Latest / Conversations with Cumberland Heights / Wearable Technology in Addiction Recovery: Expert Insights

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Wearable Technology in Addiction Recovery: Expert Insights · Conversations with Cumberland Heights

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  Have you ever done podcasts before? Yes.
• 0:02
  Oh, you're here bro.
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  I mean, I don't know if I'm not like you, but.
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  Before it is not been.
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  We, like, fell into this.
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  Well, you've been doing this for a little while, though, like 6 or 9 months, right?
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  Like a year?
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  Maybe a year. Ish.
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  Okay. As I see it on LinkedIn sometimes.
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  You know why we do it?
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  I can.
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  I mean, there's a bunch of reasons, probably, but the one I think of
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  is that we need actual, like, innovation in the space.
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  And you guys are really good at multiple pathways
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  where you are a 12 step program that actually embraces multiple pathways.
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  And we need more of it. That's why I think you do it.
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  That's very kind. Thank you.
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  We're trying.
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  And we're trying to
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  take action. Yeah.
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  But really, the primary
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  is when somebody is looking for help,
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  that they can learn more about us.
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  You know, in that you can see our faces and they can see the vendors
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  that support us.
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  They can see our staff.
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  We try to focus on our staff.
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  You know, for folks to really I mean, like, you can read a pamphlet,
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  you can go to a website.
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  That's the most polished experience.
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  And sometimes very deceiving.
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  And sometimes deceiving.
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  So we're like, you know what?
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  We need to have a nurse. We need to have a counselor.
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  We need to have a CA.
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  Yeah. You know, like, what do you do? Right.
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  100. The other, the other assumption that sometimes we make,
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  we're just rolling, by the way.
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  This is how you do it. We just love to.
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  I jumped in.
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  But people don't know how treatment works.
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  No. Right.
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  And so talking about, you know, from a chef's
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  perspective or, you know, somebody who works on it
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  or a counselor, like, okay, like, what exactly is your job?
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  And like, from day to day, how does that actually function?
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  And also like the different ways that like the different like, episodes of care.
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  Right.
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  So detox rez, PHP, IOP piece.
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  Exactly. What's what.
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  I think as a parent especially, and I have two little guys,
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  and my husband and I are both in recovery.
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  And so there's a good chance
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  one of my kiddos will have the genetic predisposition to this.
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  And, and so as a parent, like, thankfully,
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  you know, I've been through it,
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  but if my parents had no idea and like, honestly, still kind of don't.
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  Right.
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  And there really weren't resources like this,
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  even ten years ago when they were 15 years ago.
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  And we were like in it, there was nothing like this for them to learn, right?
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  We've gotten surprisingly, you know, and the whole team has heard
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  there have been, just the other day, we had our annual, concert benefit,
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  and a parent came up to me
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  and,
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  It's really about the show has nothing to do with me like I.
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  But they had watched a couple episodes, and it helps them
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  make an informed treatment decision about the people that who we were.
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  Yeah, right.
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  The spirit of Cumberland Heights and, this woman was very emotional,
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  and she actually had her son with her, you know,
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  that had just gotten out of a program that day, one of our programs that day.
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  I still watch program and just how much that it helped them learn
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  different things to to think about, by way of treatment.
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  So, that's why we do it.
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  Not trying to be an influencer.
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  I got sober with a girl.
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  Well, one of the times I ended up, you know, I relapsed again.
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  She did not.
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  And she'd come out of Stillwater's.
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  We love Stillwater and
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  is still doing well and now has two kids
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  and, yeah, really spoke
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  highly about it and was really is still involved
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  and very, very involved in 12 step and yeah.
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  Is is just, a great beacon for people.
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  So thanks for coming on. We're in Orlando.
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  We took the show on the road.
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  Love that.
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  We tried to bring, like, a taste of Nashville with us.
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  The whole thing, you know? So we brought.
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  That's cool. Yeah, I did none of this.
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  I'm. I'm not.
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  Clearly. Because this is amazing. So.
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  But thank you for spending some time. I know you're busy.
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  Who?
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  Introduce yourself.
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  Who are you?
