Ryan Douglas: FDA approves Digital Therapeutics SDK

Ryan Douglas is the co-founder of DeepWell DTx, a digital therapeutics venture lab dedicated to creating immersive experiences that address mental health challenges.

Recently, DeepWell DTx achieved a major milestone: the U.S. Food and Drug Administration cleared five mental health apps, including DeepWell's software development kit (SDK). This marks the first time digital therapeutics have been approved for medical use, paving the way for games to be reimbursed through medical insurance.

Transcript

Intro: [00:00:00] From Silicon Valley, the heart of startup land, it's Getting2Alpha. The show about creating innovative, compelling experiences that people love. And now, here's your host, game designer, entrepreneur, and startup coach, Amy Jo Kim.

Amy Jo: If you're interested in digital therapeutics, I've got some big news. Ryan Douglas, founder of DeepWell DTX, just announced that the U. S. Food and Drug Administration cleared five mental health apps, including DeepWell's software development kit.

Ryan: There's going to be three new reimbursement codes coming out in 2025 that tie digital therapeutics to a payment schedule and that payment schedule is pretty amazing because they're not just going to talk about paying the content creators. They're talking about paying the MDs and the docs to prescribe initiate and follow these treatments.

Amy Jo: This is the first time digital therapeutics have been approved for medical use, and it clears the way for games to be reimbursed [00:01:00] through medical insurance. Join us as we trace the long and winding road to FDA approval, and explore what the clearance of Deepwell's SDK means for digital therapeutics and for the gaming industry.

Amy Jo: Welcome everyone. If you're into digital therapeutics, you're in the right place.

So in digital therapeutics, we often talk about dosages and schedules and compliance and behavioral nudges. And when we work on something, we pull that all together into a patient journey, which is how I first got connected with Ryan Douglas at a gaming conference. Everybody that's working in digital therapeutics, a lot of you who are listening, you know that FDA clearance and insurance coverage, those are holy grails for unlocking the promise of our field.

 And Ryan Douglas is at the very center of this storm, and he's got some very exciting news to share today. Take it away, Ryan. 

Ryan: [00:02:00] Yeah. Thanks, Amy. So, I mean, really the center of that storm is DeepWell and a four year journey. And what we're seeing after coming off this huge hype curve, you know, billions of dollars burned down into small millions of dollars.

 And really a lot of lack of understanding. We can finally clarify where were the problems and why now are there the solutions? 

The problems were threefold. The first one was one that we came together to agree on from the beginning. We went out for the medical community starting to wield the power of media.

We said, listen, we could turn this all the way into a drug, but we completely forgot to bring with us the people that knew how to do it, right? 

So we walked in with these mechanisms of action and we said, Hey, we're going to throw this on a phone and now it's going to be frictionless and everybody's going to want to do it.

Completely the opposite. The game industry and those people that have been creating media for over 50 years, understand that there is a very specific way by which you design yourself into a very attractive play loop. And then you put your secondary game mechanics around that. And from [00:03:00] there, you get an attraction mechanism that pulls people into a dopaminergic state and eventually gets them into flow.

There's a lot to do with giving agency and control in those games and a lot to do, and you know, this better than I do. Designing the challenge condition is everything. How do we find you where you are and give you these micro transactional sort of feelings that you're doing good, not always great, but we're always telling you where you're positioned and moving you a little farther along.

Platformers like Mario nail this out of the park and they're built by the masters and we've talked about that before. So problem one was we put chocolate on broccoli and we expected people to pay attention to the chocolate and it didn't work out and we really brought a little bit of academic arrogance along from the idea that we could do this without the folks that were the masters in the area. So problem one feeds right into problem two, which was regulatory understanding of that in the FDA and what that clearance looked like. So the FDA looks at all digital therapeutics or did up to this point as software as a medical device, Sam D. And that concept comes all the way back from the [00:04:00] first software we saw in defibrillators and other sort of implantable devices.

