AI-POWERED CLINICAL DECISION SUPPORT IN MENTAL HEALTH: Strategic Applications of AI and Analytics in Behavioural Health Systems

Transcript 

Gregory Cave: Welcome to the digital health transformers, podcast where we explore groundbreaking innovations shaping the future of health care. I’m your host, Greg. And today we’re delving into the transformative role of AI and analytics and mental health joining us today is nawal Roy.  

Gregory Cave: founder and CEO of Holmusk, a global digital health company, revolutionizing mental and behavioral health through data and technology. Nawal, brings over 15 years of experience in finance and strategy, consulting to his mission of transforming mental health.  

Gregory Cave: Noel, welcome to the show  

Nawal Roy: Thank you, Gregory. Thank you for having me. It’s a pleasure to be with you  

Gregory Cave: Thank you so much. And, Noel, as I was saying before, you know I did a little bit of research on you, and you obviously have a very diverse background, rich in a lot of areas, but specifically in finance and consulting. I want to ask you, coming from that industry, what inspired you to transition into digital health and to focus on mental health through the founding of homeless  

Nawal Roy: Yes, thank you for asking, and I do get asked that question quite a lot, because one I’m trained as an economist. I’ve spent almost 15 to 20 years in finance. And you know, I have seen the sector at a global scale.  

Nawal Roy: The single biggest factor that was obvious to me was the area that how finance has become extremely data driven. And I’ve seen that transformation happening  

Nawal Roy: so it was more of a sector knowledge. And when I was starting this company or thinking about the something to do beyond finance or exploring into the idea of building something grounds up. Healthcare was becoming extremely appealing to me and the single biggest factor that was standing out, that in healthcare there is no real objective data that gets as the point of discussions for decision making.  

Nawal Roy: and that is where I started with the concept of everything related with chronic disease.  

Nawal Roy: and then layered that with the thinking that in any economy or a large sector. 5 or 6 major disease captures approximately around 70% of the cost.  

Nawal Roy: And if you double layer that and find out what is the biggest comorbidity that is driving the biggest factor. Then you find that mental health is the largest problem that, as of now, as a healthcare sector is not solving. So it was  

Nawal Roy: starting with the data as a vision, and how to really use data as an architecture for building a solution. And then on the back of it, going after the chronic disease, and converging very fast towards mental health, was the iteration for me to build  

Gregory Cave: Wow, I mean, that’s that’s like, if I was gonna pick the most difficult piece within healthcare to go to. It. Seems like that’s it right when you’re talking about the brain and solving those issues. But you’re right. It really touches on everything, and it’s largely been ignored.  

Gregory Cave: for a long time, even in this digital transformation that healthcare is going through so absolutely makes sense. So  

Nawal Roy: If I may add, is the fact that I started this in 2015, 10 years back. Okay.  

Gregory Cave: Right.  

Nawal Roy: access, and a stigma issue was even much worse. I would say, Post Covid. The word has become, you know, accepted Norm. But  

Gregory Cave: Yes.  

Nawal Roy: My intent is always to go after fields that becomes future ready down the stream, and that is why I went after it, even though it was not necessarily a hot topic to go after, you know, but I could see that the future will be ready for it. We can’t ignore this problem, and that has only become far and far more evident now. And it’s only rising up  

Gregory Cave: Oh, that’s a definition of a trailblazer. It’s a it’s a very scary space to go. Very few people tackle it because of so many unknowns, and I want to thank you so much for  

Gregory Cave: diving deep, and I know it hasn’t been easy in the last 10 years, but you seem to be taking the bull by the horn side. I would just want to thank you. From an outsider’s point of view. As far as mental health care  

Gregory Cave: has long, you know. As we’re saying, it’s long face challenges and standardization and measurement. How do you see AI and analytics addressing these issues and transforming mental health, care, delivery, Noel  

Nawal Roy: I think it will be a bit of a tug of war tug of war, because the promise is very high.  

Nawal Roy: AI is a technology and the analytics solution. One, we have seen multi-layer of solution in other therapeutic area, cancer being an obvious example, cardiology being the next one, obesity diabetes. Any one of those areas. And within healthcare, neuroscience and neuropsychiatry really suffers from that.  

Nawal Roy: And hence you will certainly have a very large, almost like a faith level thinking that someone will think around building a chat. Gpt for mental health. Okay, that need is obvious. Okay?  

