Episode 20: Anushka Patchava MD, Population and Digital Health Expert

Scott Parish Body Clock Podcast

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Dr. Anushka Patchava is a Cambridge medical graduate who is currently working at Aetna. Outside of work, her interests are embedded in the three C’s: CrossFit (power-lifting), charity (she is a dedicated volunteer, founder and fund-raiser) and creations (be it artwork or social enterprise apps). She has advised a variety of health related startups on their journey to commercialization and is most invigorated by this sort of work.

In 2003, aged 18, she was the second youngest person to complete the London Marathon — making it around the course in under 5 hours despite fracturing her knee joint at 8 miles! She continues to be active all year round, summiting mountains (most recently SE Asia’s tallest; Mt Kinabalu) and at national powerlifting competitions amongst other things! She is a leader in the field of population health and is exploring blockchain and AI solutions for healthcare.

Transcript

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Dr. Sohaib Imtiaz: Hi, guys. Welcome to another episode of the Body Clock podcast. Today, we’re fortunate to have Dr. Anushka Patchava, who is currently working in population health, digital health, blockchain and artificial intelligence. She’s got quite a stellar career working in various strategy consulting roles. She was also training to be a radiologist and she studied at some of the top institutions, including Harvard and Cambridge. So she’s an avid fitness enthusiast and I’m really fortunate that she’s on our podcast. And we’ve also got Royan, CEO of Owaves joining us for this podcast as well. So, hey, guys.

Dr. Sohaib Imtiaz: So nice to have you on. So how are you doing?

Dr. Anushka Patchava: Not too bad. It’s a bit of rainy England, rainy February evening. Very well, thank you. How are you?

Dr. Sohaib Imtiaz: Good to hear. I’m good as well. Well, Royan is probably enjoying the sun.

Dr. Royan Kamyar: Here from San Diego. It’s about 70 degrees Fahrenheit and sunny. So to default to stop repeating it and rubbing it in two different climates and time zones.

Dr. Sohaib Imtiaz: So Anushka, just to start. So could you take us through your daily routine and your kind of health habits?

Dr. Anushka Patchava: Sure. My daily routine varies according to the weather. That’s very British for me. I know, but it does. It does vary according to whether it’s winter or summer. But in essence, I tend to get up 20 minutes for I have to be into work. I like the challenge of making it out the door and within 10 minutes and normally grab a protein shake or some sort of edible yogurt on the way. Head into work. It’s a pretty grim commute on the London Underground. So if I can’t, I try to hold down a black calf, which sounds terrible. But that’s again. If the sun’s out, then I will walk more speedily, power walk into work, and then I basically stick to a very strict diet routine. I’ve recently signed up to a company called Fresh Fitness Foods in the UK. So I get my food delivery, which is my morning yoga or shake, my lunch which is calorie counted and macro counted  my dinner delivered. So from that point on, I basically. You know, eat my food and get my gym workouts and when I can during my meetings in between, I mean, as I should say.

Dr. Sohaib Imtiaz: Because you’re quite busy. So you seem to fit and fit your lifestyle around work.

Dr. Anushka Patchava: I do. Yeah. And interestingly, I didn’t realize until recently how sedentary my lifestyle at work was. And so I was lucky enough to get an Apple Watch at Christmas. And I’ll tell you something – I didn’t realize I was spending less than 200 active calories a day just at my desk job, which isn’t great. So, yeah, I tried to fit in as much activity and exercise and try to stand up every day at least 12 times to get that close ring on my watch. And I do 750 calories of active work a day and be that walking up and down stairs or walking further than I would for lunch in order just to keep and maintain my cardiovascular fitness.

Dr. Sohaib Imtiaz: So do you have a normal route? This is just your normal working day routine. So you normally have a bedtime routine or does work make you kind of vary that quite a lot?

Dr. Anushka Patchava: Fortunately, with the digital era given we will work across time zones, it’s very variable. But I do put my do not disturb on my phone on probably at about 10 p.m. and then cut out screen time, so that I can tune out and get to bed. I think that’s one of the critical things I’ve also learned is – 10 minutes meditation makes a huge difference before bed. It clears your mind, it gives you that relaxation and it allows you then to, you know, almost tune out whatever happened in your day. Calm yourself, calm your body down and then get that good night’s sleep, which is so critical. Yeah. And another thing I’ve actually started using, which I’m not a big fan of is supplements and diet pills and stuff, but I’ve really benefited from using magnesium at night, because it’s one of those muscle relaxants. And again, it takes away the stress of the working day.

Dr. Sohaib Imtiaz: So Royan, do you think you can map out that O?

Dr. Royan Kamyar: Yeah, I think we got it. I do have some questions, if you don’t mind. Anushka, so you talked about noticing with your Apple Watch, you know they have that pretty handy solution in terms of, you know, seeing how much you’re walking, obviously, and how many exercise minutes you’re getting and then how often you stand right. Like every hour for, I guess, twelve or 16 waking hours. Have you, based on the feedback you’re getting, have you thought about like a standing desk or, you know, even one of these more ambitious treadmill desks? Is that something that’s on your horizon or are you just kind of taking for granted that we kind of have to sit down most of the day?

