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October 25: Today on the Conference channel, it’s an Interview in Action live from HLTH with Sam Tullman, Head of Clinical Research at Quilt. The discussion takes a deep dive into the intricacies of continuous behavioral health monitoring using basic mobile cell phone signals and delves into how Quilt can detect a variety of health distress signs such as depression, anxiety, and stress by analyzing behaviors like phone usage and mobility patterns. More than a simple health technology tool, we delve into Quilt's innovative approach which combines an engaging game app with mobile data analytics to promote better health outcomes. So can our phones really predict our mental health emergencies? How might such a tool revolutionize the way providers monitor and treat their patients? And where does the balance between digital innovation and personal health lie?

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Welcome to This Week Health Conference. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a set of channels and events dedicated to leveraging the power of community to propel healthcare forward. Today we have an interview in action from the Fall Conferences on the West Coast.

Here we go.

Alright,

here we are from Health 2023 out in Vegas, and we are joined by Sam Tolman, Head of Clinical Research for Quilt Technologies. And I think the first question's gotta be, Quilt Technologies, tell us a little bit about Quilt Technologies.

Thanks so much for having me. What we're doing at Quilt is basically making every cell phone a continuous behavioral health monitor.

cell phones. Location data, screen usage data, steps, accelerometer. And using that, we can actually create a highly accurate prediction of people's depression, anxiety, and stress symptoms. So that's kind of what's going on in the back end.

On the front end, we're actually... A very fun, kind of almost silly game app where users can kind of play and engage and be rewarded for their steps, be rewarded for getting outside of the house. So things that we know are good for you.

It's interesting I'm thinking about the correlation here. So I'm struggling with depression, there's depression in my family as well.

Yeah. And the phone is actually a good indicator because I interact with my phone differently in times where I'm struggling versus times that I'm not. Yep. Like, what kind of, what kind of signals do you

get from the phone? Absolutely. So, of course, the high level is these data streams. You mentioned, like, phone usage, and there's the location data.

But it gets, like, a little more specific and nuanced. So, like you mentioned, it's not just, Oh, I'm spending more time on my phone, so I must be depressed. It's the patterns of usage. So, here's an easy example. We know that if somebody's using their phone a lot late at night, Probably because they're not sleeping.

It means they're having some kind of sleep disturbance. And so that's, a sign of all sorts of different clinical indications. Another example would be, it's not just about whether or not you're getting outside of the house in a day. That's a big measure, home time. But it's more complicated than that.

Some of us work from home. So it's also about whether you're following similar patterns each day. When you fall out of your routine, that's another indicator of, oh, this person might be having a crisis or in worse shape than normal.

So talk about how, so we're looking for interventions, right? So how does that lead to to an intervention?

How does that lead to a, to a healthier state for the individual?

Yeah. So I'll give a great example that we're working with right now. We're working with a large OCD provider. And one example for OCD, we know that there's great treatment for OCD, but unfortunately OCD is episodic. So even when you treat it, it goes away for a while, that's awesome, but it will likely come back at some point.

And so one thing that we're doing at Quilt is we can then take those users and monitor them over time. For them, it's just them engaging in this fun game app. So they're engaging in this fun game app over time. The back end, we're monitoring them. And when we start to notice certain signs that they might be approaching a crisis or their mental health might be declining, or we get an indication from them in a question that we ask, Hey, I'm having more obsessions now.

We can then refer them back to the additional provider who's having a tougher time keeping those people after they've gotten treated. Another example would be, with bipolar disorder. You might be fairly well controlled in living a healthy, normal life but over time, certain symptoms of mania, manic symptoms, they might come back in.

So we can detect those through a cell phone. Before they start to wreak havoc in somebody's life, refer them back to the provider

Is this a B2C or B2B, or is the provider? Essentially prescribing the use of the app? Yeah,

it wouldn't exactly be a prescription, but it would be a recommendation.

So yeah, it would be B2B.

But I would connect my provider in the app.

That's exactly right. That's exactly right. So the way we're starting as we're launching, which we're actually just launching this month, we're starting with a couple clinics, and from there we'll go to health systems. So we're already kind of linked in with this provider.

And a lot of the time, the sign up process is going to happen either through their app or through their system. Now, of course, we'll also open it up so the users can just sign up on their own and link to their provider on their own.

