For the eighth episode of MindSea’s Moving Digital Health podcast, CEO Reuben Hall speaks with Loreen Wales—a registered dietitian with dual degrees in nutrition and psychology. After managing her private clinical practice Revive Wellness for over 15 years, Loreen recently founded My Viva Plan to create a digital health platform her experience showed her that patients need. She brings both private and public-sector perspectives to this conversation.
Loreen began her career in chronic disease management at the University of Alberta Hospital, where she focused on kidney disease and concomitant health conditions. An encounter with a hostile audience very early in her tenure there opened her eyes to the frustration patients with chronic diseases felt with the healthcare system. When Loreen dug in looking for answers, she learned that patients were getting conflicting information from their varying specialists and then being dismissed when they failed to follow through on contradictory instructions. With more than 1500 patients under her care, Loreen set out to solve the problems she’d identified, appointment by appointment.
Loreen shares the results of her efforts in that early healthcare role and the learnings she has carried forward into her career since then. The siloed nature of our healthcare system, Loreen argues, puts it at odds with overall health, in which mental and physical health are inextricably linked. She illuminates the critical role patient engagement plays in health outcomes and how she has acted on that knowledge, plus some of the difficulties she faced while trying to provide the level of care and attention she knew her patients would benefit from.
It was Loreen’s determination to set things right rather than accept the status quo that eventually led her to the digital health space. She relates how she and her team developed My Viva Plan, and she and Reuben discuss the challenges and considerations involved in creating a healthcare app. Loreen describes her experiences grappling with ethical gamification and with rigorous certifications, and how her team has deftly minimized privacy concerns.
Loreen’s tenacity is inspiring, and her well-informed insights into the healthcare field and its future potential make for an engaging conversation. We thank her for joining us to share her story and key takeaways from her journey as a healthcare provider, and we hope you’ll enjoy her episode of Moving Digital Health.
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Read Transcript:
Reuben (00:00.04)
Welcome to the MindSea Podcast series Moving Digital Health. Today we’re discussing how mobile apps can manage chronic conditions and encourage healthy habits. Our guest today is Loreen Wales registered dietitian and CEO at My Viva Plan. Hi Loreen. Thanks for joining us today.
Loreen Wales (00:00.37)
Hello, Reuben. Thank you for having me.
Reuben (00:00.41)
Could you introduce yourself and talk about your background a little bit?
Loreen Wales (00:00:45)
Absolutely. So as you mentioned, I am a dietitian by trade. And I started off I’ve been practicing for, oh gosh, 25 years. I think it is this year. And I started my career in chronic disease management at the University of Alberta in the area of kidney disease. And as many of you probably know, people who have kidney disease do not have just kidney disease.
They have diabetes, heart disease, obesity, a plethora of other health conditions that they end up causing them kidney disease. And so I spent the first decade of my career there and then decided to take all of my learnings and jump into the private sector and started our bricks and mortar clinic called Revive Wellness in 2006 and and also then dove into primary care as well which I spent seven years doing before I decided to jump into the digital health space in 2013.
Reuben (00:01.57)
Cool. And could you tell us a little bit more about the journey to build the My Viva Plan app?
Loreen Wales (00:02.05)
Well, yes. So it has definitely been a journey. And I would say that that journey started back in 1998 when I started my job at the University Hospital. I was, funny story. Well, it wasn’t funny. I mean, everybody around me thought it was quite comical, but I was quite take it back. I was asked to go with the nurses to the kidney transplant teaching class and I think I was in my second week of my career and I was asked to just introduce myself as Loreen the dietician, and offer my assistance.
So I stated my name, told the group, the audience, that I was a dietician asked with a show of hands how many had never seen a dietician before. And then asked how it is that I could assist them. I had a gentleman in the audience, no word of a lie who, I had never seen these people before in my life.
And a gentleman in the audience yelled out, I effing hate you and I was so taken aback. And then two other people in the audience said the same thing. And I almost I was so stunned. I wasn’t really sure what to say. And so I went with it and asked what it is, why it is that he hated me.
