By Teresa Murray, Freelance writer In Healthtech and writer for Giant Health Conference
Four years ago, on a pleasant Autumn afternoon, Daniel Amann, Co-Founder of Edupression®, had what would turn out to be his last drink with his friend. Later that day he received a call with the tragic news that his friend had taken his own life.
He noticed nothing different about his friend that afternoon.
Too often we hear similar stories. People who commit suicide out of the blue. Those close to them mystified as to why. Perhaps an unfortunate testament to how much effort depressed people put into hiding how they are really feeling.
It is a tragedy that in this day and age, so many people feel too ashamed about being depressed to talk about it, and many actively hide it from the people around them because of stigma.
Then, you just have to look at the sheer numbers of people suffering from depression in the world to get a sense of the enormous scale of the problem. According to WHO, almost 300 million people suffer from depression the world over. And they are just the ones with a diagnosis.
Many depressed people don’t even get diagnosed.
Also, a staggering 700,000 people or more die from suicide every year. (WHO) That’s not counting those who try, but fail.
After what happened to his friend, Daniel Amann, previously a senior manager in Insurance with a background in law, was not just going to just sit around and do nothing.
Daniel started by researching depression to try to understand what had happened to his friend. He started to see that that there was a lot wrong in the system and together with psychiatrist Prof. Dr. Lukas Pezawas of the Medical University of Vienna, they founded edupression®, a digital therapeutics company with one goal in mind - to help as many people as possible suffering from depression.
Daniel firmly believes that it would be a shame to have all this scalable technology available and not direct it towards helping to improve treatment and support outcomes for people suffering from depression, many with no access to any support.
“That would make no sense” Daniel says
edupression® started off their journey small and it wasn’t easy. They had to overcome some tough hurdles at the beginning of their start-up journey. But the company has
grown quickly since. One of the early challenges that Daniel cites as being particularly difficulty was finding the right type of software developer partnership.
Then, of course another one was, and is, the rigorous demands and effort involved in navigating the different regulatory spaces of the European Union.
A particular challenge is participating in clinical trials.
But Daniel and his partner have a clear vision and a driving motivation so kept going. Their goal is focused on improving outcomes for people suffering from unipolar
depression. The more people the better. They are aiming high in terms of their ambitions of scale and with their goal of developing personalised episodic diagnostic and predictive capacities in their DTx.
Ultimately they want to develop the capacity to do digital phenotyping.
edupression® has already obtained European Union certification for its Digital Therapeutics devices. Now, they have partnered with the University of Vienna to run one clinical trial, and with Jansen to run another. They are also applying for DIGA certification. Daniel explains that participating in clinical trials and seeking DIGA certification involves a ton of paperwork and challenges in recruiting enough participants.
But Daniel and his team wouldn’t have it any other way. For edupression® there is nothing more important than demonstrating efficacy every step of the way.
No esoteric dabbling for edupression®! Daniel is very clear about that.
In terms of their market offerings, edupression® has developed two digital therapeutic devices, and built an engaging, top notch platform around them.
The focus is threefold.
First, there is a clear focus on psychoeducation, an area that Daniel found to be severely lacking. They realised that people are not as well informed about depression as they could be, even when they suffer from it. So, it was very important for them to have a dedicated system which would deliver effective, quality educational programs that took people from a basic understanding up to a more advanced level.
Psychoeducation is a key pillar in reducing stigma and increasing self-care.
Second, edupression® focuses on the delivery of evidence based Cognitive Based Therapies (CBT) therapeutic content. CBT has been demonstrated in RCTs to have a positive outcome on people suffering from depression. In fact, edupression® is already seeing impressive outcomes in the clinical trial that they are running in partnership with the University of Vienna.
Third, there is the very important pillar of tackling the stigmatisation so habitual in depression. Daniel explains that they do this by using objective measures. For edupression®, it is in the domain of objective measures where the potential for real innovation lies, and where they have a clear vision and ambition to go even further.
So, what exactly is their ambition?
edupression® currently uses active data taken from the person’s activity and feed to collect objective measures. For example, the person using the platform is encouraged to fill in a daily log and to regularly take questionnaires using evidence based scales like the PHQ9, Stroop, N-Back or the Kiesler circle.
Daniel explains that this is extremely useful, and not only for the person themselves. The platform user can also show these measures to their GP or therapist making it easier, and importantly more objective, to track the peaks and troughs of their moods over time.
Patterns emerge, and situational or behavioural triggers can be detected more quickly, facilitating prevention.
But in the future, Daniel and his team want to leverage digital capabilities to mine and leverage passive data, both sensor data as well as meta data to be able to detect changes in behaviour that signal the onset of a depressive episode before it even occurs. Digitally triggered prevention techniques and content based on the user’s own activity preferences could them be deployed in time helping to prevent the episode.
This functionality for Daniel is extremely important. After all, he never forgets what happened to his friend. To be able to detect oncoming episodes helps people to take proactive steps themselves to prevent and to receive adequate support when episodes do happen.
The idea here is that by accessing meta data via the person’s mobile device, like their GPS data, insights can be gained about their activity and even the quantity and quality of their social interactions. That way, subtle changes in behaviour or habits, perhaps signalling the onset of a depressive episode can be detected.
Daniel also mentions that digitally noticing how the person is typing – speed and pressure – can give clues about the person’s mood, energy and state of mind. This passively sourced data combined with the person’s own logging of their activities, moods and their more objective questionnaire scores can give a well-rounded view of how the person is really doing.
For Daniel, this would be a game changer for people suffering from depression. This happening to scale could contributed to reducing that figure of 300 million people depressed worldwide!
Regarding therapy itself, Daniel outlines a key feature of the platform edupression®; it can be used as an effective digital therapy for mild to moderate depression on a stand-alone basis but can also be combined with psychotherapy or drug therapy to leverage the positive effects.
While it does not offer on-platform therapy sessions via video conferencing, there is a psychologist available to answer people’s questions via chat or forms. Also, the platform displays a list of registered and psychotherapists who meet the criteria of offering evidence based, approved therapies, and users can simply connect with them via the platform in a very seamless way.
This is a very effective functionality because once a user invites a therapist to work with them through the platform, the therapist can also see what psychoeducation programmes the person has completed, which therapeutic content they have already accessed and also access the objective data about the person (i.e. the mood charts and questionnaire scores).
This way the therapist can compare and contrast subjective measures and therapy session content with objective ones sourced from the platform.
This is great for therapists. And great for their clients.
And it is why these objective measures are so important for Daniel and his team.
Daniel doesn’t miss his insurance career, but he does miss his friend. But this is what is driving him and edupression® to bring about changes in global depression treatments, one big step at a time.