They want a static piece of hardware that never changes. They want a static piece of software that has been verified and validated on that platform. They want that put together and then they don't want it to move. But if we think about it and you think about what is compelling about media and how media works in its entirety, what makes it accessible is that it's on thousands of different devices.

If you're running on Android, there's about 1100 active devices running at all times. They're updating their operating systems at will. There's complete motion within there. That is something that the FDA doesn't like on top of it. And you could teach a master class in this. Static media is not attractive.

So if you're talking about an interactive media environment, we're constantly needing to iterate to be able to get that to the place where you've captured the attention and you can hold that attention indefinitely. And really that's an ongoing place. There's no good game. The games you did from the beginning, they didn't stay the same through all the years, or they wouldn't continue to be good games.

So what we saw fundamentally go [00:05:00] wrong is the first companies that came through the door, they worked within the present regulatory environment instead of reshaping that environment to a way that was going to make sense for the digital therapeutic and saying look, FDA regulatory bodies in general around the world.

This is not a defibrillator. And so it's going to work differently and so we're going to have to look at issues of safety or effectiveness differently. So problem two, the agency was locking things down. I recently was with some of the team from Achilles and the game teams, like Noah and false deed.

And he said flat out, we knew we weren't where we wanted to be on the game, but we were so locked down. From early on in the clinicals, and you'll see that I mean, the requirements are tied all the way through. And once they were locked down, they didn't know where to go to keep that clearance. 

So they weren't disconnected, if you will, from some of the issues there as far as the FDA's expectations.

Problem three was once you got all this done, let's say you did get the chocolate off the broccoli and you did land in a place that the agency had cleared you. There was no holy grail on the other side who was going to pay you for that and [00:06:00] I think a lot of us saw this that had been a medical device for a long time wondering what pair was doing wondering where Achilles was going.

I mean, in Achilles case they went after ADHD which is today costs, someone like United Healthcare about nine cents a day to treat somebody using Ritalin and Ritalin, though it's not incredible. This is a pretty good safety profile so if you are at healthcare it's a hard sell for them to go, you know what, yeah, we'll go to a hundred bucks a month on a digital therapeutic over this drug that we already have in hand. And so there was nowhere really to get paid.

The Digital Therapeutic Alliance is the trade association that has been lobbying Congress to get some payment in place for the stuff, and they have been successful.

Right now we're in the comment period and there's going to be three new reimbursement codes coming out in 2025 that tie digital therapeutics to a payment schedule and that payment schedule is pretty amazing because they're not just going to talk about paying the content creators. They're talking about paying the MDs and the docs to prescribe initiate and [00:07:00] follow these treatments.

So we're going to finally see media and medicine connecting in a way that understanding is going to be much more ubiquitous. 

Now roll back to that. If the Digital Therapeutic Alliance had any challenges or concerns was, how are we going to get all this through the FDA. To sort of give you some sense of what's out there at the moment, 92 percent of all apps live on either Google's Play Store or therewith app.

In those environments, there are 350, 000 wellness apps. 90, 000 of them were created during the COVID emergency order, where you were allowed to take a wellness app and make medical claims about it around anxiety and depression. But since November of 2023, that's over. However, if you look in there, there's still 20, 000 of them calling themselves a digital therapeutic, which means you treat or mitigate disease, and you have to have the FDA's clearance to do that.

Now this is where it gets sticky. Only 20 of them have been cleared. Only five are for mental health. And here's the thing that we're excited to say. Deep well is number five in that clearance. We got our clearance, [00:08:00] but we are the first one ever to be a software development kit. We didn't clear a game. We cleared a toolkit that can attach to media and draw it into the reimbursement stream.

