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Your Smartphone, Your Therapist

Tuesday, January 26, 2016

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This article is cross-posted from the World Economic Forum and Huffington Post.

All over the world, mental health is a growing challenge, but is still treated as a second-class condition by most health-care systems.

In the United States, about 60 million people are affected by mental-health issues every year, and about 90% of them suffer from anxiety and depression. Anxiety and depression are all around us and take many different forms — including depression triggered by life events like divorce or moving to a new city, postpartum depression, which affects more than 30% of new mothers, PTSD for military veterans, or co-morbid depression prevalent with a majority of health disease and diabetes patients.

Despite being widespread, there is still a stigma around mental health. Talking about depression remains a challenge. The onus is on us — as leaders of government and industry, we need to create support structures in our organizations to recognize and support mental health.

Sixty percent of patients receive no treatment at all

Nonetheless, our health-care systems are not ready for this challenge. We cannot train enough psychiatrists or hire enough therapists to ensure access to high-quality care without technology playing an important role. For example, in the U.S., approximately 60% of those with mental-health illness received no mental-health services in the last year, and wait times to see a psychiatrist average between two months (cities) and eight months (rural counties).

Inadequate care results in people showing up to the Emergency Room — mood disorders such as depression are the third most common cause of hospitalization in the U.S. for both youth and adults aged 18 to 44. Doctors give most of the care in anxiety and depression, but typically end up relying on medication due to lack of other options.

We believe the combination of intelligent sensing, mobile phones and high-quality clinical care will help elevate mental health to a first-class citizen in our national health-care systems. Below are three pieces to this complex puzzle that we believe will help to improve care, without runaway costs.

1. Determine when users need help using better sensing and machine learning

A fundamental challenge in anxiety and depression is sensing how patients are doing — unlike measuring a certain form of hemaglobin in diabetes, or using an electrocardiogram (ECG) for heart disease, most data in clinical practices today is self-reported by the user. Even that information is collected infrequently. Fortunately, recent advances in mobile-sensing technology are a boon for more frequent collection of objective behavioral data. More importantly, such data allows us to understand how mental-health behavior changes are reflected in everyday behavior.

In academic settings, smartphones have been used to learn about social networks, characterize human-mobility patterns, measure physical activity and health, and estimate the spread of potential contagious airborne diseases. Our research at MIT, as well as the work of other academic researchers such as David Mohr and Andrew Campbell, demonstrates the vast potential for the application of mobile sensing to mental health.

For example, it was hard to detect when patients were isolating themselves due to their depressive state. However, with these digital crumbs of information, we can detect such an event much more easily. In reality though, the behavioral patterns indicating a patient’s state are much more complex. Depressive symptoms like lethargy and anhedonia are seen in a person’s behavior — they may have challenges getting to work, school or social activities (movement patterns), the way they interact with others changes (communication patterns), their sleep cycle is disrupted (smartphone usage). Millions of data points about a person’s behavior captured using their smartphone, help us model and predict their health state.

At my company Ginger.io, we have been able to screen more than half a million people with anxiety and depression, and and have gathered more than 600 million hours of data from them across many behavioral dimensions. Such a large and rich data set allows us to use machine learning to detect complex patterns of behaviors that predict when a user may need help. To create the best predictive models, we have built an analytics pipeline that has allowed us to explore more than 2,000 different models as our approaches evolved. These behavioral patterns are not universal and our approach allows us to customize predictions based on individual user behaviors. We are able to continuously improve our models and learn from errors, because they are used by clinicians and health coaches to provide timely interventions every day.

Understanding the state of the patient allows us to personalize care and intervene at the most appropriate time. Further, we may be able to intervene early and keep patients from reaching a severe state. Such timely care will not only keep populations healthier, but also helps reduce health-care costs.

2. Your mobile phone as a digital therapist

More than 90% of Americans report that their smartphone is within an arm’s length distance (~3 feet) most of the time. Our generation wants an effortless, on-demand consumer experience in healthcare — just as we use our smartphones to balance our bank accounts or order groceries, we want to get better from the freedom of our couch.

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Some parts of the health-care establishment see this change in consumer expectations and behavior as a burden — better screening and on-demand access require more clinicians and can increase health-care costs.

But we believe that is a limiting perspective — as consumers change their behavior, they also desire care in forms that go beyond the 50-minute therapist appointment every other week. We have an incredible opportunity to design interventions and tools to help users where they seek help today — likely on subreddits and Facebook, and not in the doctor’s waiting room.

Ginger.io users learn how to build skills based on clinically validated strategies such as cognitive-behavior therapy, mindfulness, and dialectical-behavior therapy. These approaches have been shown to be as effective as medication. Our Calm Down Kit is a practical implementation of dialectical-behavior therapy — and one of our most popular features, which includes access to a 24×7 nurse hotline. However, six times as many users would rather watch puppy videos to relax than speak to a trained professional nurse.

We invest in scientific validation of these new approaches through research studies and trials. For long-term success, it’s critical that these new classes of digital interventions are held to the same scientific bar as existing therapies and medications for symptom improvement. This will ensure we create new efficiencies and scale access in digital mental health.

3. Keeping trained health professionals in the equation

In our drive to improve care and accessibility for patients with depression and anxiety, we also recognize the fundamental importance and value of trained mental-health professionals. Mental-health professionals, from primary-care providers and psychiatrists prescribing medications, to therapists and behavioral coaches providing therapeutic relief, are critical to the success of the patient. The challenge we faced was how to include human care in a scalable manner.

