February 22nd, 2019
Tiatros CEO Kimberlie Cerrone: Why I founded a digital therapeutics startupBy Kimberlie Cerrone, MS, MBA, JD,
Digital Therapeutics How New Approaches to Behavioral Health Boosts Healthy ProfitBy Les C. Meyer, MBA Read Full Article
Digital Therapeutics: The Future of Behavioral HealthBy Les C. Meyer, MBA Read Full Article
April 25, 2018
TiE Inflect 2018 announces Tiatros Inc. as a 2018 TiE50 FinalistRead Full Article
January 8, 2018
Tiatros Is Named To The Global Digital Health 100Read Full Article
December 4, 2017
Watson-Powered Tiatros Program For Veterans Achieves Up To 73% PTSD...Read Full Article
January 19, 2017
Brian Silverstein Interviews Kimberlie Cerrone, Founder And Executive...Read Full Article
February 22nd, 2019
I've lived and worked in Silicon Valley my entire career. I'm a technology and patent attorney who comes out of two of the Valley's top law firms. I spent most of my career as part of top executive teams, specializing in structuring and negotiating the business deals that help startups grow into mega firms. I co-founded a neuropeptide company that went public in 1994. I was part of the executive team that took an internet company public in the late 90s. I have graduate degrees in neuroscience, business and law.
My entrepreneurial focus on behavioral health began after my sons returned from military service struggling with PTSD, or post-traumatic stress disorder. They both enlisted shortly after 9/11. My older boy went into the Army, where he led combat platoons during two tours in Iraq. My younger son joined the Navy, where he spent more than five years on a fast attack submarine, circling the globe.
It's important to understand that my sons came home with PTSD under arguably the best possible circumstances. They are intelligent, competent, brave young men who came home to an intact, loving, educated, affluent family and lots of friends who were able to support them. They came home to San Francisco, where excellent healthcare services are available and superior insurance to cover it. My husband is a psychiatrist. With all of the odds in their favor, it took us two years to get our sons the help they needed.
Both have fully recovered now and gone on to have happy and successful lives, but our family's experience taught me how hard it is for most Americans to access effective behavioral healthcare services. I can offer some facts to think about:
Before you can solve a problem, you must define it correctly. The problem is not that we don't have a good treatment for the most common mental illnesses, because we do: cognitive behavioral therapy, or CBT, is the primary, scientifically proven treatment for the most common mental health disorders. It's used all over the world to treat anxiety, depression, trauma, stress, panic, addiction, and even eating and sleep disorders. Fifty years of research studies confirm that CBT is very safe and highly effective, with 80 percent of people who complete a CBT program to the best of their ability having a complete and sustained recovery. That result is pretty much as good as it gets in medicine. The real problem is not the availability of a good treatment; it is that more than 100 million Americans cannot access the safe and highly effective treatment that is available.
Another important lesson that I learned from my family's experience is that healing is a social activity. The only people that my sons would share their stories with were other veterans, who shared their military values and understood their situations. They needed the community and support of other veterans even though they were surrounded by caring family and friends. This understanding is critical, because it is a scientific fact that people who feel isolated do not heal.
Once I understood that the challenge and opportunity for Tiatros was to provide access to existing, evidence-based treatment and social support, the idea emerged that we could leverage the therapeutic power of peer groups using social media-styled tools inside secure private social networks to teach CBT skills and to build psychological resilience. From its very beginning, Tiatros' mission was to make safe and highly effective behavioral health treatment available to the 100 million Americans who cannot otherwise access it, and to reduce its cost by 90 percent compared to traditional in-person psychotherapy.
Today, participants access Tiatros' portfolio of online psychotherapeutic and psychological resilience programs on their personal devices, in the comfort of their own homes, when it is most convenient for their individual schedules. Our programs use evidence-based narrative therapy, mindfulness training, psychoeducation and CBT exercises that are tailored by experts to be highly relatable to the specific audience. Participants in Tiatros programs work together to build psychological resilience skills and to acquire new, more effective behaviors that lead to success at home and at work.
Our proprietary platform and programs use social media-styled interfaces to leverage the power of peer groups of 12 to 15 participants who share the same health challenges and life goals. We use these tools to encourage participants to form a supportive and nurturing community that is itself therapeutic — acting to encourage every participant to actively engage in and to complete their Tiatros program. In effect, Tiatros' approach makes the peer group the "guide" in "guided self-help." Because the user experience is social, engaging and relatable, 75 percent of participants who enroll in Tiatros programs complete and benefit from them. That's an extraordinary success rate, of which we are very proud.
