NeuroFlow Secures $20M for Tech-Enabled Behavioral Health Integration Platform

NeuroFlow Secures $20M for Tech-Enabled Behavioral Health Integration Platform

What You Should Know:

– NeuroFlow raises $20M to expand its technology-enabled behavioral
health integration platform, led by Magellan Health.

– NeuroFlow’s suite of HIPAA-compliant, cloud-based tools
simplify remote patient monitoring, enable risk stratification, and facilitate
collaborative care. With NeuroFlow, health care organizations can finally
bridge the gap between mental and physical health in order to improve outcomes
and reduce the cost of care.


NeuroFlow, a Philadelphia-based digital health startup supporting technology-enabled behavioral health integration (tBHI), announces today the initial closing of a $20M Series B financing round led by Magellan Health, in addition to a syndicate including previous investors. Magellan is a leader in managing the fastest growing, most complex areas of health, including behavioral health, complete pharmacy benefits and other specialty areas of healthcare. 

NeuroFlow for Digital Behavioral Health Integration

NeuroFlow works with leading health plans, provider systems,
as well as the U.S. military and government to enhance virtual health programs
by delivering a comprehensive approach to whole-person care through digital
behavioral health integration – an evidence-based model to identify and treat
consumers with depression, anxiety and other behavioral health conditions
across all care settings.

Key features of the behavioral health platform include:

– Interoperability: Seamless EHR and system integrations minimize administrative burden and optimize current IT investments.

– Measurement-based Care & Clinical Decision Support: NeuroFlow enables MBC at scale, keeps the patient in the center of care, and continuously monitors for a consistent connection to critical data and clinical decision support.

– Performance Management & Reporting: Recognize
the impact of your BHI program, monitoring the impact of clinical interventions
on quality and cost of care while recognizing outliers requiring program
adjustments.

– Consumer Engagement & Self-Care: personalized
experience that encourages, rewards and recognizes continuous engagement and
monitoring

Maximize Efficiency, Revenue and Reimbursements

By integrating behavioral health into the primary care setting, increasing screening and self-care plans – NeuroFlow’s BHI solution can reduce ED utilization by 23% and inpatient visits by 10%. 80% of NeuroFlow users self-reported a reduction in depression or anxiety symptoms and 62% of users with severe depression score improve to moderate or better.

Telehealth Adoption Underscores Need for Behavioral
Healthcare

With record growth in telehealth adoption and historic spikes in depression and anxiety due to the ongoing pandemic, workflow augmentation solutions and the delivery of effective behavioral health care have been identified as top priorities in the industry. NeuroFlow’s technology increases access to personalized, collaborative care while empowering primary care providers, care managers, and other specialists to most effectively support patient populations by accounting for and addressing behavioral health. 

“Behavioral health is not independent of our overall health — it affects our physical health and vice versa, yet most underlying behavioral health conditions go unidentified or are ineffectively treated. Most healthcare providers are overburdened, so introducing the concept to account for a person’s mental health in addition to their primary specialty can be overwhelming and lead to inconsistent and inadequate treatment,” said NeuroFlow CEO Chris Molaro. “Technology, when used strategically, can enhance and augment providers, making the concept of holistic and value-based care feasible at scale and easy to implement.”

Strategic Partnership with Magellan

Magellan Health’s network of more than 118,000 credentialed
providers and health professionals are now poised to join NeuroFlow customers
across the country by leveraging the best-in-class integrated data and
analytics platform to meet the rising demand for enhanced mental health
services and support. By partnering with and investing in NeuroFlow, Magellan
has the opportunity to drive further adoption of NeuroFlow’s behavioral health
integration tools and drive collaborative care initiatives with its customers
as well as its vast network of credentialed providers and health professionals
across the country.

Expansion Plans

NeuroFlow will use the Series B proceeds to scale its
operations and support its growth in data analytics, artificial intelligence,
and direct health record integrations. NeuroFlow’s contracted user base has
grown 10x to over 330,000 in support of almost 200 commercial health systems,
payers, accountable care organizations, independent medical groups, and federal
agencies to provide technology-enabled care solutions.


Why Hospitals Should Act Now to Create Clinical AI Departments

Why Hospitals Should Act Now to Create Clinical AI Departments
John Frownfelter, MD, FACP, Chief Medical Information Officer at Jvion

A century ago, X-rays transformed medicine forever. For the first time, doctors could see inside the human body, without invasive surgeries. The technology was so revolutionary that in the last 100 years, radiology departments have become a staple of modern hospitals, routinely used across medical disciplines.

Today, new technology is once again radically reshaping medicine: artificial intelligence (AI). Like the X-ray before it, AI gives clinicians the ability to see the unseen and has transformative applications across medical disciplines. As its impact grows clear, it’s time for health systems to establish departments dedicated to clinical AI, much as they did for radiology 100 years ago.

Radiology, in fact, was one of the earliest use cases for AI in medicine today. Machine learning algorithms trained on medical images can learn to detect tumors and other malignancies that are, in many cases, too subtle for even a trained radiologist to perceive. That’s not to suggest that AI will replace radiologists, but rather that it can be a powerful tool for aiding them in the detection of potential illness — much like an X-ray or a CT scan. 

AI’s potential is not limited to radiology, however. Depending on the data it is trained on, AI can predict a wide range of medical outcomes, from sepsis and heart failure to depression and opioid abuse. As more of patients’ medical data is stored in the EHR, and as these EHR systems become more interconnected across health systems, AI will only become more sensitive and accurate at predicting a patient’s risk of deteriorating.

However, AI is even more powerful as a predictive tool when it looks beyond the clinical data in the EHR. In fact, research suggests that clinical care factors contribute to only 16% of health outcomes. The other 84% are determined by socioeconomic factors, health behaviors, and the physical environment. To account for these external factors, clinical AI needs external data. 

Fortunately, data on social determinants of health (SDOH) is widely available. Government agencies including the Census Bureau, EPA, HUD, DOT and USDA keep detailed data on relevant risk factors at the level of individual US Census tracts. For example, this data can show which patients may have difficulty accessing transportation to their appointments, which patients live in a food desert, or which patients are exposed to high levels of air pollution. 

These external risk factors can be connected to individual patients using only their address. With a more comprehensive picture of patient risk, Clinical AI can make more accurate predictions of patient outcomes. In fact, a recent study found that a machine learning model could accurately predict inpatient and emergency department utilization using only SDOH data.

Doctors rarely have insight on these external forces. More often than not, physicians are with patients for under 15 minutes at a time, and patients may not realize their external circumstances are relevant to their health. But, like medical imaging, AI has the power to make the invisible visible for doctors, surfacing external risk factors they would otherwise miss. 

But AI can do more than predict risk. With a complete view of patient risk factors, prescriptive AI tools can recommend interventions that address these risk factors, tapping the latest clinical research. This sets AI apart from traditional predictive analytics, which leaves clinicians with the burden of determining how to reduce a patient’s risk. Ultimately, the doctor is still responsible for setting the care plan, but AI can suggest actions they may not otherwise have considered.

By reducing the cognitive load on clinicians, AI can address another major problem in healthcare: burnout. Among professions, physicians have one of the highest suicide rates, and by 2025, the U.S. The Department of Health and Human Services predicts that there will be a shortage of nearly 90,000 physicians across the nation, driven by burnout. The problem is real, and the pandemic has only worsened its impact. 

Implementing clinical AI can play an essential role in reducing burnout within hospitals. Studies show burnout is largely attributed to bureaucratic tasks and EHRs combined, and that physicians spend twice as much time on EHRs and desk work than with patients. Clinical AI can ease the burden of these administrative tasks so physicians can spend more time face-to-face with their patients.

For all its promise, it’s important to recognize that AI is as complex a tool as any radiological instrument. Healthcare organizations can’t just install the software and expect results. There are several implementation considerations that, if poorly executed, can doom AI’s success. This is where clinical AI departments can and should play a role. 

The first area where clinical AI departments should focus on is the data. AI is only as good as the data that goes into it. Ultimately, the data used to train machine learning models should be relevant and representative of the patient population it serves. Failing to do so can limit AI’s accuracy and usefulness, or worse, introduce bias. Any bias in the training data, including pre-existing disparities in health outcomes, will be reflected in the output of the AI. 

Every hospital’s use of clinical AI will be different, and hospitals will need to deeply consider their patient population and make sure that they have the resources to tailor vendor solutions accordingly. Without the right resources and organizational strategies, clinical AI adoption will come with the same frustration and disillusionment that has come to be associated with EHRs

Misconceptions about AI are a common hurdle that can foster resistance and misuse. No matter what science fiction tells us, AI will never replace a clinician’s judgment. Rather, AI should be seen as a clinical decision support tool, much like radiology or laboratory tests. For a successful AI implementation, it’s important to have internal champions who can build trust and train staff on proper use. Clinical AI departments can play an outsized role in leading this cultural shift.  

Finally, coordination is the bedrock of quality care, and AI is no exception. Clinical AI departments can foster collaboration across departments to action AI insights and treat the whole patient. Doing so can promote a shift from reactive to preventive care, mobilizing ambulatory, and community health resources to prevent avoidable hospitalizations.

With the promise of new vaccines, the end of the pandemic is in sight. Hospitals will soon face a historic opportunity to reshape their practices to recover from the pandemic’s financial devastation and deliver better care in the future. Clinical AI will be a powerful tool through this transition, helping hospitals to get ahead of avoidable utilization, streamline workflows, and improve the quality of care. 

A century ago, few would have guessed that X-rays would be the basis for an essential department within hospitals. Today, AI is leading a new revolution in medicine, and hospitals would be remiss to be left behind.


About  John Frownfelter, MD, FACP

John is an internist and physician executive in Health Information Technology and is currently leading Jvion’s clinical strategy as their Chief Medical Information Officer. With 20 years’ leadership experience he has a broad range of expertise in systems management, care transformation and health information systems. Dr. Frownfelter has held a number of medical and medical informatics leadership positions over nearly two decades, highlighted by his role as Chief Medical Information Officer for Inpatient services at Henry Ford Health System and Chief Medical Information Officer for UnityPoint Health where he led clinical IT strategy and launched the analytics programs. 

Since 2015, Dr. Frownfelter has been bringing his expertise to healthcare through health IT advising to both industry and health systems. His work with Jvion has enhanced their clinical offering and their implementation effectiveness. Dr. Frownfelter has also held professorships at St. George’s University and Wayne State schools of medicine, and the University of Detroit Mercy Physician Assistant School. Dr. Frownfelter received his MD from Wayne State University School of Medicine.


Watch Out For Top Pipeline Therapies Making An Impact In The Bipolar Depression Market

Characterized by debilitating episodes of depression and mood elevation (mania or hypomania), Bipolar depression is an under-recognized and unappreciated phase of bipolar disorder. Since most patients exhibit depression, Bipolar depression gets misdiagnosed with other mental disorders easily. Thus, it is associated with a heavier burden of illness, morbidity, and cost. Even then, there is no cure for it. The present treatment consists of two phases: the acute phase and the maintenance phase. Acute-phase treatment focuses on the management of acute mood episodes (manic, hypomanic, or depressive) while Maintenance-phase treatment prevents recurrences of acute episodes. 

The ultimate goal of treatment is to achieve as high as possible a level of psychosocial function and health-related quality of life. However, a lot of R&D is taking place in advancing the ways mental disorders are dealt with and treated. Key pharmaceutical companies such as Celon Pharma, Otsuka Pharmaceutical, NeuroRx, among others worldwide are profoundly working in fuelling the Bipolar depression market size growth. The Bipolar depression pipeline including Abilify, NRX-100/NRX101, Lumateperone, and Zuranolone are expected to grace the market by 2024, thereby, presenting a promising contribution to the Bipolar depression therapeutics market revenue. DelveInsight estimates that the Bipolar depression market is expected to soar with a CAGR of 16.69% during the study period [2017-30] in 7MM (the US, EU5 (the UK, Germany, France, Italy, and Spain) and Japan). 

Some of the pipeline therapies that are expected to make a positive impact on the Bipolar depression market are:

  1. Lumateperone

Company: IntraCellular Therapies

Lumateperone is an investigational orally available, first-in-class small molecule that provides selective and simultaneous modulation of serotonin, dopamine, and glutamate—three neurotransmitter pathways implicated in severe mental illness. Already marketed under the trade name Caplyta for Schizophrenia in adults, it is in Phase III clinical stage of trials for Bipolar depression. 