Dr. Anushka Patchava: You know Royan, I hadn’t actually thought about that. And I wonder if my employers would invest in something like that, given, you know, space is such a limitation in a central London office. But, you know, I think I’d benefit from something like that. I don’t know how often I’d use it. I know a lot of people started buying patterns and gone into that crazy, you know, let me have a spin bike in my house – would I use it. And I debated that at home and I was thinking, you know what? I like the fact that I go to the gym and I do my exercise away from any other distraction. And so I’m not sure if I really want, maybe a standing desk, but I’m not sure I’d want a pedal desk, so to speak.

Dr. Royan Kamyar: Sure. So I’m standing at the desk right now, just so you know, because I do think this is one of the public health hazards of the time, is that most productive cells is usually in a sitting position for at least eight hours a day staring at a screen. But I think I’m hoping, you know, with Owaves and some of the technologies we rollout, we can actually become part of the solution here. Another tactic, just kind of throwing it out there that I like to use at least to kind of make sure that I’m not sitting down too much are walking meetings or taking meetings on an exercise bank or a bike, frankly. And I’ll be doing that later today. But that’s the only way I kind of you know, to fit in some movement during what could otherwise be sort of a sedentary lifestyle or approach.

Dr. Anushka Patchava: I like that. I have yet to push the boundaries of taking a call on an exercise bike. And even better, while squatting or powerlifting. I am a big fan of the 15 minute walking meetings. And, you know, it’s all part of our agile methodology. And you know no meetings should be longer than 15 to 30 minutes. And you know, if you can do it walking, then that’s even better. So I’m a massive fan of that. And actually I find that the best thing about it is that it takes you away from your screen as well. And you can actually engage in conversation and, you know you’re not  texting in the background or looking at your emails or doing all the other things that we all procrastinate with when we have a screen in front of us.

Dr. Sohaib Imtiaz: London is quite a fast paced environment. It seems like you’re trying to nail down your nutrition and exercise and your sleep from time to time as well. But but socializing. Do you get time to socialize because you obviously got such a busy job and you’re working across so many different streams?

Dr. Anushka Patchava: Yeah. So I think, again, that’s peaks and troughs. I find that in the summer because the days are longer, you have more time socializing. Again at Christmas, there was a four week period that, you know, all you did was do client dinners and friends dinners and Christmas dinners. The thing is I started eating Christmas dinner the first week of November, it didn’t stop until the first week of January. That’s great for the count at all. But in essence, I think the idea of doing the Fresh Fitness Foods is not to cut out socializing, but to cut out the inefficiencies of finding food during my day. And yeah, and also it makes me, I think because the food is fresh, it’s counter to you know what I’m working out. And it’s, you know, it’s healthy in essence. I found I had better energy levels. I was getting more vitamins and minerals, than I’d get from, you know, going to I don’t want to say want it but a prayer or you know, a Nando’s every day.

Dr. Sohaib Imtiaz: Sure. So going for that healthy behaviors normally could be quite difficult, just the whole navigation and the energy required.

Dr. Royan Kamyar: But getting that five to nine recommended servings of fruits and vegetables per day – that’s actually pretty challenging. Unless you’re quoting with a pretty huge salad for at least one meal.

Dr. Anushka Patchava: Yeah. And also pretty expensive. That was the other thing. So, you know, if you don’t meal prep and unfortunately,  I don’t want to spend my Sunday meal prepping asshole, then, you know, it’s really, really hard, you know, for an individual person to sustain that sort of fresh foods and a coffee can take. I mean, I found I actually clocked it. It was costing me about 30 pounds a day, whereas my Fresh Fitness Foods cost me about 20 pounds a day and is delivered. And it’s, you know, everything else I’ve mentioned today. So it is really, really tiny. It’s a nice solution and definitely changed my energy levels. And and yeah, it doesn’t mean I didn’t socialize. It just means I socialize only to drink.

Dr. Royan Kamyar: Anuskha, I’m curious about your meditation habit. You know, you mentioned the 10 minutes. I’m curious if and maybe what kind of techniques you use or if you’re leveraging some of these existing apps like Headspace or Calm or what would you do kind of personally to sort of get in that zone?

Dr. Anushka Patchava: Awesome. I was hoping you’d ask me that. So I was very cynical on the whole matter of meditation and yoga movement. I had a very, very stressful end of the year last year with lots going on on the work scene, you know, and lots of kind of high impact deliverables and lots going on in like life in general. You know a family illness, etc. So I really run myself to the ground I’d say and then thought, you know what? At Christmas, I’m going to do something different. I’m gonna take myself away to Goa and India and just have some sun time because sun is critical to making everyone feel better and also just discover what I’ve always kind of ridiculed. And I learnt how to meditate and do yoga out in India. It’s honestly changed my life. And in terms of meditation, again, I was cynical on apps like Headspace and Calm. They all have really what I call creepy voices. And I think by teaching yourself and utilizing something called a muse headband. So you’re training your brain to get into that meditation space. I think it’s more powerful than listening to someone dictate it and say it. And Royan you asked about techniques. Honestly, I just breathe through it and almost take the focus out of what I’m feeling and put the focus into how I’m feeling.

Dr. Sohaib Imtiaz: I started Broga recently. I can tell you it’s difficult at times, but it really feels so good after the session. And I love his music. I think he’s the one other person in the UK that uses music. I’m a fan of music.

