Using Biometric Data to Improve Recovery Outcomes

Using Biometric Data to Improve Recovery Outcomes with Eliza Foltz, Chief Revenue Officer, Pretaa, and Michael Madon, Chief Executive Officer, Pretaa

Better Connections. Better Outcomes. Pretaa shares how they are utilizing wearable technology data to produce better connections and outcomes for those in recovery. To quote one of the testimonials, “with these insights, we are able to provide the right intervention at the right time, leading to better outcomes”. Utilizing insights from the biometric data, clinicians are able to provide better care. It allows the patient opportunities for self-learning, and provides them with better support and accountability.  This is an interesting conversation showing us another way to use technology.

Transcript
Terri
Welcome back, everybody. Our sponsor today is IMI. IMI is the manufacturer of the industry leading prep lock line of tamper evident caps, which are an active deterrent to diversion. Using these caps and their tamper evident capping station, tamper evidence security could not be easier today. My guests are from Pretaa, Eliza Foltz and Michael Madon. Welcome to both of you. I want to start with where did the name Preda come from? And then we’ll hear a little bit more about you. But actually, I guess let me tell the listeners. They’re taking some of the standard information that you can get off of your Apple, Fitbit, Garmin, watch, that type of stuff, and apply it to substance abuse disorder and the recovery population. So I’m really looking forward to hearing their ideas and what they’re doing, and that’s why I invited them today. But I’d like to hear a little bit about how you came up with the company name. 


Terri
So, Michael, can you tell us and get us started? 


Michael
Sure. So thank you so much for having us. We’re excited to be on and share our as most this won’t come as a surprise to most people who are in this space, but the company name and actually the idea from a company very much came as a spiritual moment. Some would like to call it a God moment. And that’s how it happened, by meeting the right people at the right place. And a lot of it happened on a plane even before the plane was taking off. So when Preda first started, it actually started as a sales enablement tool. I had retired from the military and certainly like most of us, and Eliza can share her story too, have had personal experiences of loved ones struggling in recovery. But I was in a very different headspace. And we started Pretaa derived from the word prep, meaning ready. 


Michael
And we thought, all right, let’s help salespeople sell more stuff, and then had some incredibly intense moments meeting the right people at the right time and realized that was not the calling for the company, it wasn’t the calling for myself. And we pivoted 180 degrees. It wasn’t overnight. It was on a plane. It happened within about 30 minutes and decided to when I left the plane, I met an incredible woman who had on the plane, I had met an incredible woman who had lost her daughter to a fentanyl overdose and had just emotions, like rushing through and pivoted the company right there on the spot. And so walking off the plane, I began to call the people in the company and saying, hey, we’re pivoting our entire mission and this is what we’re supposed to do. And so people were completely supportive. And I called our team, our Dev team, which is india, who I’ve worked for years with and great teammates, and I called up the senior engineer and said, we’re pivoting. 


Michael
And there was a silence from him which I was really surprised about because out of all the people, I didn’t think that awkward sort of silence would come from the engineers. And he said, you know, michael Preda is also known as hungry ghost. It’s the Sanskrit name for a type of supernatural being described in and he’s Hindu described in Hinduism and also Buddhism and Taoism for those ghosts who are suffering greater than that of human beings, and especially suffering from want and desire and craving. And there’s actually a very well known book in the industry called A Hungry Ghost by Gabor Mate, which I’m sure many people on this call have read. And it just blew me away that there was a spiritual connection across time and thousands of miles to the name. So we, of course, kept the name, and that’s where the name comes from. 


Terri
That’s pretty cool. Another confirmation that your pivot was a great idea to stick with. Yeah, quite a pivot from sales to something like this. So, yeah, sometimes airplane rides can be pretty incredible if you’re sitting next to stories like that before that something happens during those. Okay, so, Michael, you mentioned a little bit about your background in the military. Is there anything else you want to add about your background? And you kind of told us why you do this. 