One successful approach is a collaborative-care model, where a care manager, or Ginger.io health coach, is able to connect a patient to the right sort of health-care provider at the right time, thus playing a pivotal role in balancing patient needs with available resources.

Furthermore, our behavioral-care team has continuous access to patient reports that bring together vital information collected through the Ginger.io app to better understand patients’ mental health. Rather than just an occasional trip to a therapist, data provides continuous insights on a patient’s state of mind.

As we develop such novel health-care technologies, it’s important to design for user privacy. It’s important that users opt-in get and direct value from such tools, which in digital health translated to getting quality care.

As long as patients’ needs lie at the heart of new digital tools, they can give us a much-needed revolution in mental-health care. Data has the power to make health-care personalized and proactive, to scale our clinical resources, and help us address an unacceptable shortfall in today’s health-care system.

This post is part of a series produced by The Huffington Post and The World Economic Forum to mark the Forum’s Annual Meeting 2016 (in Davos-Klosters, Switzerland, Jan. 20-23). The Forum’s Technology Pioneers program recognizes young companies from around the world that are involved in the design, development and deployment of new technologies that have the potential of significantly impacting the way business and society operate. Read all the posts in the series here.

Digital [mental] health: Healthcare’s new found superpower

Tuesday, October 13, 2015

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Editor’s note: This post by Dr. Ravi Hariprasad (head of clinical programs at Ginger.io) originally appeared on the HealthTech Conference blog, as part of a series highlighting speakers in the 2015 HealthTech Conference. Dr. Hariprasad will be speaking at the conference on October 28th in Santa Clara, CA. 

There is currently much debate surrounding the role that technology should play in the healthcare system, specifically as it applies to the delivery of mental health care.

And for good reason. As a country, we’re underserving people suffering from mental health conditions on a massive scale. The system passed the “unethical” boundary miles back, and we’ve now entered into the realm of the absurd, bordering Kafkaesque in my opinion.

Some people involved in argument believe we need to invest more heavily in human resources to “hire our way out of the problem.” Others look to the promise of technology as a panacea that solves all problems and heals all wounds. As with most things in life, the truth lies somewhere in between.

Let’s start addressing the problem by looking at the facts: 1-in-5 Americans suffers from a mental health condition, the vast majority of which have depression or anxiety as a primary diagnosis or co-morbidity. Nearly 80% of those suffering do not get the treatment they desperately need-whether that’s because of where they live, their ability to pay, the stigma surrounding mental health, or a number of other systemic conditions.

To make matters worse, the U.S. mental health system couldn’t treat all these people even if it wanted to. We’re suffering from a drastic scarcity of mental health providers with wait times ranging from 24 days (national average) to eight months or more in rural areas.

Ten percent of patients consume 63% of the health care dollar (Hussain and Seitz, 2014). These “high utilizers” are often complex patients with comorbid chronic medical and mental illness.

So what do we do? We know the human connection is critical for addressing mental health conditions. Study after study demonstrates how the relationship formed between patient and therapist and the number and frequency of their interactions are key factors in improving outcomes for people with severe symptoms.

But we also know there are simple steps many people can take to address their condition long before walking into a psychiatrist’s office. Things like sleep hygiene, physical activity, and simple CBT and mindfulness practices can serve as preventive mechanisms and provide targeted improvements in populations with less severe conditions. What’s more, these categories of self-help interventions are well-suited for digitization and mass distribution via channels like smartphone apps and web-based services.

The challenge (and the opportunity) is finding the right combination of human services and technological supplements. It’s not an either/or scenario. Empowering higher-functioning clients to take a more central role in their health through education and self-management tools enables a better patient/member/employee experience while also freeing up clinician time and resources to focus on their acute populations and deliver better care across the board.

Following this human-centered/technology-leveraged approach, more people can get the care they need when they need it, and the system as a whole can become exponentially more flexible, responsive and accessible. As a clinician and an advocate for mental health, that’s all I could ever want to achieve.

Payers, employers and providers have to consider these inputs when weighing out what’s right for their populations. There’s no question that technology needs to play a central role in the design of clinical, prevention and wellness offerings. We can’t solve the access issue without it.  For what purposes and to what extent we use technology are the issues we need to address to measurably improve upon the status quo and provide help for those who need it.

3 Critical Fixes for the US Health Care System

Friday, September 25, 2015

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Editor’s note: This op-ed originally appeared on LiveScience, as part of a series provided by the World Economic Forum Technology Pioneers, class of 2015. Dr. Anmol Madan contributed this article to Live Science’s Expert Voices: Op-Ed & Insights. View the original article here.

Possibly the most complex system that health-technology developers face today has nothing to do with hardware, software or even human behavior — rather, it’s the U.S. health care system.

I’m a data scientist by training and by trade, and we’re very pragmatic people. We identify problems, peel back the layers of complexity to look for a root cause, and develop a systematic way of addressing the problem to build a better solution for the future.

In health care, however, those layers are much more intricate, and surprisingly few people can agree on what the “problem” actually is, much less the solution.

From my experience developing Ginger.io and building mental health innovation into health care delivery, I have learned that adoption of these three reforms are critical for the global health care community to scale its impact and provide the right care for those who need it.

1. Embrace technology

We are fortunate enough to live in a time of great technological advancement. This has come in the form of machine learning, 3D printing, predictive analytics, advanced optics, impossibly small sensors and all-around computational power. But when it comes to health care, technology has clearly surpassed the ability of research to keep pace.

