Reena Jadhav interviews Walter Greenleaf (Distinguished Visiting Scholar, Stanford University) at SplashX Invent Health Behavioral and mental health at HP
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[00:01] REENA JADHAV: Hey everyone its Reena Jadhav founder of health bootcamps here at HP’s SplashX Invent house and I am so excited to be chatting with Walter Brown really Walter welcome.
[00:12] WALTER GREENLEAF: I am excited to be here too Reena.
[00:13] REENA JADHAV: So we are experiencing a crisis at epic proportions. We are seeing some pretty significant mental health spending and yet the numbers keep going up right. 200 billion spent, 30% junk in the last decade and we have had some two very famous people who we have lost lately. Do you see something of a light at the end of this tunnel in the middle of this crisis?
[00:34] WALTER GREENLEAF: I do. I am very excited because there is a lot of change underway in our health care system. The companies are declining; the tech companies are jumping into health care look at Microsoft, apple, google, Samsung the list goes on. They are moving into health care, they are bringing a lot of energy, and they are new momentum to it. Hand to hand, in that there has been a big change to how we perceive mental health and wellness and there are a lot of startups and larger companies jumping in to come up with complementary therapies that go along with the existing therapies that we have and also stand along things that people can do on their own to help keep themselves healthy and well.
[01:19] REENA JADHAV: Absolutely there is something called digital therapeutics that has become a buzzword. Share with our listeners, our viewers what is digital therapeutics and how do you see it evolving?
[01:31] WALTER GREENLEAF: Just a little bit of a buzzword but when people use it to describing the fact that we are now combining digital applications versus sensors and platforms that we have such as cell phones and smartwatches and smart houses and viewing pads with therapeutic interventions. The phrase that is often used in transquilarly is going beyond the pill not just writing prescriptions but also connecting the medication, the expertise behind the medication, the correlation of prescribing it to the consumer and giving them exact information through a digital health platform. It is not just pharmaceutical companies also the medical device companies, everybody involved in healthcare is trying to decentralize and make the patient point care as opposed to clinic or the doctor point care.
[02:21] REENA JADHAV: And really ensuring the patient is empowered to start making those health and wellness decisions because I think so far our model has been structured in the way that the patient relies on the doctor.
[02:33] WALTER GREENLEAF: Right even though the patient is at the center, education is ultimate. They are paying for the health care they are getting in one form or another. We have to shift to business model; we have to shift to every model to represent what we can do now enabled by the new technologies.
[02:50] REENA JADHAV: And pills don’t heal so I love the fact that now we are talking about therapeutics where we are truly talking about healing and it is beyond pill. There is a very exciting company and some very exciting news where they have actually received that approval-aero therapeutics.
[03:08] WALTER GREENLEAF: Apparently, recently I was one of the original team that was there so I am very excited about this and last September we received FTA certification for this digital health we set. I hope they will feel the presence and that’s a great thing to be able to have those safeties and the FAC often intervention being reviewed by the FTA and certified and that’s just the beginning there is a number other projects under way with the FTA changing its review process and looking at digital therapeutics. And by the way I am hoping the term digital therapeutics is just a temporary term, we are using it now to discuss something that’s new but I think in the future not too far from now it will just be one more part of therapeutic process it won’t be put in a separate category.
[03:54] REENA JADHAV: I hope to be the first that’s my personal hope is that if you go into the doctor’s office and the first attempt is let’s try this lets try this particular not pills.
[04:05] WALTER GREENLEAF: Or before you go into the office.
[04:06] REENA JADHAV: Oh before you go into the office?
[04:09] WALTER GREENLEAF: You have been managing your own health using digital forms. You have information about your sleep, about your nutrition, about your BP levels, about everything that is helpful to your better analysis of your issues. It’s already collected and can be provided now. We might be careful about this issue, we might see etcetera but with some powerful tools coming out that will help your better interventions and I think we shall all finish this with a lot of extra information based on the sensors that are around us.
[04:39] REENA JADHAV: Or the clinician will come to us right? That’s what we were chatting a few minutes before getting recorded that we have these sensors and the information is coming to us. Hey, your blood pressure is high why don’t you go meditate a little bit and get your blood pressure down?