Dr. Anushka Patchava: It’s the brilliant tool that no one knows about.

Dr. Sohaib Imtiaz: Yeah. Feedback. Instant feedback. I think you should also try to ordering firstly,.

Dr. Anushka Patchava: OK. Yeah, I would.

Dr. Royan Kamyar: Sohaib did you said, you do Broga?

Dr. Sohaib Imtiaz: Broga, yeah, it’s a new concept started at my health club, David Lloyd. So I went for a session. Basically, Broga was trying to kind of put yoga in more of a masculine frame to attract more males. But still more females turn up.

Dr. Anushka Patchava: It’s also more muscle based rather than breathing?

Dr. Sohaib Imtiaz: Yeah.

Dr. Anushka Patchava: It makes you feel like you’re really, really henched and strong in your tank.

Dr. Sohaib Imtiaz: That’s exactly what it is. You find out how incompetent you are pretty quickly if you’re not used to the moves. Yeah, but it’s a challenge.

Dr. Anushka Patchava: It is a challenge. And I also think, apart from Broga, I think given at the end, which again combines meditation and yoga, it’s less of a kind of flow and more and that focus. I mean we have a class at the gym I go to on a Monday and again that changes how I feel for the rest of the week, Monday evening. If I do that for 90 minutes, the rest of my week is set up.

Dr. Sohaib Imtiaz: And you also do a lot of cross fit as well. You’re a powerlifter.

Dr. Anushka Patchava: Cross fit is a cult, as everyone says. And I joined cross fit two and a half years ago. Again, it sounds ridiculous, but I bought my flat in London next to cross fit intentionally, next two cross bits intentionally in order to have access to the powerlifting movement. And yeah, I power lift, I deadlift way more than most guys I think and squat way more than most girls. And you’re not getting anywhere in between? Well, yeah, I am. I do it for competitions. I think again. It’s just the kind of thing you get a kick out of life you’re doing.

Dr. Sohaib Imtiaz: And you did marathons as well when you were 18. I was on your LinkedIn profile and it says something about you kind of fractured your knee or something and you will say.,.

Dr. Anushka Patchava: I like the fact that you’ve done your due diligence.

Dr. Sohaib Imtiaz: Obviously, I had.

Dr. Anushka Patchava: I did the London Marathon at age 18. Biggest mistake I’ve ever made in my life. And I basically did it because I do I’ve got an older brother who’s eleven months older and I copy everything he does in life, including becoming a data scientist. But he did the marathon at age 18. And I thought, well, you know what, I can do better than you. I’m gonna take onboard. I’m going to do it at age 18 and gonna be like younger than you are. And. You know, ended up fracturing my knee at 8 miles and finished into something like five and a half hours. Some, well, crazy slow time. But hey, tried it, got the medal.

Dr. Sohaib Imtiaz: So, you were the second youngest to do that at the time?

Dr. Anushka Patchava: I was the second youngest ever to have completed it. I’m pretty sure someone has taken up that record. I was 18 a very, very, very long time ago.

Dr. Sohaib Imtiaz: That’s worth the knee injury, I guess. And you do a lot of charity work and kind of you make time for that. Does that help you kind of center or does that help you have more of a purpose?

Dr. Anushka Patchava: I think so. So I do a lot of work with various charity organizations stemming from some work I did building an orphanage out in South Africa when I was 18. 18 seem to be a big year for my life. I also did a lot when I was eighteen. I was just thinking, gosh. no, sister. Yeah, I think I enjoy the charity work because I always think I get more out of it than I give. And I think having that time to self reflect on your own behaviors, your analogy, use your own. You just your own culture and you know who you are, your own cool as a person is critical. So it gives me that space to do that, thinking that I probably wouldn’t do day to day and hanging out in the social group and the workspace that I do.

Dr. Sohaib Imtiaz: And then are you a big believer of using apps?

Dr. Anushka Patchava: Social media apps, yes! I can make money on my Instagram one day, that would be perfect. I think I think I am in you know, I use my gym. My gym has a really good app. I use that. I use body tracks, which tracks kind of your metabolic rate and your fat percentage and your muscle percentage and all that. And I use my after watch out. I mean, pretty much every day, if not every day. And in terms of other apps, do I use health and fitness apps? So this is a really awesome brand I discovered in India. It came out of a movement and is called Kill Fit. And so I use that a lot. So they had some awesome classes. You could order your food from it and you could put into your library, videos and training videos then you could use when you were at the gym to train yourself. So I did use that when I was out in India. Do I use that in the UK, though? Probably not? Probably no. I think social media is probably the reason why I follow a lot of weightlifters and health and fitness freaks on Instagram. And so I just watch their videos and copy them.

Dr. Sohaib Imtiaz: Instagram is having a massive impact with the whole wellness space and human performance and optimizing health. Hopefully Owaves can become that platform Royan.

Dr. Royan Kamyar: I was hoping I was when you heard about a new idea, a new show, but you heard about it now, sir.

Dr. Anushka Patchava: Yes. And to be completely honest, having done my due diligence on you guys before having the fortune to be interviewed by you guys, I think Owaves is far beyond anything I’ve seen in the wellness space. So testament and congratulations to you guys. You mentioned earlier that you’re top of the wellness kind of search profile and that isn’t easy. It’s a very competitive space with lots and lots of startups. So well done.

