Founder of Psious predicts VR will play a major role in addressing the mental health crisis caused by the pandemic

Xavier Palomer_foto_Angela Silva_2 min min
Xavier Palomer

The last year has been busy for Xavier Palomer, the founder of Spanish virtual reality mental health startup Psious. The platform, which is a tool for mental health professionals to place their patients in a variety of different situations to try treatments such as exposure therapy or cognitive restructuring, doubled in the number of patients from 2019 to 2020. In all, 20,000 people have been treated using Psious’s platform.

And while the COVID-19 pandemic has strained many healthcare systems, it has shown the need for Psious’s tech and demonstrated the use case, too. Telehealth – where people are treated remotely from their medical professionals – has long been tomorrow’s technology. The promise has long been acknowledged, but the reality has always been that face-to-face meetings were preferred. The pandemic has challenged that notion.

“The adoption rate and interest from both healthcare professionals and patients is growing,” Palomer said. “If people are suffering, they want to use VR.” The normalization of technology in health treatment has been one beneficiary of the long stretches spent at home. “If you do something for a week, you’ll forget it,” Palomer said. “If you do it for a year or more, you get used to it. We’ve normalized this remote use.”

It’s not before time, either. While the pandemic has helped improve uptake of telehealth solutions, time spent away from loved ones, and away from physicians and psychiatrists is generating an enormous backlog of cases that Psious and Palomer hope to be able to help with.

“We’ve been locked down and isolated, with social distancing and a lot of things that make us anxious,” Palomer said. “We’re way more alone now. I used to go every day to the office; I can’t remember when I was last in the office. I don’t interact with my co-workers. When I interact with someone it’s often through a virtual connection. We don’t just talk anymore.”

Palomer thinks the increase in mental health issues is excacerbated by social distancing restrictions, increasingly negative news coverage, and general economic uncertainty for many people. “It’s like the worst mix ever,” Palomer said. “Being alone so you can’t exchange concerns or share problems. A lot of new stuff like face masks – inputs telling you something is wrong – and then bad news in everything you see or watch. It’s very easy to understand that at some point that will blow our minds.”

A mental health crisis on the horizon

Healthcare experts are already seeing the first wave of mental health issues starting to break on the horizon. “Most of us will be able to deal with it and get through it very easily, but a huge part of us won’t go through it very easily, which leads us to a growth in the number of mental health issues like anxiety and depression,” Palomer said. More than just sheer numbers, Palomer thinks physicians are also likely to see the severity of cases increase when the pandemic begins to subside. People will have lost family members; they’ll have spent a year or more locked indoors; they’ll have spent most of it worrying about what the future holds; and they may not have jobs to return to.

Palomer spoke to the head of psychiatry treatment at one of Spain’s largest hospitals. There, the department chief reported a 60% increase in caseload between January 2020 and January 2021. “For a hospital of that size, having that kind of growth in 12 months is just mindblowing,” Palomer said.

He’s concerned that we’re unsuited for what’s about to happen. “Are the systems ready, meaning healthcare providers, public and private systems? Are we ready to answer this demand?” he asks. “The answer is no. We’ll need to find, in the startup language, scalable solutions, and for me one of the best candidates is technology. Virtual reality has a very good clinical background and good validation. The scalability is there. We believe a solution like ours is needed more than ever before.”

Palomer believes Psious is a complement to, rather than a replacement for, face-to-face mental health treatment. But he thinks it’s better suited than most kinds of treatment, citing the way his back pain – the result of caring for three children and a life spent sitting at a computer – is being treated mostly through phone- and app-based physical therapy.

In 12 months’ time Palomer expects to see an even more meaningful increase in patient numbers being treated using Psious’s virtual reality systems. “We want to keep this pace in 2021,” he said. The mental health of us all may depend on it.

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CEO of Oak Street Health: When the pandemic finally subsides, let’s not forget to address root cause of health disparities

MIKE PYKOSZ   Oak Street Health (1)

With more than 525,000 lives lost to COVID-19, the United States is dealing with loss that was unimaginable just one year ago. This number is staggering, heartbreaking, and, unfortunately, growing so high that it can be difficult for people to remember that each life lost belonged to someone’s mother, father, daughter, son, or friend. Although nearly anyone is susceptible to catching the virus, people of color have been cruelly and disproportionately impacted this entire year.

While the pandemic is shining a light on the deeply rooted health disparities in our country, there is light at the end of the tunnel thanks to the marvel of science and medicine, and we are all excited for the day that we can put COVID behind us and return to a semblance of normalcy. When that happens, we must not lose focus on the need to deliver quality, equitable healthcare for all Americans – no matter their race or zip code and socioeconomic status.

These health disparities have existed well before COVID-19 did. More than a decade ago, I worked as a healthcare consultant in Chicago and was struck by the decades-wide gap in life expectancy between affluent, mostly white neighborhoods like the Gold Coast and poor, mostly black South-side neighborhoods just a few miles away. And this is still true today. Residents of Chicago’s Streeterville neighborhood live an average of 30 years longer than those in Englewood, just nine miles away. This challenging year has exacerbated existing issues with access and care quality; and we’ve seen it in COVID death rates, access to testing and as I write this now, the vaccine rollout.

So how do we fix the underlying issues with the healthcare system once mask mandates are rescinded and social distancing is behind us?