Nawal Roy: But at the same time every large, real, reliable AI or analytics platform  

Nawal Roy: is built on a quality database that can be used for foundational quote, unquote training model. Okay?  

Nawal Roy: Because if you don’t have a super solid foundational database. Then you will have extremely high degree of white noise and hallucination. Okay, right? Topics that anyone who is the credibility will get questioned. If  

Nawal Roy: the technology could be right. But the outcome may not be anywhere legitimate from clinical point of view, and hence that can create the bifurcation between the expectation. And you know what is the actual happening. But this will be a give and take. And that is what excites me a lot about hallmark from that perspective.  

Nawal Roy: Because, yeah. 

Gregory Cave: Oh, I’m sorry. Go ahead!  

Nawal Roy: If nothing. We have truly made  

Nawal Roy: the 1st scientific grade industrial scale foundational database. For, quote unquote AI platform, there can be so much more that can be built on on the back of it.  

Gregory Cave: Yeah, you and sounds like homeless is really, you’re at the right space to make that kind of very specific platform. As you’re saying, it makes sense, you know, because a lot of industries are talking about going to very specific.  

Gregory Cave: you know, generative AI or Llm, so that you know they get less of the hallucination and the mistakes, as you said so, oh, wow! That’s very interesting. So what do you think are the biggest barriers in today’s healthcare system to provide, you know, and providing quality, mental health care. And in that case, how can AI and digital tools help overcome that  

Nawal Roy: So the very 1st is, mental health is not part of the coverage right now. Okay, it. It doesn’t have parity. So parity is the very 1st challenge  

Nawal Roy: till it has parity. I don’t think, you know, it is going to be anywhere at par with physical health. That’s number one  

Nawal Roy: for parity to really exist. I think evidence is a larger problem. How do we truly answer that what the care delivery partners are delivering is only delivering the volume of the supply, or there is a effectiveness or the evidence of effectiveness. So  

Nawal Roy: I’m trying to not be science focused. But at the same time I would like to draw attention to your audience is, let me draw your attention towards evidence is a larger problem in the mental health community until we solve the evidence problem, which is a semi science problem to solve. We will have challenges fixing parity problem coverage problem, access problem stigma problem. And all of those factors okay  

Gregory Cave: So you know, you make a great point. So in that  

Gregory Cave: collecting evidence or having evidence, obviously, almost, Thomas is doing that. And you’re saying, more companies need to do what you’re doing.  

Nawal Roy: Yes.  

Gregory Cave: Is the reason why more people are not doing it, because it’s not the sexy. You know, part of healthcare. There’s still those kind of  

Gregory Cave: it’s a just  

Nawal Roy: It’s a circular officious problem. Payers will pass the buck to, hey? You know the coverage is not there, so we don’t need to cover, and we don’t have coverage because we don’t know what’s the evidence. You know the providers, as of now. Majority of them will say, Okay, since the insurance is not covering, or we don’t know the rules we are going to play by the way we are playing, so  

Nawal Roy: everyone can pass the buck to next one, and as of now, the sector is in a vicious circle of who will crack. You know the code first, st you know. And where is the entry point? You know 

Gregory Cave: So in your estimation. Who cracks that? And and why would they want to crack that  

Nawal Roy: I would say  

Nawal Roy: it’s in the best interest for both regulator as well as the payer to crack it. Okay. But if I were to really be outrageous. I will say it will not be cracked by existing member. It will be cracked by an outsider entrepreneur like us. Okay.  

Nawal Roy: we are less invested around anything of that nature, and we are truly invested. Almost success is only if the sector succeeds.  

Nawal Roy: sector succeeds only if the evidence problem gets solved.  

Nawal Roy: Our biggest risk is this sector not succeeding, and at that particular time Hull musk will be substandard success.  

Nawal Roy: But if the sector succeeds and becomes even half of it close to cardiology, or 1 3rd of say, cancer. Hallmask will be a mega success.  

Gregory Cave: Hope I hope that’s coming. But I understand what you’re saying by what you’re saying, by the challenges, and  

Gregory Cave: it’s it’s ever present. Hmm! Interesting.  

Gregory Cave: Next question. Noel, I wanted to talk about AI and predictive analytics as it relates to mental health.  

Gregory Cave: So AI and predictive.  

Gregory Cave: Excuse me. Analytics are changing, how we understand and treat mental health conditions. How is hallmarks, utilizing data, driven insights to improve care.  

Gregory Cave: delivery and patient outcomes  

Nawal Roy: Sure. So 1st of all.  