Dr. Royan Kamyar: Thank you.

Dr. Sohaib Imtiaz: So have you always been quite organized with your lifestyle? I mean, you were at Imperial, then you were at Cambridge and even you had a stint at Harvard. So going back to your student years, I know you’re probably still a student because you’re always learning and now you wanna be a data scientist. So going back to those years, undergrad and postgrad as well, how did you balance things back then?

Dr. Anushka Patchava: That’s a good question. You’re taking me back a long time now, and I think. I think it’s safe to say that the organization comes with age. I don’t think I had a regimented lifestyle in any of the academic establishments I was at. I think if my friends are listening to this, they’ll probably say that that’s true. I think I always had a very high element of fitness in my life and it’s something I started when I was 14. Again, having an older brother who is incredibly talented in the sporting arena, it helps. And I could always tag along with him to the gym and pretend I lifted as much as he did and pretend I was 16 and I could be in the gym to start with. But I don’t think I had the discipline I have now back then. I don’t think anyone did. I think at university we did a lot of not studying and a lot of academic drinking. I think it’s called.

Dr. Sohaib Imtiaz: Do you think going back if you had to, do you think it’s worth establishing good habits whilst you’re in college or university?

Dr. Anushka Patchava: One hundred percent. And I think so. I was lucky enough to have gone to a boarding school that was quite regimented. And so I did have, you know, a benchmark for those good habits. But I think having a routine very early on, particularly with things that probably didn’t affect us guys growing up like screen time, you know, being able to monitor your screen time and self monitor that, being able to seek your own kind of we always talk about empowering people to self care, but just being able to drive that without having someone drive that for you is critical, I think. And then more so just protecting your own mental health.

It’s such a big issue in the world globally now. And, you know, I’ve heard statistics that one in four 8 year olds have, you know, some form of mental health, either post-traumatic stress disorder from an incident in their childhood or, you know, anxiety or, you know, bullying, et cetera. And I think, you know, protect your own mental health, be that, you know, going for walks for 30 minutes a day or meditating or yoga or whatever it is you need to tune out from the real world and reflect is so critical and those habits I think if you develop them early, stay with you for life and do make you more productive in your day to day job.

Dr. Royan Kamyar: Sohaib, you have often mentioned this statistic that depression is the biggest comorbidity in the world’s morbidity as designated by W.H.O., right?

Dr. Sohaib Imtiaz: Yes, that’s right.

Dr. Royan Kamyar: In terms of expenses and in terms of numbers, right?.

Dr. Sohaib Imtiaz: Yeah, that’s exactly. So, it’s a massive kind of economic burden, but also a health burden for most people. Anushka, I think what you’ve said is quite profound in terms of how we have to tackle those ailments to people. But I’m guessing, did you as a person, as a student, have you gone through any ups and downs in your life? How do you deal with it? Do you have any specific strategies that you’d like to share?

Dr. Anushka Patchava: Yeah, sure. And before I say your share of them, I wanted to just say also, so I think the power actually right now lies in health care providers, be it, you know, individual physicians or health systems, governments and in payers and you insurance basis health systems. Having data and with data, could we build algorithm to predict who is likely to suffer from mental health like we do with other chronic illnesses? Yes. And the investment needs to come for us to do that. And because, you know, we all know that the mental health services in the UK are overburdened. How do we prevent people even ending up in those acute services?  Like, how do we use our data more effectively to put in place measures at school level or at primary school level? It’s scary for all of us to know that, you know, we’d have to put it in a primary school level. But maybe that’s what we need to do to prevent people later down the line having, you know, acute breakdowns and all the other symptoms and syndromes.

Dr. Sohaib Imtiaz: Do you see data as very central in terms of kind of getting a biomarker, such as, you know, the gut brain axis microbiome in the future? You know, epigenetics? Or do you think we’ll be using more kind of voice biomarkers in the future? Or is it just generally tracking people’s mood or vulnerabilities and then working out using algorithms who’s at high risk and intervening with the prevention being the core of that before our study?

Dr. Anushka Patchava: That’s an interesting question. And I think it’s a combination of all. And I don’t mean to sit on the fence that and here’s the perspective that I have is that your data sources need to be holistic and they need to be multi centric because that’s that is a human. We aren’t 2D people. We’re 3D. And I think your data sources also have to vary with environment, time, place, genetics and all the social determinants of health that a person could experience in and that that doesn’t necessarily individualize to a geography either.

So I think you know, things such as Internet of Things, wearables, integration are critical because they give you that more real time tracking of data, but so are genetic factors and so are family factors. And so, you know, early life childhood factors which could influence, you know, the social side of any condition, let alone mental health. So I think it’s a we have to have that holistic picture. And how we get a holistic picture is by collaborating and integrating data across social and healthcare. And then in healthcare alone, collaborating, integrating across payor provider and, you know, government data sources, you would say politicians.

Dr. Sohaib Imtiaz: Yeah, politicians in London, the system did well. So do you see this face of digital health such as Owaves, digital therapeutics and at prescribing being something which can be done quite well and prevention?

