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In the midst of a global pandemic, one, social interactions are limited and many of us only have access to basic necessities that are deemed essential. More and more individuals are pivoting to online therapy to deal with anxiety, depression and overall strife. Ronnie Frank, the co-founder of Talk Space, joined IT visionaries to discuss how their app is filling an important gap in the health care industry and how technology is providing people the help they need at scale.

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Enjoy this episode. It visionaries is created by the team at Mission Dog and brought to you by the Salesforce Customer 360 platform, the number one cloud platform for digital transformation of every experience, build connected experience, empower every employee, and deliver continuous innovation with the customer at the center of everything you do. Learn more at Salesforce.com platform. This podcast is created by the team at Mission Dog.

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Welcome to I.T. visionaries Ronnie, how are you? I'm good, thank you. How are you?

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Great to have you on the show today. So we are going to talk about your background, your transformation here from from software engineer to founder and all of the amazing things that you have been doing it talk space. So let's get into it. How did you get started in technology?

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So my career before talk space was completely different. I graduated with a computer science degree and worked as a software developer for about seven years and books and is a global telecommunications company. And my journey to the mental health world started when my husband Orrin, who is, by the way, is my co-founder. When Orrin and I experienced a crisis in our relationship, our marriage was falling apart and we decided to give it one last chance in couples therapy, which literally saved our marriage therapy, helped me in so many ways.

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I mean, not only saved my marriage, but I've also been introduced in individual therapy. And for me, it was so empowering and so valuable. And that inspired me to leave my career as a software developer and go back to graduate school in psychology. I thought, I want to be a therapist. It was not an easy decision to leave my career in the high tech industry, but I felt empowered to make different choices in my life that are more aligned with who I am and what I'm really curious about.

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And I was looking for a purpose. So I started my master's degree in New York and psychotherapy and psychoanalysis. And about two years into my master, I realized that the mental health system in America is completely broken if you want. No one in four people are diagnosed with mental health issue each year. Usually it's depression or anxiety. However, 70 percent of them have no access to care, which is a disgrace. We're talking about tens of millions of people that cannot access mental health services.

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So I and I, we're passionate about fixing this problem, mainly because because of our own experience, knowing how valuable it could be, we we wanted to solve this gap and to open access to quality mental health care to every person in need. And this is how the vision of the company was born.

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And so flash forward to today what is the size and the scope of the company?

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So today we served over two million people so far and we have a network of over 5000 licensed and credentialed therapists and psychiatrist.

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Wow, that's incredible. What is your your current role as obviously co-founder? So but head of clinical services, what is your day to day look like?

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So I'm head of clinical services. It means that I'm leading the supply side of the company, which is a network of over 5000 licensed and credentialed therapists and psychiatrists. And I'm also leading the quality of our service, which is all about ensuring quality at scale.

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And so I'm leading quality and the network, as you're trying to figure out how to solve this problem, you know, obviously you have a tech background, so there is going to be a tech piece of the solution. But it seems like a lot of the problems that are that are going to be solved are outside of the tech. Right. So how did you kind of balance those two things?

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So, you know, in order to fix a system, you need to understand why it's broken. In other words, why millions of people have no access to mental health care.

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So we did our research and learned that there are three main barriers to traditional mental health care. The biggest barrier is cost, which is not surprising at all. Traditional therapy is very expensive in the US. The cost of face to face, usually around fifty minutes or so, face to face, 50 minute session is anywhere between two hundred to three hundred dollars. That's a price point that most people cannot afford.

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Yeah, the second is access and convenience. Think about people who live in remote areas. Think about people with disabilities who cannot leave their house or even, you know, just to find a therapist. And even if you find a therapist, you may need to wait a few weeks before the next available appointment and. When you're dealing with pain, you need help now, maybe tomorrow, but definitely you don't when you don't want to wait a few weeks before you can see a therapist.

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Imagine that you broke your leg and the doctor told you that they can see within three weeks. So this is really unacceptable. So overall, I can say that traditional mental health service is not accessible and not convenient. And the third barrier is stigma. Unfortunately, even today, many people feel ashamed about their mental health issues and prefer to suffer in silence instead of reaching out for help. So after learning about the barriers to traditional therapy or and I started to explore how technology, how a digital platform could remove those barriers, such as cost convenience, access, stigma to make mental health care accessible and affordable for all.

