Episode 54: AI’s Role for Clinicians and Patients in Behavioral Health with LifeStance Health Chief Digital Officer Pablo Pantaleoni

November 8, 2023 Nixon Law Group

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In this episode you’ll discover:

Starting with the unmet need
Improving mental health access
Human-centered design process

Keep scrolling for a transcript of this episode.

Key Takeaways

Before you brainstorm an idea or conceptualize a product or service, consider first what problem, pain point, or unmet need you want to solve and build your organization or company around that.
Improving mental health access isn’t only about considering physical factors that hinder people from being able to access the support that they need, it’s also about considering psychological ease. A person with social anxiety, for example, may find it very difficult to talk to initiate a phone call.
Commit to having a human-centered design process where your team discovers pain points and unmet needs. Talk to people, do surveys, and do research. Don’t create a product based on assumptions.

Read the transcript

Introduction (00:01):

You are listening to Decoding Healthcare Innovation with Carrie Nixon and Rebecca Gwilt, A podcast for novel and disruptive healthcare business leaders seeking to transform how we receive and experience healthcare.

Rebecca Gwilt (00:17):

Welcome back to Decoding Healthcare Innovation. I am your co-host, Rebecca Gwilt, co-founder and partner here at Nixon Gwilt Law, where we help digital health companies navigate law and policy to build great businesses. Today I'm delighted to share the pod with Pablo Pantaleoni, chief Digital Officer at LifeStance Health, which is a behavioral health company focused on providing medically driven evidence-based treatment services for people suffering from a variety of mental health issues. Pablo also leads the Stanford Biodesign Next Program at Stanford. I know a couple of companies in the cohort actually, and before joining LifeStance, Pablo was the vice president of Global Strategy and New Ventures at Headspace, a serial entrepreneur and an economist actually specializing in international markets for banks and brokerage firms. He's been around the block. Folks, welcome to the podcast, Pablo.

Pablo Pantaleoni (01:08):

Thank you so much, Rebecca. Very excited to be here.

Rebecca Gwilt (01:12):

Yeah, so I was reading your background and it looks like we have two points of crossover that I just wanted to shout out. The first is Russell Glass is a friend of my partner, Carrie Nixon, and mine and a friend of the pod, and as you may know, used to run Ginger before it became part of HeadSpace Health. So I'm sure you have met him in the mix at some point.

Pablo Pantaleoni (01:36):

Well, I heard great things about him. We didn't overlap on HeadSpace since the merger happened after I left, but yeah, definitely, I think we met a couple times and I heard great things about him from my coworkers.

Rebecca Gwilt (01:48):

Yeah, yeah. I was really excited to see those companies come together and to see the evolution of HeadSpace and in terms of strategy and new ventures. There has been such success there. And then the other is from the way back machine. I started my career at CMS back in 2000 and my legal career back in 2000 and I want to say 11, 2010, 2011, and we worked with IDEO on the UX user interface for the health insurance exchanges way back, way back when.

Pablo Pantaleoni (02:26):

Yeah, no, look, IDEO was dream working at IDEO learned so much. There's so much talent there and having such a great exposure to everything, what's going on in the healthcare industry, but also in other industries and how everything kind of connects. I always joke and I said I did my MBA there and it was awesome. Yeah,

Rebecca Gwilt (02:51):

I imagine building a sort of consumer facing digital health company, looking at that through the lens of such a consumer focused organization must have certainly given you a leg up. So, alright, so you started your entrepreneurial journey right after university with a startup aimed at helping international students in Europe, finding accommodation, internships, language courses, and that company is now part of Grupo Avanzia. You obviously have some innovation in your blood. I'm curious about your journey from such an early success to where you are now and how you evolved into entering the behavioral health space.

Pablo Pantaleoni (03:30):

Yeah. Well look, if I'm honest, I was not definitely thinking about let's start a new company in the education space, but when I moved to Switzerland, I experienced myself how hard it was to find the right place to live and look for internships back there. And so many of my friends were struggling with the same problem. So since there were not many solutions out there together with a good friend, we said, maybe we can do something here. And again, it started very small just to help the local community and in Spain that wanted to move to Switzerland. And then we just started growing almost out of control, meaning we ended up being in 42 cities, in 14 countries in Europe and really helping people to navigate what this means, moving to a new city to live mainly for college students as well as people also earlier in their professional careers. And yeah, I learned so much. I made so many mistakes, but definitely it was a great experience and at some point the housing kind of component was the biggest one and one of the larger companies out there in Spain made a good offer and we just decided that it was the right time and the right decision to.