It allows the media to be dynamic. It allows it to be delivered over the counter or through orders and prescription. It allows it to be on any mobile platform. Dealing with all this idea and uses self validating techniques to allow the game to exist or the media to exist as it needs to in that case 

And it's available through any commercial means so we've taken a lot of the friction out of these situations. When you need a new digital therapeutic, you don't want a new piece of hardware You don't want to go to an environment You don't know and you don't want to be attached to something that you can't afford all of which didn't make any sense, but this is what we see now from the aspect of if you take what the DTA has just gotten as far as the reimbursement codes are concerned, and then you take the toolkit that DeepWell has just cleared as a software development kit, you have the ability to attach media to the medicine and bring it into the reimbursement stream.

Amy Jo: Who's [00:09:00] going to approve that the apps are using the SDK in a medically efficacious way? 

Ryan: So that's a great question. For Deepwell, that means before we look at doing any particular piece of software, we have to re evaluate each piece of it as part of our risk analysis system and the quality system, and depending on what that change level looks like, it could be an internal note to file that helps us understand that the risk has not changed.

There's no new issues of safety or effectiveness, then that's going to run with us, but that's a very stringent panel of people. There's a very specific requirement of what it looks like to review that. And I'll tell you in a minute what we can clear and what we can't clear. If it goes beyond to a place where you know there has been a fundamental shift in where this questions of safety or efficacy, we're gonna have to return to testing and then we put that into the agency.

It's still interesting though. It doesn't go in as a full five, 10 gig. It would go in as a special, which is much faster. That's a 90 day turnaround. So, that gives a lot of latitude for us to get this stuff done. So now that kind of goes all the way back to point one. Point one is that we [00:10:00] can start using the media that we already can see is effective and we can tie it up in a way, and we can give the game developers and the experience designers an environment that makes sense for them. 

So think about this, we've built a new economy here, and you know this to be true at the moment. If we go to pitch a new game at the moment, our job is to go find something is going to pay for it. When we do that work, we need to tie ourselves up in a way that we would go in and pitch across the board and more and more these days, we're creating brand new worlds great brand new environments and most of the people that are funding are asking us to see three to five slides on this amazing new experience we're going to build and 20 new slides on our monetization schedule.

It's breaking the hearts of the experienced designers. Nobody wants to be building skinner boxes, taking advantage of people. And on top of it, it's not really working anymore. It used to be about 2 percent of our folks that played our free to play game ended up being our whales. The people that was going to hold us up and take care of us and finding a player in that game would cost us between three and 5.

We're not living there anymore. Right now we're looking at about 1 percent of people pay for games at [00:11:00] all, and only 5 percent of that 1 percent are somebody that's going to spend on the higher level of this, and the acquisition costs of anybody who plays the game even free or looking more like 15 at the moment. So we're in a really different place as far as that's concerned. 

So, if we're going to keep going forward, you kind of gotten two new regulatory environments you can live in. If you want to go through traditional monetization schemes and look at potentially how you would use a loot box or how you would do micro transactional work to get it sold, you're going to live in the FTCs world now.

That's being governed without question as well. A new company called KID. Kieran runs this and he's a friend of mine. I'm getting to know him pretty well. He's over there selling services at the moment to make sure you're compliant to the myriad of rules around the world and they're considerable. The right ages, are you doing the right things? Are you disclosing appropriately what you're doing? 

But if you're an experienced designer and game designer, you're going to have a new choice now. You can design for reimbursement as a digital therapeutic. And that means you don't spend time on your monetization schedule because you are hooked up to payment and those payments go on for a period of time as long as people are engaged with the [00:12:00] therapeutic and required completely new economies to think about where folks can come back and be really into their game design, their play loops and their environments, the narratives and the stories that they want to tell.

Which will only make them better digital therapeutics because that's the hook that you and I have talked about for. The one common thing you see about the 200 studies or so that Deepwell and I have reviewed and that we've put up now on immersivemedicine. org to help you understand how we found all this.

