Patient-First Innovation featuring MEDRhythms

 

The healthcare landscape is changing. It’s more important than ever to consider the “whole person” in an all-encompassing way including wellness and mental health. In order for the healthcare system to meet new the demands presented not just by COVID but by an increasingly aging and diverse population, the system and those who work within it will need a human-first approach. That approach will have to listen to the voice of the patient and consumer, and learn its cues from them.

Listen in as Ipsos’ Steve Reeves and Alexis Anderson are joined by a panel of guest experts including Brian Harris, CEO of MEDRhythms, to discuss how leading with a patient-first mindset enabled them to bring an innovative product to market. MEDRhythms is a digital therapeutics company that uses sensors, music, and software to build evidence-based, neurologic interventions to measure and improve walking. Music has the ability to directly stimulate the brain to improve functional outcomes, and our principle underpins the science behind MEDRhythms’ digital therapeutics. Our technology platform powers a pipeline of digital therapeutics that provide direct stimulation to enable the mechanism of action across multiple therapeutic indications. 

The panel discussion also features valuable physician and patient perspectives.

As mentioned during the webinar, be sure to check out this Rolling Stone article featuring MEDRhythms.

---

AI-generated audio transcript is offered below. Apologies in advance for inconsistencies that have been included. 

0:04

Thank you for joining us for today's Ipsos webinar, Exploring Patient First Insights to Drive Innovation.

0:12

Today's discussion will feature several guest panelists including the CEO from MEDRhythms. And you can read more about our speakers on the slide in front of you.

0:24

Throughout today's session, you will remain in listen only mode, however, throughout the webinar, you may submit questions online, the Q&A feature.

0:35

Time permitting we'll answer questions at the end of today's session. However, if timeline short, then your question will be answered by e-mail. Today's webinar is also being recorded and will be directly e-mailed to you.

0:52

So now without further ado it is my pleasure to introduce today's first speaker. Steve Reeves Vice President with Ipsos is Social Intelligence Analytics Team. Steve you have the floor.

1:06

Awesome. Thanks Alan and thank you so much to everybody who's in attendance today. We are very, very excited to bring this panel to you and personally. Very excited to introduce to you. Brian Harris, who is the CEO of a MEDRhythms. I'm going to let him talk a little bit about his background and med rhythms as an organization. I've known Brian for quite a long time and just very, very excited to convey what they're doing from a patient centric product design standpoint. We also have on the line dart's doctor Alex ... from Johns Hopkins University who's a world renowned expert in neuroscience. We are privileged to have him. Thank you so much, doctor Alex. We also have Lindsay Santiago, who is part of the Patient Advisory Board on Bed Rhythms.

1:57

And also Alexis Anderson who is our principal focusing on patient centric design an innovation within Ipsos.

2:09

We are, again, really, really excited. I'm going to start this by kicking it off and letting Brian set the stage for what ... rhythms is, telling us a little bit about your story and then we'll get into it, so Brian, take it away.

2:26

Well, thank you, Steve. And thank you, everybody, for having us. It's an honor to be here. And anytime we get an opportunity to share the journey that we're on and met with them, it's always an honor for me to do so. So I appreciate you here and letting us tell the story. And it's certainly an honor to be here with with Alex and Lindsay who have been integral to really driving bed rhythms to where we are now as parts of our patient and scientific advisory boards. But I'm a co-founder and CEO, as you mentioned, and I'm a board certified music therapist by training.

2:55

And I have advanced training in the neuroscience of music, and specifically, how that can be applied through an application that's called neurologic music therapy.

3:03

And I started my career at Spaulding Rehab Hospital in Boston, which is the Harvard Medical School affiliate for neuro Rehab Hospitals.

3:10

Where I actually built their program, I was their first music therapist, treating patients with live music interventions, all based upon this fundamental neuroscience of how music could improve functional outcomes, and things like movement, language, and cognition.

3:25

And after I started the program, very quickly, after starting the program, what we were finding is that patients were getting better faster, with greater results, and we now have the neuroscience to not only explain how this was possible, but also how we could standardize and replicate it. So, we were treating patients across diagnoses, from stroke to brain injury, MS, PD, rare brain diseases, and really just seeing some very compelling and exciting results.

3:52

And, very quickly, after I started that program, because of these results, the demand for my services, both from physicians who are writing orders for me to see their patients within the hospitals, but also from patients and their family members who were saying, You know, Brian, you helped my dad walk, again.

4:07

How do I get more of this when I leave the hospital?

4:10

And at the time, the answer really was, you know, there's nothing you can do.

4:14

As you can imagine, there aren't many people trained to do this work in the world, let alone, to meet the needs that, that, that we were seeing.

4:21

And that was an awful conversation for me to have with patients and their family members on a regular basis.

4:26

As a clinician, You know, We exist, in my drive to the work, was to make an impact, and to help patients.

4:33

And being able to sit in those rooms and say, there's nothing you can do from here, was an awful conversation to have.

4:39

Where we were focusing. Most of our energy there was around an intervention that's called a Rhythmic Auditory Stimulation, which is the use of music and specifically rhythm to improve functional outcomes.

4:51

And so being able to improve things like gait speed, symmetry, overall control, and just to help people improve their walking, therefore their independence. And we were seeing that this was a really big unmet need and the world of neurologic neurology across our disease and injury.

5:09

That many, many patients were left with these deficits.

5:12

And my sort of draw to entrepreneurship and my draw to building innovation And this company around med rhythms was really around this mission of trying to figure out how do we bring this important care that we were seeing in the clinic to people around the world that we believe not only need it, but deserve to have access to it?