Rebecca Gwilt (05:03):

Yeah, I mean, I think that's the sort of magic that happens when you find a real problem when you're solving a problem, it becomes easy like that is what I've heard.

Pablo Pantaleoni (05:14):

Yeah, no, it's funny. Again, at Stanford, that's what I teach and it's not about, Hey, I want to start a new company and let's start brainstorming. Of course you can do that, but let's make sure there's a real problem. Let's go through all the different workflows, let's talk to people, let's really understand what are the two unmet needs, the true pain points. Then let's start from there.

Rebecca Gwilt (05:43):

So bring me from apartments to mental health care.

Pablo Pantaleoni (05:46):

Well, that's a great question. I'll try to do this quick, but hey, look, I come from a family of clinicians, so even I'm not a clinician myself, there's always this in my DNA. So after a party, man, I went to the finance industry, funny enough, I'm good with numbers, but was not very appealing to me. So right when I was there, this good friend approached me and said, Hey, my father owns a small outpatient kind of clinic and he's struggling with his software, and I just came up with a small solution out there. So I started helping him and we were not looking to build that business out of that small kind of solution. But as we started again proving the solution, hearing from other people who also wanted the software, we ended up building another startup and moving the company that was back in Europe, moving the company to the US.

(07:01):

And then from there, well at some point the company scaled, but I think it was time to move on since we had too many operations in Europe and in the US and there was this decision, should we double down in Europe or focus in the US? You can imagine on what side I was in. And sadly the company decided to double down in Europe, but it was, I totally understand at the time that maybe it was the right decision. So from there I was fortunate enough to know some people at IDEO and out of nowhere, they just offered me an incredible job and to leave the digital health business there. And that later, the whole healthcare portfolio, I learned so much. It was a dream come true, as I said. And then there was a common thread across all the projects that I do, even if we were working on, let's call it cardiovascular space or even pure wellness kind of project all the way to other chronic conditions, you name it, right, ecology or respiratory conditions, there was always a mental health component, always, right?

Rebecca Gwilt (08:12):

Absolutely.

Pablo Pantaleoni (08:14):

And that's what I learned. And when you have the privilege of seeing so many different projects and start connecting dots, that's when I was fortunate enough that HeadSpace reach out and share with me that they were initially more in the wellness space, but they wanted to move more into the healthcare space. And then I joined HeadSpace to help them with the move. Also started digital therapeutic subsidiary leading the strategy group. Again, I learned a lot. It was an awesome journey, but as you know, many digital companies entering the healthcare space, it's always, you need to work closely, not just with consumers, patients, but also with clinicians and mapping their workflows and understanding what the real needs and making sure that this is not an extra thing that they need to do. And again, also very, very fortunate when I was at HeadSpace and there I was not actively looking, but when I learned about LifeStance, it was a perfect match.

(09:21):

It was exactly what I was looking for. I met with the founding team and it was the perfect match of the time. So I joined LifeStance three years ago right after Covid, and it's been so far an awesome journey. Again, the way how LifeStance positioned with our hybrid model, and it's so close to my heart, the mission of the company, improving access to affordable mental health. Fortunately, some people in my family, they're struggling with mental health conditions and I can see that, that everybody's aligned in the mission to help people struggling with, especially, again, there's lack of access out there and mostly it's cash pay. So what the founding team at LifeStance did, it's phenomenal. And I do think I could offer some of my experience with technology and to come up with all this new tools and help with making sure that whatever we do, we give people option with our hybrid model to, you can engage in person or you can go through a virtual session and use some of our virtual tools, but always with the goal of meeting people where they are. And that's kind of the beauty of a model.

Rebecca Gwilt (10:48):

Well, the two things that occur to me, one is I love to explore the journey of entrepreneurs because if they only make sense looking backwards, I haven't met anyone that's said, okay, well, in 20 years I knew I'd be here, so I did X, Y, and Z to get me here. It's always a wonderful combination of disparate experiences and happenstance and bad things that happen and good things that happen. And all of that culminates in sort of the richness of experience. So I'd love to hear that story. And the second is something you touched on, which is access during the pandemic technology made it possible for lots more patients to access care. We have many more options, more mature options out now, but I haven't heard, heard that there's been a significant change in access to mental healthcare. It's always been the barrier, not enough people, not enough reimbursement, not enough culturally competent care. I mean, mental health access, as you said, is vital to every other kind of physical health system that we have. If you're depressed, you're not taking your medications. If you're depressed, you don't heal as quickly. If you're depressed, you're eating less healthy. It affects our whole bodily ecosystem. So you talked a little bit about how you're addressing that access problem. I'd love to hear you talk about it a little bit more. And in particular, any special considerations when it comes to pediatrics?