Dr. Anushka Patchava: I think so. I think the one challenge that all digital health care initiatives face is adoption and utilization. And if we can overcome the barriers that physicians and patients alike face with adoption and utilization of digital therapies, then I think the space is open. Now, I think we’ve made one step closer to overcoming those barriers in that, you know, as you’re aware in the UK, particularly, our health secretary, Matt Hancock, is pushing a digital agenda in the NHS. There’s a lot of investment, including in venture capital and private equity and healthcare tech. And then you’ve got the big giants like Apple, Google, Amazon, all trying to pave the way as well.

So I think we’re making some level of traction. And I also think as our lifestyles get busier, we realize that, you know, things that are easy and convenient are just better. And I don’t even like, I don’t even go to the store to buy my gym clothes. I just buy them on Amazon. So much easier. So much quicker. Yes, it’s convenient. It’s also ironic because it means I’m not burning the calories that it takes to go to the store, but let’s not go there. But I think that’s why, you know, what I’m saying is if we make if we open down kind of the barriers in place right now, then I think, you know, and regulation supports digital, then I think, you know, the spaces is there to grow.

Dr. Sohaib Imtiaz: Royan emphasizes with coaching. So Royan could you talk about coaching?

Dr. Royan Kamyar: Sure. Let’s see.  Okay. I was gonna go a different route, but we can talk about coaching. I guess, Sohaib what do you think about coaching as a topic?

Dr. Sohaib Imtiaz: Because digital is being mentioned. So Anushka has pointed out a few kinds of kind of adoption problems with digital, but a lot of the leading. So I was at the pole to pole launch recently. And he was talking about how these latest technologies like artificial intelligence, virtual reality, is actually going to free up health. So the care aspect of the human side is going to be emphasized more so. So with Owaves being kind of a digital platform, but coaching still being quite central to it. It’s almost resonating what he said, where the human coaching is helping with the behavior change. But the app is the kind of enabler or the vehicle for that to be delivered.

Dr. Royan Kamyar: Right. That’s definitely the pathway that we see happening. And I think that’s kind of getting ubiquitous if you look across sort of the digital health market, right. I mean, I think there’s been some early attempts. Apple has partnered with Nike to create sort of that virtual coach on your wrist. You know, Fitbit, as we know, is making a big push into clinical care and especially through coaching, and that’s being championed by their acquisition of GS. Remind me of the name Saheb, M.I.T. Media Lab, MVP HD.

Yeah, it’s got on my mind.

And this is it is a kind driver. OK. So anyways, but you know, we know Fitbit is looking heavily at coaching. And I think, you know, in total definitely outlines this. And, you know, in his last book, Deep Medicine, that really, you know, we could all use this virtual assistant that’s kind of sitting by our side and kind of guiding us towards the right health choices. And in terms of how that fits back into Owaves, you know, our key observation that I think really differentiates us from the pack is that, you know, we make this thesis based on time and ultimately, you know, all the fundamental lifestyle measures that are being advocated for depending on which governing body you’re talking about, you know, American culture, lifestyle medicine or the EU, UK equivalent bodies, you know, American College of Preventive Medicine, equivalent bodies, American Heart Association and equivalent bodies. You know, we know exercise, nutrition, sleep, stress management and love. You know, spending time with the people we care about are essentially the key ingredients for a long, healthy life. And really when it comes down to implementation, it’s based on time. It’s time spent on these activities and they’re actually usually prescribed in units of time. And so, you know, using the calendar as sort of a basis through which to guide these coaching interactions, that’s really our direction.

Dr. Anushka Patchava: That sounds great. On that coaching point actually, so I completely agree with both of you actually that coaching is critical to the health care journey. I think my perspective is if you can use health coaches and or auxiliary health care professionals to deliver lifestyle advice and targeted interventions that then prevent people needing acute services, then you are freeing up acute practitioners to practice at the top of their license and to Topol’s point, that then gives the workforce sort of better outcomes in terms of what they achieve on a day to day basis, but also better patient outcomes, because what in essence you’re doing is and you see this being done a lot in prevention models, is that your risk stratifying your populations. So those at high risk, high need, those who we feel have low engagement, who are low impact ability, we might go intensive with them.

We might do a more face to face model with them. We might get them in one on one. But those that are low risk and, you know, are highly engaged, could we just offer them a digital solution? So the example I’m using here is you know, in America, the CDC runs a National Diabetes Prevention Program which has been replicated in the UK, and soon to be, I think, if I’m not mistaken, in Singapore and other geographies. And and that’s the model they adopt, as you know, those that are really high risk and high need. Yeah, I understand they need to have one to one or group coaching in person, but then those who are lower risk, you know, could you have a lower cost model through a digital solution? And actually the outcomes for the digital facilitation is, you know, very, very, very effective. I know one of the organizations I’ve heard a lot about in the news is Labor Healthcare and co-founded by a gentleman called Roone. And the outcomes they’re achieving in terms of Type 2 diabetes, I can’t remember at the top of my head, but I remember reading about them and thinking that’s fascinating and very impactful.

Dr. Royan Kamyar: And so if I’m you know, if I’m capturing what you’re saying correctly is essentially you’re talking about sort of a spectrum of care, right, where you’re getting really high touch interactions on one side and then really high tech on the other. And depending on the severity score need of the individual, you kind of weigh them somewhere on the spectrum.

Dr. Anushka Patchava: Yeah. It’s about risk stratification and segmentation to improve well, to provide targeted interventions that then improve the way people interact with the health system, but also the way the health system delivers for those people.