5:33

And so as I was a treat, clinician treating patients, you know, I saw that need.

5:37

I saw that we could potentially have a solution to the need, and therefore, I felt like I had a responsibility to do something about it. And that was really my journey into into building met rhythms, which really around this feeling of responsibility. And so we built med rhythms to build a digital therapeutics platform. So these are products that are evidence based so they go through rigorous clinical trials regulated by the FDA and prescribed or prescription products that consist of hardware, software, and music with the underlying, as we call it. The mechanism of action. The reason why this works is the deep neuroscience of how rhythm can engage the motor system.

6:17

And so we built this platform that can be utilized in the home setting autonomously without the need of a clinician presence, so that we can bring rhythmic auditory stimulation. That's important.

6:28

Intervention to improve walking? Essentially to anybody around the world that needs and deserves it. And as I said, it's an honor for me to have our team members and Lindsay and Alex here as well.

6:41

And also, you know, as we think about patient in the loop innovation, that's one of the things that I'm actually most proud of as building the organization, is that since day one patient perspective, Patient care has always been the central domain by which we make decisions as an organization. And we were the first digital therapeutics company to actually build a patient advisory board alongside our Scientific Advisory Board to help us think about product innovation.

7:07

So thanks again for having me, Steve. It's an honor to be here.

7:10

And that's a fantastic segue in relation to the Patient Advisory Board and also to the Physician Advisory Board. Lindsey. If you could introduce yourself to the audience, we would love to hear about your journey with med rhythms and your journey as a as from what I understand the very first user of my rhythms product. And then doctor Alex, if you could also introduce yourself and talk a little bit about your background, it is, you know, it's not often that we're able to get, get physicians of your esteem and caliber on the line. It is great to have you and we'd love to hear from you. A little bit about your background. Go ahead, Lindsay.

7:51

All right. Thank you, Steve. And it's an honor to be here today to share my experience with with men rhythms. I'm a person living with MS. I was diagnosed February of 2010.

8:05

And kind of regular diagnosis.

8:09

And transitioning. We're having gate issues, But I saw my personal trainer and did all things.

8:16

And it was a wonderful thing.

8:19

We saw Brian on Chronicle a local show showing what music therapy could do. And I said, that is amazing. I want to try that.

8:32

And so I'm lucky enough to live near Spaulding Rehab Hospital and was able to come there in person.

8:38

And do some of the outpatient, This was back in 20 16. I just had my son a few months earlier, and I was hooked from the beginning.

8:49

And kind of what Brian was saying, as far as, I think it's one of the most powerful forms of rehab that there is, and to be able to get that to the masses is so important.

9:02

I feel so blessed and lucky that I was able to, to get it and have continued to use it.

9:09

And to be able to share it, I think, is just extraordinary.

9:15

So, I think it was in the fall of 2016, Brian, if I'm wrong, let me know that I actually got to try the first ever device in my apartment and in Boston and put it on my shoe and give it a go, and it's just been amazing to see the evolution and the growth of the product and seeing how it's transformed.

9:42

Because I really believe that it's such an important tool, as far as recovery wise and to be able to get it.

9:51

two, um, people all over the country that aren't as fortunate to have a music therapist in their background and their backyard, excuse me.

10:01

I think it's just really fantastic.

10:04

And I think also, another important things for men are them, it says that they did bring the patient in from the beginning.

10:12

I think that's so important, because we are the experts, you know, you can write, build the, you know, create a drug, and say it's gonna work, but if the patient doesn't want to take it, because the way it's administered, et cetera.

10:26

We kinda lose out, and so to bring the patient, And from the, from the get go, I think it's just such an important thing to do.

10:34

I currently do the Development Associate, the Accelerating your Project for IMS. And I conquer RMS dot org, where we show the value of patient reported outcomes and getting the patient's voice and sharing that and it's just to see men rhythms doing that as well.

10:55

In getting the data and providing it to people, I think, is, he's just wonderful.

11:00

And, you know, I am can say, you know, I'm one of my rhythms biggest fans and you know, I just I think what you do is so powerful and I'm so excited to be able to see where, where it goes from from here.

11:15

Actually, she said that she is one of better than the biggest fan.

11:18

I actually happen to know she has a T-shirt that says right, it's not just recorded music. It is live music as well, and they're all extremely talented. And I feel bad for the therapists that have to hear me singing along to Not at that level.

11:41

Wow.

11:42

Scale, but Yeah.

11:45

Fantastic.

11:46

Awesome, Awesome to hear your background.

11:49

Doctor pen. Totally, I would love to hear from you.

11:52

Well, let me just start off by saying that it's truly my pleasure to be here on this panel today. I feel really inspired just now hearing Lindsey's and Brian's story is it's been awhile since I've heard Brian story.

12:06

We've been working together for a number of years and I really do believe in the mission and what met rhythms as is currently doing and will continue to do.

12:18

I'm a Johns Hopkins University School of Medicine. I'm a movement disorders, neurologist.

12:23

And as such, my work has focused on diagnosis and management of patients with the various illnesses that affect movement, particularly parkinsonian disorders, the most common, of, which is Parkinson disease, and really, it's in that a role that I am here to speak with you today.

12:44

I was privileged to co-found, and now direct the Johns Hopkins Center for Music and Medicine, which began as an initiative in 20 15.

12:53

I'm proud to say, has grown over the last few years, in particular.

12:58

So our mission is to use music and rhythm to help heal a variety of illnesses. Both neurological and non neurological.