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And we launch our first product in 2012, so with the first products look like that's a great question. The first product that we launch was scheduled live sessions. Our intuition told us that instead of seeing a therapist face to face, you can just and seeing them buy a video session. That's what our intuition told us. And so we launched the first product in 2012. Basically, we had a website and there were photos of therapists. And all you needed to do is to click on a photo and schedule and schedule a session for a session.

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And what happened is that we launched we're launching the product and we start seeing. People signing up, but no one is purchasing a session and we don't understand what's going on. And so we're trying to improve the website and to improve the design design and to change the therapies and to do many things in the product that would allow us to sell video sessions. And nobody's buying a video session. And we're very frustrated and worried.

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You know, we we spend already a lot of money on this product and about this or I would say even eight months into it, we realized that we failed, that we have a big problem and the product is not working. And then something very interesting happened, I always call it our aha moment, you know, in the beginning, founders are doing everything. And I was also behind customer support. And all of the sudden I started getting. Emails from our users sharing with customer support about their psychological emotional problems.

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So instead of scheduling a live media session with a therapist. Clients starting started sending emails to customer support, and I was completely confused because customer support is all about technical support, right? So we didn't know what's going on. And we just I just started asking them, why are you not doing it, scheduling a lively session? Why are you staring at this customer support? And then we learned two things. One, that they thought with customer support, meaning customer like clinical support.

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So that was one confusion. But more importantly, we learned that they want to. Text or to message with a therapist, they don't want to schedule a lively session, they want to be engaged whenever it's working for them, when it's convenient for them and when they feel the need and they just find it way easier to write about their issues and wait for a response from a therapist. So. This basically inspired us to revamp the whole modality and to launch a new product that we called unlimited messaging therapy in twenty fourteen.

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So it was a big failure, but we learned so much from it.

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And I can tell you that as a founder, when you are in this world of innovation, you are going to test and experiment many different ideas and you are going to fail along the way. And it's so important to embrace failures and to to learn to see what you can learn from them and how to improve, because failures are going to lead you to success. We learned from this failure that, you know, we love. We didn't want to give up the mission.

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The execution was wrong and our intuition was wrong. So I always still found you always have to support your decisions based on data and based on feedback. You cannot assume that you know better than your clients what they need. You need to ask your clients, do you want to do video or do you want to detect do you want to do audio? How do you want to communicate with a therapist? How often do you want to communicate with a therapist?

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You always need to remember that they know better than you. And on the base and clients feedback and data and engagement, you can make decisions.

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Yeah, it's so interesting that a lot of the assumptions that you are making end up being proven out in totally different ways. You know, you say, hey, I think you'd you'd assume that people would rather just like take video and and and pop it up because that's that's more like a face to face visit, but is actually the exact opposite. So what where did that take the product from there? You know, obviously you have an app now kind of share more about like the app development and and what what that looks like under the hood.

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I want to explain, because I think it's very interesting and it's very relevant to the whole product development. Why clients opted for missing messaging therapy versus video therapy because. DARBYSHIRE Because we we, of course, conducted many surveys because we really wanted to learn from our clients what are the needs and develop more and more features based on the feedback and based on the data. So when we ask clients why they prefer messaging at a time, we ask them, why do you prefer messaging?

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And with a therapist over scheduling a session, they mention and the following reason. One reason is that they say they love the flexibility and convenience of messaging, the fact that they can do it any time, anywhere on the go in the middle of the night. They don't want to commit to a certain day and time. Basically, they want to communicate with a therapist when they feel the need, when they're available. For example, some of them say, oh, I want to communicate with the therapist during lunch, lunch break at work, for example.

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That was before the pandemic. But this is something else. So what can it give them full control on their schedule? So this is a big reason why they wanted messaging therapy. And now another reason is that they say measured messaging allows them to open up when it comes to highly stigmatized issues because it feels more safe to message with a therapist from your comfort zone, your own couch, you know, where you feel very safe and you have a lot of privacy versus looking into the therapists eyes.

