EP 115 - Mobio - Bechara Saab

Transcript

Roland Siebelink (00:06)
Hello and welcome back. The Scaling Without Breaking podcast is so honored this week to have a new guest, and let me introduce him by saying that he spent 15 years as a neuroscientist, including a decade leading research at one of Europe's top psychiatry hospitals - in a city where I also lived, but I didn't go to the psychiatry hospital.

He's published in Nature Communications, discovered that our brains are more plastic than we thought,and became obsessed with one question: Why can't psychiatry be as objective as the rest of medicine? So he left academia to build the answer. His technology uses a 30-second smartphone selfie to measure your emotional state through changes in your facial blood vessels. No wearables, no special equipment. And here's the controversial part, his clinical trials show that these objective biomarkers predict your mental health better than what you tell your doctor,better than what you tell yourself.

Half the psychiatry field thinks he's wrong. He thinks they're stuck in the 19th century. With that, everybody meet my guest, Dr. Besh Saab, CEO and chief scientist of Mobio Interactive.

Welcome to Scaling Without Breaking, Besh

Dr Bechara Saab (Besh) (01:21)
Thanks a lot, Roland. Great intro.

Roland Siebelink (01:23)
Absolutely. It's a new field for us. We have not touched much on psych tech - or however the term is these days - but I'm honored to have you here. Besh, you've said you can measure how someone feels better than they can say it for themselves. That's a bold claim.Walk me through what that actually means.

Dr Bechara Saab (Besh) (01:43)
Well, if you take it at face value, it means that the way that we are able to assess biomarkers from the face, provide information that is then interpreted by a neural network, form of AI, in order to create a measure of how you feel. And if we look at that compared to what people say, we find that it's superior.

It's superior - to get into a little more specifics, it's superior in a couple of different ways. One is it doesn't fall for these biases that we tend to fall for. Most demonstrated one to date is the expectation bias. When somebody starts therapy, for example, they expect the therapy to work more or less right away, at least on average people do. But in truth, therapy actually can be quite stressful at the beginning, as you're getting the hang of it and understanding if you're doing it right, et cetera. The computer picks up on that. The selfie scan plus the neural network identifies the fact that people actually have increased stress as a result of therapy early on, and that it takes five to 10 sessions before you start to see an acute decrease.

That's one way that it's clearly better. It's not falling for these tricks that our mind plays on us, these mini biases. The other way that it's better is if you use the self-reported data for how good a given psychotherapy session is, or if alternatively you use what the selfie and the neural network provide in terms of how good something is, and then you take those data sets and you use that to train and predict what will be best for an individual patient, the predictions that you get using the objective data are more accurate than the predictions that you get using the subjective self-reported data. And in fact, if you combine all the data together, you still end up with a worse result than if you just exclusively focus on the objective data.

Roland Siebelink (03:29)
A lot of this is sounding very good from a scientific point of view. But can you help us get a bit more of a concrete image? What what does it look like? What kind of biomarkers are we talking about? And in the treatment plan, for example, what kind of different options might come up with the help of the app?

Dr Bechara Saab (Besh) (03:39)
That's what it means. Great, important to introduce the apps. We have a patient-facing mobile platform. It's a multi-prescription digital therapeutic platform that has these embedded tools, both to see how people self assess themselves, as well as this computer vision technology that allows us to objectively understand how people feel. Right now, you get these recommendations after you've completed enough sessions that have the appropriate data - you start to get recommendations on particular psychotherapy sessions.
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And on our platform, it's a mixed bag. We have mindfulness, we have other forms of meditation. We're introducing self-hypnosis soon. We have sound and music therapy. A lot of psychoeducation. And then some CBT-like practices as well. Which specific psychotherapeutic session you get on our platform, the recommendation for what you should do next comes from the objective data that we've used to measure

Dr Bechara Saab (Besh) (04:56)
what previously has been efficacious for you.And it's our aim to ensure that our measures are outside of somebody's control, so that somebody can't fake how they feel by giving us a smile - but they're not actually happy. We wouldn't want to pick that up as being happy.Interestingly enough, when you fake a smile, the micro expressions around your eyes are actually different compared to when you have a genuine smile. We're essentially providing exercise for the brain. That's what our therapy is. Particularly, exercise for the prefrontal cortex and how the prefrontal cortex communicates with other areas of the brain. That is good for everybody, regardless of where you are. It doesn't matter. You don't have to be sick to benefit from the type of
"therapy" that we're as you don't have to be sick to benefit from exercise, in terms of improving your heart health and your skeletal strength and your muscle mass, et cetera. The use cases for us are profound, unlimited, one could say even.