Michael
Sure. So theme across my history is behavioral analytics. So in the Army, I spent most of the career looking at behavioral analytics about people and how people are doing changes in behavior, understanding baselines of human behavior, and then also moving that to the Cyberspace and looking at changes in ones and zeros. Baselining what normal is in terms of cyber behavior and then really identifying and analyzing that behavior. When I left active duty, I joined the Treasury Department, and I ran intelligence for the Treasury Department. People on this call might know of some of our work now with sanctions against Russia, North Korea, Iran. So I came from that space. But what were doing there was looking for anomalies and behaviors of money flows and looking for baselining what’s normal and looking for differences there. When I left the Treasury Department, I was an early member of a company that was a behavioral analytic company that looked for differences in people at work and looking for folks at work who might not be doing the right thing or may not be doing well. 


Michael
And then I then started a company that was a training company, cyber training company, which most people, I’m sure, roll their eyes about, but we used humor to help engage people because we realized that humor is an incredibly powerful motivator. But it was the same thing. We were baselining normal for how people took training and looking for differences and identifying those differences outside of normal. The preda of today, looking at someone’s biometrics and baselining what normal is, and then when something might be concerning or at a minimum, deserve attention in a conversation is a natural progression. So I’ve been looking at the human condition for roughly two and a half decades. 


Terri
Wow. Okay. All right. And we’re going to talk more about how we translate that into your product. All right, Eliza, tell us a little bit about you, then. 


Eliza
Yeah, absolutely. Thanks again for having me and having i, you know, grew up pretty normal family. It’s a story you hear a lot in addiction. I come from more the lived experience side. I played three sports, got great grades. Early on, there were definitely signs that addiction was present, but I kind of got away with it because I was a great athlete and I was really good at studying and really good at school. And so I went to Brown. I played ice hockey on the national team, got injured, prescribed OxyContin. So it changed from partying kind of like acceptable college drugs, drinking, party stuff to something different. It was when I lost a big piece of my identity as an athlete, and I was prescribed OxyContin in the heyday of when prescriptions were abundant easy to come by and doctors maybe didn’t know some of the things that they know now. 


Eliza
So it grabbed me very quickly. To make a long story short, it progressed into an absolutely crippling heroin addiction that took me the better part of well over a decade and into a second decade to beat. I went to nine different treatment centers. I had basically given up. My family did not give up, and they kept trying. And I met my husband, who’s also in recovery. We got pregnant, and I was still using. And so because of an amazing connection with a provider that I had met, I ended up getting into a great program that is a reputable mat program, a really good program for methadone and pretty good for pregnancy. And all of a sudden, things got a lot better. But I also understand I’ve seen both sides of this. So methadone absolutely saved my life. I was able to take all of the amazing pieces of my career that I had before. 


Eliza
I had these periods of addiction and going back to treatment. I had these bright spots. So I led sales at a tech startup. I worked with MIT’s Media Lab to develop a wearable in autism, the developmental disability space. And I was able to leverage that, hopefully into helping people and saving a lot of lives. But I’ve also seen on the diversion side how difficult it is for pain clinics, methadone clinics that are prescribing and dispensing these medications, how challenging that can be to make sure that people are doing that using those correctly. So while Sud and Sud treatment has these amazing tools, they do need to be handled with care and almost reverence to make sure that they’re used appropriately. 


Terri
Wow. What a fascinating story. And nine recovery programs. Wow, that’s a whole session in itself. I guess I’m guessing that part of the time you just weren’t ready. But it also maybe wasn’t the right type of treatment for you. Being pregnant made a big difference, I’m sure, but even then, that takes a lot of fortitude to push through that. So there had to have been more going on. And as you said, a great provider. And I didn’t realize you had a background then in wearables with MIT. So you lived it and so you’re bringing it, but you have that background to bring to the company too. So what a great team between the two of you? Seems like you’ve got a lot of it covered, so that’s great. Okay, so tell us about the product. What types of things do you monitor? How do you use those data points to signal a problem? Give us an overview. 