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It's less intimidating and helps them to get over the shame and open up. And the last reason they love the immediacy of messaging, they can message a therapist in real time. For example, if you feel stressed out anxious, you can literally grab your phone and start sharing your feelings with your therapist. You don't need to sit in pain and wait for your next appointment. So and the therapist is always going to respond to you same day, five days a week.

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So basically you are working on your issues almost in real time, which is very therapeutic and enhances the clinical outcomes.

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So I'm curious, on the other end of that transaction, though, then you have the platform for the therapist, right? So then they're going in on the other end of that message on their normal nine to five, I'm presuming, where they would then be able to hop in or is it like twenty four, seven?

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We built a feature for the clients and it's also for the therapist. It's called Replied By. It's all about setting expectation. So the platform tells the client until what time the therapist is going to respond to them. So for. Let's say you messager therapy, 3:00 p.m. AM, and then you will get and Platero will send you a message, your therapist is going to respond to you by midnight tonight, for example. So there is always a window for the therapist to respond to and it gives them enough time to read your message process processing and and respond to you in the most therapeutic way.

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I can share with you that based on our data and client and therapists are communicating five days a week and up to three times a day. That's the average customer. Wow, that's incredible. That's so critical. So I'm curious then how so how are you matching people with therapists in order to explain how we're matching?

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I'd like to say a few words about how you sign up, because it's very relevant to your questions so you can sign up through our website talks with dot com or download the app for both iPhone and Android. Once you sign up, you will start a free consultation with a licensed therapist who is going to assess your needs. And a consultation therapist will ask you a few questions about the issues you are dealing with, your goals and your preferences regarding your therapy, such as male, female or anything that is more specific.

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And of course, they will discuss with you the different services we're offering and what is the right service for you based on all the information that they are providing after the user purchase the service, whether it's therapy or psychiatry or couples therapy, we are going to match you with a therapist who is the best fit for your needs. And we have a very sophisticated matching algorithm that takes into account all the information you provided during consultation to identify the top three therapist based on their performance, all on the platform.

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And I'll explain a little bit about it later. So you will get the top three therapies that are best matched for your specific needs and you will be able to choose one of them based on their entire video, bio photo reviews, etc.. We believe that Biotherapies into video and bio clients are able to feel if there is some kind of connection with one of the three, which is which would make the match better. Once you select your therapist, you can start messaging in your private chat room any time as much as you want without the need to schedule an appointment.

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Now, I want to talk a little bit about how we are managing the quality on the platform, as I said, and the talk spaces mission is to open access to quality mental health care. So how are we managing quality scale talk space is a data driven platform and it allows us to manage quality scale based on a few metrics. Number one, clinical outcomes. We are tracking client progress on the platform and therapists can see whether or not clients is making progress as expected.

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And if not, they will make a change in how they intervene. Either metric is client satisfaction with the service and with the therapist based on their feedback therapists rating and more, and client engagement, of course, how engaged clients are with the platform, with the treatment. Based on those metrics, we've built a quality formula and we're able to define who are our top performers talk therapies on the platform and we will refer more clients to them. And this is how we can ensure high quality care.

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So if I'm going back for a second to our matching algorithm looks on both the client needs and the client preferences and who are the top performance. So it's a combination of client preferences and quality that provides the best match for you.

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So I'm curious then, you know, obviously of the algorithm working there to figure out matching and all the criteria that you kind of identified.

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What are some of the success metrics that you look at for how folks are engaging? How are they getting help? How are they getting support? What are success metrics that that matter to your team?

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So it's basically what I just mentioned. We're looking at three metrics and define success. The most important one is clinical outcome. Clinical outcome means that we're tracking client progress on the platform. Every three weeks, client are feeling out and in the service industry, standard assessments and we can see trends over time whether or not you are getting better. This is a very important metric, clinical outcomes and of course, also client satisfaction with the service, with the service by a client.

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And and we're looking at the data and we're measuring client engagement. How many posts are messaging a week? How many words? How many a day? What is. The right level of engagement and between declines and the therapy that would ensure good clinical results. So based on our data, we know today what's working, what's what's not working and how therapy on our platform should look like.

