mass market and a little bit more of, I suppose it's, kind of, almost a B2B to C model. 

[00:29:06] Dr. Nick Allen: [00:29:06] That's correct. 

[00:29:07] Richard Simms: [00:29:07] But you're asking folks to engage with the app daily, you know, that it's just a part of a million things they have going on and a million apps on their phone,

[00:29:17] so, especially there, yeah, I mean, that's paramount, so.

[00:29:22] Dr. Nick Allen: [00:29:22] Yeah. And, one of the important things about, that's absolutely true, and one of the important things about Vira and the way we've designed it is because we are collecting so much of the data that we need automatically through this mobile sensing approach, it actually takes away a lot of the burden that's very traditionally associated with mental health apps.

[00:29:40] So, a lot of mental health apps are very, you know, you'd need to answer lots of questions and you need to journal and you need to log your behavior, and you need to do all these things. And, as a result, you know, if someone's really motivated though, they use them and the evidence is clear that they get benefit,

[00:29:56] but the big problem is, most, 80% of people are more dropout after a couple of days and never use it again. So that's, that's the big problem. That's what they call "the denominator problem." You may have this small group of people who are getting good benefit, but all these people who try it, never, never really get the benefit. So,

[00:30:13] we're trying to build something that is more, kind of, you know, 2.0 is, you know, it's, sort of like, contextual computing. It's like, it's, it, it, it works out what you need automatically through the patterns of behavior, it can observe, and then, and then it's giving you this, kind of, what we call "just-in-time" nudges, you know, so, these

[00:30:32] things, the suggestions about how to change your behavior that arrive at the right time, and they're personalized for you. And, that's, that's a, that's the approach we think hopefully will get people to a point where it's an app that they love to use and that they, it fits into their lifestyle and therefore they can make those little small behavioral changes that we know are the building blocks of really big improvements in people's lives.

[00:30:56] Richard Simms: [00:30:56] Right, right. Makes total sense. So, you mentioned obviously that you all recently raised this round. I also saw in the writeup, you know, you all are going to be participating in this Anthem's Digital Incubator, so those both seem like big wins. I'd love to hear more about, you know, the Incubator and what, what you're, kind of, hoping to achieve there.

[00:31:20] Dr. Nick Allen: [00:31:20] Yeah, so, that, you're right, they're both very exciting developments and the work with Anthem's very exciting, we've had great, great support from that company and, and really enjoyed working with them. So, the plan there is that we're going to work with one of their behavioral health care networks that is part of their insurance network,

[00:31:37] and and, we'll be, we'll be running a pilot program with Vira. But importantly, for issues we've just talked about, is that the first phase of that is going to be a user-centered design phase. So, even though we have a product, we really want to go into these clinical contexts and, and work with all the stakeholders,

[00:31:56] so this means, you know, the clients or patients of the service, the practitioners who work in it, but the administrators and supervisors and the payers, and make sure that we're building something that is really, fits into their workflow, solves their pain points and fit for purpose. So yeah, in each of these projects that we're planning, and we have a couple of others as well, but the Anthem's really a very big opportunity.

[00:32:19] We're going to start with user-centered design, iterate on the product, make sure that we've got something that people want to use and all of those levels or those different stakeholders, and then we'll do a clinical trial to see, to look at usability, feasibility and, and effectiveness in a real working clinical environment.

[00:32:39] So that's, that's, that's the plan there. And, you know, hopefully we can really use that to prove out the return on investment for using these kinds of tools financially, but also the return on investment in terms of human health, and improving, improving people's lives. 

[00:32:55] Richard Simms: [00:32:55] Well, that's great. Yeah. Those both seem like huge milestones. I know that raising around is very, you know, glamorized in the startup world. I know it's hard and, you know, so I, I, I'm sure you all are thrilled to, kind of, be over that initial hurdle, and then, I have to assume Anthem is pretty regimented in their, you know, process for coming into to the incubator.

[00:33:18] So, it sounds like you all have hit a good inflection point with a lot of, a lot of momentum. That's awesome.

[00:33:24] Dr. Nick Allen: [00:33:24] Yes. Yeah. They are both very exciting developments. 

[00:33:27] Richard Simms: [00:33:27] So, big question. What does success look like in your mind for Ksana Health? Let's say one year from now, five years from now?