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  So I my name is Eliza.
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  I, I work for a company called Prada.
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  I'm in recovery myself.
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  I was somebody I would love to say.
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  I was quick to get it. I was not quick to get it.
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  And I actually have a Nashville
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  phone number because I tried to get sober so many times in Nashville.
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  I did not go to Cumberland Heights and maybe what have I been?
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  I know you. Had a Nashville connection.
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  Okay, so I met my husband in Nashville.
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  My husband went to Cumberland Heights twice, and it's. Silly.
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  And it's over.
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  I didn't know. You're like.
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  Yeah, yeah.
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  And you're like our number one advocate.
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  I know a lot of people that I've gotten sober with you guys and my.
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  And obviously my husband's doing well.
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  That's awesome.
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  And, and so I got really, really lucky.
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  I met some people two and a half years ago that were, starting a company
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  that was using biometric data to improve the episode of care.
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  And our CEO was one of the, the original members of people.
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  So the people that, like, you know, were found essentially found incapable,
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  and also owns treatment centers and is really forward
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  thinking, and was basically looking at like wearables for his own treatment
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  because he had a tech background, his own treatment center.
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  And, is in recovery himself, though, and, the wearables
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  that he found at the time, we were like mostly Fitbit and Apple Watch.
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  We now have a proprietary ring, which is really cool.
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  But basically the theory behind it and there's so much research,
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  showing especially like sleep and heart rate variability
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  that they are, indicators that somebody is struggling
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  with depression, anxiety, heading towards relapse.
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  And we're not just focused on substance use disorder, mental health as well.
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  I don't I personally don't believe that you have one without the other, I think
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  I mean, I don't know anybody that's like slowly killing themselves
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  because they're super psyched about what's going on in their life and whether it's
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  trauma or depression or anxiety or schizophrenia, whatever it is.
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  Right.
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  And so basically, when
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  we work with treatment centers and when a client enters treatment,
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  they get this ring, which just looks like an aura ring.
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  This is the first time I've seen this, by the way.
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  I know when I first started.
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  Like like I saw it downstairs and she was like, I have to show you that.
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  It was like, don't show it.
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  Just show it to me live.
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  And so they that's the Women's March.
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  It's a little smaller, but the they fit, they should fit on like every finger.
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  And they work on any finger and we're pulling heart rate,
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  heart rate variability, skin temperature activity, oxygen
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  sleep, deep sleep REM sleep packaging it up.
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  It goes to the client, themself and it also goes to the care team.
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  And we can send it to any supporters like a concerned parent or a spouse,
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  at the at the discretion of the treatment center.
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  And this data also goes into the air.
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  So if we're fully integrated, because we don't want clinicians
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  who are already overburdened to have to learn a new, of course, a new technology.
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  Yeah.
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  So we want to work with what they know and what they're comfortable with.
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  And, this data is really looking for anomalies.
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  So where clients are showing early signs of dysregulation, often during the episode
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  of treatment helps with like medication management understanding triggers.
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  We've had it reveal a lot of trauma.
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  So, you know, people will be sitting in group, especially veterans
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  or people who just associate, and they'll look fairly calm.
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  And then you'll see heart rate spike to 198.
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  And it's like what was happening at that time that was so triggering to that.
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  Right? Right.
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  And, and the, the many centers just charge
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  the clients with the rings because then they can see how they're doing after.
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  And alumni programs are typically just reaching out at seven
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  days, 14 days, 30 days, 60 days, 90 days.
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  But you can actually reach out ideally pre relapse and
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  and if not right away so that we can get somebody like the day
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  they relapse or the day after and get them back into care.
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  One of the things that's really interesting about the future
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  wearables, and I heard somebody a long time ago call all this stuff now
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  because you have rings and you have,
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  you know, watches bands and, geek chic.
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  You know, everyone.
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  A lot of people wear them now.
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  A lot of people wear them now.
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  What's interesting about behavioral health with these technologies is
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  for those that don't know.
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  Measurement and behavioral health
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  is different than measurement in medicine, generally speaking.
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  Right. Like you have a broken leg.