Roland Siebelink (06:11)
It sounds like there's a lot of scientific and experiential learnings going into that app. The way you talk about it, it also sounds like the recommended paths are not always going through a licensed psychotherapist.It can be some form of self-help as well, some form of meditative practice, or CBT, as you mentioned.

Dr Bechara Saab (Besh) (06:34)
Yeah, that's an important thing to discuss. We built the platform to be used in a healthcare context, with the support of a provider. However, there are many people that use it completely independently - tens of thousands of people. And it's fine in that use case, and we see the demand there, and so the next iteration of our platform will be even more easy to use initially.

That's something that we're excited to launch in May.

Roland Siebelink (07:07)
Okay, and so how do you envision the business model behind this app? Will you primarily get your compensation from the clinics that you work with or the providers, or is this ultimately a multi-sided business model? How do you look at that?

Dr Bechara Saab (Besh) (07:22)
We are B2B. The way that we commercialize depends on the healthcare economy structure within a given market. In places like the United States and India, where it's either through CPT code/reimbursement or out of pocket. India, it's majority out of pocket. Then we work through the providers and they actually are selling the software to the patients and we'll be able to capture through different mechanisms, a portion of the revenue that they generate. It's revenue generating for both the provider and for us. In markets where the health system is public, single payer, government is just paying for the bill for everything anyway, there it's much more simple. We go in and we provide a license to the healthcare institution and then it can use it for various different things. We have different prices for different use cases, but all across the board within a given use case, there's an unlimited number of patients that they can bring in.

Roland Siebelink (08:22)
What's been your strategy in which markets to target? Obviously, you're a global citizen. The map behind you tells this. But are you going all around the world or are you targeting very specific markets where you think there's a better entry point?

Dr Bechara Saab (Besh) (08:37)
We're targeting Singapore, Canada, and the United States as our primary markets. Last year, using funding that came from the Johnson & Johnson Foundation to train and treat patients across India. We capitalized on that opportunity to do some market research and understand how to go to market. And so, we have our first couple of clients in India coming online now, some excellent private hospitals. And that's more or less what we'll have our hands full, at least until the end of the year.

Dr Bechara Saab (Besh) (09:03)
Opportunistically, we have done some deals in other countries like Brazil and may continue to do so. But primarily, it's Canada, US, Singapore, now India.

Roland Siebelink (09:08)
Does that mean you're the only deal maker?

Dr Bechara Saab (Besh) (09:17)
I am not the only dealmaker that has worked for the company. Previously, we've had other dealmakers. But it's a much harder sell for them compared to myself as the founder because I know things so much more deeply and I can speak to them more passionately. And I think the client always feels more comfortable knowing that the CEO is behind the relationship.

Our strategy this year is different actually. Instead of hiring additional deal makers, we're hiring support for me as a deal maker. I'm hiring somebody who's really experienced and adept at creating the collateral, identifying who are the right potential new partners for us, and then giving that stuff to me and helping with the approach and I go in and do my little song and dance. And then hiring somebody else who's a sales operation manager - we haven't brought on board yet, but we'll do soon.And they're managing the CRM, handling small changes to the contracts that we go along to really try to help shorten the sales cycle and liberate a lot of my time so I can focus on the opening and closing.There's always a certain amount of inbound flow and the better we can automate that inbound flow, I think the better. And one of the big goals for me by the end of this year is to be able to monetize smaller institutions or even individual mental health care professionals.