And so he just went on this rant. And when the class was done, the nurses, pharmacists and social worker all said, okay, well, that was the most lively class we’ve ever had. You definitely need to come back next month. I was almost in tears thinking, Wow, what? What is going on? And so the second month they asked me to come back and I was a little bit nervous.
I said the same things I introduced myself, Asked if they’d ever seen a dietician before, asked how I could help a completely different group of people again, never laid eyes on these people before. Same thing happened. Same thing happened. And I remember going to my boss saying, I think we have a problem. And she’s like, No, I think it’s just you.
And I said, Well, I’m pretty sure. I’m pretty sure I have enough confidence in me to know that it’s impossible for it to be me because I’ve never met these people before. It’d be different, maybe if I had. But I’ve never laid eyes on these people before. And what was really bizarre to me was that, I mean, he didn’t these people didn’t just say they didn’t like me.
They just say that they didn’t want to talk to me. They didn’t just say they they hated me. They said they effing hated me. I mean, that brings a lot of emotion to the situation.
And so I was thinking, well, is this really what I want to do for a living? Like, gosh, if perfect strangers are going to tell me they hate me, is this really what I want to do? And so I thought to myself, okay, I’m going to do. Maybe it was just a weird coincidence that that happened the second time.
So third month, I’m like, I’m going to go there. I’m going to do this one more time and see what happens. And if and and guess what? The same exact thing happened. So I thought, okay, fine, I have a choice. I’m going to walk away or what am I going to do with this? I went to the nurses and I said, Can I have a list of all of the patients that were in the last three classes that I’ve participated in, and I’m going to call them, and they all looked at me and went, Well, you’re brave.
Are you sure you really want to do that? I mean, these people already said that they hated you. I’m like, Yeah, but it makes no logical sense. They’ve never met me before, so I want to understand what’s going on. And so I phoned and trust me, I got there were a lot of F-bombs being dropped and people telling me they didn’t want to speak to me and stuff.
And I, I just kept being persistent at saying, Look, I’m not here to tell you anything other than to just listen to your story. I want to understand because they’re like you said Reuben, there’s a lot of frustration there. And here’s what I learned. All of these people, the majority of them had diabetes, had diabetes, either type one or two for 15 to 20 years.
They’d go to cardiology, be told one thing, go to endocrinology to be told something different, and then come to see us idiots in nephrology and be told something different again. They’d walk away, going home thinking, Who am I supposed to listen to? Because all the stories were conflicting and they’d just feel frustrated and not follow through with anything that anybody told them.
They’d come back into the system. All the health care professionals told them that they were non-compliant and eventually just dismiss them. So imagine. So as a new health care provider, I was putting myself into their shoes as they were telling me these stories, and I could just feel my frustration filled. And I’m thinking, Well, no kidding, you’re not kidding. You don’t like us.
I mean, really like we in the health care industry are not helping support you at all and not helping you manage anything related to your chronic health condition. So that was the start of my career. And the second thing that was interesting that I learned and this came from, I have a weird degree combination.
I did a degree in nutrition and then I also did a psychology degree. And I’m why I say that is because the other thing 25 years ago that we didn’t do a good job of is understanding that mental and physical health are connected. It’s impossible for them not to be connected. Our brain does sit on our shoulders, right?
It is a part of our body where any time we’re struggling with health, it absolutely is going to affect us mentally. You compound that with multiple chronic health conditions and it’s impossible for mental health to be healthy. It’s impossible. There’s going to be issues. And so understanding that component, that mental and physical health played a role, understanding that we had a really siloed health care system based on the stories that I was hearing from patients I set about my career in really trying to figure out how to make a difference.
And one thing that I learned in that decade that I was at the U of A with was this is that I was one person being asked to take care of over 1500 patients. There was one of me how exactly am I supposed, doesn’t matter how brilliant if you if somebody thought that I was the most amazing health care professional on the planet, I would still be, it would be impossible for me to improve the health outcomes of all of those patients on my own because there’s not enough time in the day.
So I set about trying to figure out how to solve this problem because as a new health care provider, I was thinking to myself, I cannot I can’t feel like this. I can’t even tell somebody, I’m overwhelmed with this. I’ve just got to figure it out. And so with the dialysis patients that I was responsible for, I just went and got to work and I got them engaged in evaluating their bloodwork because we would do bloodwork every month.