Tiatros programs deliver eight sessions with a weekly cadence over eight weeks. Completing the work for a session takes about 90 minutes per week. Participants access their Tiatros programs asynchronously, from anywhere. This approach greatly increasing the number of therapeutic touch points with most participants engaging daily, and some up to several times per day, which creates a psycho-therapeutic milieu with more frequent and active engagement compared to traditional in-person and telemedicine styled psychotherapies. Each peer group is moderated by a trained facilitator under the oversight of an expert CBT therapist and, for some applications, a "physician of medical record." After completing their primary program, participants continue to have access to all of their program materials, their peer group and the larger user community, and to original content as part of the Tiatros' "After" program.
We study and empirically validate everything that we do, working with independent clinical researchers at top academic medical centers. This is very important to me as a scientist; everything that Tiatros does needs to be based on good science, good medicine and good design. We measure the clinical outcomes of Tiatros programs using validated measures that are in widespread use in medicine. We're proud of our results. Clinical outcomes in a recent peer-reviewed study show that Tiatros achieved a 40.5 percent reduction in perceived stress (1.8 effect size) as measured by the PSS-10; a 41.2 percent reduction in anxiety (1.2 effect size) as measured by the GAD-7; a 33.6 percent reduction in depression (1.2 effect size) as measured by the PHQ-9; and a 30.6 percent reduction in somatic symptoms (0.9 effect size) as measured by the PHQ-15.
We partnered with IBM and other leading AI companies to integrate advanced analytics and artificial intelligence technologies to personalize the participant experience and to increase participant engagement. AI data consistently show dramatic increases in positive behavioral traits associated with improved employee productivity and improved patient compliance, like dutifulness, trust, cheerfulness, and self-discipline, while unhelpful traits like worry, susceptibility to stress, melancholy, and immoderation consistently decrease. We're collaborating with our business partners to leverage cognitive computing and AI to make effective peer group psychotherapeutics available to tens of millions of Americans and ultimately to hundreds of millions of people around the world who have treatable mental illnesses. That's a big ambition, but we believe it's possible to achieve over the next few years.
To my generation's great shame, we still have Vietnam War-era veterans who are homeless and lack mental healthcare services 45 years after their conflict ended. My big fear after my sons came home from their military service was that we would soon have another generation of homeless veterans from current warfare. Not surprisingly, we targeted the first Tiatros programs to help veterans. We are now collaborating with the U.S. Department of Veterans Affairs, NYU Langone Health in New York City and the UCSF Department of Psychiatry in San Francisco and IBM Watson Health to empirically evaluate our impact on three different populations of struggling veterans at high risk of suicide and opioid addiction. We're also distributing the Tiatros "Military Leadership Development and Resilience Skills for Transitioning Veterans" program to employers who want their veteran hires to use their military training and values to become the next generation of corporate leaders.
We're also distributing Tiatros programs to U.S. companies that collectively are responsible for the healthcare of more than half of Americans. For example, Salesforce, San Francisco's largest employer and the fourth largest software company in the world, is rolling out the Tiatros "Personal Growth and Psychological Resilience at Work and at Home" program nationally. Salesforce's human resources team saw in Tiatros an evidence-based solution that was able to reach and help their entire workforce. We see that employers want solutions like ours that take a holistic approach to promoting wellness of the mind, body and spirit. They need usage and clinical outcomes data that show their workforce becoming healthier, more psychologically resilient and more productive.
We're also partnering with clinical experts and large providers to tackle the impact of behavioral health on chronic disease care. Last year, we partnered with the Allina Health in Minneapolis to create and empirically validate Tiatros programs targeted toward cancer patients who experience anxiety, depression and trauma. Oncologists are now prescribing the Tiatros "Coping with Brain Cancer" program to patients across Allina's thirteen hospitals and offering the Tiatros "Coping with Brain Cancer for Caregivers" programs to their family caregivers.
