Interview with Ran Zilca, Chief Artificial Intelligence Officer, Happify Health

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Interview with Ran Zilca, Chief Artificial Intelligence Officer, Happify Health

Ran Zilca, Chief Artificial Intelligence Officer, Happify Health discusses the significance of technologies such as AI for improving mental health and mindfulness

1. Can you tell us about your role at Happify Health?

One of Happify Health’s core differentiators is the use of advanced AI algorithms in delivering the most engaging and efficacious digital therapeutics interventions – primarily using our digital AI coach, Anna. My team is responsible for developing Anna’s machine learning and deep learning algorithms and to create a clinical model of interaction with users. The team comprises data scientists and clinicians working together to make Anna an effective and engaging hunan-like coach – one who listens to users, cares about them, and is curious about them. We are also responsible for anything-algorithmic at Happify, including content recommender systems, predictive analytics, and the signal processing algorithms used in Happify’s Breather biofeedback game.

2. Can you tell us about your journey into this market?

I went through two major professional transitions in my career. The first one, in 2005 was when I left IBM Research to start my first company, Signal Patterns. We had a joint team of research psychologists and computer scientists, and we developed the first ever intervention app, called Live Happy. The second transition was in 2011, when I was certified in coaching psychology. Both these transitions broadened my professional focus from tech-only to research psychology and its implementation in coaching. In 2013 I started another company called Intrinsic Mobile where we started working on a prototype of a conversational agent we called “Liz”. When I joined Happify in 2015, I’ve already filed for a patent on the “Liz” prototype, so I guess one can say Liz was Anna’s grandmother ?

3. What is the significance of digital therapeutics for optimized healthcare?

We are in a very unique time in the history of healthcare and medicine, where technologies that enable new treatments have advanced so fast, that the science of medicine now needs to catch up. From my perspective, Digital Therapeutics are a way to bridge that gap, namely to create digital products for treating and managing different clinical conditions in the following ways never attempted before:

Continuously. As opposed to the traditional session-based medicine, or the pill/shot you take at a certain time a day, mobile technology now allows us to be in the patient’s pocket during the day, and at their bedside table at night. So that both monitoring and intervention can be done 24/7. This is especially important since many conditions have an episodic nature, so episodes/flare-ups/attacks etc. can be detected and addressed in real time.
In an ultra-personalized way. Aggregate analysis of patient data can tell us exactly what works for whom and when, and as a result, efficacy of interventions is greatly boosted.
In a human-like way. Conversational AI technologies like the ones used in creating Anna, can engage users in-depth by providing a sense of care, listening to users, being curious about them, and learning to know them well.
At a fraction of cost and with much broader reach. The nature of digital interventions is that they are expensive to develop and test, but inexpensive to administer. In many respects this is similar to pharmaceutical interventions, and the revolution they brought medicine.

4. What is the role of AI-powered products in improving mental healthcare?

THE DESIRE TO BUILD AN AI THERAPIST/COACH HAS ALWAYS BEEN THERE, BUT THE TECHNOLOGY TO ENABLE IT ONLY MATURED VERY RECENTLY.

Back in the early 2000s I worked at the speech and natural language group at IBM Research, where we very frequently discussed the notion of creating “helping conversations” with machines. Years later in 2009, I wrote two blog posts about this topic in Psychology Today. This was the time when the very first scripted/manualized CBT software was coming out of research labs, and the company I started as an entrepreneur launched the first-ever mobile psychological intervention app called “Live Happy”. Our app mostly used structured assessments as its form of input, but already had a primitive chatbot that served as a “concierge” to guide the users through the different activities and check in with them. In the early 2010s, a series of breakthrough algorithms were introduced by the deep learning research community that finally made it possible to understand natural language in-depth, and to generate natural language responses. Today we have great building blocks at our disposal, but most solutions are still very tech-diven, and often lack deeper clinical understanding. In that sense, the Happify AI team is unique as it includes a mix of clinicians and data scientists.

5. How can technology help in amplifying mindfulness practices?

Similarly to other skills, learning to be mindful in everyday life starts with practicing mindfulness in a more controlled environment: namely mindfulness meditation and other mindfulness exercises. A digital environment like Happify can very naturally guise a user through a journey when they first learn about mindfulness, then gradually experience it, and finally exercise in everyday situations. For example, Happify includes audio-guided mindfulness meditations exercises, and also savoring exercises, and other exercises where the user commits to exercising mindfulness skills in the real world. In addition, our digital coach, Anna, helps users become more mindful by helping them reflect on situations, analyze them, and explore alternative perspectives that can reframe their way of thinking about them.