First, we continue to focus on building trust with underserved communities, educating people who have not traditionally had access to the healthcare system around the importance of longitudinal preventative care. In particular, people of color have historical mistrust in healthcare and therefore often wait until an acute episode has occurred before engaging with the healthcare system. However, when they are cared for by someone who takes the time to get to know them, treats them like a person and not a number, puts in the hard work to build trust, and provides culturally sensitive and unbiased quality care, health outcomes will greatly improve and the gap can start to close.

It also means that today’s healthcare providers need to roll up their sleeves and become part of the community they serve. Building partnerships with community leaders like Pastors and Alderman, and being a true pillar of a neighborhood in order to build relationships and educate patients and community members on important health issues.

Second, we continue structural changes to improve access. When the testing and vaccine sites set up in health care deserts and underserved communities are no longer needed they should be replaced with primary care centers. In Chicago, for example, there are mass vaccination sites held in neighborhoods that have been hardest hit by the pandemic, as designated by the City’s Protect Chicago Plus initiative. The effort includes partnerships with existing health care organizations along with proactive, targeted outreach by community organizations directly to community members to ensure the vaccine reaches Black and Latinx residents. This means that people who lack the resources like time or technology needed to secure a highly sought after appointment won’t be left behind. This strategy is working, and should be a playbook for cities across the country, both for vaccine distribution and for primary care when the pandemic subsides.

Third, we must focus on innovation and nimbleness to adapt to the needs of individuals and communities. Traditional fee-for-service, one-size-fits-all healthcare organizations can’t sustainably serve people in an equitable, culturally competent, and compassionate way. When the pandemic first hit, many primary care providers across the country had to shut down, or at the very least greatly restrict patient access. Value-based care organizations that are focused on outcomes rather than volume of services rendered have the ability to provide as much proactive, preventive care, and adapt as needed to keep patients healthy. These types of organizations were able to greatly ramp the care they were providing while traditional organizations were pulling back.

We are at an inflection point in our country as it relates to healthcare, but nothing we have learned this year is new information. We have an opportunity to rethink how we offer healthcare to the patients who need it most, and build a better healthcare system that is more equitable and just for all.

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How AI could transform post-pandemic healthcare

JOANNA SHIELDS   Astrid Stawiarz Getty Images
Joanna Shields, the chief executive officer of BenevolentAI, an artificial intelligence-powered drug discovery startup.

The toll on medical professionals during the COVID-19 pandemic has been huge. In the UK, nearly 100,000 members of the National Health Service (NHS) workforce are currently off sick – around one in 10 employees. Half of those are absent because they are sick themselves, or have been forced to self-isolate because of their proximity to someone with COVID-19.

The absences are stretching healthcare provision in the country to its limits. But it’s not just frontline doctors and nurses who are struggling to keep going due to illness. Human labor has been pushed and pulled due to the pandemic in pharmacies and laboratories processing tests and coming up with new drugs. It’s something Joanna Shields, the CEO of BenevolentAI, an artificial intelligence-powered drug discovery startup, has been working on.

“The coronavirus pandemic reinforced how human intelligence partnered with purposeful technology can achieve inspirational results, even when the world is locked down,” she told Insider. “While AI models and algorithms will never fully replace scientists and clinicians, they can save time and money – which is crucial in our current climate.”

In the early days of the pandemic, BenevolentAI set its technology to work on the pandemic, trying to come up with treatments that could help alleviate pressure on medical systems. “Our AI models ingest scientific literature at scale, deriving contextual relationships between genes, diseases, drugs, and biological pathways leading to the proposal of novel or optimal drug targets and mechanisms, as well as the identification of the patients who will respond to treatment,” Shields said. “Such relationships may be completely new, previously or previously unrecognized due to the overwhelming volume of biomedical information that is now available.”

One solution they hit upon by combing through the literature was the use of one drug, barcitinib from Eli Lilly, that could help treat COVID patients. A November 2020 paper published in Science Advances by frontline doctors who took the signals from the machine learning trawl through literature and decided to test it on patients through the National Centre for Allergy and Infectious Diseases (NIAID) in the US reported positive results. The drug, identified by BenevolentAI, contributed to a 71% reduction in mortality in patients with moderate to severe COVID-19.

The Food and Drug Administration (FDA) in the US used those results to grant it emergency use authorization on a wider scale, and it’s been used in hospitals there since the end of 2020. In the UK, barcitinib is currently undergoing tests as part of the UK Recovery Trial, where patients recuperating from COVID-19 are being given various drugs to see how best to treat future ill patients.

Quick action like this could transform post-pandemic healthcare, Shields thinks. “Experiencing a global health crisis on this scale, we have never been more aware of the fragility of human life,” she said. “One positive outcome of COVID-19 is that it has united science and tech for good, accelerating data-sharing agreements and encouraging the open publication of research results. This new environment of collaboration has provided a glimpse of the beginnings of a more open and adaptable R&D model that can accelerate the delivery of innovative and life-changing outcomes for patients.”

It’s also having an impact on those being drawn to participate and collaborate on finding solutions for healthcare problems that are blighting the world. In a trying time, Shields believes pharma- and med-tech have stepped up – and that success could draw more people into the field who can help cause future leaps forward. “We have also seen a significant increase in tech talent being drawn to healthcare or pharmaceuticals, driven by a desire to solve real-world problems and improve quality of life,” she said. “I believe that this passion and intelligence, partnered with new technologies, will propel us forward and bring new discoveries, new cures, and new hope to patients.”

It’s one that’s proven more necessary than ever before – and while AI has come under its fair share of criticism, there’s real hope, based on its use in this pandemic, that it could be harnessed for good by the time the next pandemic comes.

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