Eliza
Yeah, absolutely. So we take off-the-shelf wearables. We do have a strategic partnership with Google, but we are device agnostic, so we can use right now Fitbits. We’re going to be rolling out with Apple. We’re exploring garmin. So we take off the shelf wearables and we use our software and our behavioral analytics to help improve outcomes. So our mission at its core is to save lives by providing the right intervention at the right time. Sud treatment, you mentioned that nine treatments. So part of it was I wasn’t ready. And then a big part of it is, and this is the problem generally with Sud treatment, we are treating a chronic progressive disease with an acute solution. It’s basically the equivalent of sending somebody in for 30 days is really no different than saying, oh, you’re going to get surgery, we’re going to remove this, and then you’re going to be fine. 


Eliza
Up, done, good luck with your life. Not the way that this works. So really the problem that I had continuously was I did well in treatment. I got comfortable in treatment. I knew how to do treatment. It was after I didn’t know how to live and I didn’t know how to apply what I learned in treatment to the rest of my life. And when you’re in this bubble, life is suspended and all of your problems are suspended, but when you leave, they’re all waiting. And so how do you apply everything? And so what Preda does is really we help improve the continuity of care by not only measuring, but providing tools and accountability and support to improve those outcomes for individuals. And how do we do that? So, as I mentioned, we take the off the shelf wearables and they’re measuring things like heart rate variability, skin temperature, steps, oxygen, sleep. 


Eliza
We’re baselining normal. And when an individual is outside of the normal range, we’re reporting back to treatment centers and to their supporters and saying, this individual really looks like they’re becoming dysregulated. They need some outreach so that’s on the biometric side, we also have three other pieces of our platform. So we have psychometrics, which include clinically validated assessment tools and an SOS button so that people with Sud know that even at 03:00 a.m. On Christmas Eve, there’s always support and accountability available. All they need to do is tap we call it a dot, tap the dot. And they have text or call outreach that’s through Sam, says nine, eight line. And then again, those assessment tools are critically important because they inform some of the biometrics. And we help marry up the biometrics with some of those tools to really say where people are as individuals in an aggregate, so treatment centers can help improve their process and have a good idea of what their outcomes look like. The third piece is geofencing. We have some geofencing built in to add another layer of support. And then lastly, and I think this is a really important piece that really drives our engagement is we have positive reinforcement built into the platform. 


Eliza
We have literally hours, thousands of hours of amazing, best in class content through our relationship with Google. Mindfulness meditation, stress reduction, sleep hygiene, things that people learn in treatment, but may forget in the moment when things get challenging. And that’s all there, along with gamification and badges, to have people continue to wear this for longer. Because we know that if people make it to a year, the likelihood of a positive outcome drastically improves. But people in early recovery also don’t always know what’s going on with their body. You are struggling to even get up and have the motivation sometimes to take a shower the first week or get to a meeting. So knowing when you’re stressed or when you’re having difficulty is really not in the cards. And so we help if people understand through biofeedback what they’re experiencing, and then we can again marry that up with what they’re actually saying to also help improve outpatient care so that the individual, the gap between what they’re saying and what they think they’re feeling gets closer. 


Terri
Okay? 


Michael
And the clinician can look at that, right? And then compare and see, okay, this is how someone’s reporting how they’re feeling and this is what their body is saying and how they’re feeling, right? And that’s a really powerful, that’s really powerful information to help drive improved outcomes, because then the conversation could be so much richer. It’s about driving those conversations and reasons to connect. And what better reason? What an informed conversation that is. How much richer is that conversation than one of where just a random phone call saying, hey, how are you doing? You’re good? Okay, next. And you’re just going down a list. 


Eliza
And that’s typically how alumni programs operate, exactly what Michael just said. They’ll reach out at seven days, 14 days, 30 days, 60 days, 90 days. Well, we know that behavioral health crises and Sud cravings don’t operate according to a set schedule. They happen at all different times. And those times you may catch it, you may not. So to be able to actually use either something that they’re reporting or something that their body is reporting and reach out or as close to in the moment as possible is a really powerful tool, right? 