13:08

So, to use music as medicine, if you will, and the way that med rhythms, the work fits since it fits in within the mission of our center is that we now understand that we need to use precision music medicine in order to target an individual patient's symptoms and therefore, be able to maximize the improvement that can be achieved.

13:34

So the med rhythms product that we're currently testing, in patients, with Parkinson disease, along with Boston University, aims to achieve exactly that.

13:44

You heard a little bit earlier in the introduction from Brian about Rhythmic Auditory Stimulation.

13:49

This is a technique, that has been used for Parkinson disease since the 19 seventies.

13:57

And there is a lot more research to be done, but what hasn't been done until the study we're doing now, is adaptive rhythmic auditory stimulation where you could use sensors worn in the patient's shoe.

14:12

To detect specific gait patterns and change the music and the rhythm.

14:18

That the patient is walking to, Um, in, in a way, that will optimize that patient's improvement.

14:27

And then ultimately, one of our key goals is to prevent falls in patients with Parkinson disease, stroke, multiple sclerosis, other illnesses that affect gait.

14:36

And it is very much my hope that going forward in larger trials, will be able to demonstrate that that will be the case.

14:44

Yeah, that's fantastic, and I know that you're currently in trial right now, Brian. one of the things that I'm so intrigued by with this is the concept of personalized medicine. And I'm going a little bit off script here.

14:55

But thinking about the application that music has and the individualism when it comes to someone's preference in music, and dovetail that with the concept of personalized medicine. For me, is just such a such a unique thing. And I personally am just such a big fan having seen how product development is done outside of Pharma and healthcare.

15:18

You know, when I was, you know, early on in my career to right now where there's actually, you know, a lot that can be learned and is being learned and applied from non healthcare environments when you put the consumer in the center of the design equation. Doctor Alex, I had a question for you, If that's all right? As a neuroscientist, why is the science behind med rhythms so compelling because you could talk a little bit about that, both in terms, obviously, Parkinson's, but what it might mean for, you know, other indications?

15:53

Well, the key aspect of what we're talking about and how med rhythms, devices, are helpful, is through this concept of Rhythmic entrainment, which is a way to use external beats external rhythm with or without melodie, in fact, to influence the way that persons heart rate brain waves are firing.

16:21

And so this has been demonstrated in the last several decades, through several different studies, for example, using electroencephalography scalped, EG, unhealthy participants who are listening to different rhythms, different beats.

16:35

And it's remarkable that typically within just a few minutes, a person's brainwaves when you're looking at both hemispheres, broad swath of them, brain and it's activity and you average across the beat of the EEG, if you will, aligns exactly with the beat that is being heard from the outside.

17:00

Biologically we're designed to be sensitive to temporal changes, time, base changes, and a lot of biological processes in humans and animals, are designed that way.

17:14

You know, the 24 hour clock That's embedded in our brain when to be awake, went to be more active, when to be asleep. When it comes to walking, that's a great example of where you arrhythmic normally without having to think about it.

17:28

Now, unfortunately, in diseases like MS, illnesses like stroke and Parkinson's disease, that natural rhythm becomes disrupted because of pathways in the brain that are being damaged for one reason or another.

17:42

And what external, auditory cues, sound cues can do is help patients restore that rhythm over time, and it's remarkable that this could be observed very quickly.

17:52

We have seen this with our patients, with atypical parkinsonian disorders, That, on average, are much more severe than Parkinson disease and we have a manuscript we'll be submitting shortly showing that this simple metronome based technique can actually help.

18:07

Not all but some of these patients if appropriately targeted to their own walking pace. And so, again, coming back to adaptive rythmic auditory stimulation, which is what we're trialing.

18:17

You're using a med rhythms device.

18:20

We're very hopeful that by walking for as little as 25, 30 minutes, five days a week at home, you will see meaningful changes and improvements in the walking pattern, over patients, with Parkinson disease. When they listen to songs that have a nice strong beat and try to align their steps to the beat that they're hearing.

18:41

That's awesome. I've always wondered if it, you know, if there's differences, by genre, right?

18:47

I mean, you know, I'm a country music, fan, you know, is there an application for that?

18:53

So, interesting to hear what the, what, the BPM this might be. Prefer for different indications.

18:59

Brian, would love to hear from you about, well, first of all, there's been so much positive news about ...

19:06

rhythms, obviously with some of the partnerships that you have in flight would love to hear about the partnerships but first, we'd love to hear about how the clinical trial is going.

19:17

And from your standpoint, you know, as a pioneer in digital therapeutics, you know, I look at you and a lot of lot of people look at ...

19:25

rhythms as this bright spot in the digital therapeutics landscape and one that is really, really on the leading edge of of how to create an impactful digital therapeutics product.

19:40

Can you talk a little bit about the process for staging this to eventually bring it to market from a clinical trial standpoint? And then would love to hear about the really interesting partnerships that you have with universal music with several others.

19:58

Yeah, that's a loaded question, Steve, it's a robust question, and as we think about process, of bringing these things to market, and I think the theme here is that it takes partners.

20:11

You know, we will not be successful and successful in silos, right? And so, we need to work together, both, internally, as a team, and externally, as a team, As well to really see industry level success. And so, the US, we think about early stage clinical trials.

20:26

You know, it's most important, when, we think about success long term, the products have to work, and the products have to have a clinical benefit to the patients that we're serving. And, so, we spent the early years, I mean, you heard, you heard Lindsey talk about the fall of 2016. And she had a very, very early version of product.

20:45

But, thinking about getting the product development right, and really focusing on clinical development, like, how did we get the science, right? How did we get the product right that can create an intervention to create an outcome?