Right now, we're really stuck with the bigger contracts, which is fine. That's where the budget is. That's where we have our deals. It's great; they're awesome partners. But if you really want to, as we do, reach the entire globe, you need to have an offering that is attractive and works for all kinds of different practices - the giant mental health hospitals, as well as an individual, somebody who might even label themselves as a who could be an MD even, but they prefer the title coach because in their mind, that's how they want their clients to see them.

Roland Siebelink (11:21)
the use case that you're working on in India and Singapore, culturally, you already mentioned the payment systems, of course, are different. Are there also cultural markers you need to take into account or maybe feelings hiding under different circumstances, different ways of growing up, different cultural values perhaps, or is that something that you canobjectively just pierce through with your app.

Dr Bechara Saab (Besh) (11:49)
In terms of quantifying how people feel, we pierced through all that. We're looking at things like heart rate, heart rate variability, distribution of blood in the face. These micro-expressions, these aren't things that we believe have been impacted by any divergence in culture that's emerged over the last 100,000 years or something.

So we should be able to get objective measurements that are just as accurate for prehistoric individuals as we do now. In terms of the therapy that we deliver, the contrast couldn't be greater. In that case, we really need to go in and create things locally. And for a market like India, that's a huge, huge endeavor. Because India, while it's one giant democratic nation, it is comprised of an incredible variety of ethnicities, different languages, different cultural upbringings, there's class systems. India is definitely not one block of individuals when it comes to creating psychotherapy. And so, we go into the local areas, we work with local professionals, we vet them, we get them into the studio, and then we create content - therapeutic content specifically for certain populations.

Roland Siebelink (13:16)
I also always want to hear a little bit about the person behind the company, Besh, if you're up for that. I think in our prep talk, you mentioned a lot about growing up in that small little town of 5,000 people where there was always a party in the house with your five siblings. Talk to me about that. How has this influenced Besh who you are as a man?

Dr Bechara Saab (Besh) (13:35)
Yeah.Well, it certainly makes me appreciate nature. I was outside my entire childhood. It makes me resilient and even crave the cold. We had snow on the ground seven months a year. To me, the world has unraveled in layers,

likean onion, because I was in a very, very small town when I was young. This is pre-internet, pre social media, and all that stuff. I was in my own world. I had my friends, I had my family, I had the woods, my BMX. That was my childhood. I had skiing, played in the snow, made a lot of snowmen, et cetera. A lot of freedom, a lot of freedom. I could just run around and do whatever I wanted.

Dr Bechara Saab (Besh) (14:25)
I guess having that level of freedom as a kid has made me want to continue to have freedom as an adult. But when I went to university, I didn't even realize that a scientist was a job.

Roland Siebelink (14:32)
Mm-hmm.do you feel like that childhood full of freedom and leadership experiments has made you into a leader you are today for your team?

Dr Bechara Saab (Besh) (14:49)
Look, being a leader involves two things. Involves first, most obvious, the ability to make decisions, live with those decisions, accept those decisions, take responsibility for those decisions. But to actually make them, that's necessary. That's what people look for leaders to do is to decide on how to move forward. When to step and where.

The other thing which a leader really has to do, and it's much more related to the word itself, lead is to inspire, to build a culture. All those things that are necessary to galvanize people toward the mission. You can make a decision, but if nobody's willing to actually follow you in that decision, then you're not being an effective leader.

And I think for variety of different reasons, I've been quite good at articulating a mission. First, identifying a mission that means something, and then articulating that to other people and getting their buy-in and bringing them together and including them in that mission, including them in the decisions that we make as well.

And so, why that comes "naturally" to me, I don't know, but it always has, obviously. I think part of it is not so flattering. I think part of it is because I want to have control, even over other people, which is not necessarily a nice thing, but can be harnessed to do nice things.

I tend to be very, very empathetic as well. I don't mean I'm necessarily sympathetic, but I find it quite easy to feel how people feel if I still choose to make the effort to do so.

And that's also necessary for leading people because you have to understand where they're coming from before you can bring them somewhere else.

Roland Siebelink (17:02)
Any advice for a few founders that are behind you?