Terri
Yeah. Because when I ask you how you’re doing, I have no choice but to believe your words unless I detect something, and then I dig further, but you still might not be honest. Okay, so let’s unpack some of this a little bit. So, Michael, you had mentioned the clinicians can see and then have that people is the expectation then that these wearables come through a program and a clinician and that’s the agreement is they can see it and then I can see it as I wear it or could somebody just have it for themselves and keep an eye on things? 


Michael
Yeah. So, great question. So first, our entire program is opt in, right. Our philosophy based on well, it’s our philosophy because we are spiritually aligned with it. And then it also happens to coincide with the law, which is convenient, which is that it’s a completely opt in program. The client, the patient, the person who’s wearing the device, owns their own data, like full stop. You own your own data. There’s nothing that’s happening with Preda and our product without consent, like full stop. So that’s one that’s incredibly important to us. And we’re aligned with most laws and regulations and approaches with that. And I come from a security background, so I am super sensitive about that. I’m going to move because I think my connection is a little rough. There we go. Typically, it is through the treatment center. So whether that’s residential or IOP, regardless of the stage of care or the type of care it’s offered by the treatment provider, there could be other aspects of that. 


Michael
But treatment provider is a big term and it covers a wide variety of programs. But there’s a program and it’s offered either in treatment depending on the stage, it could be in residential or IOP. And then, as Eliza was alluding to, the real value is when the person leaves the brick building. Right. That’s where Pretaa really shines. And then there is an opportunity for someone to then use Preda and get the data derived from Pretaa separate from the treatment center, if that’s what they wish. So, again, it’s like very opt in. So there’s flexibility there, but primarily it’s through the providers. 


Terri
Yeah. Well, that accountability, I’m sure, is very important. I mean, that’s a big piece of it, knowing that somebody else has kind of got your back and watching, too. 


Michael
That’s right. 


Terri
Eliza, when you talked about the fourth piece of it, where it gives you ideas of things to know, reminder to do mindfulness, is it similar see, I have my watch on. Is it similar to when mine tells me, you’ve been sitting too long. Get up and move. Does it give you a little try Mindfulness or do they have to ask. 


Eliza
For stuff so out of the box? It does do like the get up and move piece because we want holistic health all around. So if that’s something that’s offered with Fitbits, that’s out of the box. Now we offer Fitbit Premium free to clients WIC centers using Fitbit free for a year. And so I can pull this up and show you what it looks like. But there’s so much information in there about so you can see when I click into Mindfulness, for example, there’s meditations for sleep. There’s stress reductions all in there. So they do have to go in. But what’s so cool about that is then they get to explore and kind of figure out which one they like. Just because there’s thousands of hours doesn’t mean they’re not going to look at all of them. They’re going to have maybe a handful of go to. 


Eliza
But in exploring that, they get to then kind of identify what works best for them in the moment, which can become their go to. So, for example, sleep. We’re noticing that sleep is a big people have known for some time that sleep is a precursor to Relapse. So therefore improving sleep hygiene can help really keep people on the road to recovery. And there’s so much great sleep content in there. And I think it’s also an opportunity for treatment providers to make recommendations and to work with clients, and clients then have the tool to do it. So instead of a provider saying, hey, you should try box breathing tonight, or something like that, it actually makes it easy for clients to be prompted on what box breathing is. Have the timing in the moment. If they forget it’s all right there. 


Michael
And our view is we are a software company. We’re a behavioral analytic company. We’re an outcome. We’re a tool to measure and improve outcomes. What we’re not is a hardware company. And so we’re relying on the best in breed, the Fitbits and the Apples of the world to help augment the program with the very latest and greatest in terms of engagement on that side of the house. That’s something that’s really exciting, is that’s not what our focus is on. Really? The biometric piece, the outcome surveys, that is where we’re in Usability and that’s like our attention. And then we have these relationships which allow us to provide the positive reinforcement that we know is best in breed and continually advances. So that’s something really cool. We don’t have to worry about battery life. Apple and Fitbit are worrying about that. 


