October 4, 2024 • 29 mins
Discover how you can finally conquer chronic pain without ever leaving your home. Daniel Perez, the CEO and co-founder of Hinge Health, joins us to reveal how his innovative digital health program is revolutionizing musculoskeletal care. You'll learn how Hinge Health's cutting-edge software and algorithms create personalized exercise therapy plans, health coaching, and educational resources, making physical therapy more accessible and affordable.
We also tackle the significant hurdles people face in accessing musculoskeletal healthcare, especially in large, rural states like Texas. Daniel shares insights into how Hinge Health provides a comprehensive solution that allows individuals to quickly access care from the comfort of their own homes, supported by dedicated physical therapists and health coaches. We discuss the strong connection between chronic pain and mental health, emphasizing how effective pain management can alleviate anxiety and depression.
Finally, get acquainted with the Enso device, a game-changing wearable gadget that delivers non-invasive pain relief through high-frequency electrical nerve stimulation. We'll also take you through the inspiring journey of two UK PhD students who turned personal challenges into the pioneering startup, Hinge Health. With impressive clinical outcomes and ambitious plans for the future, Hinge Health continues to transform musculoskeletal healthcare by integrating innovative digital solutions with traditional in-person care. Join us for an episode overflowing with insights and actionable advice for a pain-free life.
Learn more and apply to participate in Hinge Health today
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Perez (00:01):
You can get treated within minutes when
you're signing up for Hinge andget all of your care right from
the comfort of your own home.
We've seen with our data thatpeople are more likely to be
depressed, more likely to beanxious, when you have pain.
And the clinical research hasalso shown if you have one pain,
one area of your body that's inpain let's say you have knee
pain you're about a 2x higherlikelihood so double the
(00:23):
likelihood of being clinicallydepressed.
And if you have more than twoareas, say your knee and your
hip or your knee and your backyou're about three or four times
more likely to be depressed andanxious.
And so researchers have seenthat connection between the mind
and body for a long time, andoftentimes it's going to be
difficult to impact somebody'sdepression if we don't first
impact their back pain.
Lacy Wolff (00:44):
Hi and welcome back to the ERS Walk Talk podcast,
where we explore the latest inhealth, well-being and programs
available to help you live ahealthier life.
I'm your host, lacey Wolfe.
I'm the coordinator forstatewide well-being initiatives
at ERS, and today I'm thrilledto be joined by Daniel Perez,
who is the CEO and co-founder ofthe company Hinge Health.
(01:04):
Daniel's background is trulyimpressive.
He holds degrees from Stanfordand also went to Cambridge, and
he's a seasoned entrepreneurwith a digital health space.
His work with Hinge Health hasbeen groundbreaking in the way
we approach musculoskeletalhealth, tackling chronic pain
through a blend of technology,education and personalized care.
(01:25):
Hinge has helped thousands ofpeople across the country take
control of their physical health, avoid surgery and improve
their quality of life.
And now Hinge Health isavailable to our Health
Selective Texas participantsstarting September 1st.
Gives our health planparticipants the opportunity to
participate in a virtualphysical therapy and expert care
(01:46):
to treat back and joint painfrom the comfort of home.
Through the Hinge Health app,participants can get
personalized exercise therapy,one-on-one health coaching and
education to prevent and managechronic conditions.
In this episode, we're going todive into how Daniel and his
team are revolutionizing the waywe care for our bodies and how
(02:06):
you can use this valuablebenefit.
So let's get started.
Here's my conversation withDaniel.
Daniel, welcome to the ERS WalkTalk podcast.
It's really an honor to sitdown and have a conversation
with you.
Daniel Perez (02:17):
Thank you for having me.
Lacy Wolff (02:18):
Lacey Hoping, we could just start with having you
explain the Hinge Healthsolution for our listeners and
kind of talk about what it isand how it's different from
other musculoskeletal solutionsout there.
Daniel Perez (02:32):
Sure so Hinge Health.
We are tackling back, joint andmuscle pain.
So about one in two Americanswill have back joint or muscle
pain in any given year.
That could range from asprained ankle through a twisted
knee or chronic knee or backpain, all the way through
surgery somebody having kneearthroscopy or hip replacement
and so it's a wide spectrum, butabout one in two of us will
have something along thatspectrum in any given year, and
(02:56):
it can be really difficult toget care for musculoskeletal
conditions and oftentimes we'lljust take Tylenol or Advil
because it's hard to access care, hard to take time off, work,
hard to travel to a physicaltherapist or to a doctor, and so
what we've done with HinchHealth is we've created a
digital program so you can getyour physical therapy right from
the comfort of your own home,and so when you sign up to our
(03:18):
program, our software and ouralgorithms will create a custom
care plan for you.
So you have a custom physicaltherapy program that's delivered
to you via our software.
You get connected to your ownpersonal physical therapist who
you can message at any time.
You get to see them on a videovisit.
You could message them directlywith our app.
You also get a care team andthey're going to guide you
(03:39):
through your care plan over thenext several weeks and it's
customized to you, you and it'sconstantly changing just for you
.
You don't have to worry aboutco-pays.
You don't have to worry aboutwaiting in line.
You don't have to worry aboutsitting in traffic or getting
childcare.
You could get treated withinminutes when you're signing up
for Hinge and get all of yourcare right from the comfort of
(04:00):
your own home.
Lacy Wolff (04:01):
Really incredible because there are so many
barriers to accessingmusculoskeletal health, and, I
think, especially in Texas.
We're a huge state and we havea lot of people in rural areas.
That's one of the reasons whyI'm so excited about this
solution, because sometimes itmight take 30 minutes to drive,
even for me in Austin.
I might be close to a physicaltherapist, but with traffic it
(04:23):
can take a long time to get tosomebody.
So it's really incredible whatyou've built and I know for us
there's a huge need for it.
Like when I look at our healthclaims 20% of people in our
health plan have amusculoskeletal condition, but
I'm guessing that's probably notall of the people that could
use this solution or maybe needhelp with musculoskeletal.
Daniel Perez (04:44):
Absolutely.
A lot of folks are suffering inpain in that there's a there's
a barrier to like schedule adoctor's visit.
Like my knee pain is finallytoo difficult, or my back pain
is too difficult.
I need to go see a doctor aboutthis.
A lot of us are just below thatthreshold.
It's like three or four outof 10 pain.
But I'm going to deal with ittoday because I've got to get to
work or I've got to take mykids to school.
I can't take a half day offwork to go to the doctors right
(05:06):
now and with Hinge you couldsign up and be treated within
minutes right from the comfortof your own home.
You could sign up on your phone, you could sign up from work,
you could sign up at home andvery quickly get your care.
But also, if you're in WestTexas, where there's a few more,
a bit more difficulty maybefinding a provider because it's
a bit more rural, or you're indowntown Dallas, where there's a
lot of traffic, or downtownAustin, it's going to be very
(05:29):
consistent care, no matter whereyou are, and very quickly
you'll be able to access thecare.
Lacy Wolff (05:33):
That's amazing and having gone through the program
myself, you know I think it'sreally amazing that you get a
physical therapist assigned toyou as well as a coach.
Daniel Perez (05:42):
Absolutely Can you talk a little bit about those
two components of your program,and so we firmly believe in
bringing a full care team toeach of our members who join our
program.