  1. NRX-100

Company: NeuroRx

NRX-101 is a proprietary, oral fixed-dose combination of two FDA-approved drugs: D-cycloserine, an NMDA receptor modulator; and Lurasidone (Latuda), a 5-HT2a receptor antagonist. The idea here is the development of a sequential therapy that is a combination of intravenous NRX-100 (ketamine HCL) followed by oral NRX-101. The combination is under Phase III clinical trial for rapid stabilization of acute suicidal ideation and behavior in patients with bipolar depression and phase IIb/III trials for Bipolar Depression in patients with Acute Suicidal Ideation and Behavior (ASIB) and 

  1. Falkieri

Company: Celon Pharma

Falkieri is an esketamine formulation that acts as an NMDA antagonist. Esketamine has received approval from the US FDA in March 2019, under the brand name Spravato, in conjunction with an oral antidepressant, for depression in adults who are not benefited from any other antidepressant. Falkieri is the first such formulation, which targets both unipolar and bipolar treatment-resistant depression. Presently, Celon Pharma is conducting phase II trials in subjects with treatment-resistant Bipolar Depression (TRBD). 

  1. Zuranolone

Company: Sage Therapeutics

Zuranolone is an investigational oral neuroactive steroid (NAS) GABAA receptor positive allosteric modulator (PAM). Administered once-daily, two-week therapy, it is in development for the treatment of the major depressive disorder (MDD) and postpartum depression (PPD). In March 2020, after a Breakthrough Therapy guidance meeting with the US FDA, Sage Therapeutics announced plans to launch three additional studies of its investigational drug zuranolone. Results are expected in 2021.

  1. SEP-4199

Company: Sunovion

SEP-4199 is a non-racemic ratio of amisulpride enantiomers with the potential to be the first benzamide treatment available in the US for mood disorders. It is under phase II clinical trial for Bipolar I depression in the US and Japan, which is being conducted by Sumitomo Dainippon Pharma and Sunovion. Sunovion is working on plans to start phase III studies of the drug.

  1. Abilify

Company: Otsuka Pharmaceutical

Otsuka Holding is currently evaluating Abilify (tablet) in phase III clinical trial as an adjunctive treatment in the treatment of major depressive episodes associated with bipolar I or II disorder. However, the drug is available as a tablet and suspension for injection as a symptomatic treatment for schizophrenia, bipolar I disorder (manic depression), and major depressive disorder. Oral solution and intramuscular injection of Abilify is discontinued in the US.

Besides the emerging therapies mentioned above, candidates such as Latuda (lurasidone), and Vraylar (cariprazine) that are already commercialized in the US, are expected to expand their toefall in other major markets i.e., EU5 and Japan. This shall significantly boost the market size growth for individual geography in the forecasted period (2020–2030). Overall rising prevalence of Bipolar depression also due to a better understanding of the mental disorders are another contributing factor to the promising Bipolar depression market landscape. However, amidst the blinding light, it is to not lose sight of hurdles and snags that lie in the way. Treatment adherence is one of the major issues that physicians and patients struggle with along with the side effects of the ones that might be somewhat beneficial. There exists a high frequency of misdiagnosis when it comes to mental disorders owing to similar symptoms. Further, the inevitable launch of generics of marketed drugs Availability of generics of branded drugs such as Seroquel, Zyprexa. and Latuda is another downside. Without the grain of doubt, medical advancements have helped the world to understand mental disorders clearly, ongoing R&D exploring the use of selective biomarkers, and inclination to find a curative approach to deal with Bipolar depression is expected to uplift the market outlook for a better future. Thus, it is safe to say that the Bipolar depression market is off for a better and promising journey in the coming decade. 

The post Watch Out For Top Pipeline Therapies Making An Impact In The Bipolar Depression Market appeared first on DelveInsight Business Research.

Novartis buys neurology biotech Cadent for up to $770m

Novartis is to buy neuroscience drugs firm Cadent Therapeutics in a deal worth up to $770 million.

The big Swiss pharma already has a presence in neurology with its multiple sclerosis drug Gilenya (fingolimod) and the more recently approved Aimovig (erenumab).

With the acquisition of Cambridge, Massachusetts-based Cadent, Novartis gains rights to a portfolio of neurology drugs.

This includes CAD-9303, a NMDAr positive allosteric modulator that could be used to treat schizophrenia, and MIJ-821, a NMDAr negative allosteric modulator for depression that was licensed to Novartis in 2015.

MIJ-821 is already in phase 2 development for treatment-resistant depression in a trial overseen by Novartis and the acquisition includes a buyout of milestones payments and royalties for the drug.

Gopi Shanker, the interim co-head of neuroscience at the Novartis Institutes for BioMedical Research (NIBR), added: “There is good evidence, both from human genetics as well as clinical studies, that NMDA receptors, which regulate learning, memory and plasticity in the brain function sub-optimally in schizophrenia.

“By modulating the activity of these receptors, we think CAD-9303 could potentially treat negative and cognitive symptoms and help address one of the key gaps in schizophrenia care.”

Additionally, Novartis will gain full rights to CAD-1883, a clinical stage SK channel positive allosteric modulator in development for movement disorders.

Cadent, which launched in 2017 through the merger of Luc Therapeutics and Ataxion Therapeutics, will receive $210 million up front, and up to $560 million in milestone payments.

No other financial details were disclosed.

Cadent said that its pipeline of drugs could also be used to treat indications such as movement disorders.

The transaction has been approved by the board of directors and stockholders of Cadent Therapeutics. Cadent and Novartis expect the transaction will close during the first quarter of 2021.

Closing of the transaction is subject to customary closing conditions, including antitrust review under us antitrust laws.

Investors in Cadent include Atlas Venture, Cowen Healthcare Investments, Qiming Venture Partners, Access Industries, Clal Biotechnology Industries, Novartis Corporate and Slater Technology Fund.

 

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VC fund dedicated to psychedelic meds launches in UK

In the last few years, biopharma companies focusing on psychedelic medicines have been springing up like mushrooms – magic or otherwise – and venture capital money is starting to follow.

Today sees the launch of the first investment fund in the UK devoted to psychedelic healthcare, with plans to invest in “revolutionary mind-altering medicines to treat illnesses including depression, addiction, anxiety and inflammation.”

The fund has been set up by London-based VC Neo Kuma Ventures, a new group formed by Sean McLintock, Clara Burtenshaw and Nick David in 2019. The co-founders say it has already attracted “millions of pounds” in investment, and will continue to draw funds through the first half of next year.

Last year Neo Kuma’s founders backed ATAI Life Sciences AG, a part owner of Compass Pathways, which is a UK-based company trying to develop medicines based on a synthetic version of psilocybin, the main psychoactive constituent in magic mushrooms.

In September, Compass became the first psychedelic medicine company to float on the Nasdaq, raising $127 million, and is now trading at a market cap of $1.98 billion.

Shortly after, US biotech Mind Medicine – already trading publicly on Canada’s Neo exchange – applied for a Nasdaq up-listing as it advances a suite of psychedelic medicines based on MDMA, LSD and ibogaine derivative 18-MC. It is going after disorders like anxiety, opioid addiction and adult attention-deficit hyperactivity disorder.

Around the same time, Toronto-based Field Trip Psychedelics went public on Canada’s CSE after it completed a reverse takeover of oil and gas company Newton Energy Corp, which followed an CAD 12 million private placement deal.

As well as offering ketamine-assisted treatment clinics, the company is also working on FT104, a novel synthetic hallucinogen for mental health disorders. Meanwhile, other players in the sector include Cybin – which has just acquired rival Adelia Therapeutics for just under $16 million – as well as Numinus Wellness and Verrian Ontario.

Data Bridge Market Research published report earlier this year suggesting that the psychedelic drugs market is projected to grow at around 16% per year over the next eight years to reach $6.85 billion in 2027, spearheaded by new therapies like Johnson & Johnson’s Spravato (esketamine) for treatment-resistant depression.

NeoKuma draws parallels with the medicinal cannabis market, citing research which suggests that in the US it has surged from around $2 billion in 2014 to an estimated $35 billion this year.

“As the medical benefits of psychedelics become more well-known and regulators steadily increase their embrace of these types of drugs, the industry is set for a boom,” says McLintock.

“While much of the conversation on psychedelics is taking place in the US, Europe is the true hub of the burgeoning psychedelic healthcare sector. We look forward to investing in the most exciting, high quality and scientifically-sound European players in the industry to facilitate their ground-breaking research.”

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Digital Diabetes Market to Reach $1.5B by 2024, Research Finds

Diabetes Management Apps Global Mobile Health Solutions_7 Best Practices for Developing Successful Diabetes Mobile Apps

What You Should Know:

– The digital diabetes market is on track to reach $1.5
billion dollars by 2024, according to a new report by Research2Guidance.

– The confident growth of digital diabetes care will be driven by the growth of the global addressable market for digital diabetes services. Between 2019 and 2024, the number of diagnosed diabetics with access to smart devices is set to increase from 109 million to 180 million. 

– Digital diabetes solutions have disrupted the diabetes
care market and are changing overall chronic care, targeting not only diabetes
but also its various comorbidities, such as obesity, hypertension, and
depression.

– The report, The
Global Digital Diabetes Care Market 2020: Going Beyond Diabetes Management focuses
on the continued expansion of
digital diabetes providers into other chronic conditions (vertical expansion)
and new service opportunities (horizontal expansion), highlighting the market’s
strategic direction in the next few years. This expansion will create new
revenue opportunities, improve payer acceptance, and grow user bases beyond the
diagnosed diabetes audience.

– In the report, the Top 10 market players LifeScan Inc., Ascensia Diabetes Care, Informed Data Systems (One Drop), mySugr (Roche), H2 Inc., Livongo Health, Omada Health, Abbott, Dexcom, and Dario Health are profiled with their offerings, mobile app portfolio performance, and strategy analysis, as well as Top 10 country profiles (market opportunity size, number of solutions, downloads, number of users, Top 5 players).

Zoloft enters list of 10 most commonly prescribed drugs in Australia

Increase in women being diagnosed with depression partly behind rise in use

An increase in women being diagnosed with depression is partly behind a significant rise in prescriptions of the antidepressant sertraline – sold under the brand name Zoloft – which is in the list of Australia’s most commonly prescribed drugs for the first time.

On Tuesday Australian Prescriber published its annual list of the 10 most commonly taken drugs – based on standard daily doses for every 1,000 people in the population each day – along with a list of the 10 most costly drugs to government, and the 10 most common drugs by prescription counts.

Related: Why mental health is the legacy-defining fight Scott Morrison can’t afford to lose | Katharine Murphy

Continue reading…

Biogen bulks up pipeline with Sage drugs in $3bn deal

With the prospects for its Alzheimer’s drug aducanumab still up in the air, Biogen has moved to shore up its late-stage pipeline with a $3 billion licensing deal with Sage that adds drugs for depression and neurological disorders.

The licensing agreement gives Biogen rights to Sage’s zuranolone (SAGE-217) for psychiatric disorders including depression, and SAGE-324 for essential tremor and other neurological diseases, which both target the GABAA receptor pathway.

In return Sage gets $1.525 billion upfront – $875 million in cash and a $650 million equity investment – as well as potential milestones of $1.6 billion if both drugs meet their development and commercial targets.

The deal comes as both companies are facing a challenging period. Biogen has invested heavily in its Alzheimer’s candidate aducanumab, but an FDA advisory committee was unimpressed with the company’s rehashed data for the anti-amyloid drug and voted that it didn’t support efficacy.

The FDA may still approve the drug – its reviewer had called some elements of the data persuasive in a briefing document – but even if it does getting payers to stump up for a drug with shaky data could be a challenge, despite the lack of Alzheimer’s therapies.

Meanwhile, Biogen has suffered recent setbacks including the failures of multiple sclerosis candidate opicinumab and a gene therapy for spinal muscular atrophy (SMA) – at a time when its big selling SMA drug Spinraza (nusinersen) is facing increased competitive pressure.

At the same time, Sage has struggled to make headway with its only approved therapy – Zulresso (brexanolone) for postpartum depression (PPD), which has been held back by a cumbersome dosing schedule that requires a 60-hour inpatient infusion.

Zulresso was launched last year but sales in the recent third quarter were just $1.6 million, around the same level as the same period of 2019.

With zuranolone, Biogen gets shared US and exclusive ex-US rights (excluding Japan, Taiwan and South Korea) to a potential first-in-class, once-daily oral drug with a breakthrough designation from the FDA as a treatment for major depressive disorder (MDD).

It has positive results from two pivotal trials – a phase 2 trial in MDD and phase 3 study in PPD – although a second phase 3 PPD trial (MOUNTAIN) failed to meet its primary objective. Biogen and Sage say there will be data readouts from other phase 3 trials in MDD and PPD next year.

The partners are going after three indications for the drug, namely PPD, as a rapid response therapy for MDD, and “as needed” treatment of acute MDD, and down the line will also look at its potential in bipolar disorder and generalised anxiety disorder.

A key characteristic is a rapid onset of action, which could free patients from the need to take antidepressants chronically and “may enhance quality of life and patient adherence”, according to Biogen.

SAGE-324 meanwhile is in phase 2 for essential tremor, a neurological disorder that causes involuntary and rhythmic shaking, and is being explored for other indications like epilepsy and Parkinson’s disease. Biogen gets shared US rights to the drug under the deal, as well as ex-US rights.