Terri
For my application, my watch, if I had your product, you would integrate the information and stuff that you get off of my watch, plus give me added value of these other additional things that I can get wearing what I’m already wearing right. 


Terri
Okay. What’s an example of how the geofencing is utilized? 


Eliza
Yeah, so that’s a great question. There’s two kinds of geofencing. So one is to keep people in an area, and one is to keep people out of areas. So the more common example of how we use it is to keep people out. Right. So say I’m leaving treatment, and there’s a couple of places that I have reported that I typically will go to buy drugs, or there’s a liquor store that I stop at on the way home. Those can be geofenced. So that every time that I enter one of those areas, I get a notification and my clinician gets a notification saying, hey, you’re not where you’re supposed to be. 


Terri
Is your notification like, don’t do it? 


Eliza
Yeah, it’s more gentle than that. It’s a little more gentle. It’s just geofence notification or geofence has been breached and it enables the clinician at the next session or whenever they’re able to get to it, to reach out. And hey, like, I noticed you went to one of these areas. What’s going on? Tell me about you. Can we can geofence to specific locations or there’s parts of Massachusetts now in Boston in particular, that has become a pretty tragic epicenter of drug use, similar to Kensington and Philadelphia. And so those areas can be geofenced globally as well. So for Massachusetts treatment centers, I imagine most would really look at that area and say, is there a reason why any of our clients would need to be in this area? And if not, they would probably geofence that for the global population, it’s very individualized then, depending on where you are and what you’re right. 


Michael
And it’s done through the phone. It’s done through the phone. And again, it’s all opt in. I can’t stress that enough. So there’s no geofencing going on without the person’s explicit permission, and those permissions are granted in the phone. And really the purpose is if there’s going to be some sort of like the last thing, our entire mantra is to try to be preventative as much as possible, to prevent a slip. And if there is a slip, that it doesn’t become a fall and that there’s a compassionate engagement with the treatment center and or with your friends and family and loved ones who are supporting you throughout your recovery. Because it’s a journey, there’s no fixing. Right. It’s a process. So part of the geofencing is the purpose of it is if there’s a slip in thinking, then there’s a notification and a call can be made pretty quickly. 


Michael
The geofencing, I hate the word as a software person to say real time, because nothing’s real time, but it’s like pretty near real time on the geofencing piece. And again, these are locations that during the episode of care have been discussed and talked about. And so that’s really the purpose of it. And it’s really interesting, the responses. Geofencing is an interesting one because the responses that we get are pretty binary. We get either a response that says absolutely not, in which case, great, there’s no geofencing, or Absolutely, we desperately need this. So that’s the one in which we totally get and we support. Just like with recovery itself, there’s no one answer. It’s about providing tools for people who desperately need tools. This is an outcome tool to help measure and improve outcomes. And if one aspect works, great. If one aspect doesn’t work great yeah. 


Terri
Well, it’s a real partnership. I mean, obviously you want to have this conversation when they’re feeling positive and they want to change things, but yeah, the geofencing, I guess, because it’s not just related to their substance use disorder and recovery, it’s going to know where they are all the time. And so it’s probably kind of I could see where they even if they wanted to help them. 


Michael
Yeah. So the notifications only go out if those are specifically identified places. 


Terri
Okay, but people still technically have their data, right? Like, if you’re hooked up with your clinician, they know where you are at all times if they wanted to look at it. Is that correct, or would they only know when you’ve gone into a zone that you shouldn’t be? 


Michael
So they would be alerted and only know when you’ve gone into a zone. They’re not like tracking. 


Terri
But could they?


Michael
The way the app is structured is they couldn’t be tracking them. 


Terri
Okay. 


Michael
They can just see when they cross the zone. 


Terri
That’s cool. All right, so tell me a little bit about how the standard you had mentioned. Some of the things, Eliza, that you’re looking at is your sleep and your steps and that type of stuff. Give me a couple of examples of how that gives you insight into when somebody may be heading for trouble. 