20:56

That the beauty of the science, which Alex mentioned, that has been around since about the 19 seventies, but how you can use an external rhythm to engage systems within the brain, is that it's applicable, if it's human neuroscience.

21:11

It's about music perception and production in the human brain, which is applicable to every person on Earth, regardless of their brain injury or not.

21:18

And so we built a platform that we could launch different products and different disease states over time, that could be personalized and customized to every individual within those disease states. And so we spend a lot of time setting up these clinical trials, you know, we're going to be finishing up our pivotal trial and chronic stroke very soon, which is an eight site randomized control trial, and we have six other ongoing clinical trials with Alex and PD, We're working with Cleveland Clinic and MS We have a neuroimaging study coming up, so really focusing at first.

21:52

Fundamentally, product needs to impact, right?

21:56

But in a new industry such as digital therapeutics, there's novel ways to think about getting through regulatory approvals and thinking about commercialization for products that would be and thinking about reimbursement, which has never been done before.

22:11

And so, you know, there's a lot of, as we eat, I think we all understand the complexity of the healthcare ecosystem.

22:18

And so, when you're building a new company, particularly in a new industry where there aren't precedents each one of those avenues is, you know, a mountain to climb, that may be a little bit different than other existing industries.

22:30

And so, you know, we're working with a lot of partners in each one of those domains.

22:36

But specifically, you mentioned about the, the, the partnership with Universal Music Group, which is something that was really a very exciting moment for for med rhythms. And obviously, as a, as a musician myself, the partnership was announced and Rolling Stone, right? So yeah, oh, cool. Music.

22:53

Not only, you know, quoted in Rolling Stone, but what an honor, it was to be telling this story about the power in this way, to that audience, which was, which was awesome. But this really comes back to, to partly what you said about your ideas, and thinking about personalizing and medical intervention with personalized music and music that they like.

23:19

What we know about the neuroscience of ..., is that your brain functionally responds better to music that you like, EG, we can likely get greater outcomes, doing rhythmic auditory stimulation.

23:31

If we can do that with preferred music.

23:34

Also, we think about, like, in order for patients to use the product, they need to be able to engage, they need to be motivated to do it, there's probably a motivational value to being able to use that Music.

23:46

And so our partnership with Universal Music Group is quite robust, but one of the biggest pieces of it is that we get access to nearly their entire catalog of music, which is about 50%, nearly 50% of the world's music, They have the biggest country, music label, Steve.

24:00

So, you know, can literally, and what our, what our platform does is we can take any piece of music that a patient like So listen to and then we can mix it. Think about it like a sort of a health care DJ.

24:11

We can mix the music to make it therapeutically valuable to that patient in the moment. And so that's what gets really exciting about this partnership, and it's the first of its kind partnership in either healthcare or the music industry. And so, you know, I think we all raise each other, but it doesn't happen in silos.

24:29

Great, great response. And I was sharing the link to the Rolling Stone in our article here a couple of days ago, and people are like print mesmerized by like, that's beyond bucket list. I think it was like, Nobody has it on the bucket list to do that, and that's pretty awesome.

24:45

Lindsey, I would love to hear about your role on the patient advisory board and how that's helping to shape how decisions are made at med rhythms, and your involvement there. We'd love to get your perspective on, you know, basically your role within that in that setting and how it's impacting men rhythms.

25:07

Mom, so, the Patient Advisory Board was set up, probably Brian Kraft paper, I'm like maybe two years ago, year and a half ago.

25:15

And it's, you know, really looking at the, the patients and what we know, and from MS to Parkinson's Stroke.

25:27

And really seen, know, what? What do you need to provide people? How are you going to use? What's going to make it intriguing for you to use because, as I kind of alluded to before, like, you can have a product, that's fantastic.

25:44

But if there's something about that product, at the end, you're not going to want to do, then, No, it's not and men rhythms is really come with us from the ground up and saying, OK, what do you think of this? Do you think people would, you know, would use it, would like it?

26:01

From this And being able to, you know, you know, as a, as a patient inez, someone who's done music therapy for for quite a lot, and now, you know, to, to provide that.

26:14

That feedback has been been wonderful, and to meet such other fantastic people that are inspirational.

26:21

And just see how music has touched their lives as well.

26:27

And down, No, I think it's just incredibly important to have the patient voice there.

26:34

And for the product. And, you know, I talk a lot about today, as a patient, you need to be your best advocate for yourself and being able to get access to this type of treatment. I think this is one of them.

26:46

Thanks. And to be able to now.

26:49

No, I haven't friends with MS in Colorado and different states and things like that and, you know, soon then to be able to tell them, like, this product, you'll be able to, to use, no matter where you are and having met rhythms, Um, guide that process.

27:09

Great. It's great, Alex. Alexis, I don't think I've asked you a question yet. but I do want to ask you a question.

27:16

You know, you are, you are embedded within the landscape, if you will.

27:22

You know, your perspective having worked with other digital therapeutics companies and even, you know, on the Pharma and Medtech side of the house, where we're starting to get questions from, I mean, the gamut of, of individuals, you know, had some market research to know heads of digital therapeutics. And what's going on in this space. And what's our perspective of it?

27:41

I would love to hear, you, know, from your standpoint, what you're seeing and then, you know, what is the, I think, what is the key difference maybe from what you've seen in others versus what we're seeing and my rhythms?

