[TT 034] purifying houseplants, microexpression AI, costly healthcare, psychedelic patents, skin art
Hello again Thrivers,
I'm back at university, and this quarter is an exploration of communication skills and US healthcare through a lens of social impact and entrepreneurship. I'm also utilizing our cadre of coaches to revamp my LinkedIn profile, dial in my professional narrative, and craft a productive ask. These tools combined with my expanding network will inform my independent research project next quarter.
Just for a taste: this quarter I'm taking a writing class with a New York Times editor, a communication class with a former producer of Good Morning America & The View, a healthcare strategy class with the former CEO of Kaiser Permanente, a healthcare technology class with a prolific doctor economist, and a digital biodesign class with a vascular surgeon & a successful health technology entrepreneur. Wow.
Much to learn. Even more to do.
With recalibrating focus, let's zoom in to this week's Thriving Thursday.
On the placebo of purifying houseplants
It's often cited that house plants are good for purifying air - is that supported by scientific inquiry? Turns out, not really for ozone but possibly for 2.5PPM particles when there are enough plants.
To get an appreciable effect in a standard 15' x 15' room, you'd need something like an entire wall of plants. But there is no scientific clarity yet on what plants are the best air filters.
On the plus side, a simple survey suggests indoor greenery supports mental health. Indoor plants definitely make me happier.
I learned that lesson in undergrad. During New England winters I'd get SAD until my brother gifted me some houseplants plus full spectrum light bulbs. Hard for me to tease apart primary and secondary causes, but I immediately felt happier and more stable with plants in my dorm room.
I also brought plants + full-spectrum bulbs to campus this go around. My plants can't compare to a powered HEPA filter for fire smoke days, but I sure am happy to have them here with me.
On tech-forward personalization of coaching & therapy
The last 2 years have accelerated the adoption of telehealth technologies, especially in mental and behavioral health services. So far, that's mostly been focused on coaching, therapy, or psychiatry visits through Zoom.
I predict in the next 10 years consumers will start seeing artificial intelligence in mental and behavioral health. Specifically, computer vision algorithms will scan my face for microexpressions (mentioned in TT 029) while natural language processing will parse my words for psychosocial profiling. Machine learning will serve me a hyper-personalized care plan with the most effective sequence of content, interventions, and check-ins based on my biometrics, psych profile, and ongoing engagement with previously offered content. Most importantly, all this data will be collected passively through wearables and existing interactions like video calls.
On the continuum of care, this will be useful for individuals exploring solo, folks working with coaches, and patients working with licensed professionals. For counselors or psychiatrists, this will be useful for between-session "video diary" entries as well as real-time during a session as a faster feedback loop to improve communication and outcomes with their client.
The AI technology isn't quite there yet, but it's only a matter of time until calibrated machines can read our inner emotional landscape as expressed through our body and verbal language. I already know some companies (like Babylon and Ginger) and projects that are taking primitive baby steps in that direction.
I have no doubt this is coming, and relatively soon. My main question is how to steer these forces in the direction of uplifting and empowering human Thriving.
On the spiraling costs of US healthcare
US healthcare costs over the last 30 years have ballooned 6x in per capita, inflation-adjusted dollars. From 2000-2010 things were looking really bad and it seems like there has been some cooling of the national cost growth in the last decade.
Sadly, costs for individuals continue to grow as a percent of income. In 2020, an average family of four spends 20% of their income on healthcare. According to one of my classes, that's up from ~8% just 20 years ago.
This New Yorker article from 2009 compares two Texas towns, El Paso and McAllen. McAllen is the highest cost per patient in the US and El Paso is roughly average, even though their population, demographics, and health indicators are roughly the same. So what explains the difference?
The author Atul Gawande, a practicing surgeon and long-time contributor to the New Yorker, pointed to a number of considerations but I found one especially compelling: when doctors and specialists have more collaboration, costs tend to go down. When providers are siloed, they tend to over-utilize costly procedures.
After some provisions in Obamacare, we are starting to see more value-based payments instead of the fee for service described in the article. At least partially that explains the slow down in US healthcare cost growth in the last decade.
Another critical issue is huge price variances for the same procedure with no transparency. Some procedures cost more for insured patients than those without insurance. Others can vary as much as 10x cost difference with absolutely no difference in the quality of care.
I'm especially interested in how this finding maps to the continuum of care in mental / behavioral health. The vast majority of mental health providers are working on their own, siloed from other medical or relational contexts. They also operate on a fee-for-service basis - every hour of counseling (service) gets a fixed fee from the insurance or out-of-pocket payer. And, on a smaller scale, the same exact therapist makes different rates based on the negotiated payout cap with each insurer.
Given the rapid rise of mental health services post-pandemic, I think there is going to be a lot of attention to not repeating the same mistakes from physical health. We can do better for patients and their pocketbooks.
On extractive threads weaving into the psychedelic tapestry
In last week's newsletter, I noted a fictional story "We will call it Pala" regarding a psychedelic clinic company that goes public.
This isn't just fiction. Compass Pathways has questionable ethics in legal structures as well as patent filings and they have already gone public (ticker: CMPS).
Psychedelic patents are heating up and according to Psilocybin Alpha's patent trackers, at the time of this newsletter there are 71 psilocybin, 59 MDMA, and 64 DMT patents published or pending. Chances are high that these numbers will balloon in the next 24 months.
Shayla Love does a great job balancing the discussion on patenting psychedelics. In short, it's nuanced and complicated with no easy or obvious answers. Still, some things definitely feel sketchy beyond tolerance.
That's why it's so important to lay the foundation of ethics now before the industry becomes too unwieldy to steer. I deeply admire the North Star Ethics Pledge (can we have this for every industry?!) and the dialogue swirling around regenerative, purpose-driven, and steward economics.
As it relates to Pala, I think the story is equal parts beautiful and terrifying. Every step in the progression is perfectly understandable though the final outcome is devastating (for no other reason than I could easily see myself in those shoes).
And, without any doubt, we will see tech-forward psychedelic treatments within the next 10 years.
On inking one's own skin
When I was a kid, we would draw on our skin when we were bored in class. But nothing like artist Randa Haddadin with this collection of ink on skin drawings. Some of the flower and dancer themes are deeply evocative whereas the contrast of architecture on human skin gives me some serious cognitive dissonance.
Randa does much more than just skin, and her Instagram is pretty impressive.
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Together we embark on another quarter of exhilarating discovery. In the words of my writing professor, may you feel positive and test negative.
Transparently yours,
~Henry