Hospitals and doctors are adopting new technologies as they become clinically and commercially viable, but convoluted and burdensome systemic pressures — such as competing incentives, byzantine payment models and legal hurdles — have stymied the pace of innovation. This not only increases the time it takes for these new technologies to enter the market, but also can be a major deterrent to new entrepreneurs — a barrier to entry in an industry that is arguably the most worthy of innovation and human ingenuity: saving lives. [Surgeon’s Helper: 3D Printing Is Revolutionizing Health Care (Op-Ed)]

Nations have the tools to create a much healthier global population, but they’re missing clear opportunities to leverage technological solutions in response to global health threats such as malaria, heart disease and depression. The global community must invest in helping entrepreneurs tackle these difficult problems and navigate the complicated bureaucratic structures currently in place.

2. Give patients the tools to self-manage

We’re now living in an era defined by self-service. People prefer ATMs and smartphones to banks, online shopping to brick-and-mortar stores, and Wikipedia to libraries. When younger generations get sick today, they are more likely to visit WebMD.com or perform a quick Google search to understand their symptoms long before they reach the doors of a doctor’s office. This represents a huge shift and a serious opportunity for both patients and providers of health care. [9 DIY Ways to Improve Your Mental Health]

Research from Accenture shows that more than 90 percent of patients want to self-manage their health care through technology. This includes managing their data and health care records, of course, but it also extends to managing chronic and acute health conditions. In fact, mobile applications analysts at research2guidance estimate that 1.7 billion people will have downloaded health apps by 2017, adding up to an impressive $26 billion global industry.

For patients, the value is clear: Credible information can empower those who hold it to feel more confident in managing their condition and offer some guidance as to when and how to engage with the health care system, improving outcomes and access to health care services in the process.

These activated and engaged patients also benefit health care providers. When patients are empowered to self-manage their condition, there are many beneficial ripple effects: Strain on the system is decreased; emergency departments no longer act as triage units for people in stable condition; and doctors can focus on being doctors, instead of hospital administrators or reimbursement accountants.

3. Address mental health, head on

At some point in modern history, the health care community decided to separate the treatment of mental health from the treatment of physical health. Fortunately, the pendulum is starting to swing back the other way, and we’re coming to realize what people knew long ago: The mind-body connection is very real and very symbiotic. [For Mental Health, Social Media Removes the Silence (Op-Ed) ]

Addressing mental health is crucial to helping patients manage their physical health, especially when it comes to chronic conditions such as diabetes, cancer and heart disease, the latter of which can have depression rates of up to 60 percent. The existence of depression in combination with chronic diseases is shown to dramatically reduce the quality of health outcomes while also driving up costs by an average of $505 per patient per month, according to actuarial consulting firm Milliman.

But the impacts are not only for chronic diseases. Robert Gatchel of the University of Texas has estimated that more than 70 percent of all primary care visits stem from a psychological issue. Primary care is often referred to as “the front lines of health care,” where the average primary care provider will see the full spectrum of mental health conditions (ranging from depression and anxiety to substance abuse and psychiatric disorders) in just one week.

Ask anyone to think about a time when he or she was sad or angry or anxious. Ask them how those feelings manifested physically. You’ll get an immediate response about heart rate, body temperature, posture or pain in a very real sense. Any perceived separation between mental and physical health by health care providers is negligent at best, and downright dangerous at its worst.

As a global society, we have enough tools to “fix” many aspects of health care today. The practice of medicine will always be an evolving science, as the human body is an infinitely complicated and beautiful system. But we can take real steps to improve the standard of care today.

To do so, we must act with a higher degree of urgency in bringing new products and solutions to market, and we must dedicate real resources to applying advanced technologies to the life sciences.

It’s just a matter of having the will to stand up to an entrenched system and shout: “There is a better way!”

World Economic Forum Names Ginger.io a 2015 Technology Pioneer

Wednesday, August 5, 2015

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Today, Ginger.io was awarded the title of “Technology Pioneer” by the World Economic Forum. Technology Pioneers represent a selection of the world’s most innovative early-stage companies who are poised to have a significant impact on business and society today. Ginger.io is the only mental health company selected as one of the world’s 49 most promising Technology Pioneers to change the way mental health is delivered.

“We’re very excited to join the World Economic Forum as a Technology Pioneer” said Anmol Madan, co-founder and CEO of Ginger.io. “We hope this exposure to new audiences will help us serve more people with depression and anxiety who are currently not getting the care they desperately need.”

As the leading cause of disability worldwide, depression affects more than 350 million people globally and more than 16 million American adults. Despite the scale of this problem, a shocking 80% of people do not receive the care they need. Ginger.io hopes to help the people behind these numbers through a combination of proven clinical interventions, free digital tools for managing depression and anxiety, and a personalized patient experience that leverages advanced data science and machine learning methodologies.

Ginger.io joins 49 other Technology Pioneers from around the world and representing a wide range of sectors such as life sciences and healthcare, energy and environment, and information technologies and new media. Learn more about the winners here.

The Technology Pioneers were selected from among hundreds of applicants by a selection committee of 68 academics, entrepreneurs, venture capitalists and corporate executives. Notable members of the committee include Arianna Huffington (founder, Huffington Post) and Henry Blodget (editor-in-chief, Business Insider). The committee based its decisions on criteria including innovation, potential impact, product, viability and leadership.

Past recipients include Google (2001), Wikimedia (2007), Mozilla (2007), Kickstarter (2011) and Dropbox (2011). More information on past winners can be found here.