Nawal Roy: what we do is our biggest work is all around. Curation of the data.  

Nawal Roy: Curation of the data is a precondition for building anything industrial scale and scientific grade. So with the highest of clinical and the science being the driver, we are the 1st company who have truly normalized raw data to a data that can be queried in a very serious way. Okay? And  

Nawal Roy: not to be geeky. But that curation is  

Nawal Roy: literally a massive science and technology problem, and we have done it with the highest of the order. And our  

Nawal Roy: proof of the pudding is not  

Nawal Roy: believing what I’m saying, but literally looking at the scientific publications, we have 70 plus peer reviewed plus scientific abstracts, total amount around 20 peer reviewed and approximately around 50 plus scientific abstracts that we have published with the industry stakeholders. Even  

Gregory Cave: Wow!  

Nawal Roy: Independent parties like Oxford and Stanford have used our data to publish. So that rigor and that scrutiny is very 1st condition on it. That’s number one. Okay.  

Nawal Roy: once you have done it, then we truly have worked with every pharmaceutical companies to literally make this data useful, for mostly their phase, 4 studies and potentially for registry and phase 3 studies as we go along. Okay, this database has the potential to become, quote unquote, regulatory database for fdas of the world and emas of the world. Okay.  

Nawal Roy: on the provider side we have been able to help large healthcare system, and it is mostly in Uk with Nhs where our tools have been able to help the hospital system to stratify high risk patient. So how do you stratify high risk to medium risk and low risk patient that risk stratification is very important to really improve the care delivery.  

Nawal Roy: Can it be extended at individual patient level? 100%? Yes, okay. But there comes the the willingness of a partner who wants to go there.  

Nawal Roy: and a commercial machinery that justifies that, as of now.  

Nawal Roy: in mental health, no one is incentivized to improve the care. No one that architecture doesn’t exist.  

Nawal Roy: Okay.  

Nawal Roy: and that is where I’m trying to figure out as to how the science of delivering it versus the economics, 101, or the incentive to make that work  

Nawal Roy: as and when that happens, if it happens tomorrow, trust me, we’ll be the 1st party to go there  

Gregory Cave: No, it it sounds it. And and it’s unfortunate because I can hear what you’re saying. It’s it’s not like a space any other like retail or gambling, or anything where the obvious, the Roi is obvious right here. The Roi isn’t obvious, and that’s where the struggle is ultimately. So you’re  

Nawal Roy: Roi is non-existent. Okay, so Roi on cancer is, you know, if you make the delta, if you can save a patient by even reduce the mortality by even 0 1 basis point all on a sudden that gets reflected in the cost of the care. Okay, both at individual patient level, the impact is obvious on patient level and at a cohort level. Okay?  

Nawal Roy: But it doesn’t exist in mental health.  

Gregory Cave: I appreciate that, I’ll I’ll definitely keep that in mind, because that makes a lot more sense. There’s no question. So in this case. Can you share an example of how a specific example of how predictive modeling or AI driven insights have assisted healthcare providers in making a better decision?  

Gregory Cave: Absolutely. That’ll help you  

Nawal Roy: I’ll give you one of the prime example of a Nhs hospital called Mercy Care. In Uk. They have approximately around 1,000 bed facility and their key task was given. Our front staff and limitations on their staffing, like every hospital system, suffers that they’re looking for is, how do I stratify? Who is my top 100 high risk, patient or top, 50 high risk patient.  

Nawal Roy: so that I can manage and care for them different than others. Okay, we essentially took all their clinical data and converted them into a tool by which their clinicians and the front end staff can use it on a continuous basis into their case, management and care management.  

Nawal Roy: and all on a sudden monitoring and doing it on a continuous basis, has been able to reduce crisis event by approximately around 12%  

Nawal Roy: full independent study on it.  

Nawal Roy: And you can literally take that study objectively done by Nhs not funded by us. And you know, and that study is a prime example of what is sheer potential behind this. And what can be done.  

Nawal Roy: Okay.  

Gregory Cave: That’s amazing.  

Gregory Cave: And especially, you know. So basically in these situations, these are things that  

Gregory Cave: they wouldn’t have norm, they wouldn’t have been able to see otherwise. And obviously this data helped them see things and kind of set things up so that they were ready. Wow! That’s powerful  

Nawal Roy: And this one  

Nawal Roy: we can do for any large healthcare system we can do for Va. We can do, for you know, we can do for jail system and all of those places where there is a high concentration of mental health patients  

Gregory Cave: Yeah, that’s and very well that when you said Va and the the jail system, it’s it really opened my eyes to. I wasn’t even considering that space. Wow.  