I get this panel. All of it had nutritional implications to it. So I tell them a story, Here’s what’s going on, here’s what I see, and then I’d say, Where are you at? How are you feeling? Do you want to do anything about this? And we’d set a goal that they’d want to work on over the next month, and then I’d go back.
We do. They do the bloodwork all over again, and we’d evaluate where we were. After a couple of months of being there, I had a knock on my door from the medical director, Dr. Sandra Cofield, and she said something is strange with or something is different about the bloodwork and that the dialysis units, there are two units that had better bloodwork than others and it just and after some evaluation we realized that you were the common denominator.
So she said, I’m curious if you can tell me what you’re doing. And my response was, I don’t know my job. I seriously said that to the ad and she laughed. She’s like, No, no, no, tell me, tell me what you’re doing. And so I described it to her. I said, It’s not really rocket science. I’m just reviewing it with them, asking the patient if they want to, what they want to do and then moving forward with a plan.
And so what I learned is that it was important to get patients engaged in their health. And so from the very beginning of my career, I realized that that was a mandatory component to the equation. If I wanted to actually improve the clinical health outcomes for the patients that I had the privilege of working with, I needed to get them engaged.
And I also, as I said before, needed to integrate the care and include the mental and physical health component. So when you ask me why it is that I ended up getting engaged on digital health, the reason was as a health care provider, as I started throughout my career, every time I turned around, it was I was frustrated with the fact that I didn’t have any systems, I didn’t have any programs, any standardized programs to give to my patients to manage their chronic health conditions.
I had a paper resource that I could give to them, a website that I could send them to. I could actually create them something or I could verbally explain and recommend something. That’s it. That’s all I had at my fingertips.
Reuben (00:12.13)
You said you’re one person and so many patients need help.
Loreen Wales (00:12.19)
Exactly! Well, and then the other thing too, Reuben, is that less than 1% of the clinical care happens in the clinical setting. The rest of it is in the patient’s world, wherever that may be. So when you put those two things together, knowing that, okay, is the health care professional, when the 1% of time that we are engaging with them, I’m just, you know, talking to them, giving them a resource, sending them to the website, that’s all, what, 99% of the care is outside of that.
And we’ve given them really nothing to manage it. How exactly do you not think that that might have an impact on the clinical outcomes that we’re seeing today with where chronic disease does that?
Reuben (00:13.07)
Of course. So wondering with that personal experience and then how did how have you translated that into a digital tool? What are some of the aspects of the app that empower people to take that ownership and be engaged in their health?
Loreen Wales (00:13.29)
So we took, I took all of that and I had no intention of going down the digital health path. To be perfectly honest. I wanted to find a solution that could actually help support my patients, but turned out that there wasn’t anything. And so again, that stubbornness and tenacity of we need to do better within health care set me along the path to actually build that.
So the foundation of where this of what our program, My Viva Plan is built on is the foundation around building self-awareness. So we have used Dr. Albert Bandura’s theory, social cognitive theory of self-regulation to build out the mental health component of our program using cognitive behavioral therapy techniques in getting patients engaged, in doing daily reflections.
So asking patients or users really simple questions about how they’re feeling and how they’re behaving related to their self-care. So how are they sleeping? How many glasses of water are they drinking? Are they moving their body in the day? Are they eating balanced? And it takes a couple of minutes to do. And once they actually answer those questions, then we graph it for them so they can visually see their results.
What naturally starts to happen, as Dr. Albert Albert Bandura proved many years ago, is that when people, when humans, when we humans collect objective data about how we’re feeling and how we’re behaving, we naturally start to evaluate that data and we use that data to determine which direction we want to go next. And so it builds that self-efficacy that we and it builds that intrinsic motivation to determine which direction we want to go, both of which are critical to building long term sustainable behavior change.
Reuben (00:15.35)
And what would you some of the results that you’ve seen of this technique?