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  You know, you use a machine called an X-ray to take a picture
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  in behavioral health today, really
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  the standard of care is a combination of, you know, clinical experience.
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  So the, the the wisdom of a clinician observing a client
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  patient preference,
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  client report.
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  So standardized assessments,
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  both the clinical interview style and the self-report style
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  is really how measurement and behavioral health works is how diagnosis works.
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  Right. There are 11 indicators for substance use disorder.
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  And usually a physician should be a physician or a highly skilled clinician.
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  Is the individual
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  again, walking through a patient
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  or a client or a guest through a process
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  to ensuring that they're being diagnosed appropriately.
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  What I find interesting about the future of these technologies is
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  I don't know about you, but I wasn't very good at telling people.
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  You take the words out of my life.
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  How I was doing, you know what I mean?
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  Like, I wasn't an expert in being like, oh, I think I'm actually, like,
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  probably 5 or 6 indicators of depression, impulsivity.
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  Like, you know, I was.
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  So dependent on what's going on in that moment.
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  Right?
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  So these kind of like psychodrama,
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  don't tell me, show me.
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  Right.
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  The data, the data themselves
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  hopefully would be able to show a treatment team,
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  that something might be going on, like you said, maybe it's related to
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  sleep, maybe it's related to heart rate variability and the activation.
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  So I told you I was going to tell you about a couple grants that we're doing.
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  We just submitted a grant on the 4th October for okay.
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  I don't even know what day it is, but it's early October 2024. And,
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  we are using Active Graph
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  if we get funded, research grade wearables,
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  because what we want to try to understand is how to prevent treatment failure. Yep.
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  Because at Cumberland Heights, with our own data
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  and obviously the body of work over the last 50 years
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  longer, somebody is engaged, agnostic of the program.
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  The longer somebody is engaged,
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  the higher likely they are to have success long term. Yep.
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  And there's always a problem with, with,
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  an individual, just like in our own experiences, we're like, you know what?
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  Enough's enough. I'm done. Right.
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  I am leaving against medical advice. Yep.
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  And hopefully these data can help us
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  predict that maybe somebody is at risk for flight.
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  Exactly. Or maybe it's.
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  Just in their body, which is where trauma is stored, right?
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  Showing up to group and being really activated.
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  I don't know about you, but when I'm uncomfortable, you know,
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  like around Thanksgiving dinner or whatever, I'm like, you know what?
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  This has been great, but I think I'm going to like,
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  go back and get in my normal homeostasis.
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  Right? Right. And it's the same thing with treatment.
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  When we've taken away the best coping mechanism that an individual has had.
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  Right. In some ways the only. Yeah.
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  And maybe the only hopefully this technology will help a little bit.
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  Are you guys, doing any research?
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  So. Yes.
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  We are right now engaged in research,
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  with Harvard and McLean on we,
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  are hoping to, in about nine months, be able to identify craving in real time.
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  Oh that's. Cool.
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  Where somebody like this guy that we're working with is so renowned,
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  is probably the foremost researcher
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  in the world on on biometrics and cravings specifically.
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  And like, has the the equation for it.
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  And what we're trying to do is get the rings sensitive enough.
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  Right.
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  And, to pull data fast enough without dying.
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  The battery life is an issue there, right? Right.
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  To be able to pull the craving in real time, because then it's
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  like millions of lives saved overnight like that.
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  Like what if somebody can reach out?
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  What's great about what you're doing is, is, like, often a lot
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  because there's there's been a lot of wearable,
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  research, like, if anybody's interested, you know,
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  Dartmouth has a center for technology and behavioral health.
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  I sit on an advisory board, and they they do,
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  they were the analytics partner for Pear Therapeutics.
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  Okay.
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  Before they went through their, their, troubles.
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  I think they just ran out of money.
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  From a technology company perspective, which it it happens.
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  But what Prada is doing
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  that's interesting is they're trying to go in
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  instead of an academic center taking a long time to do this research.
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  You're investing yourselves in the tools and the feedback loops.
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  So providers, because we don't have the infrastructure.
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  To save lives to build.
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  These technology platforms. Right?