Essential tremor is estimated to affect over six million patients in the US, while 17 million Americans have symptoms of depression every year, and those numbers have led analysts to predict potential blockbuster sales for both zuranolone and SAGE-324 if approved.

Shares in Sage dipped after the announcement, with Jefferies analyst Andrew Tsai suggesting that might be because of disappointment that Sage hadn’t held out for potentially more favourable deal terms if zuranolone hits the mark in trials due to read out in 2021.

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How Care Coordination Technology Addresses Social Isolation in Seniors

How Care Coordination Technology Addresses Social Isolation in Seniors
Jenifer Leaf Jaeger, MD, MPH, Senior Medical Director, HealthEC

Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, and even death.

Physical limitations, lack of transportation, and inadequate health literacy, among other social determinants of health (SDOH), further impair access to medical and mental health treatment and preventive care for older adults. These factors combine to increase the impact of chronic comorbidities and acute issues in our nation’s senior population.

COVID-19 exacerbates the negative impacts of social isolation. The consequent need for social distancing and reduced use of the healthcare system due to the risk of potential SARS-CoV-2 exposure are both important factors for seniors. Without timely medical attention, a minor illness or injury quickly deteriorates into a life-threatening situation. And without case management, chronic medical conditions worsen. 

Among Medicare beneficiaries alone, social isolation is the source of $6.7 billion in additional healthcare costs annually. Preventing and addressing loneliness and social isolation are critically important goals for healthcare systems, communities, and national policy.

Organizations across the healthcare spectrum are taking a more holistic view of patients and the approaches used to connect the most vulnerable populations to the healthcare and community resources they need. To support that effort, technology is now available to facilitate analysis of the socioeconomic and environmental circumstances that adversely affect patient health and mitigate the negative impacts of social isolation. 

Addressing Chronic Health Issues and SDOH 

When we think about addressing chronic health issues and SDOH in older adults, it is usually after the fact, not focused on prevention. By the time a person has reached 65 years of age, they may already be suffering from the long-term effects of chronic diseases such as diabetes, hypertension or heart disease. Access points to healthcare for older adults are often in the setting of post-acute care with limited attention to SDOH. The focus is almost wholly limited to the treatment and management of complications versus preventive measures.  

Preventive outreach for older adults begins by focusing on health disparities and targeting patients at the highest risk. Attention must shift to care quality, utilization, and health outcomes through better care coordination and stronger data analytics. Population health management technology is the vehicle to drive this change. 

Bimodal Outreach: Prevention and Follow-Up Interventions

Preventive care includes the identification of high-risk individuals. Once identified, essential steps of contact, outreach, assessment, determination, referral, and follow-up must occur. Actions are performed seamlessly within an organization’s workflows, with automated interventions and triggered alerts. And to establish a true community health record, available healthcare and community resources must be integrated to support these actions. 

Social Support and Outreach through Technology 

Though older adults are moving toward more digitally connected lives, many still face unique barriers to using and adopting new technologies. So how can we use technology to address the issues?

Provide education and training to improve health literacy and access, knowledge of care resources, and access points. Many hospitals and health systems offer day programs that teach seniors how to use a smartphone or tablet to access information and engage in preventive services. For example, connecting home monitoring devices such as digital blood pressure reading helps to keep people out of the ED. 

Use population health and data analytics to identify high-risk patients. Determining which patients are at higher risk requires stratification at specific levels. According to the Centers for Disease Control and Prevention, COVID-19 hospitalizations rise with age, from approximately 12 per 100,000 people among those 65 to 74 years old, to 17 per 100,000 for those over 85. And those who recover often have difficulty returning to the same level of physical and mental ability. Predictive analytics tools can target various risk factors including:

– Recent ED visits or hospitalizations

– Presence of multiple chronic conditions

– Depression 

– Food insecurity, housing instability, lack of transportation, and other SDOH 

– Frailty indices such as fall risk

With the capability to identify the top 10% or the top 1% of patients at highest risk, care management becomes more efficient and effective using integrated care coordination platforms to assist staff in conducting outreach and assessments. Efforts to support care coordination workflows are essential, especially with staffing cutbacks, COVID restrictions, and related factors. 

Optimal Use of Care Coordination Tools

Training and education of the healthcare workforce is necessary to maximize the utility of care coordination tools. Users must understand all the capabilities and how to make the most of them. Care coordination technology simplifies workflows, allowing care managers to: 

– Risk-stratify patient populations, identify gaps in care, and develop customized care coordination strategies by taking a holistic view of patient care. 

– Target high-cost, high-risk patients for intervention and ensure that each patient receives the right level of care, at the right time and in the right setting.

– Emphasize prevention, patient self-management, continuity of care and communication between primary care providers, specialists and patients.

This approach helps to identify the resources needed to create community connections that older adults require. Data alone is insufficient. The most effective solution requires a combination of data analytics to identify patients at highest risk, business intelligence to generate interventions and alerts, and care management workflows to support outreach and interventions. 


About Dr. Jenifer Leaf Jaeger 

Dr. Jenifer Leaf Jaeger serves as the Senior Medical Director for HealthEC, a Best in KLAS population health and data analytics company. Jenifer provides clinical oversight to HealthEC’s population health management programs, now with a major focus on COVID-19. She functions at the intersection of healthcare policy, clinical care, and data analytics, translating knowledge into actionable insights for healthcare organizations to improve patient care and health outcomes at a reduced cost.

Prior to HealthEC, Jenifer served as Director, Infectious Disease Bureau and Population Health for the Boston Public Health Commission. She has previously held executive-level and advisory positions at the Massachusetts Department of Public Health, New York City Department of Health and Mental Hygiene, Centers for Disease Control and Prevention, as well as academic positions at Harvard Medical School, Boston University School of Medicine, and the Warren Alpert Medical School of Brown University.


VHA, Ontrak Launch 3-Year AI Study to Help Prevent Veteran Suicide

Veterans Health Administration Taps Ontrak to Help Prevent Veteran Suicide

What You Should Know:

– The Veterans Health Administration has selected Ontrak
in collaboration with Harvard Medical School and Brown University to transform
suicide prevention care for veterans.

– Leveraging AI developed by a Harvard Medical School
professor and the core analytics of the Ontrak platform, the three-year study
will look at the effect of intensive care coaching in addition to the standard
of care for veterans at high risk of suicide after inpatient hospitalization at
a psychiatric hospital. The trial will include 850 patients at six VA
hospitals.

– Suicide prevention is a focus for the military as well
as for the population as a whole as the U.S. grapples with the COVID-19
pandemic.


Ontrak, Inc., an AI-powered
and telehealth-enabled,
virtualized healthcare company, announced a cooperative research and
development agreement with the Veterans Health Administration (VHA) to conduct
a 3-year research study on the effect of intensive care coaching in addition to
the standard of care for Veterans at high risk of suicide-related behaviors
after psychiatric hospital.

Research Study Details

The study will leverage AI developed by Dr. Ronald Kessler
of the Harvard Medical School, as well as the core analytics of the Ontrak
platform. Dr. Kessler is the McNeil Family Professor of Health Care Policy at
Harvard Medical School and a principal in the STARRS Longitudinal Study of
suicide prevention among US Army soldiers. “We are excited to have Ontrak
helping us evaluate the effects of an intensive intervention to prevent
suicidal behaviors among Veterans at very high risk,” stated Dr. Kessler.

 Why It Matters

Suicidal ideation has been elevated since the pandemic and
the CDC reported on August 14 that a survey of U.S. adults in June 2020
indicated that 11% had seriously considered suicide in the past 30 days, which
was twice as high as in the previous 12 month period.

Addressing Veteran suicide is a top VHA priority and Ontrak is proud to apply their AI and virtual care coaching model in a trial of 850 patients at 6 VHA hospitals selected from a total of 98 in the country. This study has the potential to not only reduce suicide risk but also to produce secondary reductions in risk through interventions that address co-occurring medical conditions.

Dr. Judy Feld, Medical Director of Ontrak, stated, “Suicide is the 10th leading cause of death in the U.S. with rates steadily increasing over the past decade and worsening during the Covid-19 pandemic. We know that individuals with behavioral health conditions such as depression, substance use disorder, and post-traumatic stress disorder are at higher risk for suicidal ideation or attempt. Importantly, the rate of suicide among our country’s military Vets is double that of non-Veterans. As a pioneer in the development of evidence-based interventions for engaging individuals in care for anxiety, depression, and substance use disorders, Ontrak is honored to partner with the VHA healthcare system and collaborators from Harvard Medical School and Brown University to advance the medical community’s understanding of the most impactful case management for Veterans at high risk of suicide after inpatient hospitalization.”

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

What You Should Know:

– Ontrak acquires LifeDojo Inc, a San Francisco, CA-based
comprehensive, science-backed behavior change platform.

– The acquisition broadens Ontrak’s addressable market
and footprint to lower acuity populations enabling new interventions and remote
patient monitoring.


Ontrak, Inc., a
leading AI-powered
and telehealth-enabled,
virtualized healthcare company, today announced that it has acquired
LifeDojo Inc, a comprehensive, science-backed behavior change platform.
Financial details of the acquisition were not disclosed.

Behavior Change Platform for Consumers and Employers

Founded in 2013, LifeDojo is a platform that makes
transformative life changes possible for members in over 16 countries.
Supported by decades of public health research, the LifeDojo approach to
member-centric behavior change delivers lasting health improvement outcomes,
high enrollment, and better engagement than traditional programs. Clients
include Fortune 500 companies and high-tech, high-growth organizations who use
LifeDojo’s 32 behavior change modules.

COVID-19 Spawns Mental Health Surge

The Journal of the American Medical Association (JAMA) this month reported accumulating evidence of a “second wave” mental health surge that will present monumental challenges for an already greatly strained mental health system and individuals at high risk for mental health disorders such as anxiety, depression, and post-traumatic stress. A June 2020 survey from the Centers for Disease Control and Prevention of 5,412 US adults found that 40.9% of respondents reported “at least one adverse mental or behavioral health condition,” including depression, anxiety, posttraumatic stress, and substance abuse, with rates that were three to four times the rates one year ago.

4 Ways LifeDojo Acquisition Advances Ontrak’s Growth
Strategy

With the coronavirus pandemic rapidly increasing demand for
“telemental” health solutions, the acquisition of LifeDojo is expected to
advance the Ontrak growth strategy in four ways:

First, the acquisition adds a technology-first,
digital business deployed by blue chip customers in the employer space.

Second, LifeDojo enhances Ontrak’s market-leading
behavioral health engagement capabilities for new and existing customers, with
the addition of the LifeDojo digital tools that drive member value and lower
cost. The combination of behavioral health coaching and digital app-based
solutions meets accelerated payer demand for a comprehensive suite of
behavioral health services and solutions.

Third, the LifeDojo platform increases the company’s
addressable market by enabling the creation of lower cost, digital
interventions across behavioral health and chronic disease populations.

Fourth, LifeDojo’s member-facing apps enable remote
patient monitoring capabilities, initially focused on member reported data,
that will feed Ontrak AI capabilities and further personalize Ontrak’s
evidence-based coaching.

“As a public company and leader in virtualized healthcare, Ontrak is uniquely positioned to attract companies, products and technologies that expand our value proposition and footprint with health plan and employer partners. We will endeavor to make additional strategic purchases that expand our addressable market and maximize customer value. LifeDojo and these other intended acquisitions can possibly expand our total addressable $33.7 billion market by up to 100%,” said Mr. Terren Peizer, Chairman and CEO of Ontrak.

COVID-19 Pandemic Further Exposes Systemic Racism…

Pandemic Further Exposes Systemic Racism… Healthcare Technology Digital Health
Michael A Greely, Co-Founder & General Partner at Flare Capital Partners

This will be ugly and sad. Racism has cost this country $16 trillion over the last twenty years according to a recent Citigroup report. Much of this loss ($13 trillion) was attributed to discriminatory lending practices and the 6.1 million fewer jobs created as a result, while disparity in wages ($2.7 trillion) and discrimination in housing policies and lost income due to restricted access to higher education accounted for the balance. The report estimates that if these gaps were to be closed, an incremental $5 trillion can be added to U.S. GDP over the next five years alone. Obviously, this does not even begin to account for the extraordinary pain and suffering racism inflicts on our country, much less the dramatic implications to the health and wellbeing for those impacted by racism.

The dramatic increase in unemployment since the onset of COVID-19 has garnered significant attention. While the overall unemployment rate of 7.9% in September is down from the pandemic-high of 14.7% in April, this improvement masks the dramatic discrepancies in rates for minorities; according to the U.S. Bureau of Labor Statistics, white Americans are 7.0% unemployed while the Black unemployment rate is 12.1%. Somewhat jarring, last week Columbia University published an analysis showing that eight million more people are now living in poverty just since the expiration of the Cares Act three months ago, disproportionally hitting minorities.