Loreen Wales (00:15.43)
So what we see well over the years, it’s been quite funny because patients have said to me, you’re like this witchdoctor Like what? At first I thought you were like off your rocker. Like, how is it that me collecting? Because we used to do it on paper before we built it in the application. How is it that just collecting this basic information is going to do anything for me Loreen?
I mean, seriously, I just need you to tell me what to do and like, Well, that’s if your objective is. You’re telling me that you haven’t had success with anything that you’re doing and you want me to help you come up with this solution that is going to be something that you can follow for the long term.
In order to do that, we have to dive in and we have to collect this data. And so there’s something really fascinating that starts to happen, and it only takes a week or two for people to just answer these questions, collect the data. The first time they see me, their head is in a fog. They describe that they just have no they know they don’t feel good mentally or physically.
They’re incredibly frustrated, but they don’t know which ends up. And so they’re seeking my support to figure it out, get them to do their reflections, tell them to come back and see me in a week or two. And again, they walk out the door thinking, I’m not sure I’m going to go back and see this lady. I think she’s a little off her rocker.
They come back and see me though, and they tell me something really interesting. First they start with, I thought you were the witch doctor, and I wasn’t sure. I thought you were full of a bunch of hot air, but holy cow, guess what I learned in the last two weeks? I learned that I’m not eating breakfast and I’m not eating lunch and I’m loading all of my calories on to the latter part of the day.
And all I crave is sugar. I just want to eat sugar, sugar, sugar. And I’m not eating any vegetables. I’m having problems with digestion, constipation. I am irritable all day and want to bite people’s heads off. I have no interest in exercising and I’m not sleeping good at night. Well, all of a sudden the story completely changes from the first time they came in to see me having no clue what was going on.
To all of a sudden now they’re seeing what’s happening and I’m like, okay, so what would you like to do? Well, I need your help to actually help me figure out what I should be eating for breakfast. Because I think if I start eating breakfast, I’m actually going to have more energy and feel a little bit better throughout the day.
I’m like excellent. Okay, let’s start there. And so this natural process starts to happen. And and like I said, sadly, we have actually somehow along the way, I don’t know how this has happened, but we have allowed we have somehow convinced people to believe that they don’t have what it takes to take care of themselves and that they need a pill, that they need somebody else to tell them what to do.
Our self efficacy is so low. Our belief in our self-confidence is so low. And so when I I’ve been known to make people cry and the reason I make people cry is by saying this, you actually have what it takes to take care of you. You do, and I’m going to prove it to you. And they and the tears come.
That makes me so sad. As a health care professional, how is it that as humanity we’ve gotten to this state? I don’t understand that. I really don’t. But that is the key, right? That is the key to actually getting people to change behavior is to build in that self-awareness.
Reuben (00:19.40)
And then the next magic trick is how do you extend that revelation with a digital health tool? Because, you know, when you in person face to face, you can really guide people and coach them through the process and and relate one on one. And that can be so impactful and to guide someone through the process in a more self-guided version in the app is another challenge altogether right?
Loreen Wales (00:20.16)
Exactly. And so our system is 100% correct. The engagement, I think the health sector applications that we have the lowest engagement rate and the lowest retention rate, I think it’s about 18% at the one year mark and I think it’s about 30% after 90 days. So there’s yeah, the retention isn’t great. So we knew going in that it was bad and we were thinking to ourselves, well, when you look at building an application, what is it that you want it to do?
Do you want it to actually function asynchronously, or does it have to function synchronously with the health care provider? And my response as a health care professional is that it has to do both. And it’s important that it does both. It’s important that we provide the care that it can be asynchronous so that the user can engage in it whenever it is that they want and build that provide that kinesthetic learning along the way to help build that self-efficacy.
But at the same time, we want to integrate with the patient’s health care ecosystem, their health care team for their health care team, to use it within their practice and their coaching to hold the patient accountable. Based on the research that I’ve seen, that’s where the magic starts to happen is to provide to have that dual type of relationship.
And so and then from there, like you said, people need to be engaged. Well, and so when it comes to developing technology, it’s not easy because the whole I mean, the UX UI design, the patient mapping out the patient journey of what does that guiding the patient along the way within the application, making it fun. So adding gamification in with the focus that we’re not, I mean one of the biggest challenges that we faced is with gamification.