[04:54] WALTER GREENLEAF: One of the things I am excited about is that I do a lot of work with virtual reality and automatic technology and I am finding it to be a very powerful tool. We do and we have this one by Hewlett Parker but every major technology company has jugged in to get involved with developing the VRAR technology. There is thousands of startup companies coming up with the enabling applications and health care there is at least 400 of these jumping in to come up with some very powerful and there is a lot we can do. In mental health, we have to go through secondary help with anxiety, contraction, and a little help.
[06:02] REENA JADHAV: VR-AR yes.
[06:06] WALTER GREENLEAF: I am really excited about emerging technologies such as VRAR technology will help propel this change we are talking about in terms of aero therapeutics. In mental health, there are a lot of profound things we do. We have anxiety and depression but also we have come to aging, help with destruction from painful procedures, help with dermatitis disorders. Very difficult problem such as autism has precaution; we haven’t had the solutions we would like to have to deal with these difficult problems. Now we have a technology that really can you conversant. We can create a situation for people and that allows us to do better assessments and better interventions and accurately.
[06:52] REENA JADHAV: I would love some examples.
06:55] WALTER GREENLEAF: Well for example dealing with post-traumatic stress, we do exposure therapy. We started asking the person with the head trauma to think about the trauma, to teach them the common skills to manage their burned fear of response to that trauma. If I could ask you the worst thing that could happen but if I could use a virtual environment, I would gradually take you there to expose your therapy proteome, teach you not to have that fear response. Another example is for both the pain using VR it is very effective intervention in the hospital environment I think the painful procedure to both destruct them and also teach them the skills they need to manage the pain.
[07:41] REENA JADHAV: And that is such a huge crisis right the crisis again is huge crisis. How quickly do you think we can get this technology out so we can start the stem the bleeding?
[07:52] WALTER GREENLEAF: Well the good news is we had VR technology and done research on what works and doesn’t work in that line of work for such a decade now it’s just we are using refrigerator-sized computers they cost half a million dollars and they are in this place they are still heavy we had to carry them with a crane but now we have things that are affordable, comfortable and it is not just fully immersive VR systems, we can use our cell phones and our display tablets to enhance our system. We also have help from the AI people we have virtual humans they can interact with us and talk with us and do assessments in that way so it’s also virtual in terms of health soon it will come out. It has already been described here now it’s still at the doctor phase but I can see it start moving out per the standard.
[08:43] REENA JADHAV: So are you bullish on that? Do you think we will see a quick? How many years? Let’s play guessing game here so how many years out do you think we are when someone who has got anxiety and depression can walk in and be prescribed on VR solution?
[08:59] WALTER GREENLEAF: We can do it now but in terms of when and how soon is going to be a commonly done thing. I think it is going to be 4 or 5 years or it is going to be 20 years.
[09:13] REENA JADHAV: How long do you accelerate it Walter that’s so far away.
[09:16] WALTER GREENLEAF: Well let me tell you what it depends on. I think it depends on what happens with the consumer electronics companies how much they are willing to jump into the health care arena, how active they are and also changes in how we quickly evaluate and regulate and reimburse this. If the winds are capable and people see oh this is an effective intervention compared to huge reimbursement system to address it you could have everything. We already have some systems, which is the whole spectrum. Stroke rehabilitation for example but until we have that C change in technology, underwriting and professionalism by the clinical community that’s why it could either be very soon or later on.
[09:58] REENA JADHAV: If you were to make one prediction in the mental health space what would that be?
[10:02] WALTER GREENLEAF: I think in the mental health space. I think we are going to have stress we mentioned it education system. Systems that help one with generalizing disorders, panic attacks, I think we are going to come out, consumers will see it in the next few years, and they will be available to help people in a greater way. Then move over to the arena for more serious problems, problems like depression disorders in the next five years or so but I think we are going to start that with some hazard clusters.
[10:36] REENA JADHAV: And other than VR what is the one other technology you are really excited about that you think would make a big dent in the challenges that we face?
[10:43] WALTER GREENLEAF: I think the fact that we are using our cell phones as data collection tools that then the tech behind it to get more information about ourselves, it can be used to help us understand ourselves and send that back to an expert that is helping us like a conditioner or our coach I think that is one thing that is going to be used to collect information, analyze it better used to predict a model. It will understand more precision that is really what we like instead of having one symptom.
[11:14] REENA JADHAV: Thank you!
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