We have similar initiatives in progress for heart disease, stroke and diabetes patients. I'm currently looking for a clinical partner who wants to tackle chronic pain management with us. This strategy is critically important to reduce the pain and suffering and the enormous cost of the treatable, but currently untreated, mental illness that co-occurs with chronic disease care. I recently asked an executive at the American Heart Association what percentage of people who have a heart attack also experience anxiety, trauma and depression. His answer was: "100 percent do."
We recently began collaborating with expert clinicians at UCSF Medical Center in San Francisco and several California public school districts to develop and distribute Tiatros programs to the K-12 and higher education sector. This work is very important because schools have taken on the role of being the primary point-of-service for healthcare services for millions of children and young people.
I saw in my own family's struggles that effective behavioral health interventions are life-changing. We founded Tiatros to ensure that every American who is struggling with stress, anxiety, depression and trauma can get the expert quality, evidence-based psychotherapeutic and psychological resilience skills training that helped my sons.
April 25, 2018
San Francisco, California, USA
Tiatros Inc. is excited to announce that it has been selected as a "2018 TiE50 Finalist" for the prestigious TiE50 Awards Program recognizing the world's most innovative tech startups. This awards competition is part of TiE Inflect 2018, the world's largest conference for tech entrepreneurs.
“The Tiatros team is delighted to be recognized by Tie50 as a thought leader in Digital Therapeutics for Behavioral Health. Our role in this space is to offer evidence-based psychotherapeutic and psychological resilience programs and new, data-driven tools that enable the Human Resources and Employee Benefits groups in large self-insured companies to take a far more active role in managing the mental health and resilience of their entire workforce,” states Kimberlie Cerrone, Founder and CEO, Tiatros Inc.
"TiE50 has become a global brand that attracts thousands of tech startups worldwide. This year, we screened more than 7400 companies from 28 countries and selected the best-of-breed as our "2018 TiE50 Finalists." These companies are finalists in the ultimate runoff for the 50 winners. Our program has gained notoriety over the past decade as a competition run with the highest level of integrity and vigorous screening and judging by domain experts,” reports Kamal Anand, TiE50 Program Chair.
"As a 26-year not-for-profit organization dedicated to fostering entrepreneurship and with a global footprint of half million entrepreneurs, enterprise executives, and investment professionals, we pride in the fact that we are one of very few competitions without any pay-to-play incentives,” states Ram K. Reddy, President, TiE Silicon Valley.
About Tiatros Inc.:
Tiatros is a San Francisco-based company that offers a portfolio of engaging and relatable online psychotherapeutic and psychological resilience programs that use scientifically-proven therapeutic and online learning methods; advanced analytics and AI; and the power of peer communities to teach healthier, more successful behaviors, enabling our corporate customers to improve the health, productivity and psychological resilience of their entire workforce. www.tiatros.com
About TiE Inflect 2018:
TiE Inflect (previously TiEcon) is the world's largest conference for entrepreneurs and intrapreneurs with participation from top technology companies, leading venture capital firms, and global services providers. TiEcon 2017 attracted 5400+ attendees from across the world - including CEOs of established companies to first-time entrepreneurs creating new companies, to leading investment professionals and corporate executives. The conference was listed by Worth Magazine as one of the 10 best conferences for ideas and entrepreneurship along with TED and the World Economic Forum. For more information, please visit http://www.tieinflect.org.
The Indus Entrepreneurs (TiE) is a not-for-profit organization founded in 1992 in the Silicon Valley by a group of successful entrepreneurs, corporate executives, and senior professionals. TiE is the world's largest network of tech entrepreneurs. We are a cohesive global network with a footprint of half million entrepreneurs, enterprise executives, investment professionals and other accomplished individuals. We operate from 60 cities in 18 countries. http://www.tieeco.org.
January 8, 2018
We are delighted to be able to announce our 2017 Global Digital Health 100.The Global Digital Health 100 is one of the HealthTech industries foremost technology awards programmes, celebrating innovation and entrepreneurship. It recognises and supports health technology companies that are demonstrating the greatest potential to change the way that healthcare is delivered.
Over the past four years, the Global Digital Health 100 has become established as the international benchmark of innovation in the healthcare technology industry. This year's 100 sees many new entrants from all sides of the HealthTech spectrum, from new innovators looking to apply technologies like blockchain and AI to healthcare, to solution providers who are demonstrating rapid growth in more established tech-led services like teleheath.