Pablo Pantaleoni (12:27):

Yeah, that's a great question. Well, the way how we approach it is going back to the human-centered design process and truly understanding the admin needs. When I started, we launched this project, this discovery project, to really map the whole experience end to it for both patients, clinicians as well as team members.

(12:51):

And we spoke with hundreds of patients, really hundreds, and also surveyed even more patients on top of all this one-on-one interviews and trying to understand where are the barriers of access. Of course some are related to reimbursement, some others are related to the channel. There are people that want to see people in person, others they want to go virtual, but some others are the tools, meaning, for example, for some people, the struggle with anxiety, it's very hard for them to pick the phone and call and to talk to somebody appointment. So this is why one of the things we've done, it's build this online booking and intake experience to help people find the right clinician and go through the whole process online in their own terms and the right time.

Rebecca Gwilt (13:51):

Yeah, it's an interesting point. I think when we think about access, we often think even now, I mean I work in technology a hundred percent of the time. I mean, I often think can't get to the office from a technology perspective. I guess that could be broadband, but we often think of external barriers to access, but what you're talking about is quite important. What can the perceived safety of an online environment or perceived pressure like lower pressure of an online environment, how can that help with adherence to mental health care and the internal barrier to seeking that help?

Pablo Pantaleoni (14:31):

Exactly, exactly. And this is going back to understand where are the two gaps there and just co-designing solutions with patients, clinicians, that's what we do. Because at the end of the day, if you don't do it with them, going back through my journey and made so many mistakes early on in my career, making a bunch of assumptions doesn't work. And you definitely need to do it together with potential users and also with going out there and you're looking at other industries. So one fun story is when we were looking at, when we mapped the whole journey, we understood that finding the right match between a patient and clinician, it's a key moment. Unfortunately, we also heard there are some patients out there, they just go through the first experience, they're not satisfied with the right matching. And this goes both ways, right? It's a matching also clinician, but some patients, they go back and they're afraid of going again through that same journey, and they don't seek care.

(15:43):

So it's a real problem. So this is why we definitely need to do a good job matching the right patient with the right clinicians. And somebody on my team said, we've tried all these solutions out there. They're all pretty similar. They have great things and they have also some gaps. Why we don't look at dating sites, for example, and see how this works. And because, again, when you're matching, it's not just matching based on, of course, things that are important based on the experience, right, based on your needs, based on insurance, based on location. But also there needs to be some kind of connection between the clinic and the patient in the behavioral health space.

Rebecca Gwilt (16:26):

Yeah, that's really interesting to look at what the dating applications have learned over time. So is this where some of the AI that you're building into the product comes in? Is that part of what helps with the matching, or is that used for more clinical purposes? In what ways are you leveraging the massive explosion in our ability to use AI to build a better product?

Pablo Pantaleoni (16:52):

Yeah, I mean, look, I've been working with AI, different kinds of use cases for years now, and I do think, and people are always thinking about all the shiny ways where AI can help. And there are definitely opportunities out there, but I'm going to be very honest with you, AI and other technologies to help automate some of the internal processes. Those are the most effective ones upfront, meaning, the perfect example is we want to empower clinicians to really spend as much time as possible with patients. So helping with all this admin tasks, documentation, there is a big opportunity there with AI tools. That's just one example, but there are many, many different other areas where AI can help.

Rebecca Gwilt (17:51):

Yeah, I know we've talked a lot about solutions that impact patient care and the importance of being patient-centric, but you mentioned something earlier about helping clinicians make sure that you're helping them. And I know there's a growing set of innovators that are trying to address clinician. I mean, not just innovators, I mean, it's everybody in healthcare. It's been a real problem ever since Covid and probably beforehand, but trying to reduce clinician burnout and really empower the healthcare workforce. How do you think about designing with those providers in mind?