National Healthcare Innovation Summit – 2015

Saturday, May 16, 2015

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Editor’s note: This Q&A post by Karan Singh originally appeared on the HIMSS blog, as part of a series highlighting speakers in the 2015 National Healthcare Innovation Summit. Mr. Singh is speaking at the summit on June 16. View the original article here

Why is innovation crucial for improving the delivery of healthcare and fulfilling the Triple Aim?

Since the 1950s, the majority of innovations in mental health have been largely focused on the development of pharmaceuticals. Drugs that may or not work, but definitely come with a laundry list of side effects.

Karan-Singh

But with 1-in-4 Americans suffering from a mental health illness like depression or anxiety and the cost of developing new drugs now skyrocketing into the stratosphere, the medical community is looking for new ways to understand, manage and treat mental health conditions on both the individual and population levels.

Layer on top of that that fact that people with mental health conditions have shockingly few resources to help them manage conditions on their own, and you have an incredibly strong case for innovation in the mental health space.

Innovation in mental health care stands to advance our understanding of diseases, improve access to desperately needed services, and increase patients’ ability to manage their condition. Our data shows this combination of measurement, access and self-management directly drives results across the Triple Aim.

But it all starts with the patient. If health care providers can engage the right patients with the right information at the right time, outcomes are demonstrated to improve. This requires a new way of thinking about (and delivering) care with the incredible tools we now have at our disposal. We need a new paradigm of care for the Information Age.

To begin, episodic care needs to be replaced with more continuous, responsive care practices. If I need help today, what good is my appointment in three weeks?

Secondly, care teams need to better understand the intricacies of human behavior. Did I miss my medication because it has negative side effects or because Tuesdays are a busy day for me and the kids?

Lastly, we need to leverage the data that’s all around us to make more informed care decisions. How do I know what’s working for my patients unless I use objective and consistent measures across the continuum of care?

The good news is, it’s already happening. These types of innovations are not pie-in-the-sky thinking. They are there for systems to put in place today and measure the impacts tomorrow.

Can you share one example, from your own experience and expertise, where an innovative technique or approach did make a difference in patient care?

One story that sticks in my mind was from a young woman who was going through a particularly difficult time managing her depression and anxiety. Her work was suffering, her family was suffering, even getting out of bed to shower had become too difficult for her to manage. Her psychiatrist and care team were running out of options to help her.

After a few weeks on Ginger.io, she was able to better understand her symptoms and articulate her issues to her psychiatrist. The psychiatrist was also able to objectively measure what was working and wasn’t, and together they narrowed down the meds and dosages that were right for her and established a treatment plan that was both manageable and effective.

Today, she reports that she’s finally getting her life back from the crippling grips of depression and anxiety, and that she is securely on her way to a more active, happy and fulfilling life with her family.

This is a great example, and we get hundreds of similar stories from people writing in to share the positive impact Ginger.io has had in their lives. It’s extremely inspiring, but it’s also very humbling. The fact that we can touch this many lives is a testament to the power of digital mental health programs like Ginger.io. But it’s also a resounding critique of the system in it current state. Quite simply, people are not getting the care they so desperately need. We need to do better as a system and as a society.

To provide a brief preview to your session at the National Healthcare Innovation Summit, can you share up to two insights attendees will learn from your presentation?

In a sentence: The smartphone is the most powerful sensor in health care.

If you think about the smartphone: it’s always on, always near you, and it can be trained to understand a wide array of human behaviors. It’s the ultimate wearable that you already own and use—there is no hardware to buy, no learning curve to overcome, and no disruption to a person’s daily life.

By leveraging this incredibly powerful device that’s already widely deployed in the marketplace, we can engage people in their health in a variety of new and exciting ways:

• Uncovering connections between life and health through deep analytics and simple, actionable insights

• Improving access to healthcare services through remote care monitoring, telemedicine and responsive outreach from providers when a person is in need of help

• Setting people up for success, rather than failure, by giving them access to tools, information and self-management strategies they need to get and stay healthy

• Enabling and encouraging behavior change through smart program design and engaging, consumer-grade experiences

We built Ginger.io on the premise that the smartphone is the most powerful sensor in healthcare, and I’m happy to say that today we’re no longer alone in this thinking.

We’re now joined by Apple, Samsung, Google and whole host of startups who are centering on the smartphone not only as a key portal for patient engagement, but also (and more importantly) as the central means for patient empowerment.

We’re literally putting a person’s health into they’re own hands. And we believe that’s a big step forward.

Ginger.io Raises $20M to Expand Its Digital Mental Health Offering

Monday, January 12, 2015

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Startup Aims to Improve Delivery of Care by Addressing Behavioral Health

San Francisco, Calif. – Ginger.io, the leading digital mental health solution, today announced $20 million in financing to accelerate the development and expansion of its healthcare technology platform. The Series B funding round saw participation from Ginger.io Series A investors Khosla Ventures and True Ventures, as well as the addition of new strategic investors.

Ginger.io’s technology platform uses data collected from a patient’s smartphone to help connect the dots between behavior and health. Developed at the MIT Media Lab, Ginger.io’s machine learning technology uses smartphone data and self-reported surveys to identify trends in a patient’s health and wellness. That insight is then shared with healthcare providers and care teams (such as spouses or family members) when the patient trends toward a negative health outcome—enabling timely, targeted and effective interventions that can reduce patient readmissions and visits to high-cost care settings, such as emergency departments.