27:56

Yeah. No, absolutely it's a, it's a great question. And so you know I mean you know I work and I can add the patient engagement team here at Ipsos also sort of work in digital health. And so my life's work is really around making sure that we're helping clients spring, you know, the right solutions to the right patients and more faster and kind of efficient manner. And so, you know, a lot of the work that I do with our clients tend to focus around helping them update or refine their strategy for how they're gonna, you know, better kind of bring patient engagement to the center of everything we do, Not help them evaluate partnerships, new opportunities, and then, you know, bringing that inside to the internal workings of an organization. So kind of making the rubber hit the road there.

28:38

So I'm personally, so inspired and motivated by this, this med rhythms, you know, what my rhythms has been able to accomplish because they think it's just such a beautiful case study, almost of how true patient centric engagement, innovation, how it works. And it's, um, you know, I wrote down a couple of things here that just kinda stuck out to me. As, you know, lessons learned are kind of opportunities for the industry. And the first thing that came to mind for me was this importance of really starting with patient needs.

29:08

So, for example, you think of someone with a neurological condition, and, you know, you think maybe if they're able to walk, that's, that's good enough. But it's really, it's really not, and I think Brian really touch on that really well, There's this emotional component of being able to walk well, and being able to get from one place to another. It's not just a physical component, that's also this emotional, and it's not just on the patient side of things, that's also from the healthcare providers, saying, Sorry, you know, that's, that's what gets kinda get. And, you know, I'm so thrilled that, you know, with this story, when, it was about, not just stopping there, but kind of going forward, because it's something that really matter to clinicians and patients to kind of address it.

29:46

I think another kind of key takeaway for me from this is, you know, sometimes the best innovations are things that are right in front of us. And it's because those are the things that are easiest for patients to adopt. Now, for example, music, it's, you know, some people want to listen to anyway, and if there's a way to turn that into medicine, and we lower that threshold to adoption. It's just incredible, and applying that it can have on a digital scale, helping us reach people, no matter where they are. I think it just makes the playing field so much more readable and accessible, which is something we really need healthcare right now. There are a couple other things which I will just kind of maybe you mentioned 1 or 2.

30:20

Which is, I think this is a really great example of pivoting and kind of being agile, and I loved what Brian kinda mentioned, and of course, Lindsey will probably be able to speak to us. You know, better than anyone, but this evolution of the product over time. So, bringing something to market. But, then, staying nimble, staying Agile, talking to patients about what's working, what's not working well, and being able to kind of start from scratch again, to make those improvements incrementally over time, and, you know, 20 16 to now is, you know, given what Matt Rhythms as accomplishing. It's not that long of a timeframe for, you know, what is truly incredible innovation right now. So, I'd be curious myself, you know, Lindsey, if you could speak to the evolution that you've seen from, from those early days to now.

31:05

I mean, it's quite dramatic.

31:08

You know, it was a little chip that, when in them, all my shoe, and Owen had a computer, and, you know, trying to, like, figure out how to that recording isn't not to now having, you know, you guess.

31:25

Oh, and there's special a headset, and you put this on your left button, this, on your right foot, and it's, you know, night and day, and I can also speak to, you know, I'm very excited for the partnership as well, with the, They include the, the library of music that's to come, because, I think, and I think it was either, Brian, you, Senator Steve, but like, if you know, you're a country guy, If there's no country music, you're not gonna like, what I do, well tested the product.

32:00

But, as Brian knows it, it's probably not the music that I really listen to right now, on the, on the device.

32:07

So, when things, you know evolve, I'll be able to, to have that opportunity to use the music that really speaks to me.

32:16

And then, therefore, it's gonna allow me to, I'm gonna want to do more, Um, know, working on it, and things like, that will be more enjoyable, all see more progress, hopefully. And, it's kind of that, that sort of fall.

32:32

Yeah, it's just amazing how you can start with an idea, and, and, kind of, see it all the way, way through.

32:39

It, since, really remarkable, though.

32:43

I didn't know what it was when I, you know, six years ago. I'm, like, what are they doing? I don't really get it. OK, you, I'm gonna put this information.

32:50

I remember, so, I, I remember sitting in so mad rhythms, at one point like, Early On, was in a co-working space.

32:59

Not, too far from their, their corporate office, right now, but I was in there, I was working alongside them, and I know Owen, and I know, Brian, and just to see, I remember, you know, I think it was five years ago just to see the excitement like, that was in the room. Like, you guys were, I think you were working on some of the gait training, for the, for the platform.

33:23

I remember talking to one of your data scientists and, you know, it's just a, apart from digital therapeutics and innovation in the healthcare space. It's actually a really amazing story for the State of Maine as well, which is obviously, where Brian and I, reside.

33:40

Right?

33:41

There, we go up there to try to point to it serves. A purpose back, there?

33:48

Brian? I think those are a testament to the fact that like, Lindsey was willing to keep coming back as early, is early days of product, when we have it. We talk about building mobile products, right? Mobile product. Our mobile product was a netbook that you carry. It was literally a computer that you carried with these awful sensors, that, like sporadically collected data, and the music that people were listening to her, literally, these awful MIDI files. Like, it was really, really, really bad, but it was what we needed to prove a concept, Right Exam.

34:24

We're very lucky that Lindsay like, have that experience and said, hey, I'll try this again. That's awesome. And that was that was in the summer and main, right? None of them went, yeah. Brian, how do you, when you think about and I think about this from time to time.

34:41

like getting from point A to point B to point C, we just talked about building an MVP, you know, six years ago. A minimum viable product. What do you think about scale? Where do you want to take it?

34:53

Tell us your vision like, we would love to hear it!

34:57

Yeah, as I said at the beginning, we started this company purely with the mission of helping people that need help the and what we fundamentally believe deserve to have the highest quality of care.