When you look at the gaming industry, they will use the hook model, which creates this addictive pattern of behavior that keeps people coming back to it. When we’re health care professionals, I lose my license if I actually did that right. And so it was like, okay, if we don’t if we can’t use the hook model, how are we going to do this right? And so this has been a challenge.
Reuben (00:22.52)
Yeah, you don’t want to resort to kind of tricking people subconsciously, even if it might be a good behavior. And you don’t want to use those tactics to get them there.
Loreen Wales (00:23.04)
Exactly. Because like you said, even if it is a good thing and that’s what many people said to us, Oh, well, Loriene, relax. You’re encouraging them. You’re going to make them addicted to healthy behavior. I’m like, if only that was true, right? I mean, when you open up that part of the brain to actually do that, other things, negative things start to happen with that addictive mindset.
And you see that with people struggling with addiction, that they’ll maybe finally kick the habit of the gambling. Then all of a sudden they take up drinking or they all of a sudden take up smoking or right like that. It’s a slippery slope. And so we didn’t want any part of it. And a lot of the external cues, the extrinsic motivation like points rewards, external rewards.
I get a discount here. I get after I earn these many points. We just we didn’t want to do that. And so that’s taken us a good six years of research to try and figure out. And we finally did in and we’ve built an augmented reality avatar that actually does have points in it. But here’s the funny thing. So the avatar, the augmented reality avatar is intended to keep the user accountable to themselves.
In doing their self care. And once the user engages in doing the daily reflections and doing their self care, they earn points and they earn points to basically get these rewards to furnish and clothed and reward. YARO, our avatar so furnished YARO’s House and all of the different rooms change up his clothing and his accessories. Treat him to or he or she or they it because it can be from a gender perspective, it’s completely neutral and treat them to the spa or to some different types of rewards.
So the intent is have the user take care of themselves and the user’s then going to take care of the avatar concept. And so that’s something that we’re right now. We actually just did a presentation this morning about it to launch our version two that’s in the moving into the beta testing stage with patients. So we’re really excited to eventually be integrating that into the program to help support patients in navigating their journey of life, living with their chronic health conditions.
Reuben (00:25.48)
So YARO becomes kind of like the coach or the guides in health care.
Loreen Wales (00:25.57)
Yeah. YARO is there, is there accountability, buddy, to help them stay accountable to taking care of themselves? And then YARO is also there to help them just have conversations. So using AI and natural linguistic technology solution to, to integrate more of that natural conversation you have with the Avatar, the avatar is not at all ever going to replace a health care professional.
That’s not the intent. They’re not the avatar is not going to be recommending any clinical providing any clinical recommendations. YARO is simply there to listen to the user and to walk the user through the challenges that they’re facing and taking care of themselves and if necessary, will recommend. I think this is something that I would recommend you talk to your doctor or maybe you need to talk to a fitness trainer to help you with that. Maybe you need to talk to a mental health worker or a dietitian about that or even just a friend.
Reuben (00:27.05)
And does the program have check in points with a health care practitioner as well, or is this kind of version of it more asynchronous and self-guided?
Loreen Wales (00:27.17)
So the avatar is more asynchronous. The platform, how we’ve designed it, and again, in the health tech space, one of the challenges with getting it out there to the masses, I think we fit the area that we belong in is the primary care space. Primary care. All primary care clinics have electronic medical records or EMR. The number one obstacle to integrate technology into any primary care clinic is the integration with an EMR.
We had never even considered integrating with an EMR. Had no reason to and still to this day feel. We’ve been told that we’re flat out wrong on that. There’s definitely people that disagree with us. But here’s the thing with privacy how privacy has continued to evolve. It used to be that, oh, the patient medical record was the health care providers.
And now that philosophy has transitioned to that medical record is the patient’s and the patient should get to see everything in it, and the patient gets to decide who it is that gets to see their medical information. So we have built our platform with the mindset from the very beginning that the patient is in control of all of the data within their program.