So, when you join, we're goingto do an intake and we're going
to ask you the same questionsyour doctor would ask you, your
physical therapist would ask youabout your knee pain or your
back pain.
So we understand how it's beenimpacting your life and we share
that with our care team.
You're going to be assigned adedicated physical therapist
(06:05):
who's familiar with yourcondition and they're going to
design your program for you.
They're going to customize yourprogram for you and your health
coach, however, is part of thatcare team and they're here to
help you overcome some of thebarriers and challenges all of
us face in life.
You know you might have a sickkid this week or overtime at
work, and your health coach isgoing to work with you like well
(06:25):
, how can we find 10 minutestoday to focus on your hip pain,
right?
How can we find 10 minutestomorrow to focus on your knee
pain?
And they're here to help youstay adherent, to do something
you may not want to do, which isto move a painful joint, but I
tell you what movement ismedicine, and too many of us
think, when my knee is hurting,I just shouldn't move it, and
that's not the case for chronicknee pain.
You actually want to move it.
(06:45):
Even if it's a little bit sore,you're actually going to feel
better in the long term, and ourhealth coaches are really great
about being your partner andyour collaborator over time to
help you stay adherent to yourtreatment plan, but also help
you with other things like yourdiet, your nutrition, your sleep
, your stress levels all ofthese other things that might be
impacting your health, and yourphysical therapist is there
(07:06):
along the way as well wheneveryou have questions about your
specific condition.
Lacy Wolff (07:09):
That's wonderful and there's such a strong link
connection between mental andphysical health and I think
often in the health care spacewe separate these two things.
But it seems like your solutionreally does bring that together
and focus on those habits thatwill help the whole person.
Daniel Perez (07:28):
Absolutely.
Yeah, we can separate it.
We've seen with our data thatpeople are more likely to be
depressed, more likely to beanxious, when you have pain.
And the clinical research hasalso shown if you have one pain,
one area of your body that's inpain let's say you have knee
pain you're about a 2x higherlikelihood so double the
likelihood of being clinicallydepressed.
And if you have more than twoareas say your knee and your hip
(07:50):
or your knee and your backyou're about three or four times
more likely to be depressed andanxious.
And so researchers have seenthat connection between the mind
and body for a long time andoftentimes it's going to be
difficult to impact somebody'sdepression if we don't first
impact their back pain.
Lacy Wolff (08:06):
Right.
Daniel Perez (08:07):
Because no matter how much antidepressants we
might give you, if theunderlying reason why you're
depressed is because you're notsleeping well at night, because
your back hurts and you can'tfind a great comfortable
position, we need to firstaddress your back pain.
Or you might be depressedbecause you're being a bit
socially isolated because yourknee is hurting and you're not
able to hang out with yourfriends or walk with your spouse
or play with your kids.
(08:27):
Once we address that underlyingknee pain, we'll be able to go
back to living your life.
That's a big impact on your mooddisorder.
Lacy Wolff (08:32):
And I'm going to go completely off of my order of
questions here, because, aswe're talking about pain, one of
the things that you're bringingin is this Enso device.
Daniel Perez (08:42):
Can you?
Lacy Wolff (08:42):
talk about Enso.
What is it and how can it helpwith pain?
Because that is such a huge,it's such a common thing that
folks are dealing with, like yousaid, and untreated pain.
Daniel Perez (08:52):
Well, that's why we're so excited to work with
the state of Texas.
We bring a full suite of careto the members who join our
program, and physical therapy isa cornerstone of conservative
management care for people withback, joint or muscle pain.
But a lot of times people arein too much pain to move or
they're having frequentflare-ups, and you might wake up
in the morning and your back'sreally hurting.
(09:13):
But you've got work to do,right, right, and it's almost 9
am and you've got to show up towork.
And maybe you're aschoolteacher or you work for
the state government somewhereand so you've got to show up.
And so Enso is about the sizeof a half dollar and it's a
device, a wearable device, thatwe've developed that you could
put anywhere in your body, justabout, and it delivers
electrical nerve stimulationright through your skin.
(09:35):
And Enso's devices have beenavailable over the counter for a
long time.
Our innovation is that wedeliver very high frequency
electrical nerve stimulationthat previously could only be
achieved by surgicallyimplanting the device.
Our breakthrough is that we'reable to deliver this without it
being surgically implanted, andit delivers completely
non-addictive, non-invasive painrelief.
(09:56):
And we've shown that itimproves pain relief even more
than just physical therapy aloneand what our members tell us.
It just kind of melts theirpain away.
So to put it on your lower back,it fits right beneath your
clothes.
It's completely wireless.
You could use it with your appand the average user, when we
send them an Enso, will use itfor two, three, four hours a day
(10:16):
and it just slips rightunderneath your clothes.
The battery lasts nearly allday and it's just a really
pleasant feeling to just get thepain away.
Other people will wear itaround their knee, other people
wear it on their shoulder or ontheir neck, just wherever your
pain might be.
You could put on our Enso.
It's offered at no cost.
Just ask your physicaltherapist for it if you're
(10:37):
having frequent flare-ups, andwe'll send you an Enso right in
the mail in two days, and it'sone of the most delightful
aspects of our program.
Lacy Wolff (10:44):
It's amazing.
Yeah, I used it myself and Ican talk about my own health
conditions on the podcast.
I can talk about other people's, but I had a flare up with my
SI joint and low back pain andhave scoliosis, so some issues
with that on and off, and thatreally did help.
I felt a significant decreasein the pain just after wearing
(11:05):
it one day.
Daniel Perez (11:06):
Yeah, we just lost our Enso 3.
We put a lot of engineeringit's it's taken a lot of R&D
work to just push Enso forward,but we are.
We are super delighted Our theusers on Enso.
They've they rave about it.
We've had, you know, we had anemployee at Hinge Health move on
recently and she said the onething she wants to make sure is
(11:26):
that she still has access to herEnso forever.
And so we told her for as longas I'm CEO, you will always have
access to Enso.
We will send you new gel padsand new upgrades free.
It's a very, very popularaspect of the program because,
yeah, if it melts your pain away, you want to keep using it.
Lacy Wolff (11:45):
Absolutely.
And the other thing that Ithink is so great about your
program think about, like, thewhole continuum of
musculoskeletal conditions.
You have a program for peoplethat want to prevent injury as
well and kind of teaching peoplehow to move properly.
I think that was one of theneatest things.
I took the.
(12:06):
I took my hinge kit over tomeet one of the executive
directors at an agency andactually he had just had two
knee replacements and he I putthe, I put the, my iPad out and
I had it going through the squatform technique.
It's locating his joints, it'sgiving him feedback and he said
this is exactly what my physicaltherapist told me.
Daniel Perez (12:28):
Yeah, so we're excited to do it.
And prevention's key Like evenif you're not in pain, you
should be moving.
A lot of us are like at ourdesks for a long period of time
and we're not moving enoughduring the day.
I'm sorry.
Movement is medicine.
It lubricates your joints oryour cartilage doesn't have
blood supply, and so when you'renot moving, it joints, your
cartilage doesn't have bloodsupply, and so when you're not
(12:49):
moving, it's not exchangingnutrients, and so when we move
our joints, we're actuallyhelping them breathe in many
ways.