[00:33:39] Dr. Nick Allen: [00:33:39] I think a, one year from now,

[00:33:42] because success means that we have established good product market fit, you know, we've built a product that, that, that people who want to look after their own mental health want to use, that they want to use when they're working with a therapist, that therapists want to use, and that healthcare systems see as a, as a, as something that they want to have implemented.

[00:34:05] So, if we have established that kind of product market fit in a year, hopefully a little less, then we can really, you know, start to go out and, and get people to adopt it and, and, and, you know, really start to implement it. So, that's the one-year goal, strong product market fit, scale and sales. The five-year plan, the five-year goal is that we want to be part of a transformation in mental health care.

[00:34:36] So, we want part of a whole new way of doing it, that, that has evolved and matured, so that we've got a system where people have better access to mental health care, people get better quality, they, they get better, better outcomes, that it responds to them, you know, as an individual person and their needs. At the moment, my main critique, and I say this as someone who's part of one of the professions, is that it's set up for our benefit,

[00:35:02] it's not set up for the patient's benefit. You know, we have our, I sit in my office, you know, people come to me, they wait in the waiting room, they come and talk to me when it's convenient, they go away. If they're having a crisis at midnight the next night, they probably wont bug me, you know, like, the whole thing is just set up for my convenience and that's not the way we want our healthcare working,

[00:35:24] it's not the way we want any product working. We want it to be something that come, comes to people where they are. And so, that's where we, that's why I think the big opportunity of this digital transformation is, I mean, that's a hackneyed term, but it's, what it means is that we're using these digital tools and the data that we can understand for them to actually make something that responds to you as an individual and comes to you when you need it and makes your life better.

[00:35:49] And, I think mental health care is, it's ripe for that kind of transformation, and Ksana is not going to be the only player in that, but I think we'd like to be part of that transformation, a player in that and contributing to that, so that when people want to get mental health care, their first thought isn't like, "How do I do that?

[00:36:10] Where do I start? What do I, you know, like who, who should I call?" You know? And their, their first experience of it isn't just calling a bunch of therapists who all have long waiting lists and don't have any space, you know, like, it's something that feels accessible and that you can move into and get the help you need

[00:36:26] and you can move up and down  different levels of care. So, that's the five-year plan. And so, yeah, and obviously to do that, the company has to be successful, so hopefully we've, you know, bringing in money and, you know, growing and raising and all that kind of stuff. But for me, the ultimate goal is to see a healthcare system that's working better for the people who need it.

[00:36:49] Richard Simms: [00:36:49] Yeah, that's awesome. And, it makes total sense and I appreciate you, kind of, speaking to the bigger trend 'cause I, I certainly see that. And, going back to what we were saying earlier, you know, I think there's just a, kind of, revitalized sense of looking at all this stuff with more of an open mind, you know, "Does this checkup really need to be in person?" you know, "Do we want to keep people from unnecessarily visiting hospitals for very routine check-ins?" And, you know, I think it's, it's super exciting,

[00:37:23] you know, we've gotten to do a good bit of work in, like, the wearables space obviously. I think there are, kind of, endless applications there and obviously a lot of relevance for, you know, your products. So, it's, it's exciting stuff, you know, obviously I think you all are on the right track and I'm sure you are gonna be very successful and be a big part of that, that conversation and the transformation.

[00:37:46] So, last question I have for you, knowing what you know now and, kind of, where you are in this journey, for someone listening, you know, what advice would you give to someone in the very early stages of pursuing a new, a new digital product?

[00:38:13] Dr. Nick Allen: [00:38:13] I think, well, there's a couple of things that have been important for me. I think one thing is, don't do it alone, like, get a team, get some, get a partner, or get some partners and get a group of people who will hold each other accountable because it's a hard journey. And, if you, you, if you have that sense of a team of people who have an aligned vision or mission, then I think it really helps you get through the hard time.