The story is even more dire when looking at the “True Rate of Unemployment” as defined by the Ludwig Institute for Shared Economic Prosperity which presumes that one needs to earn a minimum living wage of $20,000 to be deemed employed. Under such a definition, Black unemployment is 30.4%, although an improvement from what was seen for the ten years after the Great Recession of 2008.

Source Data: Ludwig Institute for Shared Economic Prosperity; Chart: Axios Visuals

It is estimated that 100.6 million Americans are out of the labor force now, many of whom are from disadvantaged segments of the population. In fact, for those earning more than $60,000 annually, the unemployment rate is a mere 1.0% below where it stood at the onset of the pandemic. For those who make less than $20 per hour (equivalent to a salary of approximately $27,000), the unemployment rate is 17.5% below where it was in February 2020 according to Opportunity Insights. Shockingly, America’s billionaires net worth has increased more than $850 billion since April.

The difference in life expectancy between white and Black Americans is criminally high – nearly five years, even when adjusted for gender, according to the Centers for Disease Control and Prevention (CDC) data. While the underlying causes are complex and fraught with political overtones, this issue is now front and center as the country struggles with the pandemic.

Sutter Health recently published COVID-19 data that attributed the 2.7x increase in hospitalization rates in their hospitals for Black patients versus white patients to, in part, more advanced illness at the time of admission, arguably reflecting a cultural aversion to the healthcare system or challenges around adequate access. CDC data are even worse, tabulating a 5.0x higher rate of hospitalization, 2.3x greater mortality rate, and 3.0x greater infection rate for Black versus white Americans, respectively.  This is particularly troublesome now with case counts spiking 17% just this past week and as winter sets in.

Life Expectancy

The Kaiser Family Foundation (KFF) forecasts that Medicaid roles will increase by 8.4% in 2021; in June there were 67.9 million Medicaid beneficiaries. It is quite clear that the pandemic is hitting minority and less educated segments of the population harder, often because they tend to be front-line essential workers and/or struggle with greater levels of unemployment. McKinsey recently estimated that as many as 10 million Americans will lose employer-sponsored health insurance due to COVID-19 by the end of 2021.

KFF also highlights the discrepancies in private health insurance rates by race: in 2018, white, Black, and Hispanic uninsured rates were 7.5%, 11.5% and 19.0%, respectively, which further exacerbates difficulties for minorities to access effective healthcare. The Affordable Care Act had a dramatic impact over the past decade as uninsured rates in 2010 were 13.1%, 19. 9% and 32.6%, respectively. This year the average family health insurance premium rose by 4% to more than $21,000.

While there is a heightened level of concern about the pace of coronavirus vaccine development, and whether there will be inappropriate political pressures applied to compromise long-cherished safety protocols, the Black community is expressing a particularly high level of skepticism. According to another KFF study, just under 50% of Black respondents would not take a free and safe vaccine, while only 17% would “definitely” do so. While further underscoring long-held distrust of the healthcare system, this phenomenon risks perpetuating the relatively poor health conditions experienced in many of those communities.

Recognizing this and the other numerous challenges introduced by the pandemic, the Healthcare Anchor Network (HAN) of 39 provider systems (many of whom are Flare Capital LPs) reiterated in September that racism is a public health crisis, putting forth a number of steps to chip away at these issues. First and foremost was a commitment to dramatically improve access to testing in underserved communities, as well as more robust inclusive hiring practices and greater spending with diverse suppliers and vendors. 

Importantly, the HAN spotlighted that systemic racism uncouples the public health infrastructure from the private healthcare system, often leading to “generational trauma and poverty.” A profound characterization. A recent Wall Street Journal analysis of CDC data showed a strong link between racism and mental health: in the week following the murder of George Floyd in May, 40.5% of Black adults exhibited symptoms of anxiety and depression (a five-point increase from the week just prior). While somewhat similar to post-traumatic stress disorders, racism is chronic and on-going much like an injury, and should not be considered a disorder. Clinicians have now developed a “Race-Based Traumatic Stress Symptom” scale when evaluating minority patients.

Advances in healthcare technology hold profound promise to improve the health and wellbeing of those most afflicted by racism, particularly during such difficult economic times. According to a provocative analysis by McKinsey (below), many of the most seminal transformative reforms in healthcare have come on the heels of major recessions. Arguably, what has been unleashed on the U.S. economy by COVID-19 may lead to a dramatic restructuring of the healthcare industry, which could usher in a wave of significant innovation to improve conditions for those most disadvantaged.

Entrepreneurship has been one of the great elixirs in the face of such devastating economic conditions and is often looked upon as one approach to reduce economic disparities due to racism. Here, unfortunately, the record is mixed. Given how critical access to capital is, the evidence that racial discrimination compromised many minority groups from accessing emergency funding programs like the Payroll Protection Program (PPP) this past spring is particularly painful. According to the Center for Responsible Lending, 46% of white-owned businesses had accessed bank credit over the past five years (compared to less than 25% for Black-owned businesses) which meaningfully facilitated their ability to secure PPP loans from those same institutions.

Furthermore, a 2016 Federal Reserve Bank study found that only 40% of minority credit applicants secure the full requested amounts of credit when applying as compared to 68% for white-owned applicants. Consistently minority-owned companies pay higher interest rates and have more onerous borrowing terms according to the Department of Commerce’s Minority Business Development Agency. The financial landscape confronting Black-owned businesses is materially more hostile than what white-owned businesses face. Full stop.

Source: Federal Reserve Bank of Atlanta

Rock Health, a leading seed-stage healthcare technology investor (and partner of Flare Capital), recently conducted an extensive diversity survey. These sober findings further highlight the issues around access to capital for minority entrepreneurs. White and Asian founders were nearly twice as likely to backed by venture capitalists; 48% of Black founders bootstrapped their companies versus 25% of white founders. Of the nearly 250 founder respondents in the survey, 12% identified as Black but only a disappointing 5% of the 425 senior executives in those companies were Black. Just over 80% of Black respondents felt that the digital health sector was either the same or less inclusive from when they initially joined the industry. Obviously, much work is still to be done.

Source: Rock Health

These issues are not at all lost on my partners and our firm. Since we started Flare Capital over six years ago, we have been committed to diversity and inclusion. In addition to simply being the right thing to do, it is the best thing for our business. We will make better investment decisions with a broadly diverse set of perspectives and experiences. 

But as inclusive as we felt we were, it is time to do even better. There are systemic causes to these inequities in our industry that we can help address. Over the last four months, we developed a set of new initiatives (summarized below) that we implemented earlier this summer. In summary, we identified two broad dimensions that we are committed to improving upon more equitable access and accelerated career development. Structural challenges exist for many underrepresented entrepreneurs to meet with venture capital firms, much less successfully raise capital. These are fundamental problems that require deliberate, measurable steps from engaging with more diverse founding teams, recruiting more diverse management teams, and partnering with venture firms equally committed to diversity.  



BIPOC = Black, Indigenous, People of Color

We recognize that it will take time and significant effort to address these inequities, and that success will be built, in part, upon many small victories. Arguably, Black Lives Matter is the largest movement in our country’s history. The New York Times recently estimated that between 15 to 26 million Americans likely participated in demonstrations since the death of George Floyd in late May. We are proud to be a part of that movement.


About Michael A. Greely

Michael A. Greely is the CoFounder and General Partner at Flare Capital Partners, a venture capital firm focused on investing in early-stage and emerging healthcare technology companies. Previously, Michael was the founding General Partner of Flybridge Capital Partners where he led the firm’s healthcare investments. Current and prior board seats include Aspen Health, BlueTarp Financial, Circulation, Explorys, Functional Neuromodulation, HealthVerity, higi, Iora Health, MicroCHIPS, Nuvesse, PolyRemedy, Predictive Biosciences, Predilytics, T2 Biosystems, TARIS Biomedical, VidSys and Welltok (observer).

70% Taking Common Antidepressants Suffer Sexual Side Effects

What’s the latest on treating depression with the spice saffron? Years ago, I covered a head-to-head comparison of saffron versus Prozac for the treatment of depression in my video Saffron vs. Prozac, and saffron seemed to work just as well as the drug. In the years since, five other studies have found that saffron beat out placebo or rivaled antidepressant medications.

It may be the spice’s red pigment, crocin, since that alone beat out placebo as an adjunct treatment, significantly decreasing symptoms of depression, symptoms of anxiety, and general psychological distress. Perhaps, its antioxidants played a role in “preventing free radical-induced damage in the brain.” The amount of crocin the researchers used was equivalent to about a half teaspoon of saffron a day.

If the spice works as well as the drugs, one could argue that the spice wins, since it doesn’t cause sexual dysfunction in the majority of men and women like most prescribed antidepressants do. SSRI drugs like Prozac, Paxil, and Zoloft cause “adverse sexual side effects” in around 70 percent of people taking them. What’s more, physicians not only significantly underestimate the occurrence of side effects, but they also tend to underrate how much they impact the lives of their patients.

Not only is this not a problem with saffron, the spice may even be able to treat it, as I explore in my video Best Food for Antidepressant-Induced Sexual Dysfunction. “In folk medicine, there is a widely held belief that saffron might have aphrodisiac effects.” To test this, men with Prozac-induced sexual impairment were randomized to saffron or placebo for a month. By week four, the saffron group “resulted in significantly greater improvement in erectile function…and intercourse satisfaction,” and more than half of the men in the saffron group regained “normal erectile function.” The researchers concluded that saffron is an “efficacious treatment” for Prozac-related erectile dysfunction. It has all been found to be effective for female sexual dysfunction, as well, as you can see at 2:35 in my video. Female sexual function increased by week four, improving some of the Prozac-induced sexual problems but not others. So, it may be better to try saffron in the first place for the depression and avoid developing these sexual dysfunction problems, since they sometimes can persist even after stopping the drugs, potentially worsening one’s long-term depression prognosis.

This includes unusual side effects, such as genital anesthesia, where you literally lose sensation. It can happen in men and women. More rarely, antidepressants can induce a condition called restless genital syndrome. You’ve heard of restless legs syndrome? Well, this is a restless between-the-legs syndrome. These PSSDs, or Post-SSRI Sexual Dysfunctions, meaning dysfunctions that appear or persist after stopping taking these antidepressants, can be so serious that “prescribing physicians should mention the potential danger of the occurrence of genital (e.g., penile or vaginal) anesthesia to every patient prior to any SSRI treatment.” If you’re on one of these drugs, did your doctor warn you about that?

All hope is not lost, though. Evidently, penile anesthesia responds to low-power laser irradiation. After 20 laser treatments to his penis, one man, who had lost his penile sensation thanks to the drug Paxil, partially regained his “penile touch and temperature sensation.” However, he still couldn’t perform to his girlfriend’s satisfaction, and she evidently ended up leaving him over it, which certainly didn’t help his mood. But, before you feel too badly for him, compare a little penile light therapy to clitoridectomy, clitoris removal surgery, or another Paxil-related case where a woman’s symptoms only improved after six courses of electroshock therapy.

Pass the paella!


For more on the spice, check out:

Those drug side effects sound devastating, but depression is no walk in the park. However, when one balances risk and benefit, one assumes that there are actually benefits to taking them. That’s why the shocking science I explored in Do Antidepressant Drugs Really Work? is so important.

What else may boost mood? A healthy diet and exercise:

For more on sexual health generally, see:

What else can spices do? Here’s just a taste:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously
Dr. Jacob Lazarovic M.D., IMCS Group

As you read this, over 200,000 American deaths have been attributed to the virus. The influx of cases continues, while state and local economies are experiencing hardship, children are shuttered in their homes learning remotely, grown children are moving back home and the “new normal” disrupts nearly all of life’s plans. 

Yet, these issues don’t reveal all the traumas that Americans are experiencing 10 months into the pandemic. The pandemic’s impact continues to be swift and brutal, showing little sign of slowing down. Loneliness and isolation are gripping many American adults, as the nation settles in for a long fall/winter.

Growing evidence supports the notion that this virus is spread through aerosols, that is, person-to-person transmission by means of inhalation of infectious particles. With the onset of colder weather and the approaching holiday season, conditions are rife for spreading the virus. Flu season is imminent and COVID-19 cases are increasing.

While the safest choice is to isolate until the widespread availability of a vaccine arrives (within the next 6-12 months), this is an unwelcome option for some already suffering from “pandemic fatigue” and not really an option at all for others (like those who work outside the home).

Either way, America’s mental health is at risk. According to the CDC, reports of mental health conditions (anxiety, trauma, substance abuse, suicide) have considerably increased during the pandemic with more than 40% of American adults reporting mental health struggles. Frontline healthcare workers are particularly affected, and over 71% have experienced psychiatric symptoms, including depression, anxiety, insomnia, and distress. Even run-of-the-mill loneliness and isolation contribute to substance misuse and disorders, which, by the way, contribute to an increased risk for COVID-19.