We're bringing in oxygen, we'retaking out waste, we're
bringing in new nutrients, andso I love that your colleague
could use our technology andjust move a bit more during the
day.
Do different types of movement.
Whether you're in pain or not,you should always be thinking
about light stretching andstrengthening or moving every 30
minutes, and it's so healthyfor your joints.
Lacy Wolff (13:09):
It is the reason why we are all having so much
musculoskeletal issues, I guess,is because of our sedentary
lifestyle.
For the most part, it's notbecause, we're picking up heavy
things.
Daniel Perez (13:19):
And just running in the morning.
You know just if you do a 30minute run or six minute run in
the morning, it doesn't excusesitting at a desk for eight
hours, sure.
Lacy Wolff (13:27):
Yeah.
Daniel Perez (13:29):
It's better than nothing.
But it's probably even betterto move periodically throughout
the day than just move at oneperiod during the day in my
morning workout or my eveningworkout.
Lacy Wolff (13:36):
Right, I understand you also have a walking desk
that you use quite a bit,personally I do.
Can you share how you do that.
Daniel Perez (13:47):
Yeah, I just got it.
I don't want to use the wordlife-changing, but I don't have
another word to use other thanwalking very gingerly like one
mile an hour, and it's beengreat for just my overall energy
(14:16):
level, my focus, making surethat I don't feel too sedentary
over the course of the day andit doesn't impact my work.
I'm going like one mile an hourso I can type just fine, I can
do video calls just fine andthey're about $200 now, which
isn't cheap it's still $200, butit makes a big impact on your
health, right, yeah, and I thinkI've even seen them.
Lacy Wolff (14:35):
You know people try things and get rid of them on
the marketplace.
Daniel Perez (14:38):
Yeah, you get over a hundred bucks yeah exactly.
Lacy Wolff (14:40):
So.
We've talked a lot about Hingeand what it can do for people.
I'd love to kind of transitionand hear your story of how you
built Hinge Health, you and yourco-founder.
I understand that you had anaccident that kind of sparked
your interest or then yourealized there was kind of a gap
in this space.
Can you tell your story?
Daniel Perez (15:01):
Sure, yeah.
So when I was younger Iactually had a biking accident
so I broke my arm and my legwhen I was younger, had about 12
months of rehab.
I then went to the UK to do myPhD in the medical sciences.
I met my co-founder while hewas there.
He had also had amusculoskeletal injury so he
tore his ACL when he was younger.
He also had 12 months of rehaband he was also then pursuing
(15:22):
his PhD specifically in jointregenerative medicine, so he was
trying to regrow cartilage forpeople who have had joint
injuries.
That was his area of researchand we got together and we were
poor PhD students but committedentrepreneurs and so we weren't
paying as much attention to ourcoursework.
But we were very interested inthe science around healthcare
(15:44):
and particularly usingtechnology to improve healthcare
outcomes, and we remembered ourrehab experience and as we
dived into the clinicalliterature, what we found was
that there is really solidagreement there was not much
argument really solid agreementon what the best practice care
is for people withmusculoskeletal conditions, you
know, with back pain, knee pain,hip pain, shoulder pain, and
(16:06):
it's like they should not beescalated to opiates up front.
They should be escalated tosurgery upfront, not even
imaging per se, unless there's ared flag.
They should be encouraged to dophysical therapy.
They should be given somebehavioral health support,
because it could be difficult toadhere to a physical therapy
program, particularly whenyou're in pain, and they should
be given some education tobetter understand their
condition, to understand theirpain, understand the risk
(16:28):
factors, but also thatparticularly understanding that
movement, even if it makes you abit sore, is not bad.
So you know, we realized thatwhen we abstracted the treatment
it was, you know, it's physicaltherapy or exercise therapy, it
is patient education and it'sthat behavioral health support.
And we're like really solidagreement across all the
literature.
But then in all the researchpapers, at the end of every
research paper, there's often adiscussion section and almost
(16:52):
invariably in these discussionsections we would read the
authors would lament about thefact.
Oh, but, by the way, nobodydoes this, it's too difficult to
do this.
You know, nobody has the timeto like go to the physical
therapist office three days aweek for the next 12 weeks, take
time off, work, pay the copay,pay for childcare, and so
typically, particularly inAmerica, people eventually get
(17:12):
shunted to surgery.
Or they'll get shunted toopiates because it's just easier
, or they'll just deal with thepain you know, pop Tylenol, pop
Advil, until the pain gets sobad that they have a knee
replacement or they have aspinal fusion.
So we thought, golly, could weuse technology to simply better
deliver the evidence thatresearch shows already exist?
And could we use technology togo beyond the evidence base in
(17:32):
the future, in a digital-first,mobile-first world and this was
10 years ago could we usetechnology to redefine what best
practice care should be forpeople with knee, back, joint
and muscle pain?
And that was our inspirationand we've been pushing it.
It's an open door since thenand people have really enjoyed
the convenience of our programand our average pain reduction
is about 68 percent for people.
(17:52):
We Stanford published a studylooking at 10,000 consecutive
patients going through Hinge.
They showed a 68 percentreduction in pain for the
average participant and we'reavoiding two and three surgeries
for people going through theprogram.
So it really works and frombaseline through the, through
the end of the program, we'realso reducing depression and
anxiety rates by about 50%.
So, great reduction in pain,great avoidance of surgery,
(18:14):
which nobody necessarily wantsto do surgery, they just want
their pain to go away.
So, giving you an alternativesurgery and helping with your
mood disorders as well.
Lacy Wolff (18:21):
That is amazing.
So you and I understand youwere at Oxford.
Your partner is at Cambridge,so you're two smart guys.
Sure, you're like okay, we seethere's a gap here and you're
able to fill that gap.
You built this product.
I can only imagine thechallenges, because I think this
(18:41):
is a pretty competitive spacethat you're in, but y'all have
built this and are definitelythe front runner, in my opinion,
in the musculoskeletal digitalspace.
Where did it all like?
Can you share your firstcustomer, your first client?
Your first member experience.
Daniel Perez (18:58):
So I'll talk to our first member and then I'll
talk to you a little bit aboutour first client as well.
So the first patient who usedour program when we founded
Hinge, we were actually shuttingdown another startup that
didn't work out.
So we were founding startups inour PhDs.
Again, poor PhD studentscommitted entrepreneurs, but we,
as co-founders, we didn't wantto split break out.
We were in our late 20s at thetime.
(19:21):
It was about 10 years ago and wethought you know what let's go
to like what we're absolutelypassionate about, which is
musculoskeletal munitions, whatwe both had experience with, and
we whiteboarded what the typeof rehab we wish we would have
had.
And we did all the clinicalresearch and we're like, very
quickly, we're like this is whateverybody's aligned with.
Could we use technology tobetter deliver this?
And we set a goal for ourselves.
(19:41):
This was October 1st of 2014.
So we're almost exactly 10 yearsago today and we said let's
have our prototype ready ineight weeks and put it on our
first patient and let's see ifwe could do it.
We missed our deadline by twoweeks, but 10 weeks later, so
mid-December our prototype wasready and we sent emails around
our campuses just trying torecruit volunteers Any students
(20:04):
who might have knee pain.