“At Ginger.io, we believe there is tremendous opportunity to revolutionize healthcare by bringing new classes of behavioral data into the clinical assessment process—including mobility, sleep and communication patterns,” said Dr. Anmol Madan, co-founder and CEO of Ginger.io. “To achieve that, we’ve built a company that combines the best of data science and machine learning principles with leading clinical insights and gold standard population health management practices.”

Since the 1950s, the majority of innovations in behavioral health have been focused on the development of pharmaceuticals. But with nearly 1-in-5 Americans suffering from mental health illnesses and the cost of developing new drugs now exceeding $2.5 billion, the medical community is searching for new ways to understand, manage and treat behavioral health conditions. This includes management on both the individual and population levels. Additionally, today’s mental health patients have remarkably few tools to help them understand and manage conditions on their own—a surprising fact in an era defined by self-service and consumer apps. Ginger.io’s unique approach combines leading clinical expertise with user-centric design and engagement principles to support patients and providers across the continuum of care.

Such innovation has brought together investors from diverse backgrounds including Vinod Khosla, founding partner of Khosla ventures. “Ginger.io’s continued success in data science and acceptance by established healthcare partners demonstrates the game-changing nature of this technology.” Khosla continued, “We look forward to working with established organizations to bring Ginger.io to even more patients, leading to better clinical outcomes.”

The Series B round of funding comes on the heels of a strong performance year in 2014 for Ginger.io. Commercial deployments at Novant Health and Centerstone/CRI demonstrated strong results, including increases in patients’ confidence to manage their conditions, improvement in standardized health measures and decreases in ER visits and hospitalizations.

Additionally, public-private partnerships such as that created by Ginger.io, the Cambia Foundation and the Association for Utah Community Health (AUCH) have demonstrated how payors, providers, health agencies and technology companies can work together on system-wide redesign initiatives, including serving those in underserved and low-income populations.

“I’m incredibly proud of the many partnerships and huge successes the Ginger.io team has created since True provided seed funding in 2011,” said Jon Callaghan, founder and managing partner of True Ventures. “We have long believed in Ginger.io’s vision for the power of smartphones to dramatically improve the quality of care across large patient populations, and we are thrilled to continue our support of this extraordinary company.”

Ginger.io’s portfolio of research collaborations also continues to expand, now including eight of the top ten academic medical centers in the U.S. with the newly announced UC San Francisco, Partners HealthCare (Massachusetts General Hospital, Brigham and Women’s Hospital, and McLean Hospital), Duke University, UC Davis and University of Nebraska Medical Center.

As of this announcement, total investment in Ginger.io now amounts to $28M since the company’s founding in 2010. In 2015, the company plans to scale its commercial relationships, expand emergent digital therapies and continue to build its team of industry-leading data scientists, application engineers, healthcare experts and user experience designers. For information on open positions at Ginger.io, visit https://ginger.io/jobs/

About Ginger.io
Ginger.io uses patient smartphones to improve behavioral health in primary and specialty care. Through passive data and deep analytics, this mobile application identifies patterns in patients’ behavior and mental state that may impact their health and well-being. Providers can use the Ginger.io platform to reach out when patients need support and deliver the right care at the right time. Ginger.io is currently working with leading U.S. healthcare institutions including UCSF, Novant Health and Centerstone/CRI. A spinoff from the MIT Media Lab, Ginger.io was recently named one of The World’s Top 10 Most Innovative Companies in Healthcare by Fast Company. Learn more about Ginger.io at www.ginger.io

About Khosla Ventures
Khosla Ventures offers venture assistance, strategic advice and capital to entrepreneurs. The firm helps entrepreneurs extend the potential of their ideas in breakthrough technologies in clean energy, mobile, IT, cloud, big data, storage, health, food, agriculture and semiconductors. Vinod Khosla founded the firm in 2004 and was formerly a General Partner at Kleiner Perkins and co-founder of Sun Microsystems. Khosla Ventures is based in Menlo Park, Calif. More information is available at www.khoslaventures.com

About True Ventures
Founded in 2005, True Ventures is a Silicon Valley-based venture capital firm that invests in early-stage technology startups. With four funds and approximately $900 million in capital under management, True provides seed and Series A funding to the most talented entrepreneurs in today’s fastest growing markets. With a mission to make the world a better place for entrepreneurs, True encourages each founder’s vision and has built resources to empower the employees, families and communities of its portfolio companies. The firm maintains a strong founder community and offers innovative educational opportunities to its portfolio, helping entrepreneurs achieve higher levels of success and impact. With more than 150 companies funded and multiple companies acquired, the current True portfolio has helped create over 3,500 jobs. To learn more about True Ventures, visit www.trueventures.com.

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Ginger.io, AUCH and Cambia Health Foundation Launch “Utah SmartCare” Project to Integrate Delivery of Mental and Physical Healthcare

Tuesday, December 2, 2014

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Partners Aim to Improve Care for Patients with Complex Needs in
Low-Income Populations

San Francisco, Calif. – Ginger.io, the leading digital mental health solution, today announced the launch of Utah SmartCare — a next-generation care management project designed to improve patient engagement and health outcomes in low-income Utah populations. The project focuses on integrating mental and physical health delivery through an innovative technology platform, with the goal of improving the quality and cost of healthcare for this historically underserved population.

Screenshot of Ginger.io appUtah SmartCare is supporting a partnership among three local mental health authorities, two community health clinics and the patients they serve. These participating organizations are committed to improving the health of the most vulnerable members of their communities.

“The project offers an innovative approach to improving communication not only between patients and providers, but also between mental and physical healthcare teams,” said Alan Pruhs, Executive Director at the Association for Utah Community Health (AUCH), the agency leading the collaborative project. “Innovative approaches like this are crucial to the successful integration of physical and mental health.”