December 4, 2017
IBM Watson Health (NYSE:IBM) and Tiatros Inc, a digital health company, today announced that the Tiatros-enabled post-traumatic stress disorder programs achieved up to 73% completion rate for veterans who begin the PTSD sessions. The Tiatros Post Traumatic Growth for Veterans is a Tiatros psychotherapy program designed as a secure social network to support veterans suffering from post-traumatic stress disorder. The program connects veterans with their peers online, in a platform that is designed to reduce barriers to access and deliver evidence-based cognitive behavioral therapy that is personalized to each individual, with help from Watson APIs.
January 19, 2017
Brian Silverstein, Healthcare IT Project Manager at Direct Recruiters, Inc. had the opportunity to interview Kimberlie Cerrone, Founder and Executive Chairman of Tiatros, a digital therapeutics company that offers online, clinician moderated, peer group psychotherapeutic programs for patients with treatable mental illnesses. Kimberlie shared about her interesting background, advice for entrepreneurs, the digital health industry, and more.
Please share a little about your background and the company you founded, Tiatros. What was your inspiration behind this endeavor? What was.....
A CEO’s Perspective on Scaling Technology to Bolster Employees’ Resilience in the Workplace
As corporate America rethinks its approach to behavioral healthcare, disruptive technologies are spearheading a new breed of personalized care support that represents the best hope for optimizing employee experiences and sustained engagement — especially in the behavioral health area.
In kind, a broader value proposition has emerged in the corporate integrated behavioral health space. Instead of discussing return on investment in the context of healthcare costs, savvy C-suite executives are now focusing on their people – and their functional wellbeing – as the core mission of value-on-investment analysis that centers on resilience in the workplace and the business impact of organization health.
Simply put, if the mind is working at full capacity, then so will the body — and vice versa. “Behavioral health, a term inclusive of both mental health and substance use, is unfortunately considered by many to still be an ‘emerging’ topic,” says Bruce Sherman, MD, FCCP, FACOEM, Chief Medical Officer, National Alliance of Healthcare Purchaser Coalitions and Medical Director, Population Health Management, Conduent HR Services.
But research is showing that companies should change that perception. Focusing on the mind-body connection is good for business, and disruptive technology is emerging as a game-changer as more organizations embrace a total rewards approach to value-based benefit design plans to attract, motivate, engage and retain top talent.
“The pursuit for enterprise-wide strategic agility is centered on health promotion to improve the health and well-being of employees, their families and communities,” says Karen Moseley, Vice President, Education and Director of Operations, Health Enhancement Research Organization (HERO).
Finding a scalable solution for whole-person health
One of the problems has been that reaching the lofty goals endowed in system-wide health promotion has proven to be an uphill battle. The nation’s largest employers lose nearly $200 billion in productivity each year due to untreated mental illness while spending another $200 billion to treat anxiety and depression in the workplace.
While mental health services are largely accessible in big cities, they are beyond reach for most Americans. More than 30 million people in the U.S. who have treatable conditions cannot access affordable care, according to the National Institute of Mental Health (NIMH). But there are also other factors to consider. The stigma surrounding mental illness, for example, and the critical shortage of skilled psychotherapists, as reported by the U.S. Surgeon General.
About one-third of all chronic disease care expenses are directly attributable to co-occurring untreated mental illness, according to estimates from the Centers for Disease Control and Prevention.
“Improving behavioral health requires a solution that is individualized, scalable, patient-centered and science-based, and that empowers patients and practitioners to work together to address, broadly, the underlying biological systems that have to be balanced to remediate disease and promote optimal wellness,” says Cary Sennett, M.D., Ph.D., President of Medical Education and Research at the Institute for Functional Medicine. “Technology will be essential to that.”
Kimberlie Cerrone, founder and CEO of digital therapeutics firm Tiatros, Inc., was astonished to learn from the U.S. Surgeon General report that more than half of all U.S. counties do not have a single qualified psychiatrist, psychologist or licensed clinical social worker with the necessary training and experience. The San Francisco-based company creates and distributes evidence-based behavioral health and psychological resilience programs that combine the benefits of evidence-based therapeutic and online learning methods; advanced analytics and AI; and the power of peer communities to enable healing and healthier, more successful behaviors.