We were focused on knee painfor our prototype at the time.
Please raise your hand and we'dlove for you to trial our
program.
No students really signed up,but all the reception desks.
When you send it to thedepartment reception desk there
was typically an older ladywho's working the reception at a
few of the buildings and all ofthem raised their hands.
Lacy Wolff (20:24):
I would personally like to volunteer for this.
Daniel Perez (20:26):
And our first patient was a 55 year old or
maybe 60 year old lady We'llcall her Maggie at the
university and she raised herhand and we went and we saw her
in person.
We had wearable sensors.
Then we gave it to her in aTupperware box and with a tablet
computer was, you know,preloaded with software, and she
, she did five quick exercisesright there in front of us and
(20:50):
we were scared that it was goingto be buggy.
It wasn't going to work.
It worked perfectly.
And then she looked at it andwas like, can I keep this?
And she kept using it andwithin like three weeks her pain
had reduced by 41%.
Lacy Wolff (21:01):
Wow, and we're like I think we're onto something.
Yeah.
Daniel Perez (21:03):
And we tried to figure out from there how do we
expand coverage?
Because physical therapy weexpect our health insurance to
kick in, so we knew we need topartner up with health insurance
companies.
We're in the UK at the time andI'm obviously American.
I wanted to come home and itwas a bit more difficult to
crack into the NHS and inAmerica there's a lot more
(21:25):
health innovation and we thoughtcould we transition the company
back to the US and we startedgoing to health care conferences
here in the US and a lot offolks in the US get their health
care from their employer andwhat's interesting about that is
that every employer is apotential backer for you.
As an early stage company or astate plan that covers benefits
(21:48):
for their members or a stateplan that covers benefits for
their members.
They are individually trying toinnovate and trying to improve
the health of the members ontheir plan and they each have
their own approach to doing thatand in some ways that could
lead to waste, but in other waysit leads to a remarkable
innovation, and so I think mostdigital health innovation is
(22:10):
happening in America because youhave so many different entities
trying to innovate, so they'reall trying new things and that
means when something works, itcould quickly spread for other
sponsors, for other states, forother employers.
And our first customer I methim at a conference and he was
giving a talk.
I emailed him the night before.
(22:31):
He had not replied.
That's fine, so I showed up tohis talk anyways and I beelined
after his talk and he actuallyremembered.
He was like actually I didn'thave time to reply, but I saw
your email.
Muscle skeletal conditions, backjoint and muscle pain is like
20% of our healthcare costs.
It was a ski resort in Colorado.
It was a resort and we startedtalking.
He had to fly back to Denver.
(22:52):
The conference was in Vegas andhe came to give the talk, but
he was very busy and he neededto leave and so I kept walking
with him out of the conferenceroom.
Then I walked with him to thecasino and then we hit the
escalator.
He looked at me, I looked at himand I went down the escalator
with him and then we got to thetaxi cab line and he's like
you're not getting into the cabwith me.
I would have gotten to the cabwith him if it meant continuing
(23:14):
the conversation, but then theyagreed to do a pilot.
I flew the team from the UK toColorado and we did the pilot in
person and it worked and I'lltell you it's.
One of the beautiful thingsabout American healthcare is
that we were able to kick offthe revolution in digital
physical therapy from one of thebest resorts.
Don't get rid of the fail.
(23:34):
Resorts is the number one, Ithink, hospitality company in
the world, but they're also anincredible healthcare innovator
and I they deserve a lot ofcredit for being so forward
thinking.
Yeah.
Lacy Wolff (23:46):
A lot of.
I think a lot of people can berisk averse to anything new.
Um, a lot of people also don'trealize that maybe work for the
state or higher educationinstitutions that receive health
insurance from ERS, that we area self-funded plan.
I think a lot of people justexpect their health insurance
picks up and that we are reallytrying to be innovative, to
think about ways that we canhelp our members feel better so
(24:10):
that they can enjoy longretirement, to improve their
health and then, at the end ofthe day, when we help members
reduce risk and chronicconditions, it helps all of us
and cost savings as well, sothat we can have a sustainable
health plan for a long time.
So, absolutely yeah.
Daniel Perez (24:28):
And so you keep covering new benefits and you're
charged with how do you createa great experience, improve
their outcomes?
But you have a finite budgetand so you have to get creative
in terms of like how you'redelivering these healthcare
benefits, and it's everybody hasa challenge.
The federal government has achallenge, like employers have a
challenge with healthcarebenefits going up, or I should
say, healthcare costs going up,and so, yeah, we all have a role
(24:49):
to play.
Lacy Wolff (24:49):
It really does give me a lot of hope when you know
the fact that we're bringing insolutions that I believe are
very sustainable, like Hinge,hello, heart, learn to Live the
benefits that we launchedSeptember 1.
And just hearing your story isquite incredible, and the growth
of your company over 10 yearsis amazing.
What's next for you?
Do you have any?
What's in your roadmap?
Daniel Perez (25:11):
Well, we are.
We're focused on several things.
One is digital physical therapy.
There was a lot of work to doto just make this experience
even better than it is today, sothat if you are, if you have
back, joint or muscle pain, youcome to us first and we are your
first port of call if you'relooking for physical therapy,
and we have an extensive roadmapto continue to improve our
exercise therapy experience.
We're hiring a ton of providers.
(25:33):
Physical therapists are in all50 states, but particularly here
in the state of Texas, we havea really big footprint a lot of
members, a lot of employers anda lot of state plans here in
Texas that we're working with.
We're really focused onimproving digital physical
therapy, but we're also focusedon in-person care and how can we
better integrate with in-personcare.
I actually I've been running adigital health company for 10
(25:54):
years.
I am a.
After 10 years of running adigital health company, I am
more committed than ever toin-person care and how important
in-person care is for all of usand how important in-person
care providers are for ourcommunities as well, and so I
don't think the future ofhealthcare is digital or
in-person.
I think it's a mix of the twoand points of care.
(26:14):
I want to see an in-personprovider, maybe for an initial
assessment or to see me, andthen follow-up visits could be
digitally.
It could be rendered digitally,and I think most people out
there would like a mix of thetwo.
They like the comfort and rigorof an in-person interaction and
they like the convenience ofdigital interactions as well,
and we shouldn't have to choosebetween the two.
(26:35):
So we're really focused on howcan we better integrate with
in-person care moving forward.
And the last bit is around AI.
Ai is permeating tech right now,but for healthcare it could
serve a really great purpose ofhelping personalize programs
better for you, helping to speedthe convenience of information
back to you as a member andwe're investing very, very
(26:58):
deeply in the AI and also toscale our care team to allow
them to reply much more quicklyto our members, to give them a
snapshot of every member whenthey're interacting with
somebody.
If they have a panel of 150members, how could they know
about John Smith, who they'reinteracting with now, and could
the AI help summarize?
This is his condition.
This is how he's been over thelast two weeks.
(27:19):
This is how engaged he's been,and here are some challenges
he's faced, to help give you aleg up as you're trying to wrap
your head around this particularclinical case.
So we are investing in AI.
So those are the three thingsDigital physical therapy we're
not done yet.