The one common thing through all of that is the fact that they are done by the masters. These are the best games that you've ever seen. And those play loops and that engagement mechanism is exactly what we need. We need you in flow. We need you dopaminergic. We need you running through a situation where you have agency, you can take control over a situation, the challenge condition is managed in a way that we have a microtransactional sort of situation with you, where not for your dollars, but for your attention, you are achieving over time.

Now, you can't be on a constant path to achievement, if there isn't something to overcome, it's [00:13:00] boring. But if you also challenge somebody too hard, at that point, they just walk away in frustration and that's what the masters know how to do. And that's what they're going to be able to get back to do a great storytelling.

This is the return of the golden age of media, as far as I'm concerned, connecting it up to a greater purpose and letting people know what these designers have known for a long period of time that they want to create a really special experience for you. And of course, it's having an emotional and physical effect on you.

Amy Jo: So what is the mechanism? Is it controlling your breathing? What is your therapeutic mechanism underneath the world building and all?

Ryan: That's right. It's a biofeedback mechanism. But what's really interesting about it, and we talked about this last time. As one of the last usability studies we did, and one of the points I've been making the whole time is you can't force the overt therapeutic mechanic into play action and break the fourth wall.

When you do that, people just go, Oh, that's the good for me part and it kind of falls apart. Now if you remember last time that we were together we talked about our CEO and chief product officer, right, Jeffrey saying who you've worked with together before. He's one of the [00:14:00] masters. And I kept saying he was brave.

He was brave because your career is only about as many titles as you can get out. And we know Jeffrey's had 50 titles. We know that he created a whole new genre of games and are just amazing.

But you still can't have too many flops out there. But to make the point in the last usability we needed, while we were dealing with the agency, and this is for internal review, we had the game set up where you could use the overt mechanic optionally as one way to call your powers and energy, but you could also use rhythm, motion, and precision to manage the way through.

And there was some question about whether or not that overt mechanic needed to be pushed forward. And there was a lot of debate between the serious games folks and all this stuff. So Jeffrey pushed it forward, even though he had great play debt test data that showed before that that wasn't the way people want to play and he released Zengeance in that environment in that way to make a point.

And the point gave us new data, we quickly had thousands of people playing this game and we could see that our seven day numbers didn't look like they used to when people made the choices, and ultimately less people arrived at the therapeutic use of the [00:15:00] game by being forced into it. So as a result of that, you're going to see him make a big update now to Zengeance that were through the clearance, and it's really exciting to be able to do that. 

And now the way we're cleared, we can integrate this therapeutic mechanic in three different ways. You can put it right into the middle of gameplay and make that a choice, but you're going to work with us closely on that because again, you can't force it.

You can put it adjacent to it. So in Zengeance there's two ways to play. One way you're actually using that biofeedback mechanism in the middle of gameplay, and we set and have you work with your breath patterns and that, but there's also a cool down room in there where you go in and you get additional spiffs and stuff like that for the fact that you went in and used the room and you can pull that back into play action. Those are two ways to integrate. 

We also got a third and I think wonderful way to go. And this is something Amy, you talked to us about before too. A lot of game developers don't like SDKs and they don't want to change the game. So the third thing that we got set up is the idea that you can run integrated but adjacent.

So we can have a standalone place over here that it gets to know you, it gives you a [00:16:00] biofeedback mechanism that you can utilize through your play, and it directs you to a whole bunch of other consolidated games that are unchanged.

And it's not just games, we can connect to other forms of media. We can connect to social media. We're even talking about live experiences. So there's a whole range of media that's been created and new media that can be created again. That's going to be able to be attached to this and utilized as the delivery mechanism for part of the therapy.

And that brings it in to the reimbursement stream and also allows it to be much more dynamic because we have the biofeedback mechanism locked down in a way. That's what you were talking about as well. 

Amy Jo: It sounds like the biofeedback mechanism is kind of what's embedded in the SDK. 