Key Ways Mental Health Providers Can Help  

Because mental health threats are now part and parcel of living amid the COVID-19 pandemic, it is important to routinely gauge the health of those close to you, (and this is paramount for those recovering from COVID-19, frontline workers, and first responders.) Consider consulting a mental health provider if you notice any of these characteristics in yourself or someone you know:

– Displaying frequent, uncharacteristic anger, anxiety, irritation; 

– Withdrawing from friends and family;

– Ignoring personal hygiene;

– Engaging in high-risk activities, such as heavy drinking, illicit drug use, or self-destructive behavior;

– Exhibiting feelings of overwhelming sadness, hopelessness, grief, or worthlessness 

Nearly every American is impacted mentally, financially, and emotionally by the pandemic, and even the fortunate few who aren’t already personally affected are feeling the stress of an uncertain future. Mental health providers aim to improve coping skills, relationships, and self-care regimens to reduce anxiety, depression, or other mental illness. From generalized anxiety to neuropsychology related to recovery from COVID-19, behavioral health specialists are equipped to help in a myriad of ways such as these: 

1. Building resilience by introducing coping and stress tolerance activities, such as mindfulness and meditation, or a simple shift in perspective 

2. Shoring up social connections and relationships to serve as a layer of protection and diffusion from life stress

3. Ensuring self-care activities, such as adequate sleep, diet, exercise, and more to sustain mood and self-esteem

4. Delivering grief and loss counseling for those who have suffered acute human losses during the crisis

5. Counseling for substance abuse and addiction

6. Initiating a short intervention using cognitive behavioral therapy techniques

Those with pre-existing mental health issues, including depression, PTSD, social anxiety, agoraphobia, generalized anxiety and major depression, may benefit from an increased intensity in treatment, by frequency or duration.

For survivors of COVID-19 who have had significant cardiac and respiratory complications including prolonged periods of dyspnea (shortness of breath), hypoxemia (decreased blood oxygen levels), and hypoxia (decreased oxygenation of organs), neurocognitive screening and ongoing monitoring of mental status will be helpful.


Advances in Telemedicine 

Recent advances in computer-administered neurocognitive testing have allowed

clinicians to administer psychological and neurocognitive assessment instruments by telemedicine, and there are now many more neurocognitive assessment batteries available to aid in the detection and quantification of neuropsychological functional deficits.

Historically, psychologists, psychiatrists, and L.C.S.W.s have not done virtual sessions with patients, but COVID is changing that, and increasingly insurers are receptive to this practice. The technology, capability, and compliance aspects of virtual appointments were available prior to 2020, but COVID has brought “distance meeting” into the American vernacular. Medical doctors now treat patients via telehealth in numerous instances, and mental health patients can be treated using similar meeting applications.

Telebehavioral health could not be more timely. In the fight against isolation, virtual technology allows human beings to check on one another and meaningfully connect, at the same time allowing people seeking mental health services to receive treatment safely without risking infection from a devastating disease.  

Even as the pandemic presents a common threat like none other we have faced in recent years, it also offers us the opportunity to reach out and check on one another. Everyone is affected in some way by COVID-19, be it the disease itself or simply disruption to our routines and mass anxiety. It’s definitely time to take mental health seriously. Our technology ensures that we do not have to be alone in isolation, and relief may be just a call away. Through mutual understanding and effort, we can focus on the unifying experience of overcoming this crisis.


About Dr. Lazarovic

Dr. Lazarovic, M.D., F.A.A.F.P., has nearly 40 years of medical administration/managed care experience, including 18 years as Chief Medical Officer at Broadspire/CRAWFORD, a global third-party administrator of workers’ compensation, disability, auto and medical product liability claims. Experienced in clinical guidelines, medical cost control and strategic planning, Dr. Lazarovic has conducted and published original research and analytics and presented at multiple industry conferences. Dr. Lazarovic is currently the CMO responsible for the development of advanced, evidence-based clinical applications at MyAbilities Technologies, a medical software and services company in the workers’ compensation and disability sector.  


AWS, PHDA Collaborate to Develop Breast Cancer Screening and Depression Machine Learning Models

AWS, PHDA Collaborate to Develop Breast Cancer Screening and Depression Machine Learning Models

What You Should Know:

– Amazon Web Services (AWS) and the Pittsburgh Health Data Alliance (PHDA) announce a collaboration to produce more accurate machine learning models for breast cancer screening and depression.

– In work funded through the PHDA-AWS collaboration, a research team led by Shandong Wu, an associate professor at the University of Pittsburgh Department of Radiology, is using deep-learning systems to analyze mammograms in order to predict the short‐term risk of developing breast cancer. 

– A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging, including researchers from the
University of Pittsburgh Medical Center (UPMC), the University of Pittsburgh,
and Carnegie Mellon University (CMU), are working together to develop a more
personalized approach for patients undergoing breast cancer screening.


Last August, the Pittsburgh Health Data Alliance (PHDA)
and Amazon Web Services (AWS)
announced a new collaboration to advance innovation in areas such as cancer
diagnostics, precision medicine, electronic health records,
and medical imaging. One year later: AWS collaboration with Pittsburgh Health
Data Alliance begins to pay dividends with new machine learning innovation.

Researchers from the University of Pittsburgh Medical Center
(UPMC), the University of Pittsburgh, and Carnegie Mellon University (CMU),
who were already supported by the PHDA,  received additional support
from  Amazon Research Awards to use machine learning
techniques to study breast cancer risk, identify depression markers, and
understand what drives tumor growth, among other projects.


Accurate Machine Learning Models for Breast Cancer Screening
and Depression

In work funded through the PHDA-AWS collaboration, a
research team led by Shandong Wu, an associate professor in the University of
Pittsburgh Department of Radiology, is using deep-learning systems to analyze
mammograms in order to predict the short‐term risk of developing breast
cancer.  A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging are working together to develop a
more personalized approach for patients undergoing breast cancer screening.

Wu and his colleagues collected 452 de-identified normal
screening mammogram images from 226 patients, half of whom later developed
breast cancer and half of whom did not. Leveraging AWS tools, such as
Amazon SageMaker,
they used two different machine learning models to analyze the images for
characteristics that could help predict breast cancer risk. As they reported in
the American Association of Physicists in Medicine, both
models consistently outperformed the simple measure of breast density, which
today is the primary imaging marker for breast cancer risk,  The team’s
models demonstrated between 33% and 35% improvement over these existing
models, based on metrics that incorporate sensitivity and specificity.


Why It Matters

“This preliminary work demonstrates the feasibility and promise of applying deep-learning methodologies for in-depth interpretation of mammogram images to enhance breast cancer risk assessment,” said Dr. Wu. “Identifying additional risk factors for breast cancer, including those that can lead to a more personalized approach to screening, may help patients and providers take more appropriate preventive measures to reduce the likelihood of developing the disease or catching it early on when interventions are most effective. “


Tools that could provide more accurate predictions from screening images could be used to guide clinical decision making related to the frequency of follow-up imaging and other forms of preventative monitoring. This could reduce unnecessary imaging examinations or clinical procedures, decreasing patients’ anxiety resulting from inaccurate risk assessments, and cutting costs.

Moving forward, researchers at the University of Pittsburgh
and UPMC will pursue studies with more training samples and longitudinal
imaging data to further evaluate the models. They also plan to combine deep
learning with known clinical risk factors to improve upon the ability to
diagnose and treat breast cancer earlier.


Second Project to Develop Biomarkers for Depression

In a second project, Louis-Philippe Morency, associate
professor of computer science at CMU, and Eva Szigethy, a clinical researcher
at UPMC and professor of psychiatry, medicine, and pediatrics at the University
of Pittsburgh, are developing sensing technologies that can automatically measure
subtle changes in individuals’ behavior — such as facial expressions and use of
language — that can act as biomarkers for depression.

These biomarkers will later be compared with the results of
traditional clinical assessments, allowing investigators to evaluate the
performance of their technology and make improvements where necessary. This
machine learning technology is intended to complement the ability of a
clinician to make decisions about diagnosis and treatment.  The team is working with a gastrointestinal-disorder
clinic at UPMC, due to the high rate of depression observed in patients with
functional gastrointestinal disorders.

This work involves training machine learning models on tens
of thousands of examples across multiple modalities, including language (the
spoken word), acoustic (prosody), and visual (facial expressions). The
computational load is heavy, but by running experiments in parallel on multiple
GPUS AWS services have allowed the researchers to train their models in a few
days instead of weeks.

A quick and objective marker of depression could help
clinicians more efficiently assess patients at baseline, identify patients who
would otherwise go undiagnosed, and more accurately measure patients’ responses
to interventions. The team presented a paper on the work, “Integrating
Multimodal Information in Large Pretrained Transformers”, at the July 2020
meeting of the Association for Computational Linguistics.


“Depression is a disease that affects more than 17 million adults in the United States, with up to two-thirds of all depression cases are left undiagnosed and therefore untreated,” said Dr. Morency. “New insights to increase the accuracy, efficiency, and adoption of depression screening have the potential to impact millions of patients, their families, and the healthcare system as a whole.”


The research projects on breast cancer and depression
represent just the tip of the iceberg when it comes to the research and
insights the collaboration across PHDA and AWS will ultimately deliver to
improve patient care. Teams of researchers, health-care professionals, and
machine learning experts across the PHDA continue to make progress on key
research topics, from the risk of aneurysms and predicting how cancer cells
progress, to improving the complex electronic-health-records
system
.


Why Hasn’t A More Holistic Approach to Patient Care Become The Norm?

Why Holistic Healthcare Is Worth the Cost

When food production technology made it possible, wheat flour processors started to eliminate the tough exterior (bran) and nutrient-rich core (germ) of the kernel to get at the large, starchy part (the endosperm) only. The bread produced from this process is white and fluffy, and it makes great PB&Js and takes forever to grow mold, but it is almost totally lacking nutritional value.

Nutrition experts eventually pointed this out, of course, after which commercial bakers tried fortifying their bread by adding back essential nutrients stripped out by processing. It didn’t work. While white bread from refined flour is still available, nutrition experts strongly recommend whole grain products as the healthier alternative.

Opposition to this reductionist approach to nutrition is perhaps best captured by the idea of the sum being the whole of its parts: If inputs are lacking, the end result will fall short also.

Each human being is also a sum of parts, and the reductionist approach to healthcare is essential when it comes to advancing many aspects of medicine and healthcare.

“Historically, the invention of the microscope, the defining of Koch’s four infectious disease postulates, the unraveling of the human genome, and even intelligent computers are salient examples of the dramatic benefits of biomedical reductionism,” explained Dr. George Lundberg.

These successes, however, may have convinced many in both the medical community and society at large that reductionism is a necessary, if not sufficient, approach. The numbers say otherwise.

“Classical medical care interventions contribute only about 10 percent to reducing premature deaths compared to other elements such as genetic predisposition, social factors, and individual health behaviors,” Lundberg goes on to say. “Most contemporary medical researchers have concluded that the chronic degenerative diseases of modern Western humans have multiple contributory causes, thus not lending themselves to the single agent-single outcome model.”

Paging Dr. House. It turns out your particular form of genius just isn’t frequently that useful.

And nowhere is the single agent-single outcome model arguably less effective than in behavioral health and chronic disease management. What many in medicine and healthcare now realize is that a vicious cycle of alternating physical and mental ailments are the norm with both chronic illness and long-term mental health challenges.

“Depression and chronic physical illness are in a reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses,” says Professor David Goldberg of the Institute of Psychiatry in London.

It’s an unsurprisingly intuitive conclusion to reach. A man with depression lacks the desire to eat well, exercise, often practice necessary daily hygiene. As his untreated depression deepens, his physical health declines as well. A woman with chronic, untreated pain feels like it will never end and her life is over. Faced with a seemingly unmanageable challenge, she falls into a funk that eventually metastasizes into full-blown depression.

A reductionist approach to these scenarios might be to encourage more exercise or prescribe antidepressants. While both are necessary, neither will likely be sufficient.

So why hasn’t a more holistic approach to patient care become the norm? In a nutshell, because it’s expensive. Chronic illnesses, generally, are the most expensive component of healthcare.

According to a New England Journal of Medicine study, patients “with three or more chronic conditions (43 percent of Medicare beneficiaries) account for more than 80 percent of Medicare health care costs.”

For this expensive, highly at-risk group, holistic care is what actually works.

The NEJM articles conclude that “an intervention involving proactive follow-up by nurse care managers working closely with physicians, integrating the management of medical and psychological illnesses, and using individualized treatment regimens guided by treat-to-target principles improved both medical outcomes and depression in depressed patients with diabetes, coronary heart disease, or both.”

Of course, the regimen included in the NEJM study is expensive—perhaps more so than what qualifies as holistic care now.

But it requires a certain type of twisted logic to argue for holding down costs by rationing care inputs—by reductively treating only just the most obvious health concerns—when this approach invariably leads to readmissions, more office visits, more disability payments, more days of work missed.

Indeed, a reductive approach to accounting—silos of financial impact across the continuity of a life lived—hides the fact that specific healthcare costs are not alone the measure of how chronic illness detracts from both individual life satisfaction and broader societal efficiencies.