How do we interact within-person care and how can we
weave AI through our program tomake sure that the end user has
(27:39):
a phenomenal experience?
Lacy Wolff (27:40):
That's amazing.
I am so honored to get to spendtime with you and hear directly
from you about this incrediblecompany that you've built and
that we are able to offer thissolution to our members.
Is there anything else that you, that I missed, or that people
should know about Hinge Health?
Daniel Perez (28:00):
Well, first, of all, just I am so grateful to be
able to work with ERS andmembers here in Texas.
It's been really exciting tosee just how committed your team
is to getting the word out, butalso how committed your team is
to just healthcare innovation.
Healthcare is really tough totackle.
That's the reason why it's soexpensive in America and it's
(28:21):
going to take creativity, and sowhat I want your members to
know is that when they joinHinge Health, whatever they see
today is going to be even bettertomorrow.
We have 500 people on our R&Dteam, and every every week we're
pushing out new updates, and soit's going to be radically
different even six months fromnow and 12 months from now.
So we commit to you know,members here in Texas, is that
(28:43):
it's going to get better andbetter every time you interact
with our program, and that'swhat we're committed to never
being satisfied with.
Lacy Wolff (28:52):
I love that.
It's great today.
It's going to be bettertomorrow.
Yeah that's wonderful.
Well, thank you so much, daniel.
I really appreciate your timeand your innovation, and we look
forward to great thingssupporting our members.
Daniel Perez (29:03):
Thank you, Lacey.
Lacy Wolff (29:05):
Thank you so much for tuning in to this episode of
the ERS Walk Talk podcast.
I hope you enjoyed ourconversation with Daniel Perez
and learn more about how HingeHealth may be able to help you
with managing chronic pain andimprove your overall well-being.
If you're ready to take thenext step in your health journey
, be sure to check out our shownotes for details on how you can
enroll in Hinge.
(29:27):
This is a fantastic benefitthat's now available to Health
Select of Texas andconsumer-directed Health Select
participants at no cost.
If you enjoyed this episode,please don't forget to subscribe
.
Leave a review, share thepodcast with your coworkers,
your family members that mayalso be eligible for this
benefit.
Your support and feedback helpsus to continue to bring
(29:48):
valuable health and wellnessinformation to you.
Until next time, keep walking,keep talking and stay well.
Take care everyone.
You can get treated within minutes when
you're signing up for Hinge andget all of your care right from
the comfort of your own home.
We've seen with our data thatpeople are more likely to be
depressed, more likely to beanxious, when you have pain.
And the clinical research hasalso shown if you have one pain,
one area of your body that's inpain let's say you have knee
pain you're about a 2x higherlikelihood so double the
(00:23):
likelihood of being clinicallydepressed.
And if you have more than twoareas, say your knee and your
hip or your knee and your backyou're about three or four times
more likely to be depressed andanxious.
And so researchers have seenthat connection between the mind
and body for a long time, andoftentimes it's going to be
difficult to impact somebody'sdepression if we don't first
impact their back pain.
Lacy Wolff (00:44):
Hi and welcome back to the ERS Walk Talk podcast,
where we explore the latest inhealth, well-being and programs
available to help you live ahealthier life.
I'm your host, lacey Wolfe.
I'm the coordinator forstatewide well-being initiatives
at ERS, and today I'm thrilledto be joined by Daniel Perez,
who is the CEO and co-founder ofthe company Hinge Health.
(01:04):
Daniel's background is trulyimpressive.
He holds degrees from Stanfordand also went to Cambridge, and
he's a seasoned entrepreneurwith a digital health space.
His work with Hinge Health hasbeen groundbreaking in the way
we approach musculoskeletalhealth, tackling chronic pain
through a blend of technology,education and personalized care.
(01:25):
Hinge has helped thousands ofpeople across the country take
control of their physical health, avoid surgery and improve
their quality of life.
And now Hinge Health isavailable to our Health
Selective Texas participantsstarting September 1st.
Gives our health planparticipants the opportunity to
participate in a virtualphysical therapy and expert care
(01:46):
to treat back and joint painfrom the comfort of home.
Through the Hinge Health app,participants can get
personalized exercise therapy,one-on-one health coaching and
education to prevent and managechronic conditions.
In this episode, we're going todive into how Daniel and his
team are revolutionizing the waywe care for our bodies and how
(02:06):
you can use this valuablebenefit.
So let's get started.
Here's my conversation withDaniel.
Daniel, welcome to the ERS WalkTalk podcast.
It's really an honor to sitdown and have a conversation
with you.
Daniel Perez (02:17):
Thank you for having me.
Lacy Wolff (02:18):
Lacey Hoping, we could just start with having you
explain the Hinge Healthsolution for our listeners and
kind of talk about what it isand how it's different from
other musculoskeletal solutionsout there.
Daniel Perez (02:32):
Sure so Hinge Health.
We are tackling back, joint andmuscle pain.
So about one in two Americanswill have back joint or muscle
pain in any given year.
That could range from asprained ankle through a twisted
knee or chronic knee or backpain, all the way through
surgery somebody having kneearthroscopy or hip replacement
and so it's a wide spectrum, butabout one in two of us will
have something along thatspectrum in any given year, and
(02:56):
it can be really difficult toget care for musculoskeletal
conditions and oftentimes we'lljust take Tylenol or Advil
because it's hard to access care, hard to take time off, work,
hard to travel to a physicaltherapist or to a doctor, and so
what we've done with HinchHealth is we've created a
digital program so you can getyour physical therapy right from
the comfort of your own home,and so when you sign up to our
(03:18):
program, our software and ouralgorithms will create a custom
care plan for you.
So you have a custom physicaltherapy program that's delivered
to you via our software.
You get connected to your ownpersonal physical therapist who
you can message at any time.
You get to see them on a videovisit.
You could message them directlywith our app.
You also get a care team andthey're going to guide you
(03:39):
through your care plan over thenext several weeks and it's
customized to you, you and it'sconstantly changing just for you
.
You don't have to worry aboutco-pays.
You don't have to worry aboutwaiting in line.
You don't have to worry aboutsitting in traffic or getting
childcare.
You could get treated withinminutes when you're signing up
for Hinge and get all of yourcare right from the comfort of
(04:00):
your own home.
Lacy Wolff (04:01):
Really incredible because there are so many
barriers to accessingmusculoskeletal health, and, I
think, especially in Texas.
We're a huge state and we havea lot of people in rural areas.
That's one of the reasons whyI'm so excited about this
solution, because sometimes itmight take 30 minutes to drive,
even for me in Austin.
I might be close to a physicaltherapist, but with traffic it
(04:23):
can take a long time to get tosomebody.
So it's really incredible whatyou've built and I know for us
there's a huge need for it.
Like when I look at our healthclaims 20% of people in our
health plan have amusculoskeletal condition, but
I'm guessing that's probably notall of the people that could
use this solution or maybe needhelp with musculoskeletal.
Daniel Perez (04:44):
Absolutely.
A lot of folks are suffering inpain in that there's a there's
a barrier to like schedule adoctor's visit.
Like my knee pain is finallytoo difficult, or my back pain
is too difficult.
I need to go see a doctor aboutthis.
A lot of us are just below thatthreshold.
It's like three or four outof 10 pain.