Nawal Roy: Look at us, I mean us has approximately 7,000 suicide among the vas every year  

Gregory Cave: You know. 

Nawal Roy: If can reduce.  

Gregory Cave: It’s like.  

Nawal Roy: Percent of that. It’s a lifesaver, you know.  

Gregory Cave: It’s a it’s a huge, huge thing. Wow! You guys, telehealth and remote, patient monitoring have expanded access to care. How is homeost integrating virtual care solutions into its mental health care, model  

Nawal Roy: So as of now, I mean, we are in discussion with multiple parties, and we are very keen to really go that path. We are directly not involved into the care delivery and purposefully so so that we can stay extremely dependent and do the work on the data point of view.  

Nawal Roy: but we would be very open to working with any hospital system, or any remote monitoring platform, either through virtual or through a combination of virtual plus, you know, in insight  

Nawal Roy: to help them to leverage the data that we have. So we have approximately data of 35 million patients.  

Nawal Roy: And there is a lot of learning to be taken as to what works and how to reduce that trial and error in the care delivery.  

Nawal Roy: I personally think that anytime. Any one of these platforms want to go there and are incentivized to improve the care. Then the historical database of 35 million people are going to be extremely useful and relevant  

Gregory Cave: I mean when when I hear you talking and explaining what Homeos does, it almost sounds like  

Gregory Cave: if you have a system, and you’re treating these kind of patients.  

Gregory Cave: How are you not adopting a platform like this? Because, you know.  

Gregory Cave: you know what is, you know, what are you really doing? It’s just kind of amazing. The more and more we think about it. We we talked. I was gonna ask you a question about  

Gregory Cave: real world success story, but I think you gave me that with the 1,000 bed facilities and  

Gregory Cave: but you know, I want to ask beyond patient outcomes, how do these innovations, assist healthcare providers and payers in creating more sustainable, scalable mental health care programs if it can  

Nawal Roy: Yes. 

Nawal Roy: so I would say, a healthcare system. Every healthcare system will tell you that only 5% of my patient pool has mental health. And 20% of the cost is, you know, attached to that 5%. Okay.  

Nawal Roy: that question is a question that every  

Nawal Roy: large insurer as well as asios and healthcare system is struggling with it. And it’s impacting from the system point of view, it’s impacting from quality metrics and from payer point of view, it’s impacting their cost curve.  

Nawal Roy: But both of them are not doing anything to find a solution  

Gregory Cave: I was afraid you were. Gonna say that  

Nawal Roy: Okay. I’m sorry to be that Blunt, but that is the reality right now. Now they are absorbing the cost in 1,000 different ways.  

Nawal Roy: But status quo is not the solution. Not doing anything is not the solution. And right now it’s a massive acceptance of the status quo, and not making any change to do anything.  

Gregory Cave: Wanna ask you a question. That’s a little bit of a of an aside like back in, you know, 2,008.  

Gregory Cave: There was the initiative by, you know, the United States Government to kind of push forward. You know, technology within healthcare and trying to deliver better outcomes. Do you feel like  

Gregory Cave: the Government in some way, and not to get political or anything like that. But there should be some mandate.  

Gregory Cave: That kind of gets a little bit more, you know.  

Nawal Roy: But  

Gregory Cave: Myopic, as far as healthcare is concerned, to push some of these initiatives forward  

Nawal Roy: Absolutely. I can give you 2 precise example on which, if this rule changes, tomorrow, everything will change. Number one is high tech act of 2,009,  

Nawal Roy: 2,009, 2011. Government has given approximately around 37 billion dollars subsidies from epics to certain of the world to really digitize metabolic healths. Okay?  

Nawal Roy: And all of these companies have benefited from that. But behavioral health is not part of that. Okay.  

Nawal Roy: do nothing. Add mental health and behavioral health as part of that subsidy plan.  

Nawal Roy: All on sudden you will find that we have extremely large, full convergence around. Truly knowing what is the coverage of digital health, you know. Literally, you will have patients not on paper and pen and paper. You will have their coverage record on the digital platform. That’s very basic  

Gregory Cave: That’s right.  

Nawal Roy: Number 2 Parity Act was written in 2,008.  