Eliza
Sure. Absolutely. So there’s a couple of major indicators. Heart rate variability. There’s a lot of research being done on that. Sleep is another big one, and I’ll go into kind of examples of some of these and then heart rate. So heart rate, if somebody’s heart rate is really high, there’s an opportunity to reach out. Is it anxiety? Is it a relapse? Again, these are just fueling opportunities to reach out. We are not a diagnostic tool, and we really want to be really viewed as an ability to improve the relationship between providers and treatment centers and individuals. When that engagement is there, the outcomes are drastically improved. So the biggest one that we’ve noticed, again, is sleep. So when we look at the data that’s come in from some of our earliest adopters and what we found is that most of the instances where people were really struggling based on the anecdotal information that they provided back to that center when they were contacted based on a report being received. 


Eliza
So a sleep report was received, that center reached out and instead of the individual saying yes, doing great, like they usually do or often do when alumni centers will call, the alumni center would say, hey, we got a report. How are you sleeping? How can we help? Tell us what’s going on. The individuals opened up and in many cases were not doing so well. Sleep is a big indicator of depression, big indicator of anxiety. And those are behavioral health concerns that, again, bring people back to Relapse pretty frequently. It can also be an indicator of Relapse right. In tandem with other biometrics like HRV, like an increased heart rate. All of it in aggregate can be married up again to what they’re saying, where we’re able to really get a good kind of 360 degree view of how somebody is doing in their recovery so that we can reach out. 


Eliza
To quote Michael, not in real time, but in as close to real time as possible so that individual can get support and the clinicians can have a really good sense of how they’re doing. So again, the major ones that we’re seeing are sleep and HRV. 


Eliza
All right. 


Terri
And the heart rate variability, obviously, if I set mine to go exercise, that’s not going to be included into the heart rate variability. You’re going to see that, okay, there was an exercise thing going on and you’re looking at the outside of. 


Michael
Heart. Go ahead, Eliza. 


Eliza
No. Go, Michael. 


Michael
So heart rate variability is heart rate variability would incorporate if you’re exercising, right? Because you’re either showing some sort of movement heart rate variability is really about again, we can do a deeper dive into it, but it’s really about whether you’re feeling whether a low heart rate variability is typically not a great sign. So if your heart rate is going up when you’re feeling stressed or you’re exercising, that’s great. And if your heart rate is going down when you’re relaxed and in a more calm state, that’s great. So showing that variability between high and low, typically that’s a good sign. So if you are exercising and your heart rate is going up because you’re exercising, that’s great. That’s all sort of wrapped into HRV, but HRV, that being said, HRV is typically measured at night when the body is actually at rest. That’s when a lot let’s the HRV is really showing how your heart is responding to stressors. 


Terri
Okay, got it. All right. So your product is live and it’s being used, right? Okay. 


Michael
Yes. 


Terri
And the focus right now is on those in recovery to help keep them there and give them more chance of success. Where I could see this really being used is a big discussion in hospitals for when they’ve had employees that have been found to have an Sud and have diverted medications from the hospital is, are we going to have a reintegration plan? Are we going to bring them back? 


Terri
Are we going to allow them to continue to work for us after recovery, obviously after they get some things settled and hospitals are reticent to do that. And I don’t blame them. There’s a patient safety issue and a liability issue and that type of thing, but I could totally see the preda device being part of that reintegration program. It’s like, okay, if you want to come back, we’ll take you back. But this is one of the conditions, is that you wear this and increase your success. And then I, as an employer somehow, through the clinician or the recovery program or whatever, is not the manager and not HR, obviously, but has access to this data, which then can also see what’s going on with an attempt to also reduce liability. Because we’re thinking of now the patients in the facility, not just the person in recovery. 


Terri
Have there been any discussions with that? Do you see it being used in that way at all? 


Eliza
I think it’s a great idea. We do know that you look at programs for doctors and pilots, that three to five year programs, they have amazing outcomes because those programs are relatively stringent and they are long and arduous, so people that make it through them tend to do really well long term. I went to treatment with more than one pilot and they stayed in recovery for very long periods of time and actually all but one of them. So I went with three of them and two of the three are still in recovery many years later. So I think it’s a great idea. Of course, when we get into anything like compulsory where people would need to show data being really a program driven by consent, I think that gets a little bit dicey. Right. Because we want to make people comfortable wearing it well. 