I'm thinking as a former CIO for a 16 hour hospital system, I'm thinking, is this the kind of thing that's a standalone app, or is this something that could potentially come to our digital experiences that we're delivering?

Yeah, so I mean the app functions as its own app, but we'd love to integrate with different digital experiences that are already there. I think that's the way that we're seeing this. So for example, with this virtual clinic that we're working with right now, we're already linked up with their app on the back end.

So all somebody has to do is click a button. Now they're in our app and it's essentially a continuous ecosystem.

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 Head of clinical research, what kind of research are you looking at? I mean...

Yeah, well, there's a lot that goes into it. So there's the external research and there's the internal research. So the internal research is basically figuring out how do we optimize these different signals that we're getting so that we can predict not only depression today, but we can provide even more value for the patient and for the provider by saying, hey, this person looks like they might take a downturn in a week.

Or in two weeks, so getting that predictive analytics. So that's kind of the internal research that we're working on. And then externally, of course, it's excellent to prove this out and show that we're getting better outcomes and reducing cost of care. So that will be the external research.

Are there any studies that you guys are producing and that kind of stuff to get out there?

Yeah,

so we're working on a few clinical studies right now. But we're also founded on a wealth of studies in what's called mobile sensing. So this really falls nicely into mobile sensing, where people are using location, screen usage data, and other signals to predict.

So where is Quilt at in their life cycle as a company?

Yeah, so we just closed seed funding. We closed about three million in seed funding. Should give us about a year and a half of runway. then we'll be on to Series A.

So, you have a little bit of a healthcare pedigree with your last name. Yes, yeah. And I interviewed your father earlier. Is this your first interview or have you done a bunch of these

already?

This first interview, but it's my first interview for Quilt.

Oh, there you go. So there you go. Was this just inevitable that you were going to be in healthcare? Or, I mean, or is it your personal journey took you to healthcare?

It's a little bit of both and. I think there was a period where I was trying to figure out what it was that I was interested in and for quite a while, my focus was really on the brain and so my background in research is in neuroscience.

I was going at behavior from a neuroscience perspective. And then what I started realizing is... We don't need to be looking directly at the brain to actually understand people's behaviors and to make impacts on it. And in fact, we can make a bigger impact on behavior just looking at people's actions, looking at their behavior.

And so that's really how I got back into it.

It's really interesting because, you know, the people you live with, the people around you, they can recognize things. You can almost pick up on the signals, you were saying like a couple weeks ahead of time. Oh yeah. Typically the people around you don't pick up on those kind of signals.

Yep. But your behavior, your interaction with your phone is so personal that you can't pick up on that.

Absolutely. And some of this has already been proven out in the mobile sensing research. So we predictive signs in, for example, people's movement patterns that can predict weeks out of whether they're going to be depressed or not.

And so, we're not taking any huge leaps from a scientific standpoint. What we've done, what we've done is make a great user experience so that people actually want to do this. People want to

engage.

So, is the message for providers that they could look into Quilt and potentially offer it out to their,

Communities?

Absolutely. So, yeah, so for providers, essentially this is a remote therapeutic monitoring solution. And so we know you can get 50 plus dollars per month on reimbursement for remote therapeutic monitoring. We're providing all the data for that. So basically all they have to do, briefly review it with their patient, who they're going to see anyways.

And then you can add that reimbursement, and then it's also helping you produce better outcomes. If you know more about your patient, and if you know where they're going to go ahead of time, or for example, if you're only seeing them once every two weeks or once every month, and all of a sudden you're a week or two weeks away from seeing them, you see they're really taking a nosedive in their mental health.

You can then step in.

Are there CMS

Yeah. So that's the Remote Therapeutic Monitoring Code. So that's the 50. Yep, that's 98980. Yeah, we've memorized it.

Oh yeah. What about the commercial payers at this point? Are they reimbursing for it as well?

We're really interested in working with them. We haven't spoken to any of them yet.

That'll

be interesting. Sam, I love it. What about an individual? What about a consumer? Can a consumer do this, or do they have to go through a...

So right now, it has to go through their provider, but eventually in not too long, really, we're 2024, is opening this for

your time. Yeah, thank you so much. It's great being here.

Another great interview. I want to thank everybody who spent time with us at the conference. I love hearing from people on the front lines. It is phenomenal that you shared your wisdom and experience with the community and we greatly appreciate it. We also want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

They are CDW, Rubrik, Sectra, and Trellix. Thanks for listening. That's all for now.

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