“We’re already receiving great feedback from clients enrolled in the program,” said Brandon Hatch, Executive Director of Davis Behavioral Health, one of the local mental health authorities participating in the Utah SmartCare initiative. “This data will allow us to better assess how our clients are doing between appointments and catch any potential problems earlier, leading to better clinical outcomes.”Davis Behavioral Health delivers mental health services for 6,000 people across Davis County. Of these patients, nearly 80% live at or below the poverty line.

All five sites are using the Ginger.io technology platform to integrate primary care with mental health services, but how they achieve that goal varies from site to site. One site, Wasatch Mental Health, is using the technology in a crisis center capacity to better manage patients in the acute phase of their behavioral health condition. Another site, Health Connections at Weber Human Services, is integrating the Ginger.io technology into existing workflows to support and improve the outreach of current case managers on staff.

“This new technology allows us to touch base with clients as they experience increased stress, rather than after the fact,” said Juergen Korbanka, Executive Director of Wasatch Mental Health. “This will enable us to respond more quickly and avoid more complex interventions.”

Utah SmartCare is a first-of-its-kind collaboration between a private business venture, public service organizations and a nonprofit foundation.

Funded by the Cambia Health Foundation, Utah SmartCare focuses on improving care for high-cost patients suffering from serious mental illness (SMI), generalized anxiety and generalized depression, in conjunction with a serious physical health condition such as diabetes or heart disease. The initiative will focus on serving low-income patients living at or below 200% of Federal Poverty Guidelines who are Medicaid beneficiaries or are uninsured.

“This is the sort of imaginative and collaborative community-focused healthcare improvement model we try to support in whatever way we can,” said Jennifer Danielson, Cambia Health Foundation board member. “We believe this innovative and well-integrated approach will improve the quality of care delivered to residents and reduce costs in the process.”

In the past, integrating primary care with behavioral health delivery has proven an effective yet elusive method of treating patients with mental health conditions, according to Dr. Anmol Madan, Co-Founder and CEO of Ginger.io.

“Up until this point, we haven’t had the technology to effectively measure how patients are feeling outside of a care setting. Now that this remote data is more readily available, we are integrating it with the existing healthcare system and using it to deliver the sort of personalized outreach that improves care for patients and drives down costs, both of which substantially benefit the entire system.”

About AUCH
The Association for Utah Community Health (AUCH), formed in 1985, is the voice of Utah’s Health Centers and their patients. As the Primary Care Association in Utah AUCH cultivates access to primary healthcare for everyone throughout our diverse state. The organization represents over 40 not-for-profit community clinics who provide quality healthcare services including medical, dental, and behavioral health, particularly for low-to-moderate income, uninsured or underinsured Utahns who might otherwise not have access to healthcare. Association  members include federal Health Center grantees and other providers who strive to meet the needs of all Utahns in rural and urban areas. More information about AUCH is available at www.AUCH.org

About Cambia Health
Cambia Health Foundation is the corporate foundation of Cambia Health Solutions, a total health solutions company dedicated to transforming the way people experience the health care system. A 501(c)(3) grant-making organization, the Foundation partners with organizations to create a more person-focused and economically sustainable health care system. Through its recently launched children’s health program, the Foundation seeks to partner with community and school-based organizations that are pursuing holistic, integrated approaches to addressing children’s health issues. For more information, visit http://cambiahealthfoundation.org/ or www.twitter.com/cambiahealthfdn.

About Ginger.io
Ginger.io uses patient smartphones to improve behavioral health in primary and specialty care. Through passive data and deep analytics, this mobile application identifies patterns in patients’ behavior and mental state that may impact their health and well-being. Providers can use the Ginger.io platform to reach out when patients need support and deliver the right care at the right time—building a stronger connection between patients and providers. Ginger.io is currently working with leading U.S. healthcare institutions including Kaiser Permanente, UCSF, Novant Health and Centerstone/CRI. A spinoff from the MIT Media Lab, Ginger.io was recently named one of The World’s Top 10 Most Innovative Companies in Healthcare by Fast Company. Learn more about Ginger.io at www.ginger.io

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Ginger.io Announces Research Collaborations with Leading U.S. Healthcare Institutions

Wednesday, November 5, 2014

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Research partners include UC San Francisco, Partners HealthCare, Duke University, UC Davis and University of Nebraska Medical Center


San Francisco, Calif.
– Ginger.io, the leading digital behavioral health solution, announced a series of new research collaborations today and released early findings from several ongoing research engagements. The newly announced institutions include UC San Francisco, Partners HealthCare (Massachusetts General Hospital, Brigham and Women’s Hospital, and McLean Hospital), Duke University, UC Davis and University of Nebraska Medical Center. With these and other collaborations, Ginger.io is now working with more than half of the top 10 academic medical centers in the U.S.

01-Call to Activate“Like providers, academic medicine is looking for better ways to understand how patient behaviors affect health outcomes,” said Dr. Anmol Madan, co-founder and CEO of Ginger.io. “Ginger.io’s smartphone app and analytics engine is essentially a new class of microscope that helps quantify and understand real-world behavior at scale, in many different disease areas. For our academic partners, this offers new insight about clinical characterization, and it may lead to better diagnosis and new therapeutics and interventions for these conditions.”