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  So you're doing it by way of the providers
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  so that like you said, you know, if you want to
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  better improve your ability to identify
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  some of these risk factors, you can use this platform.
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  Yeah.
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  And it's and it's a little bit
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  of a self-selected population that works with us.
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  Right. Like right.
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  There. Are studies.
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  Like you guys who are innovative and data driven and patient centric
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  and want to treat people as individuals and really
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  look at like what's going on at any given moment.
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  What's the cost though?
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  Let's like so it got less expensive when we started talking,
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  we were using the Fitbits and Apple Watches,
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  which have implementation kind of hiccups too, with like,
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  you know, they have to create, for example, of iPad or Gmail.
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  And so that was we learned pretty quickly that was difficult to do,
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  for just difficult for centers, especially if they have like 100, 200 clients.
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  Like it's not super easy to do, right?
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  And so the fact the rings are so easy, from an implementation standpoint,
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  it's $50 per ring and then it's $50 a month per client.
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  And so and if you do three months at a time, because clients continue
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  through a continuum of care, you want outcomes for when they discharge,
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  you know, that first 30 days
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  being the most vulnerable period typically for clients.
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  So you want to cover that first 30 days for alumni
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  to make sure that their clients are safe.
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  It's $150 for a client that includes the hardware for three months.
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  Yeah.
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  And we usually waive implementation.
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  I'm going to stop doing that soon,
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  but we've been, of course, our early glass early guys.
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  And, and then we also have, technology
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  that is, real time for just the detox,
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  oxygen and heart rate through the rings, through the rings.
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  Just a different ring.
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  I mean, it's just.
• 15:40
  Under.
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  The same ring, but it's just
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  it looks the same, but it's just a different version of it.
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  That's going to the nursing station.
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  And that's to make sure that if somebody does get something
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  in, and it does happen from time to time, right.
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  That you're able to know or if somebody is vulnerable,
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  and has a seizure or something like you're getting that which happens.
• 16:02
  Yeah. And finding out right away.
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  But really the, the core offering is more focused
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  on the long term episode of care and making sure that clients
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  make it to the first year because we know the first.
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  If they make it to the first year, the likelihood of success goes way up.
• 16:19
  Have you guys been talking at all internally about
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  trying to,
• 16:28
  petition third party payers to reimburse for these services?
• 16:31
  So we've been approached by a few, and they need more data.
• 16:35
  Right.
• 16:35
  Like which I get we work with about
• 16:39
  40 centers now, and you need a whole bunch of data
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  to show long term that you've saved money where we are
• 16:46
  seeing, insurance covering it.
• 16:50
  And I use that in quotations purposefully
• 16:53
  because the data, we do all the self-report matters to you.
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  You probably remember, like they got 7 to 9 and we can compare
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  what's going on physiologically with what the client is reporting.
• 17:05
  Which is super cool.
• 17:07
  But,
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  Self-report is one piece of the picture and it can be,
• 17:14
  you know, it's it's unfortunately it's subjective.
• 17:18
  So insurers will say, well,
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  no, 28 days, 30 days, we're done.
• 17:25
  If you use this biometric data and you say the client's
• 17:28
  not ready to leave, their sleep is just regulated.
• 17:31
  It's a mess.
• 17:32
  Their heart rate variability is dropping.
• 17:34
  They usually will give more days.
• 17:37
  And so we found on average centers are seeing at the detox rates
• 17:42
  level of care are 3.8 days, which is huge.
• 17:46
  And that's kind of and we no longer stays better outcomes.
• 17:52
  So that's where insurance is sort of been covering it.
• 17:54
  But the payers have been approaching us for data and we just
• 17:58
  we don't have enough of that. Right?
• 18:00
  Yeah.
• 18:01
  I mean, if I was a payer, I would be trying to lean on,
• 18:05
  the marketplace, for lack of a better term,
• 18:09
  to try to innovate, to try to innovate quicker
• 18:12
  and try to identify technologies that can assist teams to better
• 18:19
  effectively treat people, you know, and, again, prevent treatment failure.