Dr Bechara Saab (Besh) (17:07)
There's a few things that I did in the early days, which I'm really happy I did. One is I made a huge focus on culture, and a culture that I would love - that's important. People say that all the time, culture is really important. It is, it's absolutely important. Another thing that I did, and this would be relevant for anybody who doesn't come from a business background, is read a lot of business books.

I read a lot of books on strategy - don't just read Peter Thiel's Zero to One. Read 20 different books. My co-founders, Mark Thoburn and Avetis Muradyan and I, we read one business book a month for three years and we took notes and we shared our thoughts and we rated them. And at some point in time I had this vision that we'll publish this list and maybe I will someday still. But it's out of date, I suppose now.

But anyway, read the books from every perspective. Great advice that I got from my father a long time ago is that there are no heroes. There are no people in the world that you can hold up and say, that's the person to be like. But there are aspects of all kinds of different people that you could pull from. That's something you can aspire to. And I think the same way about these business books - get a bunch of different ones, pull them together, help you frame your thinking. And one thing that, particularly if you're doing it with your co-founders, it gives you a lexicon that you can leverage together. Exactly.

Roland Siebelink (18:34)
Yeah, it's a common language, right? Yeah.And I think it's the same with advisors and investors. None of them, I think, should consider a full hero in terms of they have all the answers. It's more like picking up elements that are useful to you from anyone that can offer them to you.

Dr Bechara Saab (Besh) (18:52)
Yeah, and a side point of choosing your culture is choosing your team, and that includes your investors. We were very and have been and continue to be extremely careful who we led onto the cap table and have turned down money multiple times. Not because we're the greatest company, everybody wants to invest in us. No, no, no, no. It's not because we're flush with cash, we couldn't use it. It's because I see the cultures being

Roland Siebelink (18:55)
Yeah. I love that. Yeah.Mm-hmm.Mm-hmm.

Dr Bechara Saab (Besh) (19:20)
the most important thing to the long-term success and the total amount of growth that we can achieve.

Roland Siebelink (19:29)
Besh, think those are great closing words. Thank you so much for coming on the Scaling Without Breaking podcast. This has been an honor. Where can people reach you or find out more about Mobio?

Dr Bechara Saab (Besh) (19:42)
Mobio has a website, mobiointeractive.com. We have a LinkedIn page. I'd be happy if you would follow the company LinkedIn page. My LinkedIn is BecharSaab. And that's about it. That's pretty much all we got. We have a YouTube page. We have a SoundCloud if you want to get access to some stuff, but mostly LinkedIn and our website is the place.

Roland Siebelink (19:55)
and we'll put it all in the show notes and of course.Can people tryout the app or should they be in touch with you first or how does that work?

Dr Bechara Saab (Besh) (20:09)
Absolutely. Our app is subscription-free actually. People can completely use it. Our healthcare partners are essentially paying us for the interaction and the data that we provide and all that stuff. Anybody can just jump on and use it freely, perpetually.

Roland Siebelink (20:12)
Okay.Is it available in an app store or how do they find it?

Dr Bechara Saab (Besh) (20:27)
It'scalled Amdtx, A-M-D-T-X, at least until May. After May, it'll be called Dawn, D-A-W-N. But for now, it's Amdtx, and then soon it'll be Dawn space D-T-X. And it's in the app stores, in Google Play and app stores. People people can go ahead.

Roland Siebelink (20:30)
And did the X okay? Yep.Don't, okay. Very lucky.Okay, perfect.Excellent.Okay, we'll put all those links in the show notes for everyone to enjoy and learn more about themselves because it doesn't matter what you feel. What matters is the objective reality, right? I'm just a populist journalist summarizing everything. But no, of course you didn't say that and I was just joking. But thank you anyway for joining the podcast, Besh. This has been an honor.

Dr Bechara Saab (Besh) (20:57)
I didn't say it doesn't matter.doesn't matter as much.

Roland Siebelink (21:14)
And for the audience, of course, we'll have another amazing founder again for you next week.
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When Half Your Industry Thinks You're Dead Wrong

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