Ryan: That's right. For the most part, that's correct. There's also back end metrics. There's a lot more going on that has to do with it. Because remember, there's data that needs to be delivered to the doctor. There's also a lot of other things that make it a medical device and hold it down in a certain way. We just announced some really big IP. One is around a dynamic quality system that [00:17:00] allows to keep track of these two different things and puts it together in the way the agency is happy. Another thing is self validating module, kind of work that makes sure that the code has not been altered through various places where you get outside of what the agency calls the control condition or you outside the threat boundary.

So when we give the game over to steam. We don't know what's happened to the code and the agency didn't like that very much. So we had to show them how it was that we remained in control of it. So there's more to it than just the biofeedback mechanism. There's a labeling that's in control. There is data collection and HIPAA level compliance that's in control.

And there's also other things that help fine tune the game a little bit more, but yeah, on top of it, there is definitely the biofeedback mechanism sitting in there. And that is the prime. 

Amy Jo: Got it. So a lot of the folks in our audience are game developers, whether they're triple a mobile or Indy. A lot of people really use game techniques in their product and app work.

So let's imagine, I think it'll really [00:18:00] help folks to think about what this is. Let's imagine it's six, eight months out. Right. This is out there in the world. And let's say someone's an indie developer or game developer, and they're interested in this. How do they work with you? I mean, as I listened to you, it reminds me of Nintendo first party and third party, but you always have to get approved by Nintendo.

Ryan: That's right. There's a green light. 

Amy Jo: It's similar to that kind of structure. Okay. 

Ryan: We're going to have a green light process. It's going to start with an evaluation. If you already have a demo or let's say you remember you can do this with a pre existing game, Amy, that means like we can wake up the Sims and put a tail on it again, right?

There's things that can be done here that I think are really exciting, but we're going to take a look at what you've got. And we're going to let you know whether or not you fit in. In our world, this is going to make sense to you because you've been watching The posting and the work we've been doing for a period of time.

We've been working really hard to talk about what it is in media that is actually good for you and what it is in media that's actually bad for you. Now, there are very little in the world of play mechanics themselves that [00:19:00] are actually bad for you. Action games have been shown to be some of the best therapeutics you can build.

Turns out, and we did this with Zengeance first person shooting is not bad for you and does not make you a first person shooter, but there are some things in games that we're not going to be okay with. The first is going to be any sort of predatory monetization schedule. Something that gets you highly dopaminergic, a loot box that doesn't actually tell you what likelihood you have of being successful.

The next thing is going to be free and unmoderated chat. We can't take a vulnerable population and bring them into a game or gate situation. That isn't going to work out. If you don't have good control over your socials, then we can't clear you. 

Then we're going to talk about the other dark energy mechanics. Most of which are all tied back to monetization again. Something that tries to pull you back into the game to preserve the money, friends, and time you've already invested or built or gained, that's going to be a problem. So those kind of games, it's okay if the world goes on without you. It's not okay if the world starts tearing down your work because you're not there.

Amy Jo: Right. 

Ryan: So it really turns out that it encourages us right back to the golden age of gaming, right? [00:20:00] Take away all of those monetization loops, all those things that you've been part of building economies. I've sat in and seen how these things are built. And we got a lot of early coaching from Todd Coleman and Joseph had done wizard one on one and they were, you know, they always had to think about, cause they were the big game for, from the time you're about six to the time you're about 10 and they are always having to be really careful about what those monetization schedules look like.

Don't have to worry about that anymore. The monetization schedule is the reimbursement that's available to you. So then it comes back to the best experience design. And because this is the kind of dollars that actually makes sense, we can start to draw those people in that otherwise would have been making money through more of these traditional monetization means and through freemium and micro transactions.

There's real dollars here to connect back up to the stuff to draw in the professionals that really know how to make the media that we need to be a therapeutic. 