But I'm going to deal with ittoday because I've got to get to
work or I've got to take mykids to school.
I can't take a half day offwork to go to the doctors right
(05:06):
now and with Hinge you couldsign up and be treated within
minutes right from the comfortof your own home.
You could sign up on your phone, you could sign up from work,
you could sign up at home andvery quickly get your care.
But also, if you're in WestTexas, where there's a few more,
a bit more difficulty maybefinding a provider because it's
a bit more rural, or you're indowntown Dallas, where there's a
lot of traffic, or downtownAustin, it's going to be very
(05:29):
consistent care, no matter whereyou are, and very quickly
you'll be able to access thecare.
Lacy Wolff (05:33):
That's amazing and having gone through the program
myself, you know I think it'sreally amazing that you get a
physical therapist assigned toyou as well as a coach.
Daniel Perez (05:42):
Absolutely Can you talk a little bit about those
two components of your program,and so we firmly believe in
bringing a full care team toeach of our members who join our
program.
So, when you join, we're goingto do an intake and we're going
to ask you the same questionsyour doctor would ask you, your
physical therapist would ask youabout your knee pain or your
back pain.
So we understand how it's beenimpacting your life and we share
that with our care team.
You're going to be assigned adedicated physical therapist
(06:05):
who's familiar with yourcondition and they're going to
design your program for you.
They're going to customize yourprogram for you and your health
coach, however, is part of thatcare team and they're here to
help you overcome some of thebarriers and challenges all of
us face in life.
You know you might have a sickkid this week or overtime at
work, and your health coach isgoing to work with you like well
(06:25):
, how can we find 10 minutestoday to focus on your hip pain,
right?
How can we find 10 minutestomorrow to focus on your knee
pain?
And they're here to help youstay adherent, to do something
you may not want to do, which isto move a painful joint, but I
tell you what movement ismedicine, and too many of us
think, when my knee is hurting,I just shouldn't move it, and
that's not the case for chronicknee pain.
You actually want to move it.
(06:45):
Even if it's a little bit sore,you're actually going to feel
better in the long term, and ourhealth coaches are really great
about being your partner andyour collaborator over time to
help you stay adherent to yourtreatment plan, but also help
you with other things like yourdiet, your nutrition, your sleep
, your stress levels all ofthese other things that might be
impacting your health, and yourphysical therapist is there
(07:06):
along the way as well wheneveryou have questions about your
specific condition.
Lacy Wolff (07:09):
That's wonderful and there's such a strong link
connection between mental andphysical health and I think
often in the health care spacewe separate these two things.
But it seems like your solutionreally does bring that together
and focus on those habits thatwill help the whole person.
Daniel Perez (07:28):
Absolutely.
Yeah, we can separate it.
We've seen with our data thatpeople are more likely to be
depressed, more likely to beanxious, when you have pain.
And the clinical research hasalso shown if you have one pain,
one area of your body that's inpain let's say you have knee
pain you're about a 2x higherlikelihood so double the
likelihood of being clinicallydepressed.
And if you have more than twoareas say your knee and your hip
(07:50):
or your knee and your backyou're about three or four times
more likely to be depressed andanxious.
And so researchers have seenthat connection between the mind
and body for a long time andoftentimes it's going to be
difficult to impact somebody'sdepression if we don't first
impact their back pain.
Lacy Wolff (08:06):
Right.
Daniel Perez (08:07):
Because no matter how much antidepressants we
might give you, if theunderlying reason why you're
depressed is because you're notsleeping well at night, because
your back hurts and you can'tfind a great comfortable
position, we need to firstaddress your back pain.
Or you might be depressedbecause you're being a bit
socially isolated because yourknee is hurting and you're not
able to hang out with yourfriends or walk with your spouse
or play with your kids.
(08:27):
Once we address that underlyingknee pain, we'll be able to go
back to living your life.
That's a big impact on your mooddisorder.
Lacy Wolff (08:32):
And I'm going to go completely off of my order of
questions here, because, aswe're talking about pain, one of
the things that you're bringingin is this Enso device.
Daniel Perez (08:42):
Can you?
Lacy Wolff (08:42):
talk about Enso.
What is it and how can it helpwith pain?
Because that is such a huge,it's such a common thing that
folks are dealing with, like yousaid, and untreated pain.
Daniel Perez (08:52):
Well, that's why we're so excited to work with
the state of Texas.
We bring a full suite of careto the members who join our
program, and physical therapy isa cornerstone of conservative
management care for people withback, joint or muscle pain.
But a lot of times people arein too much pain to move or
they're having frequentflare-ups, and you might wake up
in the morning and your back'sreally hurting.
(09:13):
But you've got work to do,right, right, and it's almost 9
am and you've got to show up towork.
And maybe you're aschoolteacher or you work for
the state government somewhereand so you've got to show up.
And so Enso is about the sizeof a half dollar and it's a
device, a wearable device, thatwe've developed that you could
put anywhere in your body, justabout, and it delivers
electrical nerve stimulationright through your skin.
(09:35):
And Enso's devices have beenavailable over the counter for a
long time.
Our innovation is that wedeliver very high frequency
electrical nerve stimulationthat previously could only be
achieved by surgicallyimplanting the device.
Our breakthrough is that we'reable to deliver this without it
being surgically implanted, andit delivers completely
non-addictive, non-invasive painrelief.
(09:56):
And we've shown that itimproves pain relief even more
than just physical therapy aloneand what our members tell us.
It just kind of melts theirpain away.
So to put it on your lower back,it fits right beneath your
clothes.
It's completely wireless.
You could use it with your appand the average user, when we
send them an Enso, will use itfor two, three, four hours a day
(10:16):
and it just slips rightunderneath your clothes.
The battery lasts nearly allday and it's just a really
pleasant feeling to just get thepain away.
Other people will wear itaround their knee, other people
wear it on their shoulder or ontheir neck, just wherever your
pain might be.
You could put on our Enso.
It's offered at no cost.
Just ask your physicaltherapist for it if you're
(10:37):
having frequent flare-ups, andwe'll send you an Enso right in
the mail in two days, and it'sone of the most delightful
aspects of our program.
Lacy Wolff (10:44):
It's amazing.
Yeah, I used it myself and Ican talk about my own health
conditions on the podcast.
I can talk about other people's, but I had a flare up with my
SI joint and low back pain andhave scoliosis, so some issues
with that on and off, and thatreally did help.
I felt a significant decreasein the pain just after wearing
(11:05):
it one day.
Daniel Perez (11:06):
Yeah, we just lost our Enso 3.
We put a lot of engineeringit's it's taken a lot of R&D
work to just push Enso forward,but we are.
We are super delighted Our theusers on Enso.
They've they rave about it.
We've had, you know, we had anemployee at Hinge Health move on
recently and she said the onething she wants to make sure is
(11:26):
that she still has access to herEnso forever.
And so we told her for as longas I'm CEO, you will always have
access to Enso.
We will send you new gel padsand new upgrades free.
It's a very, very popularaspect of the program because,
yeah, if it melts your pain away, you want to keep using it.
Lacy Wolff (11:45):
Absolutely.
And the other thing that Ithink is so great about your
program think about, like, thewhole continuum of
musculoskeletal conditions.