35:11

I think that anybody that has walking deficits should have best in class services provided to them, and we saw firsthand the impact this could make.

35:21

And so, when we think about our vision and our scale, it's bringing this to every single person that has a walking deficit.

35:28

I mean, obviously, there's a, there's a vision, and there's an execution, right?

35:32

So, the vision is bringing this to every single person that has a walking deficit around the world, you know, walking deficits don't just happen in the US, right? This is a global problem.

35:41

These walking deficits impact nearly every aspect of somebody's life, quality of life, their independence, fall risks, safety, right, the feeling of self efficacy, feeling of safety and independence, and these types of things around the world.

35:57

And so we're hyper focused right now. Obviously, on the US, first. We have to be to execute there to do this well.

36:03

But our vision is that this is something that we can bring to the world, because the world needs it.

36:09

That's a great point. I'd love to have one of the things I didn't mention earlier is that I think is another kind of key lesson when I think about my rhythms as this kind of willingness to depart from kind of traditional expectations, traditional processes and in some ways it's sort of forging a path and anyway. And so, I'm personally curious, you know, for myself, Brian, doctor can tell you that, Lindsay, or you're served perspective, so, how has kind of this partnership that you have with ..., Brian, from your perspective, the partnerships that you have externally? How have you will have you come across any challenges with this kind of new way of working together? You know, how have you, know, gone forward? and what kind of lessons learned do you feel like you're taking away from, from your experiences together?

36:56

I'm happy to start, and they would welcome. What would welcome their thoughts?

37:01

Yes, there are challenges across every aspect of the organization, in terms of, as I mentioned, health care, it's very difficult, but I don't think that we can.

37:10

We can lie to ourselves without explicitly acknowledging, Bringing a product to market in healthcare is hard.

37:18

It's hard to do, there's so many things that you have to get, right.

37:22

You have to get the product, right, you have to get the clinical trials, right. You have to get the FDA, right, you have to get the doctors, right, in terms of prescribing, you have to get reimbursement, right.

37:29

There's so much that has to align to have the success that we've talked about, them, that we dreamed of, right. And so in every aspect of that, there's been challenges.

37:40

Our approach, though, to offset those challenges, has been, we acknowledge that on day one, in 20 16, that this was going to be really hard, so that when they happened, we weren't going to be surprised by them. And then with that frame of mind, you can keep your blinders on and hyper focused at each stage of what you need to do to overcome them.

38:00

And then we fundamentally believe that you don't overcome them without creativity and health.

38:06

So we know that, like everything, even our partnership with Universal, like, that's a very novel type of partnership that we had to get really creative to. Figure out how that was going to work.

38:16

Right, Islam, product development. We had to get really creative to figure out how we're going to put a therapist in a box, and an app, and a product, and send it to. Right. So, but, these are not like, we were sitting in a room by ourselves, drawing on a whiteboard. Right. I mean, we were talking with Alex.

38:32

We were talking with Lindsay, and we were talking with the universal, we're talking with all our clinical trial sites, to say, how can we do this together, and how does this make most sense to the world?

38:42

So, yes, lots of challenges.

38:47

Doctor Nantel. Yeah.

38:48

That's sure.

38:51

I have to say that from the get go, the process, from my standpoint of interacting with Brian and with others in the Med rhythms organization has been rather smooth.

39:03

You know, the day-to-day challenges of any clinical trial, which is something that I've come to expect over the years are there.

39:11

But, you know, thus far, the I don't know if you could call it a challenge.

39:15

The main feedback from our study participants has been that they wish the music were a little different.

39:22

And to Steve's point, about country, it seems that with the partnership that has been concluded with Universal Music group.

39:30

That should be going away in the next iteration of the product. Then.

39:36

Other than that, you know, the product is easy to use. That's the one we're using, in our trial, for Parkinson disease.

39:45

To illustrate that, I, the first person who tried to decide for me, when we got it shipped to us.

39:51

It was my three year old son, and he didn't want to take off the headphones. He really enjoyed it.

39:56

It seemed like he had trained to the beat reasonably well. I think I mentioned this to Brian early on.

40:02

And so that's a good, that's a very good illustration of what needs to happen. People, with Parkinson disease, people with stroke with multiple sclerosis.

40:11

Suffer, not only from movement difficulties, but their emotional and cognitive challenges as well.

40:17

So ease of use is particularly relevant if you're talking about segments of the population, aged 65 and older, which is the vast majority of patients, with Parkinson disease.

40:29

So I think that box is checked successfully. With a product, we're currently trialing and that's very important.

40:36

And the day-to-day week to week interactions, we have constant interactions with our study participants per the protocol over trial.

40:44

That's a 360 degree loop because we are in touch with ...

40:49

rhythms and people on their side to make sure the data are being uploaded appropriately and they are entered sharing.

40:58

They're feedback with us from the data that are collected from our participants.

41:03

So it's a constant iterative process and that's very important.

41:06

Just to step back, one thing that I've been hearing, which I really feel we need to emphasize is that music based interventions and rhythm based interventions will never be a one size fits all.

41:19

It's something that we really need to emphasize.

41:22

There's still this kind of, know, in the general among the general public, this mistaken, since maybe Mozart is going to cure everybody well, my background is as a classical violinist share birthday with Mozart, which is kinda random. But I happen to love his music.

41:38

But I know that that's not going to cure everyone, with Parkinson disease or anything else. Some people might like Mozart in my like walking to Mozart. That's not going to be most people.