So we don’t need we have no interest or desire to ever integrate with EMR. We don’t need to. The patient is in control of that. They can download their report, their progress report to actually give it to all their health care providers and their health care providers can upload that report into the EMR and use that data to determine next steps from a clinical perspective on how they are going to support a need to support the patient.
Reuben (00:29.20)
Oh, okay. Interesting. So the data that users can can download like what a format to they get that and is that like a PDF or.
Loreen Wales (00:29.31)
Yes. Yeah. And so then they can just print it off or email it to their health care provider and it’s within their control so they decide where it’s going as opposed to us. And so from a privacy and security perspective, it absolutely helps make our life a thousand times easier because we’re not sharing data that’s up to the patient to share their data.
Reuben (00:29.55)
Yeah, that’s true. It can definitely be a challenging balance to strike between the idea of interoperability and making sure data can be shared between systems and the fact that once that data is out of your system, it’s out of your control. And you know, and it is also puts it at more risk of being accessed or or compromised in some way.
Loreen Wales (00:30.30)
Absolutely. Yes. And yeah, and it’s a nightmare because the regulations that you have to jump through with a digital health program are very it’s good. They’re they’re absolutely very robust. But what’s interesting is it feels like they’re 1000 times more robust than what I have as I have a private practice clinic. I haven’t had to jump through the million hoops that I’ve had to jump through with my the digital health solution. It’s it’s very, very interesting.
Reuben (00:31,08)
Yeah. Yeah. We talked before about how you’ve put in a lot of the legwork to do the research and ensure that My Viva plan really follows those privacy regulations and that you’ve been working through the process of complying with the ISO standard for health and wellness apps, specifically ISO/TS 82304. Now, I think this is a great thing that there is more standardization and more strict guidelines are being in place.
Those are certain the offer certainly is the opportunity for a poorly executed product to really be harmful. Maybe you can tell us about that process of going through the standard and maybe how it’s helped or or hindered me in terms of some of the hoops that you’ve had to jump through.
Loreen Wales (00:32.07)
On an annual basis. We do. We have to do external penetration testing review, do threat risk assessments, do privacy impact assessments within this country, every every province. So 13 of them and and the territories to make sure that we comply with all of the standards within each of those of those jurisdictions. And a couple of years ago, we had a company called Therapix reach out and they wanted to do an evaluation on our application.
And so we agreed to do it because we thought, wow, like you said, there are no standards. And unfortunately Canada seems to be lacking a robust standards within the digital health space compared to when you compare it to other countries. And so this was it was a really fascinating opportunity a few years ago with Therapix.
And I said, Oh my goodness, I love what you guys are doing. And this needs to everybody needs to engage in it. And so last fall, they reached out to us and said that they were doing a pilot project, too, with 3 to 5 companies to roll out and walk these organizations through the new ISO 82304-2. I think I got that right certification, would we be interested? And we said, Absolutely.
Well, I didn’t really know what I was getting myself into, even though our threat risk assessment was based on the ISO 2701. And which was a lot that it was a lot. The evaluation to go through this new one for a digital health app was our it was significant.
And because every single question there are five different areas, five different lists of questions that you have to answer. And each of the questions you have to prove is you have to show the evidence, you have to show the evidence of the research that’s been done or the reports that have been created or screenshots of how it’s actually integrated into the platform.
And we’re talking from UI UX design to security to privacy to how the code is built. Like you name it, it is a very thorough evaluation. And what was interesting when we are going through it because we literally just finished it, I said to them, I said, Well, okay, that question cost me $15,000 and oh that question to get the evidence, cost me ten and that one was 20.
So over the course of the last two years, we’ve been able to build all of this up. So we were ready to actually do it. But holy cow is all I can say like it is. It is very intense and very costly to get to and there is no way that any one organization could have this. Just like you can’t go through that evaluation and have it done tomorrow. It’s impossible.
Reuben (00:35.23)
No. It would certainly slow down the adoption and rollout of any tool like that. I’m wondering if the end of the day, looking back like did it make your app a better product, Did you find holes that you had to fill or was it more like you were you were kind of already covering all the bases. You just had to go through the process to check all the boxes?