“This means to me that behavioral health is the horizontal play for all of chronic disease care,” Cerrone says. “If we can lower the rate of untreated mental illness by making the effective, empirically validated treatment universally available, then we would start to lower somatization rates, thereby lowering utilization rates and the cost of healthcare.”
Weaving integration into the solution
The only way to solve these problems is through a high-impact, technology-enabled solution, Cerrone insists – one that is scalable to reach millions of people. Such personalized care is available online to everyone, delivered with consistently expert quality, in the comfort of their own homes, on their own devices, when it works best for their schedules. The experience is social, engaging, and relatable, so many more people complete their programs and benefit from them.
Yet most telemedicine-based solutions lack a critical function – the integrative medicine skill set that can solve the root problem for psychological services. “There simply are not enough people who are trained in psychotherapy to provide the service, even if it’s delivered by telemedicine,” Cerrone says.
Therein lies a real dilemma for corporate America, as the economic costs of mental illness continue to rise and are projected to outpace combined spending on cancer, diabetes and respiratory ailments, according to NIMH data.
“The largest and most difficult-to-quantify part of every corporate healthcare budgets is spent indirectly on mental illness, i.e., hundreds of billions of dollars of healthcare spending on chronic gastrointestinal illnesses, musculoskeletal illnesses, insomnia, pre-diabetic conditions, heart disease, substance abuse, migraine, and other chronic illnesses that are greatly exacerbated by untreated co-occurring mental illness,” Cerrone says.
More companies are offering a variety of behavioral health and resilience solutions to their employees that include mobile wellness apps and on-demand, telemedicine-style clinical services. While these programs work well for some employees, Cerrone cautions that they’re not designed to reach an entire workforce. A large technology company in Silicon Valley, for instance, told Cerrone they cannot meet the demand for behavioral health services on a one-to-one basis without economies of scale and meaningful program elements.
Her company’s cognitive behavioral therapy (CBT) approach is at the core of behavioral economics and behavior change. These elements “are necessary for making any meaningful inroads on controlling costs for employers while improving the well-being of their employees — there is no health without behavioral health,” says Fikry W. Isaac, MD, MPH, FACOEM, CEO, WellWorld Consulting, former Head of Global Health Services, and Chief Medical Officer, Health & Wellness Solutions, Johnson & Johnson.
Heeding a personal calling
For Cerrone, taking a leadership role in behavioral health is part of a personal mission. She developed a keen interest in raising the bar on treatment after both of her sons returned from military service struggling with post-traumatic stress disorder. One of the things she learned is that healing is a social activity, which led to group therapy emerging as a centerpiece of behavioral health treatment and her business model. The approach features eight, weekly sessions of 90 minutes and an aftercare component.
“It’s a scientific fact that patients who are alone and isolated do not do well,” Cerrone explains. “People want to share their stories with others who understand what they are experiencing.”
Tiatros employs a proprietary software-as-a-service platform to create a unique, private social network for each peer group of 12 to 16 participants who have the same health challenges and life goals. It is compliant with the Health Insurance Portability and Accountability Act (HIPAA).
“We put people who have common health challenges and health goals together into a unique private social network, and then we teach them cognitive behavioral therapy skills in a way that is really engaging and relatable,” Cerrone explains. She notes CBT is the best, scientifically proven treatment for common mental illnesses, with over 80% of people who complete a CBT therapy course having positive clinical outcomes and a sustained recovery.
These programs incorporate a variety of methods, including narrative therapy, storytelling, journaling and mindfulness meditation — with components tailored to resonate within each group. For example, some might be struggling with combat-related trauma; while others involve women who are dealing with postpartum depression.
Each peer group is monitored by a trained facilitator under the direction of an expert CBT therapist, and in some cases, a physician of record. Social media-style methods are used to encourage members to form a supportive and nurturing community that is itself therapeutic.
Focusing on people value – not costs
As technology becomes increasingly sophisticated, Cerrone is excited about using artificial intelligence tools and advanced analytics to overcome “the structural barriers to delivering effective mental health care to millions of people in the U.S. and around the world.” Tiatros, which has partnered with IBM to advance the delivery of scalable digital therapeutics for mental health, supports what she calls “the unfettered and untouched capture of structured and unstructured behavioral health data contained in psychiatric evaluations, patient narratives, and patient interactions.”