[00:38:40] So, I think that that's, that's one thing I'd say, don't do it alone. Get fun people. And you do, and you need a lot of, you need a lot of different skills to, to, you know, build a product and, you know, you need business skills, you need organizational skills, you need people who've got, kind of like, the mission of, the vision of where the mission is going,

[00:39:00] you've got people with technical skills, you gotta have all of that, you can't just,  and you've got to have product skills, as I said before. So, they're, they're important things. I think, yeah, and you know, this is, this is advice I'm sure everyone gives at this point of it, you do have to be persistent. So, and that is, like I say, that's something where I think the academic background is helpful because you know, in, occasionally in Academia, people do this thing where they publish their CV of failures, you know, and so what they do is they list out all the grants they didn't get and all the jobs they didn't get and all the papers that were rejected and so forth. And, it's, kind of, most of us couldn't do it. It's too, it's too, too challenging. But, but, but it's a good, but occasionally people are kind enough to do this, and it's a good reminder that actually, in a way, you mostly fail or it's tasks, and it's, and it's really the, the it's really the persistence and that, that sense of vision that gets you through.

[00:40:00] And then, after a while, people look at you and they go, "Hey, what a success you are," and it's only because you're essentially only talking about the wins at this point, you're forgetting about the losses. So, they would be two things, persistence, everybody knows that's super important. But yeah, get it, get a team.

[00:40:16] And, and, I think, yeah, and the other thing is just be a learner, you know, like, have a learning, be more of a learner than a knower, you know, you've got to, you've got a lot, you can learn from all sorts of people and talk to everyone you can talk to and just, just be really, each and every one of those conversations, knowing that you can learn something and that, that's, that's the point of the conversation, not to, not to show what you know, but to learn something new. 

[00:40:42] Richard Simms: [00:40:42] Yeah, those are both good pieces of advice. And, it's funny, yeah, I was speaking with a previous guest who similarly was really advocating for having a co-founder, and in my experience, I've always had a co-founder and found it extremely helpful, you know, certainly for, kind of, adding skills and bandwidth, but to your point, just, kind of, emotional support because there are a lot of highs and lows, and it's just good to feel like someone is in it with you,

[00:41:08] and usually, you know, they can, kind of, bring you back to middle terrain on a given day. And then, yeah, certainly, you know, your other point, as far as there's, there's so much, kind of, out there about the overnight success startup that came out of nowhere and, you know, the founder is 23, just out of college, but really the vast, vast majority of those that make it, it's a long,

[00:41:34] long, you know, 10 year in the making overnight success, and that's really important to keep in mind, so. I'm right there with you. Good tips. So, we're just about out of time. Really appreciate it, Nick, this has been great. Before we sign off, where can listeners go to connect with you and learn more about Ksana Health?

[00:41:54] Dr. Nick Allen: [00:41:54] Yeah. So, the web site is ksanahealth.com. I should spell it though, because it has an unusual spelling. So, Ksana is K S A N A, it's actually a Sanskrit word that comes up from, that refers to the smallest unit of time in Buddhist philosophy that you, or psychology, I should say, that you can be aware of and be aware of the opportunity associated with that moment.

[00:42:19] So, you know, when you practicing meditation or some of the other Buddhist  practices, the idea is to become aware of each moment, but be aware of the possibility of the moment. And so, we like the meaning of that word because it reflects what we're trying to do. We're trying to use these tools to become, to help people to become aware of the opportunity, to improve their behavior and their mental health on a, kind of, bold moment tomorrow. Wait. But anyway, so it's Ksana Health, K S A N A H E A L T H.com, and there's lots of information there. You can get in touch with us, you can read about the products, read about the company and, and yeah, and get in touch with us through that, through the website.

[00:42:56] That's the, that's the best way. And, of course you can also find me at the University of Oregon. All academics are pretty easy to contact these days. 

[00:43:06] Richard Simms: [00:43:06] Well, Will has offered that I could come stay at his place in Eugene so that I can some hike, hiking around there. So, if I take him up on it, I'll, I'll let you know. It's a beautiful state. If you haven't been here, you definitely should, if you like hiking. 

[00:43:19] Oh, yeah. Oh yeah. Well, thanks again. It's been great having you on The Digital Footprint, very excited to, you know, continue following your growth with Ksana Health and yeah, thanks again for joining us and for the good insights.

[00:43:31] Dr. Nick Allen: [00:43:31] Thanks, Richard. It's been great to, great to chat. 

[00:43:34] Richard Simms: [00:43:34] You too. 

[00:43:35] Dr. Nick Allen: [00:43:35] Okay. Bye.