You have a program for peoplethat want to prevent injury as
well and kind of teaching peoplehow to move properly.
I think that was one of theneatest things.
I took the.
(12:06):
I took my hinge kit over tomeet one of the executive
directors at an agency andactually he had just had two
knee replacements and he I putthe, I put the, my iPad out and
I had it going through the squatform technique.
It's locating his joints, it'sgiving him feedback and he said
this is exactly what my physicaltherapist told me.
Daniel Perez (12:28):
Yeah, so we're excited to do it.
And prevention's key Like evenif you're not in pain, you
should be moving.
A lot of us are like at ourdesks for a long period of time
and we're not moving enoughduring the day.
I'm sorry.
Movement is medicine.
It lubricates your joints oryour cartilage doesn't have
blood supply, and so when you'renot moving, it joints, your
cartilage doesn't have bloodsupply, and so when you're not
(12:49):
moving, it's not exchangingnutrients, and so when we move
our joints, we're actuallyhelping them breathe in many
ways.
We're bringing in oxygen, we'retaking out waste, we're
bringing in new nutrients, andso I love that your colleague
could use our technology andjust move a bit more during the
day.
Do different types of movement.
Whether you're in pain or not,you should always be thinking
about light stretching andstrengthening or moving every 30
minutes, and it's so healthyfor your joints.
Lacy Wolff (13:09):
It is the reason why we are all having so much
musculoskeletal issues, I guess,is because of our sedentary
lifestyle.
For the most part, it's notbecause, we're picking up heavy
things.
Daniel Perez (13:19):
And just running in the morning.
You know just if you do a 30minute run or six minute run in
the morning, it doesn't excusesitting at a desk for eight
hours, sure.
Lacy Wolff (13:27):
Yeah.
Daniel Perez (13:29):
It's better than nothing.
But it's probably even betterto move periodically throughout
the day than just move at oneperiod during the day in my
morning workout or my eveningworkout.
Lacy Wolff (13:36):
Right, I understand you also have a walking desk
that you use quite a bit,personally I do.
Can you share how you do that.
Daniel Perez (13:47):
Yeah, I just got it.
I don't want to use the wordlife-changing, but I don't have
another word to use other thanwalking very gingerly like one
mile an hour, and it's beengreat for just my overall energy
(14:16):
level, my focus, making surethat I don't feel too sedentary
over the course of the day andit doesn't impact my work.
I'm going like one mile an hourso I can type just fine, I can
do video calls just fine andthey're about $200 now, which
isn't cheap it's still $200, butit makes a big impact on your
health, right, yeah, and I thinkI've even seen them.
Lacy Wolff (14:35):
You know people try things and get rid of them on
the marketplace.
Daniel Perez (14:38):
Yeah, you get over a hundred bucks yeah exactly.
Lacy Wolff (14:40):
So.
We've talked a lot about Hingeand what it can do for people.
I'd love to kind of transitionand hear your story of how you
built Hinge Health, you and yourco-founder.
I understand that you had anaccident that kind of sparked
your interest or then yourealized there was kind of a gap
in this space.
Can you tell your story?
Daniel Perez (15:01):
Sure, yeah.
So when I was younger Iactually had a biking accident
so I broke my arm and my legwhen I was younger, had about 12
months of rehab.
I then went to the UK to do myPhD in the medical sciences.
I met my co-founder while hewas there.
He had also had amusculoskeletal injury so he
tore his ACL when he was younger.
He also had 12 months of rehaband he was also then pursuing
(15:22):
his PhD specifically in jointregenerative medicine, so he was
trying to regrow cartilage forpeople who have had joint
injuries.
That was his area of researchand we got together and we were
poor PhD students but committedentrepreneurs and so we weren't
paying as much attention to ourcoursework.
But we were very interested inthe science around healthcare
(15:44):
and particularly usingtechnology to improve healthcare
outcomes, and we remembered ourrehab experience and as we
dived into the clinicalliterature, what we found was
that there is really solidagreement there was not much
argument really solid agreementon what the best practice care
is for people withmusculoskeletal conditions, you
know, with back pain, knee pain,hip pain, shoulder pain, and
(16:06):
it's like they should not beescalated to opiates up front.
They should be escalated tosurgery upfront, not even
imaging per se, unless there's ared flag.
They should be encouraged to dophysical therapy.
They should be given somebehavioral health support,
because it could be difficult toadhere to a physical therapy
program, particularly whenyou're in pain, and they should
be given some education tobetter understand their
condition, to understand theirpain, understand the risk
(16:28):
factors, but also thatparticularly understanding that
movement, even if it makes you abit sore, is not bad.
So you know, we realized thatwhen we abstracted the treatment
it was, you know, it's physicaltherapy or exercise therapy, it
is patient education and it'sthat behavioral health support.
And we're like really solidagreement across all the
literature.
But then in all the researchpapers, at the end of every
research paper, there's often adiscussion section and almost
(16:52):
invariably in these discussionsections we would read the
authors would lament about thefact.
Oh, but, by the way, nobodydoes this, it's too difficult to
do this.
You know, nobody has the timeto like go to the physical
therapist office three days aweek for the next 12 weeks, take
time off, work, pay the copay,pay for childcare, and so
typically, particularly inAmerica, people eventually get
(17:12):
shunted to surgery.
Or they'll get shunted toopiates because it's just easier
, or they'll just deal with thepain you know, pop Tylenol, pop
Advil, until the pain gets sobad that they have a knee
replacement or they have aspinal fusion.
So we thought, golly, could weuse technology to simply better
deliver the evidence thatresearch shows already exist?
And could we use technology togo beyond the evidence base in
(17:32):
the future, in a digital-first,mobile-first world and this was
10 years ago could we usetechnology to redefine what best
practice care should be forpeople with knee, back, joint
and muscle pain?
And that was our inspirationand we've been pushing it.
It's an open door since thenand people have really enjoyed
the convenience of our programand our average pain reduction
is about 68 percent for people.
(17:52):
We Stanford published a studylooking at 10,000 consecutive
patients going through Hinge.
They showed a 68 percentreduction in pain for the
average participant and we'reavoiding two and three surgeries
for people going through theprogram.
So it really works and frombaseline through the, through
the end of the program, we'realso reducing depression and
anxiety rates by about 50%.
So, great reduction in pain,great avoidance of surgery,
(18:14):
which nobody necessarily wantsto do surgery, they just want
their pain to go away.
So, giving you an alternativesurgery and helping with your
mood disorders as well.
Lacy Wolff (18:21):
That is amazing.
So you and I understand youwere at Oxford.
Your partner is at Cambridge,so you're two smart guys.
Sure, you're like okay, we seethere's a gap here and you're
able to fill that gap.
You built this product.
I can only imagine thechallenges, because I think this
(18:41):
is a pretty competitive spacethat you're in, but y'all have
built this and are definitelythe front runner, in my opinion,
in the musculoskeletal digitalspace.
Where did it all like?
Can you share your firstcustomer, your first client?
Your first member experience.
Daniel Perez (18:58):
So I'll talk to our first member and then I'll
talk to you a little bit aboutour first client as well.
So the first patient who usedour program when we founded
Hinge, we were actually shuttingdown another startup that
didn't work out.