Loreen Wales (00:35.53)
I think the reason they told us that they selected us is because they were pretty confident that we had already checked all the boxes. I know. So because we’re health care providers, because of the way the program was built, because we’re very big on making sure that everything is evidence based, we had a lot of it. So to get that badge, Reuben, that we’re going to get to see that we comply with the ISO certifications, that’s a huge deal.
And so we’re lucky that we actually had all of it done. I mean, I guess it feels good to, it basically helps me feel like, okay, so the blood, sweat and tears that we put into building this over the last eight years is paying off because now I have this certification and the fact that that certification is global, I’m hoping that it is going to be the gold standard of what digital health applications are needing to strive to.
It’s a good thing. And why it’s a good thing. It’s a good thing for patient care. It’s a good thing for the health care industry. One of the biggest obstacles that we face in integrating technology into the health care ecosystem is the fear. A few fears from health care professionals. One Where’s the validity? What’s the research behind it?
Where’s the economic validation around it? And then the second one is the fear that it’s going to replace them. Well, technology will never replace health care professionals. That’s impossible. And so I feel like we will get more buy in from health care professionals if they can trust that there is a certain standard that is required to have those badges.
Reuben (00:37.48)
Yeah, that trust factor is huge now. Okay, so once you’ve gone through the certification, you get the stamp of approval. Do you think that that’s in the current environment? Is that actually going to help adoption or are there still other barriers that you have to contend with to be able to, you know, roll this out on a bigger scale?
Loreen Wales (00:38.19)
I think that it and it’s certainly not the floodgates are not going to open. No, I don’t agree that I wish, but I don’t think that’s a reality. I think that it is going to help. It’s already, I’ve already been told in talking to I mean the whole investment world, that that feels very foreign to me because I’m a health care professional.
But it has definitely increased our valuation 100% by getting that. So from a, and also something that we can actually it’s a claim to fame at some it’s a positive thing that we can use in a marketing strategy because people, like I said, are really reluctant to engage. So I think it will help open the doors. But as I said, one of the biggest obstacles that I think digital health has faced globally is the lack of adoption by health care providers.
And I say that when I look at I remember reading the IQVIA Report back in 2017, and these guys do a global evaluation. They have twice now. There is a report from 2017 and 2021 looking at digital health therapeutics across the globe and the research around it and the status quo. And what they said back in 2017 was something that just it was incredibly frustrating to me, and that was that within a decade.
So from 2007 to 2017, there were only 520 research papers published using digital health products in a decade. In a decade? I mean, I don’t know. I don’t know. Reuben Off the top of my head, how many research papers are published on a day, but I know it’s in the thousands, so think about that. In a whole decade they were 520 that’s it. So we weren’t engaging with it. And, and within since 2017, there have been, I think, over 1000 papers published. So it shows that it was definitely up since then.
And the pandemic, the one silver lining that I would argue in this and it has helped this space is the pandemic. It has absolutely made healthcare professionals realize, oh, technology can help enable my practice, not replace it. Right. And so that, I think is a positive. So I think that, and the other piece that I would say within health care that is a huge obstacle for us is sadly for whatever reason there seems to be this mindset of learned helplessness in health care that the system is so big. I’m only one person. I put fires out every day. I don’t know how to fix it, right?
Reuben (00:41.31)
Yeah. I think when you’re overworked and stressed within the existing system, any change to your system or day to day in the short term is just additional stress for that health care worker, even though in the long term it might actually improve things. They’re so maxed out already. That’s, you know, they don’t want to take on one more thing or, you know, have to deal with one more tool.
Loreen Wales (00:41.59)
Exactly. And getting people, like you said, beyond the mindset that, yes, I’m busy, but in order to actually improve my efficiency within my clinic setting, I need to take a step back and evaluate what’s going on and figure out how to actually improve things. And so if we in health care don’t engage in doing that, I was in a conversation in a meeting a couple of days ago, and a gentleman was speaking and he said to me, Loreen, forget, forget the government, like forget the health care ecosystem and the public sector.