The key, then, is to make holistic health both the norm and affordable. How can that be done? By creating initiatives designed to achieve a core set of goals:

Incentivize primary care: In the last two decades, the number of primary care providers (PCPs) available to patients in the United States has decreased by about 2 percent. This may not sound like a lot, but the decline comes as the population has increased, naturally, which means fewer patients have a PCP. As healthcare shifts to pay for performance, not services, the PCP is the natural quarterback of patient care. The country needs many more PCPs, not fewer, and the federal government has an opportunity to use loan forgiveness incentives and other tools to nudge medical school students in that direction.

Embrace technology: Arguably, holistic care only became possible with the digital age. Chronic disease management requires frequent measurement of patient vitals, which is very expensive without wearables and similar digital age technologies. Now, patients can regularly provide data with no clinical intervention, that data can automatically upload to an electronic health record, and that EHR can alert the clinician when results are alarming.

Make poor choices expensive: Perhaps only because smoking has become so socially unacceptable can the cost of cigarettes be so high ($7.16 per pack in Chicago with all taxes) without creating significant protests. But the data is clear that higher costs equal fewer smokers. The same types of behavioral economics programs can also apply to fast food, soda, etc. Yes, people will get upset and complain about the nanny state, but absent some attempt to change behavior, we may want to consider changing the name to the United States of Diabetes.

Reward smart choices: Healthy people use healthcare and insurance less often, which drives down costs. Duh. Combining technology and incentives (avoiding diabetes), Utah’s Intermountain Healthcare engaged almost 1,500 pre-diabetic employees in a program through Omada Health that collectively yielded 9,162 pounds lost. Omada billed Intermountain based on the level of success, and without speaking to specific numbers, Intermountain felt the cost of the program was a wise investment when compared with the costs of diabetes treatment.

These four bullets are probably just the most obvious suggestions, of course. They don’t account for the complexities of the American healthcare system focused on payment models, the profit motive, or what to do with the uninsured, homeless, and devastatingly mentally ill.

But the benefits of holistic thinking when reductionism is inadequate applies to both individual care and the healthcare system as a whole. Public health, for example, takes a holistic approach to communities by looking at how housing, transportation, and education impact general overall health. Where this approach is done well, the benefits are obvious.

Reductionist isolation will always be necessary when identifying specific genes or determining which natural elements are effective in treating disease. But it’s wise to always bring the right tools for the job.

Anthem Expands Relationship with doc.ai to Power Digital Health Offerings

Anthem Refuses Full Security Audit of IT Systems from OIG

What You Should Know:

– Anthem extends the use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users.

– doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.


Anthem, today announced it is extending its partnership with doc.ai, an enterprise AI platform accelerating digital transformation in healthcare to power its digital health offerings. The expanded relationship extends Anthem’s use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users. Payors, pharma, and providers license doc.ai’s enterprise AI platform that unlocks the value of health data.

Most recently, Anthem licensed Passport, doc.ai’s privacy-first COVID-19 evaluation tool for a safer entry to the workplace, and Serenity, a guided mental health chat companion that helps manage anxiety and depression. In addition, doc.ai’s technology has streamlined Anthem’s ability to create an ecosystem of developers. doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.

Appoints New CEO and Chief Scientific Officer

In addition to the expanded relationship with Anthem, doc.ai
has announced key executive leadership appointments: Sam De Brouwer, co-founder
has been named its new CEO; Walter De Brouwer, co-founder takes on the newly
created role of Chief Scientific Officer. Dr. Nirav R. Shah, MD, MPH has been
appointed as its first Chief Medical Officer.

Sam De Brouwer, co-founder, and previous Chief Operating Officer has taken on the role of Chief Executive Officer, with a focus on scaling its enterprise offerings. Co-founder Walter De Brouwer has transitioned from CEO to the new role of Chief Scientific Officer where he will focus on vision and will lead research, innovation, and engineering efforts for the company. As doc.ai’s first Chief Medical Officer, Dr. Nirav R. Shah, MD, MPH will lead the clinical focus and medical research of the platform company. These new appointments will join doc.ai’s leadership team alongside current CTO Akshay Sharma and CFO Greg Kovacic.

“What doc.ai has accomplished in a remarkably short period of time is impressive, and I’m excited to join such a talented team,” said Dr. Shah. “Doc.ai has brought cutting-edge technologies to the market that will help break down many of the silos in healthcare, and will ultimately increase the pace of innovation and create pathways to better health outcomes.”

Dr. Shah is a Senior Scholar at the Clinical Excellence Research Center, Stanford University School of Medicine. His expertise spans across the health industry as a member of the HHS Secretary’s Advisory Committee, a Senior Fellow of the Institute for Healthcare Improvement (IHI), and as an independent director for public and private companies and foundations.

He served as Senior Vice President and Chief Operating Officer for clinical operations at Kaiser Permanente in Southern California, where he oversaw the region’s health plan and hospital quality while ensuring effective use of technology, data, and analytics to produce better patient health outcomes. In addition, he served as Commissioner of the New York State Department of Health, where he was responsible for public health insurance programs covering more than five million New Yorkers and led public health surveillance and prevention initiatives.

Lyra Health Reaches $1.1B Valuation After $110M Series D to Meet Demand for Teletherapy

Lyra Health Reaches $1.1B Valuation After $110M Series D to Meet Demand for Teletherapy

What You Should Know:

– Mental health benefits provider Lyra Health raises $110M
in Series D funding, bringing its valuation to $1.1 billion.

– Lyra has grown significantly in 2020. So far this year,
the company has added more than 800,000 new members to the population eligible
to receive Lyra benefits, bringing its total member population to more than 1.5
million. 

– Amid, the COVID-19 pandemic, Lyra is focused on
expanding its enhanced teletherapy offering — Lyra Blended Care — which pairs
video therapy sessions with personalized digital lessons and exercises based on
Cognitive Behavioral Therapy (CBT) principles.


Lyra
Health
, a Burlingame, CA-based provider of mental healthcare benefits for
employers, today announced a Series D financing round of $110 million. Addition
led the round and was joined by Adams Street Partners and existing investors,
including Starbucks chairman emeritus and former CEO Howard Schultz, Casdin
Capital, Glynn Capital, Greylock Partners, IVP, Meritech Capital Partners,
Providence Ventures, and Tenaya Capital. This financing enables Lyra to invest
more aggressively in innovative, tech-enabled mental health treatments; to
partner with more customers; and to expand and diversify its high-quality
provider network.

Accessing and receiving mental healthcare is notoriously
challenging for many Americans today. Cost, social stigma, and navigating the
mental health system make it daunting for individuals to get the care they need.
In addition, only a small fraction of therapists in traditional health plans
are practicing proven methods and accepting new patients.

Founded in 2015, Lyra connects employees to high quality, effective mental health providers, and gives employees the flexibility of in-person care, live video therapy, and digital self-care tools. Lyra’s therapists only practice evidence-based therapies, like Cognitive Behavioral Therapy (CBT), and are available for appointments in just a few days.

Expanded Teletherapy Offering

The company is also focused on expanding its enhanced
teletherapy offering — Lyra Blended Care — which pairs video therapy sessions
with personalized digital lessons and exercises based on Cognitive Behavioral
Therapy (CBT) principles. Lyra Blended Care provides a scalable, tech-enabled
solution optimized for better care quality and clinical outcomes. In July, new
peer-reviewed Lyra research was published demonstrating the effectiveness
of this treatment program for clients with depression and anxiety. The company
plans to continue the expansion of Blended Care to serve Lyra members —
including couples and adolescents — who are experiencing a range of mental
health challenges. Lyra’s solution offers a simple and supportive member
experience, ensures immediate access to care, and prioritizes fast and durable
symptom improvement.

Why It Matters

American workers are experiencing a surge in mental health
challenges as they grapple with historic adversity amid the COVID-19 pandemic,
economic uncertainty, and a national reckoning with racial injustice. Arecent
study
 led by Lyra Health and the National Alliance of Healthcare
Purchaser Coalitions found that 83 percent of U.S. employees today are
experiencing mental health issues.

“Whether you’re dealing with a preexisting mental health condition that has intensified or new symptoms that have arisen during the pandemic, these are challenging times for many people. We are proud to support employers that are prioritizing mental health and will use this new funding to help even more organizations support the mental health and well-being of their most important asset — their people,” said David Ebersman, Lyra Health CEO and co-founder

Recent Traction/Milestones

Lyra has grown significantly in 2020. So far this year, the company has added more than 800,000 new members to the population eligible to receive Lyra benefits, bringing its total member population to more than 1.5 million. Lyra also is on track to surpass a milestone this month by delivering the one-millionth session of care through its exceptional provider network. In the last several months, leading employers in the retail, tech, energy, financial services, and the food and agriculture industries — including Morgan Stanley, Asurion, and Zoom Video Communications — have stepped up to prioritize workforce mental health by partnering with Lyra to offer employees immediate access to proven, evidence-based care from thousands of Lyra providers nationwide. This financing, on top of the Series C round completed earlier this year, positions Lyra to take advantage of the burgeoning market opportunity and the urgent need for better mental health solutions.

Boarding Appointments

The company also announced the addition of Kerry Chandler to its Board of Directors. Chandler is Chief Human Resources Officer at Endeavor, a global entertainment, sports, and content company, and she previously served as a senior executive at Under Armour; Christie’s; the National Basketball Association; ESPN; and ESPN’s parent, The Walt Disney Company. She has also served in human resources leadership roles of increasing responsibility at IBM, Motorola, Exxon, and McDonnell Douglas. Chandler brings an extensive background in human resources operations, strategy, and executive leadership.

Sonde Health Acquires NeuroLex Lab’s Voice-Based Survey Platform

Sonde Health Acquires NeuroLex’s Voice-Based Survey Platform

What You Should Know:

– Sonde Health acquires NeuroLex Laboratories, Inc. to forms
one of the world’s preeminent biobanks focused on vocal biomarkers.

– NeuroLex’s core product, SurveyLex, makes it easy to
create and distribute voice surveys in less than a minute as URL links through
web browsers.


Sonde Health, a
Boston-based digital vocal biomarker technology platform announced it has acquired
NeuroLex Laboratories, Inc., a leading
voice-enabled survey and data acquisition platform. The
acquisition brings together two of the leading forces in the vocal biomarker
space.

Sonde will acquire NeuroLex’s popular web-enabled voice
survey and analysis platform, as well as its rich dataset, which when combined
with Sonde’s leading voice-based dataset, forms one of the world’s preeminent
biobanks focused on vocal biomarkers. In addition, merging Sonde’s mobile and
voice-assistant platforms with NeuroLex’s web-based capabilities will enable
the delivery of voice-enabled heath detection and monitoring over any platform.

Democratizing Voice Computing

Over the past two years, NeuroLex has built one of the
largest laboratories in the world to collect, label, and model voice data
tagged with health conditions comprised of over 40 research fellows across 12
universities that have published over 5 peer-reviewed journal articles.
NeuroLex’s core product, SurveyLex, makes it easy to create and distribute
voice surveys in less than a minute as URL links through web browsers. With
this product, NeuroLex has curated a biobank comprised of over 500,000 voice samples
from over 30,000 individuals alongside a host of pharmaceutical and academic
partners. 

Acquisition
Benefits for Sonde

“At Sonde, we have unlocked voice as a new vital sign to enable secure, accessible, and non-intrusive monitoring of health. Incorporating NeuroLex’s impressive work in voice-based surveys and research moves us significantly forward in becoming the one-stop shop for health condition detection and monitoring through voice,” said David Liu, CEO of Sonde Health. “NeuroLex’s voice-based survey platform and biobank will accelerate our research and development, and our collection and analysis of high-quality voice data, bolstering all the products we provide to our customers.”

Sonde’s proprietary technology works by sensing and
analyzing subtle changes in the voice due to changes in a person’s physiology.
The company’s respiratory and depression health checks are available
today. 

As part of the acquisition, Jim Schwoebel, the chief executive
officer of NeuroLex, will join Sonde’s leadership team as Vice President, Data
and Research.

“I am thrilled to bring Jim and his team on board,” continued Liu. “His experience in building NeuroLex, shared mission of using vocal biomarkers to move healthcare forward, and expertise in building large voice-based datasets and machine learning make Jim a tremendous addition to the Sonde team.”

Financial details of the acquisition were not disclosed.

Led by Mount Sinai, Trellus Health Nabs $5M for Precision Platform for Complex Chronic Conditions

Led by Mount Sinai, Trellus Health Nabs $5M for Precision Platform for Complex Chronic Conditions

What You Should Know:

– Trellus Health secures $5M in seed funding and
collaborates with Mount Sinai to deliver resilience-driven, connected care,
integrating expert clinical and behavioral health for better outcomes.

– The first disease Trellus will tackle is IBD, which is
one of the costliest chronic conditions with a high mental health burden.


