Each month we profile an innovative, growing company from across the Greater South East of England. Ieso Digital Health is a world leading digital health company in Cambridge, specialising in internet enabled evidence-based psychological therapies. We spoke with Rob Brougham, UK Managing Director, about their exciting research in mental health and their aim to speed up patients’ recovery rates.
What do Ieso Digital Health do?
Iseo is a digital health company, however, we put the emphasis very firmly on the health part of our name. We are a healthcare company first and foremost, and it just so happens that the way in which we deliver the care is using digital tools. We are working in the mental health space and we provide high-quality, evidence-based, cognitive behavioural therapy. So, we are helping patients with depression, anxiety and other common mental health issues.
How does this work in practice?
In the UK, we work within the NHS Improving Access to Psychological Therapy (IAPT) programme, which has been running for about a decade, and it was created to bring cognitive behavioural therapy to as many people as possible across the country. It is a very data-rich part of the NHS, so they are recording outcomes to try and improve quality over time.
We are suppliers into that, so our customers are the CCGs and the NHS mental health trusts. We are also now starting to work in the US with some of the big healthcare companies there.
How big is the company?
We have 500 therapists in our network and they provide therapy to patients which is very similar to face to face therapy, but in an online manner and it is through typing as opposed to physically seeing each other. Typically, they meet once a week, for an hour, and it is the same therapist each time. The therapists and the patients can be wherever is convenient for them, such as from their home or in a meeting room at work.
We’re treating NHS patients who would normally only be given the option of Monday to Friday. When you give them a choice, over two thirds of them choose to have therapy at a different time and it’s a time when they can fit therapy around their life and not the other way around.
How did the company come about?
It was founded by two clinical psychologists who were working within the NHS about 15 years ago. They were delivering cognitive behavioural therapy (CBT) to patients within the NHS, and they could see how beneficial it was. They felt that they’d be able to use the internet to make it easier and more convenient for patients to access CBT. So, they had the original vision and it turned out they were right – the core of the service they created is still the foundations of what we deliver today. And we’ve now built on that and we treat many thousands of NHS patients across the country every single year.
What impact would you say that your technologies have had?
Making it convenient and easy for patients to access therapy has been a really important thing that we’ve brought to the party. Because we have 500 therapies and because of the way in which we are organised, we don’t have a wait list at all. One thing that is very well researched is that the longer a patient waits for therapy, the less likely they are to recover.
We have also been able to support clinical outcomes because of the way we deliver therapy and for the first time ever, we can see exactly what happens in every therapy session and we’ve used that to create an effective supervision and training environment.
We are now applying sophisticated data science to begin to understand, in detail, what works best for patients, and to create artificial intelligence-based tools that can help our therapists to provide even better results going forward.
Can you tell us about your use of AI in your technologies – and what do you think the future looks like for AI and healthcare?
We have developed a suite of tools which are focused on what we term ‘therapist augmentation’. These are therapist facing tools that help them to do a better job to support more patients and then ultimately get more patients better more quickly.
One example is our dropout predictor. Dropout is common in CBT, because the patients may not feel ready or it is inconvenient for them. Based on the initial presentation of the patient, what they first type and what they first put into the system, our AI tool can predict which patients are at a higher dropout risk and can advise the therapist accordingly. So that therapist can then adjust his or her approach, such as by booking in the next few appointments at the end of the first session
CBT is very much evidence-based and there is a lot of research over many years showing what works and what doesn’t work. We’re working on a tool which can provide therapy insights; it can tag the active ingredients of a therapy session and show that back to the therapist so they can see what they could be doing better to support that patient. The therapist can then make sure they add those positive active ingredients back into the session, in real time.
Which organisations do you work with?
Alongside our work within the NHS, we’re very much a clinical and a scientifically-led company that is backed up by evidence. We are very active in terms of doing research in collaboration with universities, such as University College London, the University of East Anglia and Queen Mary University of London and we are expecting to do some active research projects with Cambridge University.
How have you gone about funding your technologies?
We recently won an Innovate UK grant, but most of our funding has come from investors. Our early-stage angel investors from Cambridge Angels Network are still actively involved as investors in the business. As the company developed and as the evidence base grew stronger, the company was able to secure some venture capital funding with our biggest funding coming from IP Group and Draper Esprit.
Why did you choose to base your business in Cambridge?
We are situated in Cambridge because it is great in terms of attracting the talent that we need. We’ve invested very heavily in the technology and in the commercial aspects of the business and we found Cambridge to be the perfect place to find the right people with technical, commercial and other skills necessary in order to build the business. But, of course, we deliver therapy wherever and whenever patients need it.
What’s next on the horizon?
Firstly, we’re very excited about the therapy insights tagging tool that we’re developing. This is likely to evolve to help therapists to adhere to the evidence base, and we could begin to work out how we could personalise mental health care delivery.
We’ve also conducted research into depression which has always been one of the hardest conditions to treat with CBT, our data indicates that it isn’t just one condition but actually multiple sub conditions. These subtypes of depression respond differently to different therapy protocols, so we are looking to identify which of those protocols is best able to treat which subtype on depression and begin to drive up recovery rates.
The Innovate UK grant will be used to research into digital biomarkers, by gathering insights from patients’ smartphones sensors. Over time, we want to extend that to identify earlier, the onset of mental health issues, and help patients by treating them more effectively with more affordable treatments.