Terri
It would be part of the contract process. Right. It’s like, if you want to come back here, these are things that you have to agree. If you don’t want to greet, then that’s fine, but then we’re not going to hire you back. 


Eliza
Yeah, I think it’s an amazing tool. I think anything that we can do to support people reintegrating into work or reintegrating into life, leaving treatment, is really important. People right now, the way it goes. Is there’s a saying in recovery, oh, the relapse happens before the relapse. And it absolutely does. Looking back on, every single time that I relapse, there were signs 100% that I can see now, but I could never see them at the time. And so it’s a big responsibility to put on people who are already struggling in their lives, to not only notice when they’re slipping physiologically, but then also to write the ship to do things on their own, to get themselves back on track, or course. Correct. Very challenging to ask of individuals. 


Terri
Yeah, no, that makes sense. I think for lots of things in life, we don’t see it coming when we’re in it. It’s only when you look back and you realize, oh, okay, I should have seen that coming. But we don’t, and so this is nothing different. So I like that idea. Relapse happens before relapse happens. So if we can get an indication of when you’re starting to head for trouble and then let you know, right? And then you’re like, oh, yeah, you’re right. Didn’t even realize that. But thank you for catching that and helping me change that direction. 


Terri
Yeah, I like that. Do you see any application at all? I don’t know. Maybe I answer my own question for people that don’t have a substance use disorder, but we know it could hit us at any time after we’re exposed to any of these medications, and we don’t know that we are at risk until it’s happened. Do you see any application for those that don’t currently have one? But I don’t know, broadly speaking. So I’m thinking, you’re in the hospital, you’re a healthcare provider. We want to prevent things from happening. Everybody wears one and agrees to that if you’re working there just to keep an eye on things. But you talk about a legal thing, but it would be really great if we could put it on every healthcare professional and know when they’re starting to head for trouble. 


Eliza
Well, I mean, I think there’s high risk positions, right? Like the charge nurse of you would know the terminology better. The thing that you did that had the charge nurse where you’re responsible for signing out all of the high risk medications, that anesthesiology I think there’s also to be a little bit more broad, I think there’s implications for suicidality. I think there’s implications for pain clinics, individuals that are prescribed very potent opioids for long periods of time. I think there’s implications for that, for behavioral health in general. Right. The way the body responds to us is a human condition that is not specific necessarily to people with Sud. So while initially we are tremendously focused on Sud, I think there’s massive implications to help people with all sorts of potential difficulties, everything from people who could potentially become addicts due to pain medication exposure or, again, suicidality depression, anxiety. 


Michael
Right. For hospitals, one of the screaming problems is Er, generally, right? They’re overworked. There’s not enough resources there. The priorities are correct, but with the increase in overdose and overdose deaths, ers are becoming overrun. And so what we’re exploring with a local hospital is if someone has some sort of primary care and they’ve relapsed, well, wouldn’t it be a great idea for that hospital group to offer that person preda in conjunction with a treatment center in conjunction with primary care. Being aware of this so that the relapse rate and the returns to the Er are drastically reduced. And if there is someone who’s returning to the Er, it’s less severe. And so that, to me, is like an initial no brainer because that’s such a the Er is, of course, focused on this acute problem, but it’s only acute for that moment when the person is having an overdose. 


Michael
But that is just a manifestation of the larger chronic disease. 


Michael
And so as a society, we’re getting stuck on this, and we’re getting sort of caught in focusing on this acute problem and not treating the chronic disease. We’re just treating the manifestation of it. So it’s like if someone has diabetes and they have to go to the emergency room, it’s like saying to that person, okay, see you later, and not providing them with diabetes medication and not providing them with any sort of help. Right. That’s not what happens. Right. There’s all sorts of wraparound services if someone goes to an Er due to something going sideways, if they have diabetes. But when someone’s suffering from Sud, there’s nothing. So I think a real low hanging fruit is that for hospitals and then within the hospitals themselves, I think offering it initially as a volunteer program to at least offer it I get a little reluctant when it’s like when anything like this is forced because it’s just not going to work, which we know to be true. 