Trellus Health, a New York City-based provider of resilience-driven care for people with complex chronic conditions, announced it has raised $5 million in seed funding to transform the way chronic conditions are treated, with an initial focus in Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis. The seed round was led by Mount Sinai Health System (MSHS) and EKF Diagnostics, a global medical manufacturer of point-of-care and central lab devices and tests. Trellus has also entered into an exclusive multi-year contract with MSHS to commercialize its patent-pending GRITT-IBDTM resilience assessment and personalized treatment methodology.

What Is Resilience-Driven Care?

Resilience-driven care incorporates positive psychology
principles into all aspects of chronic disease management, with a focus on
building acceptance, optimism, self-regulation, self-efficacy, and social
support. Proven health benefits of resilience include increased longevity,
cardiovascular, immune, and cognitive function, as well as physical well-being
and reduced risk for depression and anxiety.

Platform for Complex Chronic Conditions, Starting with
IBD

Through its multidisciplinary connected care platform,
Trellus coordinates expert whole-person care, including both clinical and
behavioral health, to improve outcomes and to reduce healthcare costs for
patients, employers, and the healthcare system. The Company leverages its
patent-pending GRITT-IBDTM resilience assessment and personalized treatment
methodology, developed at the Mount Sinai Health System, to support patient
resilience and wellness for better outcomes.

Key features of the platform include:

– Convenient telehealth interactions are coordinated with
in-person visits with local GI providers trained on the latest guidelines for
IBD diagnosis, therapy and medications

– Experienced professional health care team provides care
and coaching to build resilience and help prevent flare-ups with personalized
care plans for symptoms, triggers and lifestyle needs

– 24/7 access to digital tools for expert IBD management,
stress relief, nutrition, and continuous remote monitoring

Why It Matters

According to the CDC, 90% of the U.S.’s $3.3 trillion annual
health care expenditure is for chronic diseases and mental health conditions
with patients suffering from both chronic and mental health conditions costing
twice as much. Despite this, traditional care models fail to address the mental
health aspect of chronic conditions, and access to expert interdisciplinary
care resources to deliver specialist-level care is highly limited. 

The first disease Trellus will tackle is IBD, which is one
of the costliest chronic conditions with a high mental health burden. It
affects 3 million patients in the U.S. (7 million globally) and costing the
U.S. healthcare system over $51 billion a year, according to the ‘Cost of
Inflammatory Bowel Disease: An Initiative from the Crohn’s & Colitis
Foundation 2019.’ Since 2016, the company’s co-founders, Marla Dubinsky,
MD, and Laurie Keefer, PhD, who together bring close to 50 years of experience
managing IBD and serve as co-directors of the Mount Sinai IBD Medical Home,
have integrated resilience-driven multi-disciplinary care into the management
of IBD patients.

“Our research on over 200 IBD patients indicates that more than 70% believe their condition would be better managed if they had support for anxiety or depression,” said Dubinsky, who along with being a co-founder and board member, is also a Professor of Pediatrics and Medicine, Chief of Division of Pediatric Gastroenterology and co-director of Susan and Leonard Feinstein IBD Clinical Center at Mount Sinai. “By personalizing care to address the psychosocial needs of all IBD patients and applying the latest evidence-based clinical approaches, we can help patients achieve disease control and enjoy a significantly improved quality of life.”

Digital depression therapy offers hope during COVID-19 pandemic

A new digital therapy is aiming to tackle depression during the COVID-19 pandemic, using a brain stimulation headset and therapy app that claims to have similar beneficial effects to drugs but with fewer side-effects.

Flow is the first drug-free at-home treatment of its type to be approved in the EU and UK.

While using the Flow headset, patients engaged with a therapy app program, which offers personalised behavioural therapy in areas proven to reduce symptoms of depression, including nutrition, exercise and sleep. NHS trusts and healthcare professionals can now recommend the Flow app to patients as it was recently added to the ORCHA App Library.

UK clinics, including The Chelsea Psychology Clinic in London, are now offering patients the Flow treatment in combination with traditional therapy options.

In a user analysis, the manufacturer said 81% of 850 patients involved reported feeling better after three weeks of treatment while 34% of patients reported an improvement in their mood.

Meanwhile 32% of patients reported a reduction in anxiety and 29% reported a reduction in suicidal thoughts.

The transcranial direct current stimulation (tDCS) used in the Flow headset has been shown in several clinical randomised controlled trials, including New England Journal of Medicine and the British Journal of Psychiatry, to have a similar impact to antidepressants, but with fewer and less-severe side effects.

The manufacturer said that the tool could be used during the pandemic when home-based treatments are becoming increasingly popular.

Daniel Mansson, clinical psychologist and co-founder of Flow, said: “COVID is changing how depression is managed, and driving a meaningful increase in demand for effective, at-home treatments that are safe, have minimal side effects and do not require a prescription.

“The results in this user analysis are comparable to antidepressants and demonstrate the significant benefits of using Flow to self-manage depression.

“They add to the growing body of medical evidence that supports the use of transcranial direct current stimulation (tDCS) for the treatment of depression.”

The headset can be bought over the internet for £399, which can be split into three payments, and the app is free to download on AppStore and GooglePlay.

 

 

 

 

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Ginger Lands $50M to Expand On-Demand Mental Health Support Platform

Ginger Lands $50M to Expand On-Demand Mental Health Support Platform

What You Should Know:

– Ginger announces $50 Million in Series D funding to expand
access to its on-demand mental healthcare system led by Advance Venture
Partners and Bessemer Venture Partners; joined by Cigna Ventures and existing
investors.

– Company has more than tripled revenue over the past year, now brings access to on-demand mental healthcare to millions around the world through 200+ employer clients and leading health plans.


Ginger, a San Francisco, CA-based provider of on-demand
mental healthcare, today announced a $50 million Series D funding round led by
Advance Venture Partners and Bessemer Venture Partners. Additional participants
include Cigna Ventures and existing investors such as Jeff Weiner, Executive
Chairman of LinkedIn, and Kaiser Permanente Ventures. This latest round of
investment brings the company’s total funding to over $120 million. 

On-Demand Mental Health Support

Founded in 2011, Ginger’s on-demand mental healthcare system
brings together behavioral health coaches, therapists, and psychiatrists, who
work as a team to deliver personalized care, right through your smartphone. The
Ginger app provides members with access to the support they need within
seconds, 24/7, 365 days a year. Millions of people have access to Ginger
through leading employers, health plans, and its network of partners.

By delivering evidence-based behavioral health coaching,
therapy and psychiatry right from a smartphone, Ginger is the only end-to-end
telemental health provider designed to meet this skyrocketing demand at a
fraction of the cost of traditional care.

Key benefits of Ginger’s on-demand mental health platform
include:

On-demand, anywhere: On average, members in 30
countries around the world can text with a Ginger behavioral health coach
within 44 seconds, 24/7, 365 days per year; first available video appointments
with a therapist or psychiatrist are available on average within 10.5
hours. 

Measurement-based: The company’s proprietary
collaborative care model has been proven to be more than twice as effective as
standard therapeutic interventions; 70 percent of people using Ginger
experience an improvement in their depression symptoms within 10-14
weeks. 

Loved by members: Ginger members give an average
rating of 4.7 out of 5 stars after each session.  


COVID-19 Underscores Record Demand for Mental Health
Support

This announcement comes at a time when the world’s mental
health crisis has reached an all-time high following the onset of the COVID-19
pandemic. According to Ginger’s 2020
Workforce Attitudes Toward Mental Health Report
, nearly 70 percent of U.S.
workers believe this is the most stressful period of their careers, including
major events like the September 11 terror attacks, the 2008 Great Recession and
others. Ginger has observed record-high demand for mental health support;
during July 2020, weekly utilization rates were 125% higher for coaching and
265% higher for therapy and psychiatry when compared to pre-COVID-19 averages.

Recent Traction/Milestones

Millions of people have access to Ginger through the
company’s partnerships with innovative employers, health plans, and strategic
partners. Today, over 200 companies ranging from startups to Fortune 100s,
including Delta Air Lines, Sanofi, Chegg, Domino’s, SurveyMonkey, and Sephora,
partner with Ginger to cost-efficiently provide employees with high-quality
mental healthcare. Ginger members can also access virtual therapy and
psychiatry sessions as an in-network benefit through the company’s
relationships with leading regional and national health plans, including Optum
Behavioral Health, Anthem California, and Aetna Resources for Living.  

The company recently announced the formation of the Ginger Advisory Board, bringing together world-renowned experts from MIT, Massachusetts General Hospital, and the University of Washington to advance mental health research and innovation. 

“Our mental healthcare system has long been inadequate. But in the midst of a worldwide pandemic and a tumultuous sociopolitical climate, we’re facing uncharted territory,” said Russell Glass, CEO, Ginger, “People are demanding better care, and the largest payers of healthcare are recognizing the need to respond. Ginger is uniquely able to reverse the course of this crisis at scale. With this investment, we can accelerate our work to deliver incredible mental healthcare at a fraction of the cost to the hundreds of millions of people around the world who deserve it.”

Innovaccer, CareSignal Partner to Enable Deviceless Remote Patient Monitoring


Innovaccer, CareSignal Partner to Enable Deviceless Remote Patient Monitoring

What You Should Know:

– Innovaccer has recently partnered with CareSignal to
address healthcare’s urgent need amidst the COVID-19 pandemic: to create and
maintain solid, clinically actionable relationships with patients in a new set
of predominantly virtual care.

– CareSignal offers evidence-based end-to-end support services for chronic medical conditions such as asthma, CHF, COPD, diabetes, depression, hypertension, and hospital discharge support, and maternal health monitoring.


Innovaccer, Inc., and CareSignal today announce a partnership to address healthcare’s urgent need amidst the COVID-19 pandemic: to create and maintain solid, clinically actionable relationships with patients in a new setting of predominantly virtual care.

Partnership Details

The partnership combines more than two dozen
condition-specific patient monitoring programs with population
health
data insights for a more integrated care and improved clinical
outcomes with industry-leading financial returns.

CareSignal offers evidence-based end-to-end support services for chronic medical conditions such as asthma, CHF, COPD, diabetes, depression, hypertension and hospital discharge support, and maternal health monitoring. With a focus on prevention and addressing the social determinants of health, each program offers personalized clinically-validated features to deliver even more value from Innovaccer’s population health, care management, and organization-specific offerings. 

“Innovaccer has always stayed on top of delivering on promises to our customers, and our partnerships with leading organizations have been instrumental in achieving 100% client satisfaction,” says Abhinav Shashank, CEO at Innovaccer. “Working with CareSignal supports our mission to help healthcare care as one. With CareSignal as our partner, we will strengthen our approach towards better patient engagement and enable smart deviceless remote patient monitoring.”

Lemonaid Health Raises $33M to Expand On-Demand Consumer Telehealth Platform

Lemonaid Health Closes oversubscribed $33M Series B to expand telehealth services

– Lemonaid Health, a direct to consumer telehealth company
raises $33M in Series B funding to expand the company’s medical team and number
of services being offered to patients.

– To date, the company has treated more than a million patients
online for a variety of medical conditions ranging from erectile dysfunction to sinus infections
to depression and anxiety for roughly $25/visit (less than a typical co-pay).


Lemonaid Health,
a convenient, affordable, on-demand platform for telehealth, has raised a $33
million Series B round of funding, bringing total financing to $55 million. The
oversubscribed round was led by Olive Tree
Ventures
with participation from Artis
Ventures
, Correlation Ventures, Hikma Ventures, Sierra Ventures and others.

COVID-19 Driving Telehealth Adoption

The coronavirus pandemic has accelerated the integration of
telehealth and transformed the way consumers interact with their healthcare
providers. Providers are seeing 50 to 175 times the number of patients via
telehealth platforms than they were before the outbreak, according to a McKinsey COVID-19 Consumer Survey.

Online Doctor’s Office & Medicine Delivery

Founded in 2013 by Co-Founders Ian Van Every and Paul
Johnson, Lemonaid Health offers patients direct access to the care they need,
from consultation through treatment nationally across the U.S. The company
leverages evidence-based guidelines and the most up-to-date clinical protocols
to provide quality care for less than typical co-pays. In just a few minutes,
patients are able to interact with a U.S.-licensed doctor or nurse practitioner
for conditions like anxiety and depression, urinary tract infections (UTIs),
birth control, hair loss, hypothyroidism, erectile dysfunction, genital herpes
and sinus infections. Patients are also offered free and fast delivery of
prescription medications through the platform to speed treatment.

For $25 per visit, patients can request prescriptions by
filling out a questionnaire and attaching a picture for the doctor to write out
the prescription, and then have it automatically sent to a locally preferred
pharmacy within a 2-hour turnaround time. The visit cost is much cheaper than a
co-pay, and an email summary of the care provided is sent for the
patient’s primary care doctor.