Dr. Royan Kamyar: Got it. And so just so we’re all on the same page, that Fitbit acquisition was Twine Health and it was John Moore was the Founder and CEO. See the M.I.T. Media Lab. Yeah. So they’re definitely focusing on coaching and, you know, actually Sohaib when you ask me that question, well, I was gonna ask, you know, Anushka, we kind of started off with your daily routine and sort of naturally migrated. There’s a path here and I think would be really interesting, you know, to kind of dive in to how you identified these novel opportunities. You know, most people in your shoes, if they’ve gone to study medicine at places like Cambridge and Harvard, they’re usually practicing medicine and that kind of the more traditional style. And it’s kind of daring to sort of take that leap, you know, especially out of those conventional and sort of well-paid pathways that, you know, you’re going to be, you know, essentially guaranteed success if you kind of stick with. So what was it that really triggered you to kind of seeing a bigger picture here, if you don’t mind me saying and taking the leaps, the types of leaps that you’ve taken, you know, especially around data science, for example.

Dr. Anushka Patchava: A very interesting question. I think for me, I critically realized throughout my career but then it came to the forefront, you know, while I was training as a radiologist in London was that I actually don’t make that much impact in the system. And that is no disrespect to anyone practicing. We need doctors, we need nurses, we need physiotherapists. We need entirety of health care professionals to be able to deliver the service. But equally and this is where I think the United States do it really well, we need people who have been in the service to then drive innovation and I guess progress within the health service. I think I think, you know, healthcare professionals should be leaders of health care systems.

I think healthcare professionals should be the ones managing healthcare systems. I think healthcare professionals should be the ones setting policy and setting regulation or at least having an input into that because we are the ones that experienced it firsthand. Yeah and so unfortunately, I think I realized, well, firstly, I could have an impact out of the system doing some of those things because I’m focusing the system is so strained with workforce issues and training issues. And, you know, I guess to some extent red tape that it is very difficult to make real change. And I’m talking, you know, national change, you know, local change, and even just departmental change in the system. So I thought, well, that’s one things like, you know, if I get out of the system, can I have more impact?

And the second thing is I thought, well, if I want to learn how to run a hospital because I’m sitting here criticizing how the hospital is run, then I need to understand how a hospital was run. I unfortunately never did understand the commercial lens of how a business is run and let alone a hospital system here in the UK, the US or elsewhere. So taking myself out gave me that scope to understand how businesses are run and how strategy is set or built and how visions are created. And you know how you manage a balance sheet, for example. And then how do you put an organization through change, through culture change or people change or payment reforms or whatever it is that you want to change. And so I felt that criticizing it wasn’t the right attitude. Learn about it before you can criticize it. So that brought me out of the system.

Then the third kind of is the data science point that you made and again, inspired by my older brother, who is in data science. It was just very difficult to really see how a data driven world isn’t what we’re going towards. And fundamentally isn’t the right way. So I think again, you can’t do something unless you understand it or you can’t tell someone else to do it unless you understand it. I think that that challenged me to really try and understand it. And through that, you know, learn about how you can apply it to what might be health care, be it my daily life, you know other organizations, to be it other sectors or startup, whatever, I choose to go into that thing. I think that data science understanding is critical for all of us to have. So I think those are my three key reasons. And does that kind of answer your question?

Dr. Royan Kamyar: Well, it was wonderful. I’m inspired. I want to learn more data science.

Dr. Sohaib Imtiaz:  Well, definitely on my wavelength because I’ve been in data science – AI. Every single day I wake up to that. because I’m the cities during my life and homework this week because I have no time to do it. Okay. I’ll be doing a course today on a guy that was going through. I went through an hour. I have. But yeah, you’re speaking on my wavelength there. I love what you just said.

Dr. Royan Kamyar: And just on the last point when you’re talking about unless you understand something it’s hard to change it. That is actually you know a small bit in a small way on the, you talked about health care as a whole, the healthcare system as a whole in your daily life, you know, with Owaves, that’s really a huge inspiration, as you know, where your buckets of time go? So one of my good friends, who is one of these Ironman triathletes and an executive here locally, you know, he kind of describes it as a dot com for your time. But you can you can say that, you know, your relationships are the most important thing. But then if you go into your Owaves Stats section and you realize that less than 5 percent of your daily life is spent with your loved ones, it can kind of give you a wake up call. And especially if that that work bar is like, you know, orders of magnitude greater than everything else, it kind of gives you that internal check. So I think, you know, in terms of data science and doing it on an individualized level, I think that’s the way that a lot of digital health companies are going to give people tools, systems that help inform how to iterate and ultimately optimize in our daily lifestyles.

Dr. Anushka Patchava: Completely. And you know what, Ryan? I totally agree with you that in those little prompts, not messaging, you know, or that that prompt, you know, that realization that actually what you’re doing isn’t what you think you’re doing are so critical to behavior change. And, you know, taking a step back and going back to, I wish I had Owaves back in university and back at the end of last year, because going back to the question Sohaib asked earlier and I don’t want people to think I’m dodging the question, it was about mental health and where I was, where I felt challenged. And did I have peaks and troughs? Of course I did. And I’ve had three kind of big troughs in my life.