Amy Jo: Yeah, it's going to be an interesting time coming up. One of the issues that we've been talking about behind the scenes around digital therapeutic design is binging [00:21:00] behavior. So what you've really been talking about so far are variations on gambling loot boxes. Hijack your circuits with gambling mechanics. There's something that's why gambling is regulated. That's why you don't want gambling mechanics in therapeutic apps. And that this is a big conversation we have behind therapeutics.

But actually just today, we were talking about what about binging. One of the people was evaluating an app that was supposed to have a dosage over three weeks, but the way it was designed, you could come in in the last three days and just binge it and still get rated well, she said, is that like completely bad? What is it? And that's another one, right? 

Ryan: We have the data on that studies just in the data is really interesting. And I'll go with the everybody and then we'll get down to the specifics. On the everybody level, about three hours a day of this [00:22:00] play is as long as you're not dealing with, again, those predatory games that with the dark mechanics, you're just getting better and better results over time.

After you hit the three hour point, you either level out or start to come down and then there becomes a point where it becomes impinging upon the rest of the things that you need to do in your life. And then you definitely start to lose the resilience you're trying to build in the first place from it.

So three hours a day is a fine amount of media ingestion. Now there's some folks, depending on what they're using the media for me, they might need to be in there longer. If they're dealing with a highly stress based situation in the moment, you've got a vet that's just returned and they're doing a lot of call of duty, they might be doing exactly what they need in that moment.

In that case, we defer over to other studies that show is you're getting therapeutic benefit as long as you are building coping mechanisms within the game, where it ceases to work immediately is when you are using it to hide from something that you have to deal with in real life. So if you're building up your capability to manage real life, that's really good.

When you're to the place now, it's like, I'm going to play six more hours of this, rather than go do the [00:23:00] school thing that I need to do, overcome the challenge that I'm trying to manage at the moment. You're definitely in a place where it's going to be detrimental to you. So it's not as simple as how many hours.

So what are you doing with those hours? And where are you in a particular therapeutic journey? So that's going to be something we're part of. You're going to see all this roll up from deep well into something we call a resilience score. We can't tell you exactly that you're happy, sad in the right position at any one given time, but we can tell you whether or not the media nutrition and the things you're doing are driving you towards greater levels of resilience, or you're starting to come back down.

Think about a pedometer for your mental health, tied back to the media you ingest and the things you do. So this is where it gets bigger and we go from this being a kernel that you can put into a game to a platform that can attach to games that you're going to see us developing more over time.

And that's going to help people better understand their media nutrition across the board and have comfort with the idea that it is dynamic. Sometimes you're playing eight hours a day and it's exactly what you need to be doing in that moment to be processing [00:24:00] through a place that you're at and the thing that you need to manage.

And sometimes, you really should be hitting that three hour target per day. And really then at that point, there's other things to be done in your world that you need to go do. 

Amy Jo: So if someone wants to find out more, where can we send them? 

Ryan: Yeah. So they can go to deepwelldtx. com. 

Amy Jo: Great. We will share that and what else? 

Ryan: Well, and I was going to say, we're going to do a pretty big announcement that all this has happened. We're pretty excited about all that. And then there also is immersivemedicine. org. So if you're a doctor or you're a developer, there is the IMN network we put together.

So immersive medicine network. Also, there's a LinkedIn group, and there's already a couple hundred of us running around there. If you want to be actively involved in learning and knowing this, we've got a group that's talking about this stuff all day long. I continue to do these posts and connect them, but then in the IMN, I actually go deeper into it.

We've launched off a podcast now, that's helping people understand it. And we're going to start fireside chat. So we'll go in there and people can come in, bring your questions and we'll get [00:25:00] together. I get a lot of inquiries right now about how do I do this and a lot of times it's the same questions.

So what I thought I'd do is just start doing it with a group of people. I've noticed after I speak, if I can step off the stage for a few minutes, there's 10, 15, 20 people there. We have great conversations in that moment to try to emulate those a little bit in the fireside chats. And that's also a chance for people to get to know one another.