41:47

So adaptive and individualized approaches, which is exactly what mad rhythms is trying to do, are absolutely crucial, because that's going to maximize the impact of these therapies, which really can be a powerful way of helping people walk better.

42:05

From an emotional standpoint, there's a lot of improvement to be seen and perhaps even from the cognitive stamp doctor Alex, I have to ask as a as a trained violinist.

42:16

If you ever gotten your hands on a stradivarius That's the question that, I, I've come close but no cigar so far, Steve started its. Fair play, fair play.

42:30

Have one last question, kind of related to that, same kind of idea of feedback, and personalization, And maybe, like, Lindsey. You're the best person to weigh in on this. So, right, now, I mean, I hear clients come to me all the time, and they say, you know, we want this patient input, we want patient feedback, And, you know, that's great, because we do need to have, you know, that personalization, That iterative kind of approach. I guess, maybe this is a question for both Lindsay and, Brian, how do you balance that need? So, let's say, for example, on your end, to want to provide input, to, want to provide feedback with. Without having it be burdensome to yourself and kind of your day-to-day life. And Brian, how did you go about trying to strike that balance as well? So you want the input. You want the feedback from end to end, but how do you make it so that it's enjoyable for everyone, including you?

43:17

I'm gonna go first, Brian.

43:18

All right, well, I feel honored anytime I get to kind of give my my input and, no, I feel it's an and important for the whole kind of MS community, as well as my myself being able to provide that.

43:38

That information, especially if it's useful and helpful and, you know, I No, saying, you know, starting this six years, I will try almost anything aside, fairly safe.

43:52

No. And I think it's just so important to get the feedback to hopefully then help others.

43:57

So I'm just, that's just my personality that the more I can do, the more I can can help others.

44:05

Whether it's no telling Brian what I think of the product, whether it's, you know, talking with someone newly diagnosed anything kind of like that I'm willing to do. And I feel like many rhythms and other companies.

44:22

To know that there's like a balance, like, there's only, you know, there's so much feedback that can be provided and given and can do as much as we.

44:32

We can't, it's not, you know, kind of like a daily thing.

44:36

Ah, Every couple of months or, you know, sometimes there's more focus and then backs off because you give your feedback and then, work needs to happen from that. So, it's not a constant.

44:49

But, personally, the more I can provide my input and feedback, I feel honored to, to do that. Hopefully, you know, selfish help myself and hopefully help help others, as well.

45:05

I love what you just said there, you know, Sometimes you provide your feedback, and there's a pause, because work needs to be done and like here, you have that confidence that what the, what you gave feedback on is going to change is so powerful, you know, for me to hear. I think a great takeaway as well.

45:20

Thanks Brian, already.

45:22

Yeah.

45:26

Yeah, you're cute. Sorry. It's good.

45:31

one of the things that's really interesting about even just thinking about that is, I have never felt that the feedback was burdensome. I mean, we wants to help. So I want to hear what patients have to say good or bad about the products so that we can make it better.

45:45

I think also, our goal as an organization is when we ask for feedback. Whether it's officially through our patient advisory board, or through lots of other people living with MS, PD stroke. That we're also providing value to their lives as well. Right. Like, so, what can we do as an organization? That you're not just giving us feedback, but how can we make this mutually beneficial?

46:07

But the other thing that's really interesting that we have found is that people want to help.

46:12

You know, one of the things that I learned as a clinician is that people want their stories heard.

46:16

People want to feel like they're integrated in part of the product, because they have felt so just integrated from the health care system, throughout their journey.

46:23

And so, people are very willing to, and want to, to, to give their feedback.

46:28

The, I think, the, the larger challenge is just the setting the expectation of, of, based upon feedback, what is possible now, versus what is possible in future, right? So, we can't take every piece of feedback and make that a feature of the application tomorrow.

46:45

But also just aligning those expectations of, What is our process, and where does this go from here, is really important.

46:55

Fantastic.

46:57

We're getting close to, end of time, We got 10 minutes, and I've got a slew of questions that have come in.

47:04

I'm gonna go through them and try to find the ones that we can probably answer now and then we'll take the others offline because they might require a little bit more detail than I able to orchestrate in this 10 minutes.

47:19

The first thing that, well, first of all, people want a demo. So, is there a plan to demo this somewhere?

47:29

Um.

47:32

Well, yes. Yes. I mean, we're coming up on a, on a, you know, hopefully later this year on a commercialization, of a product by which leading up to that, you know, There will be lots of opportunities for demos. Videos of demos and how product worked, and things that we will, that we will make public so soon.

47:51

Awesome. Quite, always, welcome. I mean, in this process, we have an opportunity to engage end users, people that may actually use it for, for, for feedback.

48:01

So if there are folks, either in the audience, or people that know people that are living with stroke walking deficits, et cetera, we have opportunities for them to be involved now in giving us this continuous product feedback.

48:13

Awesome. Next question: Can the technology differentiate between shuffling steps and distinct steps?

48:20

Cool.

48:22

Great question.

48:24

Yeah. It's interesting, because the the, the data that we are collecting from the it's very high fidelity gate data. So it comes from ankle or sensors, which, in the world of motion, analysis is basically, where you can get the highest fidelity of data from wearable sensors, is from the ankle.

48:43

We get about 40 data points for every quote unquote, step that a patient takes.

48:49

Now, I would say there's certainly outliers, meaning there's presentations of gate parameters, People who take very, very fast, fast, shuffling steps that's difficult to distinguish and people who take very, very slow steps. That's difficult to detect just from the state of motion sensing technology right now.

