Mental illness is the single largest cause of disability in developed countries, even more than cancer and heart disease, says the Centers for Disease Control and Prevention. And depression in particular is under-treated in the U.S.; only half of those who suffer get help, particularly some minority groups.
We already use the Internet for countless patient interactions – why not as an adjunct to therapy? Empower Interactive, a TEDMED Hive 2013 company, developed a web-based program, Good Days Ahead, for those who suffer with anxiety, stress or depression.
“There’s a great volume of clinical evidence you can deliver some aspects of psychotherapy by software,” says Eve Phillips, CEO, who explored the potential of the technology while working as a research affiliate in the Synthetic Neurobiology Group at the MIT Media Lab.
Good Days is available in two strengths, so to speak. One is a clinical version to complement talk therapy. Roughly half of a treatment module contains targeted online education, while the other half is work one-on-one with a therapist, who can review information on how the patient is using the system.
The wellbeing version is a self-coping tool that aims to help those with mild symptoms of anxiety and depression. A related mobile app, ReThink, allows users of both platforms to record thoughts and emotions, accompanied by photos, for later reflection. Anonymized, aggregated data gives administrators feedback on user activities and outcomes.
Good Days was co-authored by psychiatrist Aaron Beck, generally considered to be the founder of cognitive-behavioral therapy (CBT). It is a treatment that examines the way that our thoughts and perceptions of situations influence our actions and how we feel emotionally. Research consistently shows that computer-assisted CBT is as effective as standard therapy, and patients using these programs better understand what CBT is and how it works. It’s more cost-effective and easier to disseminate. That’s key in an area like mental health, which is under treated in the U.S. and around the globe. CBT is also helpful for those suffering with chronic pain.
For those reasons and more, Empower has already been working with the United States Army to help enlisted personnel and veterans. They’re also working with Sutter Health and San Francisco Health Plan, and have pilot programs with other major insurers and health systems.
“Some groups are trying to integrate behavioral health into primary care, or do it in a more saleable and consistent way, or perhaps under the umbrella of under chronic disease management,” Phillips says.
Eventually, Phillips hopes to craft a program for kids and teens, too – another under-served population, and certainly one at ease with computer screens.
Building A Global Research Superhighway
“LinkedIn on steroids” is how Dr. Fabio Thiers, founder and CEO of The Hive 2013 company ViS Research, describes the web platform that helps trial planners to find investigators and sign up the perfect research center. An analytics-slash-communications tool, ViS helps planners source and sort investigators by capabilities, expertise, current trials and available patient populations, and then contact them on the closed system. Currently, some 330,000 investigators from 178 countries are represented on the system, comprising 417,000 disease-specific centers. The data is visualized according to location.
Pharmaceutical companies spend billions each year on feasibility studies, while research centers spend valuable time trying to attract them. When the twain do meet, an average of half of all centers drop off during the lifetime of a study. The inefficiencies lead to some $10 billion each year in waste, Thiers says, including greater expense and longer lead times for drug discovery.
Thiers, who trained as an MD in Brazil, also trained at the Harvard-MIT Division of Health Sciences & Technology and previously ran a research program on global resource allocation at MIT. That interdisciplinary background, plus his worldly perspective, helped him to build ViS’ global team of medical researchers, programmers, trial planners, statisticians, and designers.
The nature of the platform meant launching a global enterprise right off the bat, which ViS has done, with regional offices in the US, Brazil, Germany and India.
ViS also has the potential to be a global equalizer for industry opportunity.
“The previous system was about about who you know. More well-known sites were more likely to be chosen. Here, all sites have the opportunity and a common platform for which to share their capabilities,” Thiers says.
ViS has partnered with a number of industry groups and non-profits to expand and improve its network. They’re working with ACRES, the Alliance for Clinical Research Excellence and Safety, to help inform standards for clinical research sites. The company is also working with the Biotechnology Industry Organization (BIO) and its member companies to map more than 3,000 institutions with pediatric experience across 84 countries.
Catalyst is an ongoing series about health innovation, focusing on companies from the TEDMED Hive. For more information about The Hive 2014, click here.