On taking the lead in being innovative and making change. We’ve got to actually be focused more on the private side of things outside of the health care system to advance technology. And while I do see that, that makes sense. And I and I get it, I understand it as a health care… I wear two hats. Yes, I’m in the digital space and I’m in the private sector, but I also am a health care professional and have worked in the public space.
And I see a danger in that if we just if it if it’s all left to just one sector to actually solve the problem, I think we’re going to have a better outcome if both sides. So get engaged in doing it, because otherwise it’s frightening to see. I mean, look at the impact that the pandemic has had on our health care system. We’ve we’ve got some we have to change. We have to change how we’re doing things or we’re going to be left behind.
Reuben (00:43.50)
Yeah, it’s true. And like you said, there has been a silver lining in the pandemic that there’s certainly been an agent for change and that the pace of change has definitely picked up. Now, there’s the one on one side, you know, the you know, the pandemic dies down and people are going back to normal. Is that change going to start rewinding and things go back to where they were or can we keep that momentum going and push it further to actually, you know, cover more ground and see more innovation in digital health tools?
I certainly think that the momentum is going to keep going. And now that that change event has started, there’s no turning back now. I think there is so much more progress to be made in that direction.
Loreen Wales (00:44.48)
I agree. I don’t think we can’t let it go backwards. I mean, I do think that we are dealing, as I mentioned earlier, I mean, behavior change is hard for all of us, people living with chronic health conditions, just humans in general. We don’t like change. We definitely have a comfort zone for sure. And so we definitely have the human is who we’re up against and this rage and pushing people outside of their comfort zone to think differently and and I think you’re right.
I think that there’s been enough of a momentum that has been built that those of us within the sector just have to keep pushing forward with it and not not not accepting that we’re going backwards.
Reuben (00:45.39)
Yeah. Aside from the trend of just overall change and adoption of digital health tools, are there any other trends in the industry that you’re looking forward to or excited about?
Loreen Wales (00:45.55)
I would say the trends in the digital health, I think that the avatar that we’re building I think is really exciting. Having more of that asynchronous type of coaching available to help keep people engaged in their health. Having more digital health solutions that figure out strategies on how to instead of using what we see within the gaming industry with a hook model figuring out different ways that we can actually tackle behavior change.
Because I think that technology can be used as a catalyst to help us with that. It takes so long to change behavior. Way more time than what any health care professional, unfortunately, has time to give to each patient that is struggling. And so this is where I do see a huge play for technology to be able to help be that catalyst to crack that nut of behavior change. And that’s something that I’m really looking forward to seeing.
Reuben (00:47.06)
Yeah. And being that kind of 24/7 support tool in between those, you know, visits in the office for Primary Care.
00;47;18;13 – 00;47;46;22
Loreen Wales (00:47.18)
Exactly. I want people to be able to get back to a place where they feel like they can take care of themselves and that self efficacy matters. It has a huge impact on our ability to have resilience. And if we do end without resilience, we don’t have quality of life either mentally or physically. That’s impossible.
And so that’s that’s you know, I do feel that technology play a strong role in that. And I’m excited to be a part of this change. And it’s a pretty exciting time, I think, for digital health more than ever before. I mean, prior to the pandemic, honestly, at the beginning of the pandemic, I remember sitting there thinking to myself, I’m just thinking it reflecting on how hard it had been up until 2020 with how slow things were moving with digital health.
And now I’ve seeing what’s happened in the last two years. I know there’s been a lot of there’s been a lot of heartache that many people have experienced throughout the pandemic. And no, things haven’t moved so quickly that life is wonderful in the digital health space, but there’s actually movement, there’s hope, it gives me hope and that’s all that matters, because this journey of figuring out how to get people engaged and taking control of their health, it’s hard. And so hope matters along this journey.
Reuben (00:48.56)
Very well said. I couldn’t agree more. Thank You so much for joining me today. It’s really a pleasure to chat with you.
Loreen Wales (00:49.06)
My pleasure. Reuben, it was wonderful talking to you as well. And thank you so much for inviting me to be on your podcast.
Reuben (00:49.13)
Yes, thank you. And to all those listening, if you like this episode, please subscribe to the MindSea newsletter to be notified about future episodes.