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So Michael Phelps is involved with the company. I'm curious, how did how did all that go down?

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The partnership with Michael Phelps was very organic. Michael Phelps, the biggest athlete of all time, went through a life crisis and therapy, saved him, literally saved his life. And he realized that he can help so many people and save people's lives if he shares his story. He knew how powerful it would be for people to know that he went through this experience. And this basically became his life's mission because he really passionate about helping others and it gives him so much purpose and meaning.

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So this partnership is a deal because we have the platform that can open access and provide high quality mental health services in scale. And Michael Phelps is so helpful in increasing awareness and reducing the stigma. And because it's so organic and because our values and missions are aligned, that's why this partnership is so successful.

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So what about in machine learning?

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What what types of things are you working on with those, you know, machine learning and artificial intelligence are revolutionizing health care? There's no doubt about it. Machine learning is trained on historical data to find patterns and then apply those insights to predict anything from diagnosis to the most effective treatment plan for a specific patient. In other words, basically, basically, those models say that based on data, patients that look like you benefited the most from this or that treatment.

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And this is a powerful prediction, that health provider to deliver better care. At Talk Space, all this therapy data is collected on the platform, and with over two million people, we have large volumes of data. And with machine learning models that we built and are still building, we can help our providers to deliver better care in a number of ways. No. One, in making more accurate diagnosis, we developed a patient diagnostic profile. The wonderful example may may score a patient high for anxiety, depression and OCD with lower level of panic disorder.

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This is just an example. And number two, better treatment plan. We can predict what would be the most effective treatment for a specific patient with a specific condition. So this is really personalized care. Number three, better patient engagement recommendations such as this patient would benefit more from text over video. How many messages a week would be ideal for this client? What is the best time during the day for this patient to interact, etc., etc., all about how to engage clients?

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So I can tell you that A.I. and machine learning applications are not going to replace human professionals, but there are going to empower them, empower them to make smart decisions regarding care, and as a result, patients will get better treatment and better results. So it's very, very powerful.

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OK, let's get into our lightning round. These questions are fast and easy, just like the Salesforce Customer 360 platform. We love Salesforce, check him out, go to Salesforce.com slash platform to learn all about Salesforce Customer 360 platform. They've been with us since the very beginning. We love them. Go check them out if you haven't already. Lightning round questions. Ronnie, are you ready?

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Mm hmm. Number one, what app on your phone is the most fun?

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I'm addicted to podcasts. I'm listening all day to podcast. There you go.

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What about your favorite one day getaway? Just a fun day with my girls. What is your hidden talent or passion?

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Well, that's a good question, and I'm really passionate about my work. Honestly, it gave me a lot of purpose and meaning, and it just makes me very, very happy.

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Final question. What? Do you feel like. Is the future of. Telehealth is covid-19 is a game changer for the telehealth industry, the coronavirus pandemic shows a dramatic increase in mental health issues and at the same time, traditional services were not accessible anymore due to quarantine and social distancing. So those two factors together put a lot of stress on a system that was already broken. And this new level of crisis exposed even more the weaknesses of traditional mental health services, and that created an unprecedented mental health crisis in the country.

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As a result, consumers as well as providers started looking for remote solutions. So as people are turning to remote solutions, they're experiencing the advantages, the benefits of digital mental health, where they see that not only is it safe, but it's also more affordable, more convenient. And at the same time they are receiving high quality care. So they realize that those services may be better for them than traditional services for a variety of reasons. And there is no real no real disadvantage.

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So it would make no sense for people to go back to expensive, inconvenient, traditional services. And that's why this is a game changer for telehealth. It's such a dramatic event that it's forcing consumer to change their behavior, which leads them to experience a new service that has so many advantages and that leads to accelerating the adoption of remote care.

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Also, Romney, thanks so much for coming on the show. Really good having you on. And we'll talk soon.

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Thank you so much for having me. Take care. It visionary's is created by the team at Mission Dog and brought to you by the Salesforce Customer 360 platform, the number one cloud platform for digital transformation of every experience, build connected experience, empower every employee, and deliver continuous innovation with the customer at the center of everything you do. Learn more at Salesforce.com platform.