49:08

However, when we think about people who have a fascinating gait pattern, that, in my mind, goes, you know, too, doctor ... world of Parkinson's disease. We've seen fairly good ability to detect when this happens and to detect these steps and be able to respond.

49:26

When that happens, you know, given the fact that, you know there, there is outliers to that as well.

49:34

Makes complete sense.

49:36

We have time for a couple more questions.

49:38

So one is are there plans? Is it possible now or are there plans for the data to go directly to the to the clinician?

49:50

Yes. So it's in the TSO.

49:52

This is also part of our Rapid Feedback loop which is with physicians about what data? do they need? Do they want? Do they care about?

50:02

Because what we don't want is to burden the, the prescriber with more processes or dashboards or data that they don't, they don't want. And so we are doing rapid testing of this now to figure out what does that data look like? in early days.

50:19

It's likely a sheet that the patient can take to the clinician to give them the feedback on their, on their progress of, of how often they were doing the walking, how their speed changed, or how their symmetry changed over time. We will get smarter about that, as we, as we get farther along in the process.

50:42

Awesome.

50:44

There's another question that came in, can the gate data be tracked over a treadmill, as well as over the ground or is it ground only?

50:54

OK, I get asked this question a lot. Actually: so it's a, it's a good question.

51:01

So the, the intervention itself, rhythmic auditory stimulation can be done in tandem with a treadmill.

51:12

However, the product itself, if you think about how a treadmill works, particularly for people who have gate deficits, the purpose is to move the feet for the patient.

51:21

So, you're on a track, your foot moves, You have to walk at the speed that the track is moving.

51:27

right, but you have to be able to do that.

51:29

So, there has to be a synchronization between them auditory and the movement of the track.

51:35

So, current version of product is not synchronized that way. I mean, that would be a little different product. Right, So, we don't encourage people to do this on a treadmill because we are independently trying to drive neuro motor control.

51:49

So, we're trying to drive a change in speed by virtue of a A neurologic input, not by moving the ground underneath them.

51:56

So, the two working at the same time would be dissonant, but science could work there.

52:05

Fantastic, I think that's all the questions that we have time for today. For other questions, we'll make sure to get you a response via e-mail through one of us. Any last parting comments, thoughts from the panel? First and foremost, Thank you. It's been such a pleasure, my goodness, You know, such a pleasure to be able to speak with everybody. Any closing thoughts or comments from, from, from the group?

52:30

Just to piggyback on something that Lindsay was saying before.

52:34

two key aspects of what any successful medical grade product needs to have safety.

52:41

And it needs to be reasonably enjoyable to use if you're talking about a digital therapeutic.

52:48

And I think that, again, with our experience so far working with my rhythms, a product checks both of those boxes, the enjoyment in particular is crucial because we know that it activates the shared set of regions in the brain, inter-connected regions and network of enjoyment. That is the same network.

53:09

That is activated when you're exposed to alcohol, cocaine, heroin, other drugs, of abuse, with intense enjoyment that could be coming from music that you actually like.

53:20

Again, something that you really prefer and select yourself.

53:24

So, why?

53:26

The reason that's important is that if you enjoy something like this over time, you're going to be more likely to keep coming back to a time and time again, and in neuro rehabilitation, it's absolutely crucial to sustain and do exercises on a regular basis, So in this case, walking to a strong rythm, so we need to do that 3, 4, or five days a week in order to see improvement and sustainment.

53:52

So that aspect of being enjoyable is absolutely crucial and safety so far has been great as well so that's obviously very important for any medical product.

54:05

I'll just say thank you. Also, as I mentioned, anytime, we get an opportunity to share the journey that we're on. It's always an honor to do so. And I want to thank Alex and Lindsay as well for not only their help throughout the process of building this, this company, and you know, really focused on our mission. But also for being here today. And being willing to to talk about your involvement means, a lot to me, and we're honored to have you. So thank you for that.

54:32

Pleasure to be back.

54:35

You see any final thoughts, comments, I know you had mentioned me to ask some exciting work with I conquer MS. Give me an opportunity to talk about that.

54:44

Thank you. Yes. So one of the exciting Care projects initiatives, it's called ... dot org.

54:50

It's for people who are diagnosed with MS but also Care Partners impositions and we really focus on hearing the voice of those who have MS by using the reported outcomes, filling those out, as well as helping recruitment their studies.

55:10

And also we have a program now that allows you to submit questions regarding either copen 19 or symptoms related and voting on them.

55:19

And it's really two, to help said, you have a voice in research, You know, we need to know what, what you're interested in, and, and hopefully we can figure out a way to get those projects funded, as well as just caring, hearing the patient. Voice is so important.

55:42

Yeah.

55:42

Thank you for letting me me share that, and if anybody ever has any questions or anything I think by, e-mail's is available, and I'd be happy to, to talk.

55:55

Awesome.

55:56

Awesome. Awesome.

55:58

Anybody else before we go?

56:02

My and thank you all so much. It just think that this is going to be so powerful for so many of the groups that I work with to hear this kind of messaging. It's just, really can't be understated how, how important and valuable it is for the future of health care.

56:14

So for me, like, you know, seeing where met rhythms has come over the last 4 or 5 years and imagining, you know, what's, what's it gonna look like in two years in three years and five years? I'm so excited for the impact that it's going to have on patient's lives. And Brian and Team, Thank you so much for all that you do.

56:36

Thank you for as much.

56:40

I think that's a wrap. Audience, thank you so much for your attendance. If there are any other questions, please shoot us an e-mail, and we would be happy to respond, and we'll see you next time. Thanks so much.