Expansion Plans

Lemonaid Health has seen a surge in demand for its services
and interest from prospective partners during the COVID-19 pandemic. Although
initially a direct-to-consumer provider, the company is starting to work with
partners within the existing healthcare system to further expand reach.

With the investment, Lemonaid Health will expand its team of
medical professionals and increase the number of services being offered to
patients, including treatment for asthma, hypertension, Type 2 diabetes and
more mental health services.

“The U.S. healthcare system has struggled to deliver
the services patients need in a way that is convenient and effective. The challenges
of providing routine care has been exacerbated recently as the majority of
health resources have been focused on responding to the coronavirus
pandemic,” said Paul Johnson, co-founder and CEO of Lemonaid Health.
“We founded Lemonaid Health with a vision to increase access to
affordable, high-quality healthcare. As more consumers have turned to
telehealth in the last six months, we’ve seen significant growth in demand for
our online services. With the additional financing, we will be able to help even
more patients get the care they deserve and expand our services in partnership
with other healthcare providers.”

Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds

What You Should Know:

– A new Accenture report called “Breakthrough Behavioral
Health Access: Think Virtual” finds that the use of virtual behavioral health could
expand care for more than 53 million Americans facing these conditions.

– Demand for behavioral health specialists significantly outweighs current availability; in addition to severe wait times of 25 days for first clinical appointments, we are projected to have a shortage of 250,000 behavioral health and mental health professionals by 2025.

– Just a 1% increase in treatment for these disorders would save $2.4 billion annually and could yield as much as $2.4 billion in medical cost savings annually.


The use of virtual delivery channels could expand treatment
to 53 million Americans suffering from behavioral health issues, according
to a new report from Accenture. The
report, “Breakthrough Behavioral Health Access: Think Virtual,” is
based on a survey of more than 3,400 people in the U.S. diagnosed with or
having symptoms related to specific behavioral health conditions such as
anxiety, depression, post-traumatic stress syndrome, attention deficit disorder
or reported themselves as having addiction or substance abuse issues.

Access to Behavioral Healthcare Barriers

Access to behavioral healthcare is especially challenging.
Beyond the burden on individuals, the challenges of accessing and delivering
behavioral health services have a ripple effect across healthcare. Payers,
providers, employers, government and life sciences companies are all impacted
differently.

“The behavioral health crisis in the U.S. isn’t new, but the pandemic is clearly exacerbating it,” said Rich Birhanzel, a senior managing director at Accenture who leads the company’s Health practice globally. “The rapid expansion of virtual care models during lockdown in the current pandemic created new expectations for effective and reliable healthcare at a distance. While our research found that only 38% of respondents hadn’t been widely using a virtual channel for such treatment in the prior three years, they’re now overwhelmingly willing to do so.”

Virtual Health Can Shatters Barriers

Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds

Current data indicates that nearly 58 million adults and
8 million youth between the ages of six and 17 in the U.S. have mental
health and/or substance use disorders, yet only 43% of affected adults are receiving
treatment for them. Four in five respondents (81%) of the Accenture survey said
they would either definitely or probably engage in a virtual channel to manage
their behavioral health condition. Applying this finding to the 66 million
adults and youths impacted by these disorders suggests that virtual channels
could expand care to approximately 53 million people. Furthermore, the number
of people with such conditions is likely to rise due to the current environment
of COVID-19, record unemployment, and widespread social unrest.
 
Among the channels respondents said they’d be willing to use include on-demand
videos (cited by 55%), webchat (63%), individual therapy via voice (59%) and
individual therapy via voice plus video (56%).

The research shows younger patients are much more likely
than older ones to engage in virtual behavioral health services. The report
notes that this is critical insight for employers as they develop their
workforce and talent strategies, particularly since millennials comprise the
largest percentage of the U.S. labor force, followed by Gen Zers.

In addition to improving people’s lives, better access to
care and treatment is a potential breakthrough in terms of overall outcomes and
medical spending as behavioral health patients typically have co-occurring
medical conditions and as a result, can have two to three times the amount of
associated health expenditures. Related Accenture analysis shows that even a 1%
increase in treatment for behavioral health disorders in the U.S. could yield
as much as $2.4 billion in medical cost savings annually, due largely to the
fact that individuals with behavioral health conditions often have other
medical conditions.

From Tipping Point to Transformation

The report notes three fundamental factors that healthcare
providers should consider to remain relevant and responsive to consumers’
needs:

· Control the personal cost. Four in 10 respondents
(44%) said they would only use such channels if the services are provided at
low or no cost to them. Public and private organizations sponsoring these
solutions will need to think through how to lower costs to
consumers—particularly those in need. 

· Orbit around experience. Beyond cost, consumers want convenience and positive user experience. While consumers are hungry for behavioral health services through virtual channels, the design of the programs and consumers’ experiences will make or break adoption no matter the demand.

· Make all the connections. Coordination and integration of care with a whole-person approach is critical. Services should be offered in the context of individuals’ physical health, and data-sharing and interoperability among different healthcare stakeholders are critical to providing the most effective care.

Report Background/Methodology

For the Accenture 2020 Behavioral Health Consumer Survey,
Accenture surveyed 3,448 US consumers ages 13 and over to better understand
attitudes and behaviors related to virtual health options for treating mental
health conditions and substance abuse issues. All survey respondents were
either diagnosed with and/or had symptoms related to specific mental health
conditions such as anxiety, depression, PTSD, ADD/ADHD, or reported themselves
as having addiction issues. Survey respondents received anonymity and
represented a cross-section of the population based on age, location,
ethnicity, insurance coverage, gender and income. The survey was conducted by
Dynata in May and June 2020.

Eating Seaweed Salad May Boost Immune Function

Eating seaweed salad may boost the efficacy of vaccinations and help treat cold sores, herpes, Epstein-Barr virus, and shingles.

Billions of pounds of seaweed are harvested each year, the consumption of which “has been linked to a lower incidence of chronic diseases,” both physical and mental. For example, women who eat more seaweed during pregnancy appear to be less depressed and experience fewer seasonal allergy symptoms. There’s a problem with these cross-sectional, correlational studies, however, in that they can’t prove cause and effect. Maybe seaweed consumption is just an indicator that people generally are following “traditional Japanese dietary customs,” which have lots of different aspects that could protect against disease. To know for certain whether seaweed can modulate immune function, you have to put it to the test.

As I discuss in my video How to Boost Your Immune System with Wakame Seaweed, typically, researchers start out with in vitro studies, meaning in a test tube or a petri dish, which make for quicker, cheaper, and easier experiments. One study, for example, took eight different types of seaweed and essentially made seaweed teas to drip onto human immune system cells in a petri dish. Studies like these showed that the seaweed wakame, which is the kind you find in seaweed salad, can quadruple the replication potential of T cells, which are an important part of our immune defense against viruses like herpes simplex virus.

No one actually gave seaweed to people with herpes until a study published in 2002. Researchers gave people suffering from various herpes infections about two grams a day of pure powdered wakame, which is equivalent to about a quarter cup of seaweed salad. “All fifteen patients with active Herpetic viral infections”—including herpes virus 1, the cause of oral herpes, which causes cold sores; herpes virus 2, which causes genital herpes; herpes virus 3, which causes shingles and chicken pox; and herpes virus 4, also known as Epstein-Barr virus, which causes mono—“experienced significant lessening or disappearance of symptoms,” as you can see at 2:06 in my video. There was no control group in the study, but with no downsides to eating seaweed, why not give it a try?

Researchers also found that wakame boosted antibody production, so could it be useful to boost the efficacy of vaccines? The elderly are particularly vulnerable to suffering and dying from influenza. While the flu vaccine can help, ironically, the elderly are less likely to benefit from it because immune function tends to decline as we get older. So, researchers took 70 volunteers over the age 60. As you can see at 2:50 in my video, their baseline level of antibodies against a flu virus was about 10 GMT. What you’re looking for in a vaccination is to get a two-and-a-half-fold response, so we’d like to see that antibody level get up to at least 25 GMT to consider it an effective response. The vaccine only boosted levels to 15 to 20 GMT, though. What happened after the subjects were given some wakame extract every day for a month before the vaccination? Their levels jumped up to 30 to 35 GMT. The researchers used an extract in a pill rather than the real thing, though, so they could perform this randomized placebo-controlled study. After all, it’s kind of hard to make a convincing placebo seaweed salad.

“It is hoped that the popular seaweeds eaten daily in Japan, though almost unknown around the world outside of Japanese restaurants, will be consumed…for possible immunopotentiation”—that is, immune-boosting potential—“and for attenuating the burden of infectious diseases in the elderly.”

What else can seaweed salad do (other than taste delicious)? See my video Wakame Seaweed Salad May Lower Blood Pressure.

In general, sea vegetables are good sources of iodine, as I discuss in Iodine Supplements Before, During, and After Pregnancy, and may also be one reason Japanese women have historically had such low rates of breast cancer, which I cover in Which Seaweed Is Most Protective Against Breast Cancer?.


What else can we do to boost our immunity? Check out my videos:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Benefits of Slow Breathing

There are all manner of purported hiccup “cures,” which include everything from chewing on a lemon, inhaling pepper, or, our dog’s favorite, eating a spoonful of peanut butter. In my video How to Strengthen the Mind-Body Connection, I talk about the technique I’m excited to try the next time I get hiccups: “supra-supramaximal inspiration,” where you take a very deep breath, hold for ten seconds, then, without exhaling, breathe in even more and hold for another five seconds, and then take one final, tiny breath in and hold for five last seconds to achieve “an immediate and permanent termination to hiccups…”

When I was a kid, I taught myself to control my own hiccups using slow-paced breathing, and, as an adult, was so excited to see there was finally a case report written up on it.

There’s a nerve—the vagus nerve—that goes directly from our brain, to our chest, and to our stomach, connecting our brain back and forth to our heart and our gut, and even to our immune system. The vagus nerve is like the “‘hard-wired’ connection” that allows our brain to turn down inflammation within our body. When you hear about the mind-body connection, that’s what the vagus nerve is and does. “There has been increasing interest in treating a wide range of disorders with implanted pacemaker-like devices for stimulating the vagal afferent [vagus nerve] pathways,” but certain Eastern traditions like Yoga, QiGong, and Zen figured a way to do it without having electrodes implanted into your body.  

“A healthy heart is not a metronome,” as a study titled exactly that explains. “Your heart rate goes up and down with your breathing. When you breathe in, your heart rate tends to go up. When you breathe out, your heart rate tends to go down.” Test this out on yourself right now by feeling your pulse change as you breathe in and out.

Isn’t that remarkable?

That heart-rate variability is a measure of vagal tone—the activity of your vagus nerve. Next time you’re bored, try to make your heart rate speed up and slow down as much as possible within each breath. This can be done because there’s an entirely other oscillating cycle going on at the same time, as you can see at 2:08 in my video, which is the speeding up and then slowing down of your heart rate, based on moment-to-moment changes in your blood pressure. And, as any physics student can tell you, “all oscillating feedback systems with a constant delay have the characteristic of resonance,” meaning you can boost the amplitude if you get the cycles in sync. It’s like pushing your kid on a swing: If you get the timing just right, you can boost them higher and higher. Similarly, if you breathe in and out at just the right frequency, you can force the cycles in sync and boost your heart rate variability, as you can see at 2:36 in my video.

And what’s the benefit again? According to the neurophysiologic model postulation it allows us to affect the function of our autonomic nervous system via vagal afferents to brainstem nuclei like the locus coeruleus, activating hypothalamic vigilance areas.

Huh?

In other words, it’s not just about curing hiccups. Practicing slow breathing a few minutes a day may have lasting beneficial effects on a number of medical and emotional disorders, including asthma, irritable bowel syndrome, fibromyalgia, and depression. In the United States, we’ve also put it to use to improve batting performance in baseball.

To date, most studies have lacked proper controls and have used fancy biofeedback machines to determine each person’s resonant frequency, but, for most people, it comes out to be about five and a half breaths per minute, which is a full breath in and out about every 11 seconds. You can see the graph at 3:34 in my video. When musicians were randomized into slow-breathing groups with or without biofeedback, slow breathing helped regardless. It’s the same with high blood pressure. As you can see at 3:52 in my video, you can use this technique to significantly drop your blood pressure within minutes. The hope is if you practice this a few minutes every day, you can have long-lasting effects the rest of the day breathing normally.

Practice what exactly? Slow breathing—taking five or six breaths per minute, split equally between breathing in and breathing out. So, that’s five seconds in, then five seconds out, all the while breathing “shallowly and naturally.” You don’t want to hyperventilate, so just take natural, shallow breaths, but be sure to simply breathe really slowly. Try it the next time you get hiccups. Works for me every time!


For more tips, watch my video on How to Stop Hiccups.

And, because slowing down our pulse in general may also have beneficial effects, I encourage you to check out:

Every time I’m amazed by ancient wisdom, I have to remind myself of the video I did on toxic heavy metals—Get the Lead Out. So, though traditional healing methods may offer a plethora of insights, they still need to be put to the test.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: