March 26, 2019
Outside Opinion: We’re Just Talking... With Kimberlie CerroneBy Joe Mandato, Managing Director, DeNovo Ventures Read Full Article
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
March 26, 2019
In this final installment of his series on board governance, DeNovo Ventures’ Managing Director Joe Mandato speaks with Kimberlie Cerrone, an investor, founder, and exec at nine venture-backed companies.
A few weeks ago, to cap off this board-governance series, I had the pleasure of speaking with Kimberlie Cerrone. She brings perspective to the venture-backed company table. She has been a C-level operating executive in several technology and life sciences start-ups and was co-founder and board member at a start-up that went public. She also is CEO and chairman of Tiatros Inc., which she founded in 2011, after her sons came home from military service with PTSD. Tiatros provides safe, effective psychological resilience and behavioral health programs that improve psychic and somatic health and promote personal growth and professional success.
But those aren’t the only experiences that imbue Kimberlie with perspective. She also has an MBA, a JD, a master’s degree in neuroscience, and an undergraduate biochemistry degree, as well as experience as a practicing attorney at two top Silicon Valley law firms.
Joe Mandato: Kimberlie, you are an attorney and have been general counsel. You are also a business person, entrepreneur, and founder. A person can't have a much broader perspective on governance than you do, right?
Joe Mandato, DeNovo Ventures
Kimberlie Cerrone: Well, I’ve made my living as a dealmaker and IP strategist repeatedly helping tiny companies get formed and organized and grow into brand name companies. I think that the development of corporate law is one of civilization's great achievements. When I join a board, I join with the idea that I have a serious role to play.
What strengths do you think you bring to a venture-backed board? In other words, describe your style and how it got to where you're willing to go out on a limb to take action.
I am respectful that other members know more than I do, certainly initially. In the go-go years of the 90s, I served on a lot of boards with venture investors who, as new investors or entrepreneurs, hadn't evolved a skillset to be effective directors. Having learned from that, I start by being quiet for a year or so. I try to understand the business. Then I get more verbal and start asking more questions. Well, actually, I ask a lot of questions from day one, to be honest with you. I ask the same question of a variety of people with different business functions until I think I understand the company. Then, when I'm ready, I try to start adding value.
Few venture investors have accomplished what they want the entrepreneur as CEO to accomplish, yet they often don't recognize their own shortcomings. To that point, are there any gaps in your board experience and skillset?
Yes, of course, I have my limitations. I wish I had a much stronger finance background, and I wish I had more experience with litigation and marketing. Oh, and having a couple of PhDs in engineering and data science would be really useful to me. That said, I'm not sure that early on a Monday morning I'm ready to analyze all my deficiencies other than to say there are plenty. The deficiencies each person has are why a board should consist of multiple people with complementary views and backgrounds.
I will say, I'm always amazed at how few boards understand the company’s customer. I can't tell you how many board meetings I've been in where what the customer needs, what the customer looks like, and what the customer wants, are not part of the ongoing discussion.
Also, in my own company, which is a healthcare technology company, I want half my board and half my management team to be women. It's very difficult to fulfill this aspiration as a technology company in Silicon Valley—almost impossible, in fact, but it’s a worthy aspiration—and I want to do it because the face of the healthcare consumer worldwide is female.
That’s a powerful ambition. I’ve talked about this challenge with others. I’ve been involved with companies that are targeting female customers yet haven’t a single senior female executive. Oh, and they have a male CEO! And often, an all-male board. Wow!
Correct. It's the norm, right? The investors are male. The leadership team is predominately male. Maybe the top HR or legal executive is a woman.
Kimberlie Cerrone, CEO & Chairman,
Another issue that has come up repeatedly on the boards I’ve served on is the extent to which the board operates at the mercy of not just the management team but also the engineering team. I have noted over and over that many companies never ship their first product because the CEO and the board seemingly aren't even aware there is a product ready to ship. This happens frequently with the engineering-centric companies we have in the venture world. The first product comes out only when the engineering team is proud of it. I tend to learn about early products sooner because of the role I play in devising the IP strategy and securing intellectual property assets for my companies. In my opinion, many start-ups would benefit greatly if they put a nascent product into the market, started their branding, started getting customer feedback, and let the product evolve with customers’ fingerprints on it. Unfortunately, that often doesn't happen because Engineering's not proud enough of the product to release it yet. That can be an unfortunate and costly mistake.
Knowledge about the level of product readiness is a huge board-awareness gap, and that’s a risk to a company. Your general experiences with venture-backed company boards leave something to be desired, right? Could you elaborate?
Sure. Start-up boards often consist of one or two early investors, probably the CEO, and maybe the founder, who is often a technical person. These boards have to grow and mature. Going back to my enormous admiration for the sophistication of corporate law, a root problem is that many immature companies have immature leadership. That’s not a big surprise, but it should be addressed over time. They have immature boards that have little operational sense of the difference between the executive team and the board and their respective obligations and responsibilities.
Do you think the board of a venture-backed company has a role relating to culture and leadership? If so, tell me how engaged you get your directors and advisors in the company culture and the day-to-day leadership.
I believe that corporate culture mainly comes from one or two people at the top. It could be the CEO, the founder, or a board member. People on my board were C-level executives in major companies and have operational experience, deep domain knowledge, and worldwide connections. For them, money is not the most important factor. What they told me repeatedly is that they would like Tiatros to be a success. Yes, they would all like to make a great deal of money off of it, but their primary motivation is to see our product in widespread use in the marketplace, helping millions of people heal.
We all think that’s a problem worth solving, and it’s the opportunity we're all focused on. We don't talk about building wealth; we talk about getting good products into the hands of people who need them and changing their lives for the better. That’s a mission worth investing one’s time in.
To that end, our directors and advisors consistently tell me they feel I spend more time and effort giving them the background information they need to understand how to help the company. My goal is for them to want to help the company. I know that they can choose to pursue other interesting and lucrative opportunities, yet, what my advisors have said to me repeatedly is, "You know, you spend time making sure that we're current with the company and that we are actively engaged and really understand the business. You’re not just using my name; you’re engaging me. That makes it interesting and exciting."
I’m sure you've been on boards where there was at least negligence if not willful intent in keeping the board uninvolved and largely at bay, and that's not good for the company.
I have, and I agree, it’s not at all good for a company.
Many times, people have said to me, "Most companies just want me for my name. With you, I can roll up my sleeves and help build this company, and I love it." I have worked in many capacities and been involved many companies—experiences that have helped me build a great network, which is now paying off for Tiatros. We're getting customer introductions at the very highest levels, and our advisor who makes the introduction comes in with us; we work on it collaboratively. I'm not building a company alone I'm building it with senior people. The chances that we’ll be successful go way up. It’s also way more fun.
You’re clearly, powerfully collaborative. Conversely, much of the press covers companies where you've got a charismatic founder who is also the CEO, who is also a dominant shareholder, calling all the shots non-collaboratively. Tesla, Theranos, and Uber are some negative examples. What do you think about that?
I currently have all of those roles and positions. I'm the founder, chief executive officer, and chairman, and between my husband and me, we are major investors in the company. That said, I don't run the company as if I solely wield all those roles and power. I want to build a billion-dollar healthcare technology company. I cannot do that by myself. It’s impossible. I want people to want to help me, and that's what I'm working towards. I am acutely aware that the caliber of people I enjoy working with—board members, colleagues, and employees—have many options in their lives and can vote with their feet whenever they want. I’m grateful that they are choosing to spend their time working with me to fulfill the mission of building Tiatros into a special company. It’s wonderful, and I never take it for granted.
And you're willing to do a gap analysis to bring in the best and the brightest. It seems like you fill your gaps with people who have the skillsets to fill gaps as opposed to, for example, Tesla where Musk has brought in a few people who seem to me to be window dressing. You have people who you expect to hold you accountable to get things done.
Yes. You used the term gap analysis, which is how I think about it. My role in large part is to identify gaps and fill them. It turns out, I'm good at filling gaps, although I’m not always good at seeing the gaps right away. That’s why I have a cadre of people around me who not only identify gaps but also help fill them. For example, one of my advisors recently said, "We really need to build more expertise around a specific competency."
I said, "Yeah, you're absolutely right,” and then my mind went blank.
Fortunately, this person, having much more relevant experience than I, said, "I'm setting up a lunch meeting. Let's bring in my friend who I've worked with for 20 years. She has great expertise and connections. She'll help us think it through."
I’m proud of having that type of culture.
Let me turn to the topic of board composition. What's the right composition? You've constructed yours very consciously. Describe that process, including the diversity component, which I think is critical. You exemplify it by virtue of the fact that you're willing to hire the best and the brightest and put your ego to the side.
I’m not a fan of huge boards for the sake of huge boards. I like deeper relationships. I'm not a fan of celebrities. I'm not a fan of boards that only have financial investors, which is a common start-up board composition. The formula I’ve experienced is two young founders, two, sometimes young investors, and then me at board meetings. Sometimes it works well. Sometimes it doesn't.
I look for depth and social skills, and I look for people who are willing and able to actually spend the time. I remember in the ‘90s, I swear, [a well-known entrepreneur and investor in Silicon Valley] was on every third board in the Valley. I was practicing at Venture Law Group at the time. I never saw him come to a single board meeting, but I recall CEOs talking about how they had to hurry and get him on their board.
On your boards, you've got diversity in backgrounds, experiences, genders, etc. Did you sit down and say, "I need a diverse board, gender-wise as well as skillset-wise," or did it just happen that way?
It was very deliberate. I believe in diversity. As a general principle, it's unquestionably good. You know the data as well as I do, that diverse boards lead to more successful companies. As a woman founder and CEO, I considered it very important that at least two other women directors are on the company board. I have sat through so many board meetings where if there's one woman, her voice gets lost, and if there are two women, the boys gang up on them. You really need three women on the board, in my experience, to change the culture of the board.
So, for me, that effort was very deliberate. I also believe that my customers are people of all economic and social backgrounds, different needs, and I need both my executive team and my board to look like my customer.
That’s very good. Is there one board in particular that in your experience stands out as being especially good?
A board I have observed from a distance and come to admire is the Salesforce board. They're serious people. They've been building a great company for many years, and a few of them have been around since the beginning. It appears to be a very active and cohesive board that knows the business well. They’re serious about diversity. They take culture seriously. I've seen many boards where people come in and, because they were early at Intel or Cisco, are considered legendary investors. But every company is different. I think that type of board experience is awesome when it’s tied to actual knowledge about a company's particular challenges. That's what makes a board worth its salt. The Salesforce board has that. I have evolved my thinking a lot by plain-old copying what Marc Benioff has done.
As for bad boards, years ago I had an inside view of a venture-backed company board that had legendary and genuinely accomplished investors, but at the end of the day, they only knew what the CEO told them. Meanwhile, the CEO management style was such that whoever he talked to last had the biggest influence on him. I saw him as a raft floating in a sea of advice and information. I saw that company drift around with no clear forward direction for years. It was a financial success in that it went public, but it never got a good product to market. It’s no longer an operating company.
My observation is that people sometimes get territorial and hoard information in ways that are counterproductive.
You were involved early on with Yahoo. It’s interesting that you had that vantage point, because for a time Yahoo was a classic example of a dysfunctional board.
I watched it for over 20 years. By the time they were selling the company, some awfully good people sat on that board, and I want to be careful to note that. But I saw for a period of ten years before that talented people leaving the company, voting with their feet because, basically, the executive team and board couldn't lead it effectively. It was a shame.
I understand you aren’t calling out specific directors as dysfunctional; it’s sometimes the dysfunction of the board as an organizational structure and culture within the company overall, not the failure of one individual. How do you feel about people that hold both the CEO and board chair title in general?
Addressing my own ambitions for Tiatros, my goal is as quickly as possible to get out of one role or the other, to either be the chairman of the board and do that job, or be the CEO and do that job. I'd rather do one job well.
In general, would you say you believe that the separation of the two is more effective?
I think so. It's now on me to make a good decision about the chairman of the company. I don't want to bring on someone who is an investor with ten boards to manage and doesn't know my business day-to-day. I know I can do better than that, because my company's really cool, and it’s worth more than that. We are on a successful path, and we solve arguably one of the biggest problems in the world. If we do it right, we'll be able to attract top talent who passionately want to solve this problem. That in turn elevates the chance that we'll become more successful.
On the topic of growth and success, you’ve been through IPOs. When you evolve from the start-up phase to the IPO phase, do the board dynamics change? Does the leadership explicitly change the composition of the board in anticipation of the IPO?
Yes. I'm going through this now as a matter of fact. We recently reached a pivot point where we not only have a few products in the market, but also we're getting fantastic results in terms of clinical outcomes and usage data. We’re attracting the attention of best-of-breed business partners. We're gaining customer traction. The goal is not for me to be comfortable with the board and to feel ‘safe’; it's for the board to push my team and me forward. A great board is a great asset to a company. It’s also a lot of work for the CEO.
Regarding your own personal development as a board director, did you have a mentor who helped you get where you are and taught you how to be a great board member or senior executive?
I’ve had a lot of mentors in my career. You may remember Craig Johnson, a legendary Silicon Valley attorney. Craig and I would go to board meetings together, and he would tell me what to look for so I would see it. After meetings, he would debrief me on what additional dynamics were going on. Being a technology attorney at two of the premier law firms in Silicon Valley after my first company went public gave me the chance to go to many board meetings, and the experience to see what was happening. I repeatedly saw things that worked and things that didn't work.
Repetition is great. It sounds like he gave you good advice. Can you recall any of the specific advice he or others gave you on how to be a great board member?
Craig was very generous with sharing his wisdom with many people. I often remember him emphasizing the importance of giving actionable advice. It’s pointless to tell someone to do something if she has no practical idea on how to execute on the advice. I also distinctly remember us driving back to the office one afternoon after leaving a start-up board meeting and Craig talking about the importance of entrepreneurs working to solve problems that really matter to them. I wish he were here to help me with Tiatros. Cynthia Ringo [of DBL Partners] is another terrific friend and wonderfully skilled mentor to me. She’s been a CEO and an extremely successful investor, and she has made herself remarkably available to me over the last few years. I appreciate that she chooses to spend her precious time helping me achieve my life’s mission.
One of the things she told me, which I have seen often in other people’s companies, was "Boards always wait six months to a year too long to swap out somebody at the top role. There's never a good time to make some changes, but things won’t get better with time. Get it done.”
That’s a big-ticket piece of advice I try to remember.
Venture boards have never fired a CEO too early. Can you recommend any useful sources for a new board member to learn more about board practices, cultures, and meetings?
I would like to ask you that question, Joe! I think you would know better than me. But, meantime, I’d like to suggest that there are a lot of bad resources. Just last week, I told the CEO of a start-up company that she's receiving bad advice. It was obviously bad advice–not a tough call on my part at all. She literally did not understand that she needed to evaluate the advice she was receiving and its actual relevance to her company’s situation. Unfortunately, there's an ocean of bad advice out there. Being able to distinguish between good, actionable advice and somebody's opinion—that's a skillset. I'm getting better at it, and I have terrific people in place to help me.
If you could offer one piece of advice to a founder-CEO who's a board member or chair of a high-growth company that has other people's money, what would it be?
You can do anything you want PROVIDED that you can only do what you can pay for! That’s Kimberlie's first law of entrepreneurship.
Ultimately, the CEO is the only one accountable. The venture investors—they spend this, they spend that, but at the end of the day, as CEO, you're the only one accountable.
Exactly! One of my early investors told me a few days ago, "In about two years, Kimberlie, you're going to be an overnight success." Entrepreneurship is very humbling. You have to have a tolerance for risk, loneliness and ambiguity.
That's right. Kimberlie, this has been very special. I really appreciate your time. What comes out clearly is that you bring a deeply human component to what you do and how you think about business. Having been a Captain in the Army Medical Service Corps, I have some appreciation for what you're doing and why you're doing it—thank you!
That's wonderful to hear. Thank you, Joe!
As mentioned, Kimberlie has been on the executive team of nine venture-backed companies. In two of those─Neurobiological Technologies Inc. and Net Perceptions)─she had involvement from start-up to IPO. She has also served on several corporate and non-profit boards.
You can hear a brief clip of our conversation here.
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.