• 18:24
  As an example to ideally save resources
• 18:30
  for the payer and the treatment center, but most importantly, save lives.
• 18:35
  Yeah.
• 18:35
  So if I was on the credit team, I would be very interested
• 18:39
  and maybe even like beta testing this and
• 18:42
  like unleashing access
• 18:45
  in terms of the internal teams and trying to peer review the algorithm
• 18:49
  algorithms and the data and the outcomes so that people can
• 18:53
  so that you can get that buy in earlier.
• 18:55
  Because I think that,
• 18:57
  I don't know when, but certainly the more easier
• 19:00
  it is to use these, the more integrated they are in the treatment experience.
• 19:04
  Like.
• 19:07
  Accompanied with assessments.
• 19:09
  Because what I mean that's one day assessments might go
• 19:12
  might not be as critical from a diagnostic profile perspective
• 19:16
  as some of the more passive wearable technologies will be.
• 19:20
  And it seems really far away right now.
• 19:23
  But as far, I think five years, everybody's going to be using biometrics.
• 19:28
  You think so? You.
• 19:30
  Yeah.
• 19:31
  Because it's such like,
• 19:32
  how long have we been screaming about value based care and like
• 19:36
  I mean as like as an industry, you mean you would know better than I have?
• 19:39
  You been in this industry a lot longer?
• 19:41
  But, I think it's the quickest way to get there.
• 19:45
  Yeah, it's it's completely like.
• 19:48
  It's not subjective.
• 19:49
  It's completely objective data.
• 19:52
  And I think insurance is going to start given we have a few centers
• 19:56
  that are, using our data to try and get better reimbursement rates.
• 20:02
  And I think that's like step one.
• 20:04
  And then step two is really like working with the payers to do a bigger program.
• 20:09
  And then and then.
• 20:10
  Yeah, I mean, I think I don't know, weird to me that, that it's
• 20:14
  I think it's such a cheap way for insurers to actually like help people
• 20:19
  and get people back in care so that people aren't ending up in emergency rooms.
• 20:23
  Yeah.
• 20:23
  Or, you know, in the ICU for four days because they had to get a Narcan drip
• 20:29
  because, you know, it's like you know.
• 20:32
  So next time you're in Nashville, I want you to come by Common Heights.
• 20:36
  I would love. To.
• 20:37
  And I want you to meet, doctor Park
• 20:40
  and Corey and Johnson are two researchers who are new, which I told you about.
• 20:43
  And bring the ring and let's talk about it.
• 20:45
  Yeah, I'm a big fan.
• 20:47
  I appreciate the work that Freddy's doing.
• 20:49
  You know, genuinely, it's not easy.
• 20:52
  It's not easy.
• 20:53
  For. The brain.
• 20:54
  It's not easy starting from scratch.
• 20:57
  And, sometimes these are luxuries that treatment centers can't afford.
• 21:01
  Yeah.
• 21:01
  And so the longer that y'all are able to frankly, survive and thrive,
• 21:07
  I hope, I really, genuinely hope will lead to
• 21:11
  an ability for not
• 21:12
  only Prada but other, unfortunately, competitors for y'all.
• 21:15
  But but. Les and I mean a.
• 21:18
  Load a high tide raises all. Those.
• 21:20
  Oh not going to save.
• 21:22
  What is it?
• 21:23
  10% of people are suffering.
• 21:25
  1% of people get treatment.
• 21:26
  If we can eventually go B to C and make it so that people that aren't able
• 21:30
  to get in treatment or that they're able to get care like we can't do everybody.
• 21:36
  Yeah.
• 21:36
  So our goal is to be like the ring for behavioral health.
• 21:40
  Like what?
• 21:40
  That we want to be that for anybody who's suffering.
• 21:44
  Yeah.
• 21:44
  But we're just going to be fast follower.
• 21:47
  Look at what that.
• 21:49
  Well please I appreciate you.
• 21:51
  I appreciate you and the work you do.
• 21:53
  Well, deeply.
• 21:54
  And we'll see you in Nashville.
• 21:56
  Like follow subscribe.
• 21:57
  Thanks for watching this episode. See you next time.