My first one was first year Imperial at university. And I burnt out probably through partying, wasn’t study. But I just didn’t have the work life balance correct. I’d burn out a week before my final exams, collapsed in one of my final exams, got taken out of the exam room and my parents came and picked me up. And then I did do my final exams and I had to then reset all of them in September, knowing that if I didn’t pass any of them, I’d be out of university, which to my parents would have probably meant me being put in an orphanage and being discerned for the rest of my life. So I got the balance wrong then and then I’m almost ironically, I think last year through no fault of anyone else’s but my own and my my passion for what I was delivering on the work front and what I believed in and the propositions I was involved in, I flipped the other way.

So I actually probably didn’t enter the gym once between September and end of November. Well, and I wasted three hundred ninety pounds, which I’m not proud of a CrossFit membership that I did not even use. And I got the balance completely wrong. I was absolutely living, eating, breathing work and had what I would call is a second burnout. And that’s a massive, massive impact, when you’re above 30 and you think you should be adulting, you know, you’re lying in bed almost sobbing because you’re so tired. And, you know, then my third point was, you know, that then led to me having a massive peak when I could come out of it and start this year completely fresh, you know, get an awesome trading partner on board who is probably more addicted to the gym than I am.

And then give me the variation as well. So I didn’t think it’s all about weight lifting, I don’t think it’s all about running, I don’t think it’s all about, you know this new craze of what everyone’s doing in London called F45 Fitness. I balance myself. So some nights I go climbing in the bouldering wall, which is a completely different exercise to yoga, which is completely different to weightlifting. And it is really that burnout to balance transition that I think if I had notch messaging or Owaves or prompts would help me have realized, you know, I’m not spending time in the gym, I’m not spending time, you know, eating healthfully or seeing friends or doing those things that you know or even outdoors. I think that was the other thing. I didn’t spend very much time outdoors. My levels plummeted.

Dr. Royan Kamyar: Well, I’m sure it becomes a common problem completely.

Dr. Anushka Patchava: And so, yeah, I think that’s one of them. I think that’s why I think actually what you guys are doing is brilliant, because those people who are as busy as I am or less busy than I am or more busy than I am, those kind of prompts really do change behaviors.

Dr. Royan Kamyar: And you know, we’re studying more and more around stickin rhythms and crunch biology, which is a huge inspiration for the platform and getting the recommended dosage of bright light during the day, I think it’s something that we all kind of take for granted in terms of our mental health.

Dr. Anushka Patchava: Right. Easier said than done because you’re based in San Diego.

Dr. Royan Kamyar: I know. Like all the time you got like It’s amazing indoors that you get magnitudes less and it’s just not enough. You had to physically go outside to get the plan.

Dr. Anushka Patchava: Yeah, critically. I mean, my brother grew up in the U.K. and that was one of the reasons he moved down to Bangalore. He was just like I just can’t deal with the weather anymore. You know, I grew up in Saudi Arabia. And for me, I keep threatening from friends and family. I’m gonna move east. I’m going to move east. The reason is not only because all the activities are there and that they’re emerging markets, but because there’s sunshine and there’s beaches, that outdoor lifestyle that we don’t actually have, because, you know, for whatever reason, the weather prevents us.

Dr. Royan Kamyar: Exactly.

Dr. Sohaib Imtiaz: Becoming domesticated. But that’s a remarkable story. And that’s something I’ve been asking all recent guests. So what motivates you at the moment?

Dr. Anushka Patchava: Oh, that’s a good question. Do you know what motivates me right now? It is and again, it’s a personal journey, but it is looking back at who I was and realizing that I never knew the core of me till about a year ago, and no matter how many successful working relationships, personal relationships and activities, certificates, courses, whatever you do in your life, your achievements I had up until that point, I never really knew at the core of me. And I probably discovered the core of me less than twelve months ago. And so what what motivates me right now is to keep that core growing. This is so cheesy and I apologize, but keep glowing. And I am very, very protective on that. You know, I don’t let anyone touch that call. You can touch the outer elements. But that call and who I am and who I want to be is what motivates me. And that sounds very fluffy. And I know a lot of friends of mine was Humphrey. That sounds very fluffy for an analyst. But I think that to me, that’s what keeps me going.

Dr. Sohaib Imtiaz: It’s like you like the flame and you want it burning desire.

Dr. Royan Kamyar: So you said growing or glowing?

Dr. Anushka Patchava: Glowing.

Dr. Royan Kamyar: Nice.

Dr. Anushka Patchava: I don’t really want to grow.

Dr. Royan Kamyar: Did it come out of that second trough?

Dr. Anushka Patchava: It did come out of that second trough. Yeah.

Dr. Royan Kamyar: Amazing how sometimes that’s what it takes. I mean.

Dr. Anushka Patchava: Exactly. Exactly. And sometimes I you know, I always say this. I’ve probably seen less misfortune than people around the world. But I think, you know, it’s never you can never compare how things impact you because you know your pain, I can never feel, if that makes sense. So, yeah, I think I think even though it might seem quite superficial to other people, I think the second trough really hit me hard and it’s it’s helped me come out. And that’s what motivating me right now.

Dr. Sohaib Imtiaz: Goes to show that people who are kind of so successful, we’ve had other guests on who’ve shared stories as well. And kind of on the outside, it appears that, you know, your life is going so swimmingly for the lack of a better word. But you always everyone has their challenges and you have to use them as intrinsic motivators. So I think I think you’ve really explained that really well for our listeners.