Those folks that are looking at building immersive medicine and converting their games into digital therapeutics and learning, whether they want to do a deep well, or whether they just want to figure out how to do it in its entirety. That's up to them. And that's really what's also important about the Immersive Medicine Network.

And you know this too, we charted the entire four year journey. I've put over 600 posts out there. I left breadcrumb trails behind everything we've done. Go look at it. You're not necessarily drawn to us, right? We can be there for regulatory support, or we can be your training wheels in a regulatory environment for a period of time while you work on your own clearances. Or we can actually be the clearance for you tied back to the clearance we have.

So there's a lot of different ways that [00:26:00] we're going to be able to help out. We've joined and we're part of the digital therapeutic alliance, and we're planning to help out and teach seminars there as well and get people to understand what we've done So they can choose the best pathway for themselves to start getting access to this new remuneration and understand what they've got to do to hook their experience design and their games and their apps up to these new codes, get access to the docs that are going to be prescribing them and become part of this new market.

Amy Jo: Very exciting. So thank you so much for taking us at the high level through what's going on with regulatory changes, talking about some of those details. I do have one last question, which is, do you have any insight why now? Is there something going on in the world that pushed and triggered this FDA change?

Ryan: We've been in a 50 year health emergency for mental health. COVID is not where this started. It's just where it went from crazy to [00:27:00] unmanageable. The new Pew data has 38 percent of us as diagnosably stressed, anxious and depressed, right? That means on a subclinical level, we got to be talking about 70 percent of the population and we can feel it everywhere.

I live in Seattle when I'm not here in this location. And it's on the streets and it's not just in the streets in the massive homeless population. Seattle now is on per capita with San Francisco, as far as what we're looking at and these massive drug epidemics, right. It's also the way we exchange with one another people are more aggressive on the streets, folks are just really less forgiving with one another because we're in these high stress environments, we've seen for a period of time, I mean, social media is also another form of media, and it's powerful, just like all these other parts.

And prior to regulation, it sent itself in the direction of maximizing monetization, right? We're now just now starting to understand that social media and gaming are almost identical. TikTok is the biggest game in the world. You pursue being liked, likes, being collected, and collecting. And it gives you a whole [00:28:00] dopaminergic hit at a high frequency, higher frequencies than Amy Jo used to design for. These are getting to be like, you know, if we're not constantly beaming you with another 100%, you're doing wonderful things, then we just crash back down.

So we're surrounded by a lot of different things, whether it's climate change, what's going on politically, our media environments in general, I think we're right at the place we were, let's call it maybe in the 60s or even 70s, even when I spent a little bit of time in medical school, the food pyramid was all wrong.

And it had really been inspired by some big industries, like sugar to make us think that things worked a certain way that they didn't work fat bad. Okay, we'll take all the fat out. We'll fill it full of sugar. Just now we're coming around to the idea that it works different than we thought it was.

And we're re educating ourselves across the board. And I'm not saying that McDonald's shouldn't exist. I just think it's a really good idea when you pull up that you know that little burger has 620 calories. And this is what we got to get going with media. I'm not saying look, all media doesn't have a place in the world, but you should understand what the impact is going to [00:29:00] be when you engage in it, especially based on who you are and the situation you're in at the moment and how that can tilt the scales for you if you're someone who's a vulnerable population, which I think is right now 70 80 percent of us.

Amy Jo: Amazing. Well, thank you so much for hanging out with us. And we will look forward very much to continuing to follow this and ideally with our community and our larger network building some games on your platform. 

Ryan: I couldn't be more excited about that. And thank you really. You have really been an advocate all the way along and brought us a lot of visibility and thank you for that.

Outro: Thanks for listening to Getting2Alpha with Amy Jo Kim, the shows that help you innovate faster and smarter. Be sure to check out our website, getting2alpha.com. That's getting[number]2alpha.com for more great resources and podcast [00:30:00] episodes.