The announced partnerships are using the Ginger.io platform in one of two ways, said Dr. Ilan Elson, Head of Research and Development at Ginger.io. “Our partners are either deploying Ginger.io’s existing core behavioral health (i.e., mental health) programs in new and exciting ways, or they are using the Ginger.io platform on new conditions like heart disease and chronic pain.”

UCSF is one such institution deploying Ginger.io’s behavioral health application in a research setting. Drs. Patricia Arean and Adam Gazzaley and their teams at UCSF have launched a study to measure digital interventions in patients with major depressive disorder. The multi-arm clinical study involves hundreds of patients recruited online and delivers interventions exclusively through remote digital channels, with no face-to-face interaction between doctors and patients.

“We’re very excited about the approach Ginger.io is taking to engage patients suffering from depression,” said Dr. Patricia Arean, Professor of Psychiatry at UCSF. “Patient feedback on the experience has been overwhelmingly positive thus far, and we’re excited to learn more about what digital interventions can do for mental health.”

Just outside of Boston at McLean Hospital, Chief of McLean’s Psychotic Disorders Division Dr. Dost Öngür is leveraging the Ginger.io platform to conduct research on how to reduce hospital readmissions for patients with psychiatric conditions, including schizophrenia and bipolar disorder. By detecting early warning signs that someone is struggling to manage their illness, Dr. Öngür hopes his work will lead to the ability to better identify patients in need, and deliver effective care before hospitalization is needed.

Beyond mental health uses, several institutions are using Ginger.io technology in diverse disease areas to more effectively connect the dots between patient behaviors and specific health outcomes.

Researchers at UCSF, for example, are collaborating with Ginger.io to help patients suffering from heart disease, multiple sclerosis and post-operative recovery. As part of the Health eHeart Study, for example, Ginger.io is helping world-class cardiologists detect early-warning signals for the development and exacerbation of heart disease.

“Heart disease is the No. 1 killer in the United States and the developing world, and identifying heart disease risks and addressing them in advance is much needed,” said Dr. Jeffrey Olgin, chief of the UCSF Division of Cardiology and a principal investigator of the Health eHeart Study. “Our ultimate goal through this study and others is to provide a thermometer or ‘check engine’ light for people to be empowered in managing their own health and risk.”

Researchers at Duke University also see the potential of Ginger.io to help patients in postoperative recovery settings. Patients undergoing joint replacement surgery use the Ginger.io app to track their recovery, pain and return to functionality. By identifying which patients need the most help, providers can streamline the recovery process and deliver the right level of care to patients who are in the most need — with the added benefit of reducing unnecessary visits for healthy patients.

“We’ve been impressed by the results of the Ginger.io platform in other disease states, and we look forward to exploring its potential to streamline and improve perioperative care of our total joint arthroplasty patients,” said Dr. Chad Mather, Assistant Professor of Orthopaedic Surgery at Duke University Medical Center. “The ability to passively monitor our patients could represent an opportunity, if confirmed in clinical study, to transform the way we care for our patients postoperatively.”

Many Ginger.io research partners are publishing their results based on findings and insights driven by Ginger.io’s data collection and machine learning analytics engine.

Drs. Laura Tully, Cam Carter and Tara Niendam of UC Davis, for example, recently shared their findings from a partnership with Ginger.io in an early psychosis study. Results announced at this year’s Society for Biological Psychiatry showed the identification of specific “smartphone signatures” and patterns of behavior for symptoms of psychosis in adolescent populations.

At the University of Nebraska Medical Center, Dr. Kaleb Michaud found success with Ginger.io in an older patient population along with patients participating in the National Data Bank for Rheumatic Diseases. A poster presented at the European League Against Rheumatism conference this past summer showed a number of correlations between arthritis pain levels and patterns of travel and communication as measured by the Ginger.io app on a patient’s smartphone.

“This isn’t science fiction,” said Dr. Elson of Ginger.io. “We’re touching a huge number of patients in a wide array of clinical settings. Working alongside our partners, we’re having a real impact on population health management and improving patients’ lives—in some cases almost immediately.”

“The diversity of these deployments is what’s really exciting,” Dr. Elson continued. “We’re going into complex settings with different care delivery models and unique patient needs, and we’re still making a difference in relatively short order. It’s a testament to the strength and flexibility of our platform and our clinical approach. This could be a turning point in the history of healthcare delivery, and that’s very exciting for us at Ginger.io.”

About Ginger.io Ginger.io uses patient smartphones to improve behavioral health in primary and specialty care. Through passive data and deep analytics, this mobile application identifies patterns in patients’ behavior and mental state that may impact their health and well-being. Providers can use the Ginger.io platform to reach out when patients need support and deliver the right care at the right time—building a stronger connection between patients and providers. Ginger.io is currently working with leading U.S. healthcare institutions including Kaiser Permanente, UCSF, Novant Health and Centerstone/CRI. A spinoff from the MIT Media Lab, Ginger.io was recently named one of The World’s Top 10 Most Innovative Companies in Healthcare by Fast Company. Learn more about Ginger.io at www.ginger.io

Centerstone Research Institute, Ginger.io and Verizon Partner to Solve Healthcare’s Superutilizer Challenge

Tuesday, September 16, 2014

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Ginger.io recently teamed up with the Centerstone Research Institute (CRI) and Verizon Wireless to launch a new behavioral health program powered by data science and mobile technology. The program, known as coactionHealth, helped patients with complicated mental and physical health conditions to better manage their health and reduce healthcare costs along the way.

The targeted intervention program used a technology-driven healthcare delivery model to help patients with complex health disorders. The result? One hundred percent of patients felt comfortable managing their conditions just 30 days into the program, when zero percent felt confident doing so at the start of the intervention. That’s an amazing transformation in patient engagement, confidence and empowerment.