Pablo Pantaleoni (18:27):

Yeah, we always ask providers very openly. Everybody on my team, designers and engineers, we try to work as close as we can with clinicians and team members. So we ask them, we also have the ability with some tools to identify what are the pain points? Then we just say, we go both ways. Some of them, they said, Hey, I've seen this tool. I want to try it. Can we do kind of a quick pilot? And I'm like, okay, let's honk about this. Or also, my team identifies a solution out there, or we think that we should build something in-house to solve some of these gaps. And I'm a huge fan of coming up with a quick prototype, quick solution, pilot it, and then let's see what works and what doesn't. And I think, again, that's the only way that works, at least for me. Right?

Rebecca Gwilt (19:33):

Yeah. What I was seeing happen during the absolute avalanche of new digital health companies that came on the market in 2020 2021 was a speed of development and sale of product that I think we're seeing a better balance of now. Just you build a basic app and an interface and you start selling to patients, and that was what you had to do at the time to grab the investment and move forward. And I think, again, I think we're in a period of reset now where it's, it's actually okay and expected to iterate on these products to really spend the time before you roll this out in a meaningful way. Not only talking to patients, but talking to providers, making sure that it's actually solving a problem that exists, that it is, to your point, in mental health in particular, one bad experience can take it off the table for someone, which would be a real shame. So I think your advice about being humble, asking the questions, challenging your assumptions, all with the goal of partnering with clinicians to bring better care to patients, really resonates with me. Anything else you would say to the next crop of digital health leaders that are trying to do the same thing, designing with both patients and clinicians in mind?

Pablo Pantaleoni (21:17):

Yeah, thank you for asking me this question. I do think that, like you said, we're at different time now, and definitely you have to balance when something is working. Of course there is the opportunity to roll it out very aggressively when we're talking about technology, but at the same time, in the healthcare industry and specifically mental health, we have to be extremely careful. And one of the things that I've seen over and over and over is people really look at on the consumer side of things, which is extremely important, but you also need to understand the other side. But this means for payers, eventually for team members and especially clinicians. Clinicians, all they want, spend as much time as possible with patients and helping those patients. So even if you're totally exhausted, it's one more thing. So it needs to be completely integrated into their workflows, and they're bombarded with so many opportunities, so many different things. So you have to be extremely mindful on how you position your solution, making sure that it's not one more thing to do.

Rebecca Gwilt (22:34):

That's right. That's right. Yeah. I mean, I am not sure how well it is known outside of folks that live in healthcare every day, but in addition to there not being enough providers to provide the mental healthcare and those providers doing as much as they can still burning out, they have some of the lowest margins of any healthcare providers out there, the reimbursement for this type of service, while it is vital to so much of our health and wealth, is just not reimbursed in a way that I think reflects the value. So that's another hurdle. So I'm actually grateful so many companies are targeting mental health services because those customers don't have the biggest budgets to buy things. It's a much better bet to go to cardiologists and cancer physicians. But I'm really excited about what you're doing. I really appreciate your time and your talent today. If folks want to hear more of these kinds of insights or they're interested in exploring a business relationship with Life stance, what's the best way for them to get in touch with you?

Pablo Pantaleoni (23:42):

Sure. You can find me on LinkedIn or just shoot me an email, pablo@lifestace.com

Rebecca Gwilt (23:48):

Short and sweet. Alright, well, thank you so much for being on the pod today, Pablo. It was a wonderful, wonderful time.

Pablo Pantaleoni (23:54):

Thank you so much, Rebecca. I really enjoyed the conversation.

Rebecca Gwilt (23:57):

And thank you so much for listening to Decoding Healthcare Innovation. I'm Rebecca Gwilt, Nixon Gwilt Law, and I hope you enjoyed today's discussion on AI's role for clinicians and patients and behavioral health with LifeStance Health Chief Digital Officer Pablo Pantaleoni. If you'd like today's episode, you'll want to do a couple more things. First, if you haven't already, please subscribe to decoding Healthcare Innovation and give us a five star review in your podcast app of choice. This helps other innovators find our show. And second, you'll want to check out the show notes to find some related episodes, including one with behavioral health startup advice from HeadSpace, CEO, Russ Glass, one on practical applications of AI and healthcare, and a couple on entering the US market, US Healthcare Market from Europe. You can find the show notes for every episode along with transcripts at nixongwiltlaw.com/dhi-podcast. See you next time. Thank you for listening to Decoding Healthcare Innovation. If you like the show, please subscribe, rate and review at Apple Podcast, Spotify, or wherever you get your podcasts. If you'd like to find out more about Carrie, me or Nixon Gwilt Law, go to nixongwiltlaw.com or click the links in the show notes.

In this episode you’ll discover:

Key Takeaways

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