6. The pandemic resulted in a lot of people feeling lonely. How can Ampersand help with that?

The pandemic has caused a loneliness epidemic, with an October 2020 survey from the American Psychological Association reporting that an estimated 73 percent of Generation Z adults reported feeling lonely. Ampersand can help by helping people manage the internal feelings of loneliness that can start with self-compassion and self-acceptance and include how to create new relationships or strengthen existing ones to feel more connected to others and less lonely. Our Ampersand product includes a series of content tracks such as “Defeat Loneliness,” “Empty Nest, Full Life,” “The Friendship Improvement Project,” and “The Power of Positive Communication,” to help build skills to defeat with loneliness and build new skills to strengthen our relationships with others.

7. How can digital solutions help people battling with stress and burnout?

Stress and burnout are typically chronic rather than acute. Daily stress and excessive workload present an emotional burden that may not be noticable in the moment, but over time accumulates and takes a very harming emotional toll. Digital solutions have a unique advantage, in that they can accompany you as you go about your life, in the moment. You can address little daily stressors as they appear, and hit them one at a time, close to real time, so that they don’t build up over time.

8. Can you tell us more about your product ‘Tend’?

Our Tend product focuses on strengthening and enriching existing relationships — many of the tracks focus on family relationships or intimate relationships. Relationships can be a source of joy—a powerful antidote for stress & worry. And yet, they also can be a significant source of stress. Tend’s programs and activities help individuals build the skills for developing stronger, healthier relationships. Included in the Tend package include content such as “Build a Stronger Marriage,” “Raise Happy, Resilient Kids,” and “Take Care of Yourself After Having a Baby.”

It’s well-known that the most potent ingredient in any (human) talk therapy is the therapeutic alliance – the bond formed between therapist and client. E recognized very early on that this is the biggest challenge and also the biggest opportunity in designing Anna, so we focused all of our energy there. The outcome is that Anna, while still designed to walk you through activities/interventions, still listens to what you say, responds, and is curious and caring. The most rewarding part in our journey with Anna was hearing real users describe Anna in those same words.

Digital therapeutics users experience deeper engagement, and personalization. Also, Happify Health’s patented Adherence Fidelity algorithm increases efficacy by steering users to the optimal path of interaction with conversational interventions (details below).

9. How can healthcare organizations improve their patient engagement during and post pandemic?

A key concept that I often find missing in healthcare is the notion of intrinsic motivation, a concept defined in Ryan and Deci’s self determination theory that is based on three principles:

1. Autonomy: Companies that provide patients with the sense that they are behind the steering wheel – that they can make informed health decisions autonomously – are going to see tremendous engagement. It’s important to avoid an overly prescriptive approach that denies patients of their sense of choice and control.

2. Connectedness: It’s important to let patients feel like they are a part of a community. This can be accomplished by providing users with a neutral platform for discussions and for being informed, like Happify Health’s Kopa app.

3. Mastery: Patients should feel like they continuously acquire better skills that help them improve their health and manage and treat clinical/chronic conditions. Happify users very naturally advance to different levels as they continue to engage, and over time develop and enhance skills like mindfulness, gratitude, and the ability to reframe negative thoughts.

10. What advice would you like to give the upcoming mental healthtech companies?

Research has shown that much of psychotherapy comes from the therapeutic alliance formed between therapist and patient. When you translate this concept to software, you realize that when it comes to mental health, engagement and efficacy are interwoven. The therapeutic approaches adopted for treatment by software are important, but possibly only as important as the ability to engage users in the programs you create.

11. What movie inspires you the most?

The Wave. It’s a TV film describing the experiment put on by a California teacher in order to explain to his students how the German people accepted the actions of the Nazi regime. The first time I saw it I was in elementary school and it really shook my internal world. It was a big realization as a kid that we can all be manipulated easily, but being able to look beyond manipulation gives you a lot of choice. Many years later I was fortunate to work with Phil Zimbardo, who ran the Stanford Prison Experiment, so I could discuss these ideas personally with him. In my personal life, always try to remind myself that I have more choice than I realize. When people say “I can’t” they often mean “I choose not to”, and this choice of words makes all the difference.