One patient lost nearly 20 pounds, dropping her HbA1C levels below the threshold for diabetes. Another patient discovered the root cause of her frequent hospitalizations, and hasn’t had an ER visit or hospitalization since enrolling in the program.

“Providers now have access to more data from more sources than ever before, and connecting that data to physical and mental wellness represents an enormous opportunity to improve outcomes,” said Anmol Madan, co-founder and CEO of Ginger.io. “We’re helping providers shift from an episodic view of their patients’ health to a continuous and more comprehensive understanding of personal health trends. The CRI program shows how targeted outreach and an improved patient-provider connection can empower patients to take control of their own health.”

“The coactionHealth pilot demonstrated that technology can be a vital tool in advancing behavioral healthcare and making the healthcare system more efficient and effective for people with chronic and complex conditions,” said Dr.  Tom Doub, CEO of CRI. “By integrating mobile solutions and data analytics into a coordinated care program, CRI, Ginger.io and Verizon were able to not only reduce hospitalization costs, but create a positive mental and physical change for participants.”

The coactionHealth program was so successful that CRI and its partners is now offering the intervention service to more patients in several new locations.

Read the full description of the intervention program over at Centerstone Research Institute.

Not Tomorrow, but Today — An NIMH Keynote Presentation

Friday, May 2, 2014

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Karan and NIMHOur mission at Ginger.io is to drive better outcomes through passive mobile data and behavioral analytics. With the recent launch of our new programs in behavioral health, we were thrilled to give a keynote presentation at the 22nd National Institute of Mental Health (NIMH) Conference on Mental Health Services Research. Karan’s (Ginger.io Co-Founder) presentation on the future of technology in mental health set an inspiring tone that together, we can tackle these challenges now. You can read more in the outline of his talk below.

For us, the conference’s most exciting aspect was this focus on how the health technology ecosystem is actually making tomorrow happen today. After countless great conversations, Karan and Ilan (Head of Research at Ginger.io) came home with two key takeaways:

1) We’re not casting a wide enough net. Mental health interventions aren’t working for 80% of people.There is a big opportunity to better understand how we can help — and how new technologies can expand the tools we use to support those in need.

2) Identifying patients in need is a huge challenge. We have many ideas about new and innovative interventions, but we need to better understand who those interventions will help most. Making sure the right care reaches the right patients at the right time is key to advancing behavioral health care.

It was an honor to speak at NIMH MHSR 2014. We can’t wait to see the next wave of collaborations between technology and industry!

Karan Singh’s Keynote Presentation at NIMH MHSR 2014: It’s Not Tomorrow But Today

 

We see the following transitions that need to be made for change to take hold — and the companies that are modeling those transitions today.

Today vs. tmrw

EPISODIC VS. CONTINUOUS: health happens between office visits, but we’re largely blind to this reality. Fortunately, some companies are already facilitating continuous care:

Proteus Digital Health’s ingestible sensor brings continuous insight to medication adherence by tracking medication use, and alerting caregivers when someone may need support
Propeller Health’s GPS-enabled rescue inhalers provide continuous support to asthma and COPD patients through their mobile app, coaching, and clinician connection

SUBJECTIVE VS. OBJECTIVE: we don’t have objective tools for diagnosis and ongoing monitoring of behavioral health conditions. However, we are developing objective tools for other conditions:

Alivecor’s iphone EKG brings objective understanding to your fingertips by providing an easy way for patients to seamlessly generate heart health data for clinical analysis
CellScope’s digital otoscope brings diagnostic-quality data to remote care by empowering clinicians and other caregivers

REACTIVE VS. PROACTIVE: we’re waiting for people to show up in care settings after small issues have become larger problems. Thankfully, some companies are taking a more proactive approach today:

RecoveryRecord is empowering individuals with eating disorders. Through their mobile app, individuals can get support from the community or connect with therapists
Omada Health is digitizing the Diabetes Prevention Program with a human-centered design approach that brings online support and tracking tools
— ThinkFeelDo is enabling out-of-office web-based coaching

DOCTOR-ORIENTED VS. PATIENT-CENTERED: the patient experience is largely an afterthought for many health systems, but some people are starting to put the user back in the driver’s seat:

— Dartmouth’s Dr. Dror Ben-Zeev is empowering patients with different coping skills for mental illness
Akili has developed an immersive video game experience to treat ADHD and expand our definition of therapy
Bit Gym has developed an innovative user-centric experience encouraging people to participate in more physical activity

SMALL DATA VS. BIG DATA: we’re using DSM-V and subjective disease clusters to create broad segments of patients. Fortunately, we’re starting to utilize and understand the value of better data to inform care:

— The Health eHeart study is on a mission to gather data from over 1 million people to fight heart disease. This “digital Framingham” brings together citizen scientists, researchers and tech companies to change our understanding of heart disease
Flatiron Health is breaking down data silos for the 96% of patients who don’t participate in a cancer clinical trial with its cloud-based analytics platform

It’s invigorating to watch these companies and others create objective tools that generate continuous insights and fuel proactive, patient-centric care. However, the friction in the system is still holding us back from further innovation.

friction

As he closed, Karan challenged the audience to think about how we could address and eliminate these frictions and drive change. The stimulating panel discussion following Karan’s keynote brought to light how people are thinking about these frictions today.

What do you think? How can we make the path towards innovation easier? What other companies are helping make transitions to tomorrow, today?