Cerrone says the trouble with this information, which clinicians use to make treatment decisions for in-person psychotherapy sessions, is that “it’s always been largely discarded because there’s no place to put it into institutional electronic medical records.”
Mindful of this systemic failure, Tiatros collects and manages the data so that it can be mined for clinical use in a HIPAA-secure database.
“Tiatros-enabled services for employers eliminate confidentiality issues while providing a comfortable means for employees to relax into the program,” states Kim P. Norman, MD a practicing psychiatrist, researcher, and thought leader in scalable therapeutics, “The group therapy sessions are a way for employees to learn more positive reactions to life’s large and small challenges and to improve their overall resilience and wellbeing.”
Whereas patients in traditional, one-on-one psychotherapy see a clinician once a week for 45 minutes, most people using the Tiatros platform engage daily, with some engaging multiple times a day. This “creates a psychotherapeutic environment with much more frequent and active engagement,” Cerrone says, delivering a “remarkably high program completion rates and clinical outcomes that are as good, or at times even better than those found in traditional in-person psychotherapy,” she reports.
For example, participants in peer groups consistently reported a 70-75% program completion rate and showed fewer symptoms of post-traumatic stress and reductions in fear and sadness, coupled with significant spikes in joy, by the end of the eight-week program. (See Figure 1)
Employees also reported significantly reduced levels of physical ailments, such as headaches, body pain and gastrointestinal distress that are often seen in post-traumatic stress disorder. Some program participants also reduced their alcohol dependence.
In the end, the emphasis is on quantifiable value. “What we’re finding is we have so much more and better data than the fields of psychiatry and psychology have ever had before,” states Cerrone. “Our customers all anticipate that we will save them potentially a great deal of money,” she continues, “but no one has asked us to document cost savings. Rather, they’re interested in how the behavioral health and psychological resilience programs improve the health, productivity and psychological resilience of their entire workforce. We do this by using several validated productivity and clinical outcome measures, as well as innovative advanced analytic methods.”
In the next few years, Tiatros hopes to improve its approach and integrate bot technology so that it can scale up to meet growing demand across the U.S., and ultimately, around the world. A key objective is to increase personalization of the individual user experience for better clinical outcomes.
Tiatros’ behavioral health work-life resilience innovation lab plans to release to customers the nation’s first Behavioral Health Mind-Body Connection Index — Organization Health Resilience Wellbeing Dashboard — next year.
Mental Health in the Workplace: A Call to Action – Team Resilience at Work
Employers are taking aim at workforce behavioral health strategies and accelerating total rewards action plans to improve the mental health in the workplace via high-impact, high-value team resilience solutions that combine the benefits of evidence-based treatment; online learning; and the healing power of groups to achieve a mentally healthy business.
The annual economic costs of mental health have been estimated close to $1 trillion, per year - mostly in indirect costs related to productivity and the higher costs of associated with other medical conditions. The economic costs of mental illness will be more than the combined costs of cancer, diabetes and respiratory ailments. Importantly, chronic pain affects an estimated 100 million Americans, or one third of the U.S. population and it is the primary reason Americans are on disability. In addition, large employers paid for more than $2.6 billion worth of opioid addiction and overdose treatment services in 2016.
Better work life health and wellbeing outcomes are well within reach based on a few favorable developments, but results won't be truly meaningful unless there's a greater realization of the indisputable linkages between a healthy workforce, the value of team resilience in the workplace, a mentally healthy business and a healthy bottom line.
No more business as usual. The nation of workforce "disruptive improvement" is being transformed by disruptive-minded CEOs, CFOs and HR leaders focusing on work life health and wellbeing impact design methods and imaginative innovations that improve everyone's economic wellbeing and quality of life.
The quest for enterprise-wide agility is accelerating, sparking dramatic improvements in quality, innovation, productive advantage and speed to delivering value. Use of disruptive enabling technology is clearly a game-changer as more organizations embrace a total rewards approach to value-based benefit design plans to attract, motivate, engage and retain top talent. It also will help elevate and balance work-life experiences, igniting an innate desire and willingness to empower working Americans to live well and thrive.
Find out how a large technology company in Silicon Valley was able to meet the demand for behavioral health services on a one-to-one basis with economies of scale and meaningful program elements. Discover how "evidence-based digital therapeutics for behavioral health can deliver quantifiable improvements to the health and psychological resilience of your entire workforce.