Michael
But offering it as a positive incentive for folks who are working on the front lines, for the nurses and doctors who are working on the front lines and who are exposed to this every day would be awesome and hopefully would make a positive difference in their lives. I mean, Eliza, yeah, she has a story. She can tell it’s her story, but about just how it’s like just wearing this device has changed her life over the course of a year. Right. It’s actually really cool. 


Terri
Well, yeah, it could be part of the health and well being program for the hospital because there are many things that it is a stressful environment. And so to help your employees through that, other than just saying, we have EAP, call them what other things are doing throughout the workday or the work week that can beneficial for their employees. 


Michael
And this is one more, and it’s so inexpensive. It’s like nothing. It’s like comparison over all the healthcare costs. I walk into a hospital like, oh, my God, this is expensive. I mean, everything is so expensive. And this is not even relatively inexpensive. It’s just inexpensive. 


Eliza
The call EAP is the same thing as saying to someone in recovery, oh, identify when you’re beginning to slip and then course correct yourself. It’s like it doesn’t happen. That’s why in the first year, I get very fired up about that because I think to ask people to do that is crazy. The same thing with EAP. So I think it’s a brilliant, potentially to be looking at as a volunteer program again, where people beginning to show signs, we’re hospital, we care about you. We care about our employees. We want you to do well and to be wearing this. I started wearing this and I used to do like this mental eye roll every time Michael would say, oh, people are going to care about their health just by strapping this wearable on and everyone’s going to get better or want to care about their health and do better. 


Eliza
And in my head I was like, that is the biggest load of crap I’ve ever heard. And I started wearing this. So I was wearing it september, I had Jack, my second baby in October, started walking in November. In January I started to get not related to New Year’s, but in January I started to really buckle down on this. I swear it wasn’t related to New Year’s. Started monitoring my water, started doing walking more, taking this really seriously. Michael would continuously beat me in steps because I could see his steps. College athlete was very competitive. I was like, I can’t let that happen. So now I try to walk for fast forwarding to July, 15,000 steps a day minimum. I drink 120oz of water and I’m doing yoga five times a week. And I’m like a nut about tracking all of it and I feel so much better physically, I feel so much better, I make a point to catch up, right? 


Terri
Yeah. Now obviously I don’t have preda on mine, but very similar situation where a friend of my son’s had the watch and then got my son into it. And then my son started telling my husband about how he’s tracking his running and is working on his vo two max and all this stuff. So then my husband gets one and I’m like, oh my gosh, you guys are crazy. So my husband wants to get me one and I’m like, oh my God, okay, whatever. Okay, do you want to get me one? And now I’m like, oh, what’s my sleep score? I don’t think I agree with that. I didn’t feel like I slept that well. And my steps and now I’m looking at my vo two max, which is really not very good, but same thing. And now my daughter has one, so she’s into it. 


Terri
So it kind of happens that way just because it’s like, oh, well, let’s see what’s going on here. So, yeah, I could totally see the value. 


Michael
I have to jump. So it was awesome meeting you and getting to know you and thank you. Just to make just a quick correction on what I said about heart rate variability. So with heart rate variability, we’re tracking the variations of time between heartbeats each night so that’s the significant decrease may indicate your body is showing potential signs of stress or illness or fatigue. 


Terri
Got it. Okay. All right, that sounds good. Awesome. All right, well, we will wrap it up. Thank you both for attending. Thank you, everyone for thank you. Thank you to our listeners and hit that subscribe button and I want to thank our sponsor whose product line is an active deterrent to diversion. See IMI’s complete line of innovative tamper evident products and how they work at imiweb.com. Thank you, Eliza. Thank you, Michael. You have a great day. 

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Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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