Dr. Anushka Patchava: Hundred percent. And I think I think the best characteristic trait anyone could ever describe anyone else is resilience. And because I think if you have resilience, you can achieve and conquer anything. And so I strive I strive for people to see me as resilient. So, yeah, I think, as you say, you’ve got to find a personal challenge and then you’ve got to fight it and beat it and grow from it.

Dr. Royan Kamyar: That’s going to be one of our primary outcomes for a pilot study. Focus on resilience. That’s what we’re looking at.

Dr. Anushka Patchava: That’s interesting. And then you guys found that will change, that component is critical to behavior change?

Dr. Royan Kamyar: Well, we found that that’s what the college health administrators are looking for in platforms, because they feel like this generation of students, I guess, has a little bit less grit or resilience, that’s the key word they’re using, than previous generations. They see that as a key component for addressing this mental health crisis on college campuses.

Dr. Anushka Patchava: Nice. The other thing and I hate it to be another R. And don’t worry, I’m not going to say rest and relaxation and recovery. I was fortunate enough to have dinner with a really good friend who is quite high up at Google yesterday. Amazon just made the move across from California to Ireland. And I said, you know, what do you like most about, you know, I guess our friendship? I don’t know why that came over dinner, but it was you know, I was one of those deep, meaningful conversations. And he actually said, I like the fact that your role and I thought, you know, well, most things that are role, I don’t like a pop for sushi, but I really, really like that. And I think that if there’s any sort of them, the feedback I’ve had over the last three years since I left medicine and made a huge jump into the real world, I like that raw word. And I think we don’t have enough of that these days. I think the corporate culture doesn’t breed that. I think, you know, a society that is dictated almost by the media and social media and influenced by it, doesn’t really have that. And I think what we should all hold on to is that that’s who we are, and that rawness is really critical to mental well-being.

Dr. Royan Kamyar: Wonderful.

Dr. Anushka Patchava: So I’m going to keep raw as my word.

Dr. Sohaib Imtiaz: Keeping raw. I mean, we won’t be stealing that, but that’s just a very new word. I haven’t heard that before.

Dr. Anushka Patchava: Likewise. And that’s why I think it was innovative. No, it was worth sharing. I think it was. It caught me off guard. And, you know, I almost half looked at him and smiled that is very, very, very cool. I’ll take that. It goes to 2019.

Dr. Sohaib Imtiaz: That’s good. You’ve got these objectives and goals. And it’s been remarkable having you as a guest. Royan, have you got any other questions, before I ask her where she can be followed?

Dr. Royan Kamyar: No, I thought that, you know, that was a wonderful ending. And I can see how doing the innovative and really groundbreaking type of things you’re doing in health care and blending data science and most current technologies at population level, you know, that requires a raw mentality. If the people who are doing the habits of the past have figured that out, it wouldn’t be such a great challenge and a big problem it is today. So I think by virtue of carving out this new space for yourself and leading in this type of way, you’re almost forced to be raw because you had to deal with the truth a lot of the time and what you do. So it’s exciting and congratulations.

Dr. Anushka Patchava: Thanks Royan and Sohaib. I really appreciate it. It’s been phenomenal talking to you guys and I love following your journey.

Dr. Sohaib Imtiaz: Thank you.

Dr. Anushka Patchava: So to everyone listening, please download Owaves.

Dr. Sohaib Imtiaz: Thanks for that. And I’m glad well, I get to see you in because I’m actually on a panel at the Digital Health Show in London, which you will be speaking at. And two of our other guests we’ve had on the podcast, Jack Kreindler, who we had on, and Dr. Dan Houser, who’s a psychiatrist. So it’s interesting that the four of us will be at that show at various stages. But is there anywhere else our listeners can follow you or get in contact with you that you would like to share?

Dr. Anushka Patchava: Sure, I’m open to LinkedIn. I love growing my network, so I think I’m down as Dr. Anushka Patchava and please feel free to ping me on there. I don’t tend to use Twitter very much, but I’ve got an Instagram account. It’s not grammar. So and U.S. H s t a g r a memoir. And that comes with a warning that my Instagram account is normally weightlifting exercises and me eating really weird stuff that I like to photograph because I like to show my crazy fitness through diet or really weird yoga poses. So if you follow me on there, you’re gonna get all of that and nothing else. Sohaib I really look forward to seeing you at the Digital Health Show. It’s great to have all of us in the same room. And I think, if I could end with one thing. I think that health care has a lot of challenges right now. And if we can all bring rawness to a collaborative approach, then I think we’ll solve problems faster.

Dr. Sohaib Imtiaz: Couldn’t have said it any better. Perfect ending. Thanks for being on Anushka.

Dr. Anushka Patchava: It’s great to speak to both. Take care. Enjoy the sun, Royan.

Dr. Haroom Kazem: Thanks for listening to another episode of the Body Clock podcast by Owaves. If you enjoyed the show, please leave us a five star rating on your podcast app. Please also remember to download the free Owaves app on the Apple App Store. Please tell your friends and your family. It’s a great tool to help you optimize your life and to effectively plan your day. Thanks as always for listening and I hope you join us again next time.