Nawal Roy: Okay, you have almost 17 years passed by, and it is not implemented yet.  

Nawal Roy: Make that real tomorrow, all on sudden, Us. Healthcare. Within 5 years mental health will be as advanced as any other sector that you can believe within healthcare  

Gregory Cave: So essentially, the tools are in place  

Nawal Roy: What was that?  

Gregory Cave: Someone just needs to turn the key. Essentially  

Nawal Roy: And make it real, make it real, make it go  

Gregory Cave: Real.  

Gregory Cave: Well, let’s talk about the future of mental health and tech of. And you know, technology looking ahead, Noel.  

Gregory Cave: what are the most exciting advancements you see in the future of AI. And analytics and mental health care  

Nawal Roy: As of now. There is multiple that is happening number one the sheer advantage that I see is it is no more a  

Nawal Roy: sideline sector. But it’s a sector on which growth is happening on multiple front. Okay? So there are multiple small.  

Nawal Roy: whether it is care, delivery platform community platform knowledge platform.  

Nawal Roy: All of those are rising.  

Nawal Roy: You certainly have escatamine from J. And J. As a drug that is on the rise. You certainly have bms purchasing corona, that is, on the rise. So the drug discovery itself is on the rise and it is becoming success.  

Nawal Roy: But all of these are neuropsychiatry. There is a large amount of risk capital on the biotech side, both from the drug discovery side as well as care, delivery side and caretaking side on the neurodegeneration side. So there is a literally Alzheimer’s dementias of the world, and there is an extremely high correlation between things like cognitive impairment cognition which are related to both sides of the table. Okay, so as a sector, the sector is on rise for sure.  

Nawal Roy: and there is a more risk. Capital. There is a more innovation.  

Nawal Roy: And you are hearing at the second side, you know that. How do we really enhance the capacity of the caretaker itself? So literally using audio technology video technologies around so that we can capture better recognition and the risk factor and the evidence that okay, this person is going up and down through the technologies which is sentient technologies and all those things that can be in the background, but can capture. Okay.  

Nawal Roy: all of those are certainly becoming a more and more reality, and you will see that emerging very, very fast. Okay.  

Nawal Roy: on the cutting edge side. You certainly have. You know, the the machine man interface, and how it can truly change your neural neural circuit. And all of those is really happening  

Nawal Roy: on the data side. Certainly, companies like Hull Musk is, you know, charting. The way I would say.  

Nawal Roy: the very next one that you will see is, how do we combine the data of whole mask with a larger data set which is on the metabolic side. So how do I combine diabetes plus depression data? Okay? And the amount of glp success that you are seeing is certainly becoming very powerful.  

Nawal Roy: and as the compute of open ais and all the AI companies become larger and larger, they will need always high quality data. And so the trend is converging towards Cns becoming a legitimate sector and not necessarily staying as a secondary point in the overall healthcare sector sector, or at least  

Nawal Roy: that’s my belief. And that is where you know, I’m very partly biased, but partly also really extremely focused about it.  

Gregory Cave: It makes sense. And I mean it’s clear that you know. As you said, Home Mosque is positioning itself right there to be a part of that next wave, and and I’m glad to hear that the future is bright. You know it’s not all you know. It’s it’s it’s it’s not a negative thing and and it, just it’s gonna take a little bit more time than we probably want to. But you know, the future is definitely bright, based on what you said is is coming up so.  

Gregory Cave: No, I I just wanna thank you. I’m sorry. Were you gonna say something  

Nawal Roy: No, I was saying that directionally. It’s extremely right, Field.  

Nawal Roy: and you know we are on the right side of the history, if I may say  

Gregory Cave: Yeah, I think so, for sure.  

Gregory Cave: Well, no. While this has been an enlightening conversation, it’s evident that AI and analytics are not just improving mental health care.  

Gregory Cave: But they’re redefining how we understand and support mental well-being on a global scale. So I want to thank you again so much for giving us that insight, really opening my eyes to what’s going on and letting us know about the future. And Home Mosque is clearly at the forefront. So thank you and to our listeners. Thank you for tuning in. Stay with us for more episodes where we bring you the innovators shaping the future of healthcare. See you next time on digital health transformers.  

Gregory Cave: And that’s it. Oh, thank you so much. That was awesome. I I really appreciate the insight you really opened my eyes to some things I I wasn’t even considering, so I thank you for that.  

Nawal Roy: No, thank you, thank you for having me, and if I can be of any help always a pleasure