So we were founding startups inour PhDs.
Again, poor PhD studentscommitted entrepreneurs, but we,
as co-founders, we didn't wantto split break out.
We were in our late 20s at thetime.
(19:21):
It was about 10 years ago and wethought you know what let's go
to like what we're absolutelypassionate about, which is
musculoskeletal munitions, whatwe both had experience with, and
we whiteboarded what the typeof rehab we wish we would have
had.
And we did all the clinicalresearch and we're like, very
quickly, we're like this is whateverybody's aligned with.
Could we use technology tobetter deliver this?
And we set a goal for ourselves.
(19:41):
This was October 1st of 2014.
So we're almost exactly 10 yearsago today and we said let's
have our prototype ready ineight weeks and put it on our
first patient and let's see ifwe could do it.
We missed our deadline by twoweeks, but 10 weeks later, so
mid-December our prototype wasready and we sent emails around
our campuses just trying torecruit volunteers Any students
(20:04):
who might have knee pain.
We were focused on knee painfor our prototype at the time.
Please raise your hand and we'dlove for you to trial our
program.
No students really signed up,but all the reception desks.
When you send it to thedepartment reception desk there
was typically an older ladywho's working the reception at a
few of the buildings and all ofthem raised their hands.
Lacy Wolff (20:24):
I would personally like to volunteer for this.
Daniel Perez (20:26):
And our first patient was a 55 year old or
maybe 60 year old lady We'llcall her Maggie at the
university and she raised herhand and we went and we saw her
in person.
We had wearable sensors.
Then we gave it to her in aTupperware box and with a tablet
computer was, you know,preloaded with software, and she
, she did five quick exercisesright there in front of us and
(20:50):
we were scared that it was goingto be buggy.
It wasn't going to work.
It worked perfectly.
And then she looked at it andwas like, can I keep this?
And she kept using it andwithin like three weeks her pain
had reduced by 41%.
Lacy Wolff (21:01):
Wow, and we're like I think we're onto something.
Yeah.
Daniel Perez (21:03):
And we tried to figure out from there how do we
expand coverage?
Because physical therapy weexpect our health insurance to
kick in, so we knew we need topartner up with health insurance
companies.
We're in the UK at the time andI'm obviously American.
I wanted to come home and itwas a bit more difficult to
crack into the NHS and inAmerica there's a lot more
(21:25):
health innovation and we thoughtcould we transition the company
back to the US and we startedgoing to health care conferences
here in the US and a lot offolks in the US get their health
care from their employer andwhat's interesting about that is
that every employer is apotential backer for you.
As an early stage company or astate plan that covers benefits
(21:48):
for their members or a stateplan that covers benefits for
their members.
They are individually trying toinnovate and trying to improve
the health of the members ontheir plan and they each have
their own approach to doing thatand in some ways that could
lead to waste, but in other waysit leads to a remarkable
innovation, and so I think mostdigital health innovation is
(22:10):
happening in America because youhave so many different entities
trying to innovate, so they'reall trying new things and that
means when something works, itcould quickly spread for other
sponsors, for other states, forother employers.
And our first customer I methim at a conference and he was
giving a talk.
I emailed him the night before.
(22:31):
He had not replied.
That's fine, so I showed up tohis talk anyways and I beelined
after his talk and he actuallyremembered.
He was like actually I didn'thave time to reply, but I saw
your email.
Muscle skeletal conditions, backjoint and muscle pain is like
20% of our healthcare costs.
It was a ski resort in Colorado.
It was a resort and we startedtalking.
He had to fly back to Denver.
(22:52):
The conference was in Vegas andhe came to give the talk, but
he was very busy and he neededto leave and so I kept walking
with him out of the conferenceroom.
Then I walked with him to thecasino and then we hit the
escalator.
He looked at me, I looked at himand I went down the escalator
with him and then we got to thetaxi cab line and he's like
you're not getting into the cabwith me.
I would have gotten to the cabwith him if it meant continuing
(23:14):
the conversation, but then theyagreed to do a pilot.
I flew the team from the UK toColorado and we did the pilot in
person and it worked and I'lltell you it's.
One of the beautiful thingsabout American healthcare is
that we were able to kick offthe revolution in digital
physical therapy from one of thebest resorts.
Don't get rid of the fail.
(23:34):
Resorts is the number one, Ithink, hospitality company in
the world, but they're also anincredible healthcare innovator
and I they deserve a lot ofcredit for being so forward
thinking.
Yeah.
Lacy Wolff (23:46):
A lot of.
I think a lot of people can berisk averse to anything new.
Um, a lot of people also don'trealize that maybe work for the
state or higher educationinstitutions that receive health
insurance from ERS, that we area self-funded plan.
I think a lot of people justexpect their health insurance
picks up and that we are reallytrying to be innovative, to
think about ways that we canhelp our members feel better so
(24:10):
that they can enjoy longretirement, to improve their
health and then, at the end ofthe day, when we help members
reduce risk and chronicconditions, it helps all of us
and cost savings as well, sothat we can have a sustainable
health plan for a long time.
So, absolutely yeah.
Daniel Perez (24:28):
And so you keep covering new benefits and you're
charged with how do you createa great experience, improve
their outcomes?
But you have a finite budgetand so you have to get creative
in terms of like how you'redelivering these healthcare
benefits, and it's everybody hasa challenge.
The federal government has achallenge, like employers have a
challenge with healthcarebenefits going up, or I should
say, healthcare costs going up,and so, yeah, we all have a role
(24:49):
to play.
Lacy Wolff (24:49):
It really does give me a lot of hope when you know
the fact that we're bringing insolutions that I believe are
very sustainable, like Hinge,hello, heart, learn to Live the
benefits that we launchedSeptember 1.
And just hearing your story isquite incredible, and the growth
of your company over 10 yearsis amazing.
What's next for you?
Do you have any?
What's in your roadmap?
Daniel Perez (25:11):
Well, we are.
We're focused on several things.
One is digital physical therapy.
There was a lot of work to doto just make this experience
even better than it is today, sothat if you are, if you have
back, joint or muscle pain, youcome to us first and we are your
first port of call if you'relooking for physical therapy,
and we have an extensive roadmapto continue to improve our
exercise therapy experience.
We're hiring a ton of providers.
(25:33):
Physical therapists are in all50 states, but particularly here
in the state of Texas, we havea really big footprint a lot of
members, a lot of employers anda lot of state plans here in
Texas that we're working with.
We're really focused onimproving digital physical
therapy, but we're also focusedon in-person care and how can we
better integrate with in-personcare.
I actually I've been running adigital health company for 10
(25:54):
years.
I am a.
After 10 years of running adigital health company, I am
more committed than ever toin-person care and how important
in-person care is for all of usand how important in-person
care providers are for ourcommunities as well, and so I
don't think the future ofhealthcare is digital or
in-person.
I think it's a mix of the twoand points of care.
(26:14):
I want to see an in-personprovider, maybe for an initial
assessment or to see me, andthen follow-up visits could be
digitally.
It could be rendered digitally,and I think most people out
there would like a mix of thetwo.
They like the comfort and rigorof an in-person interaction and
they like the convenience ofdigital interactions as well,
and we shouldn't have to choosebetween the two.
(26:35):
So we're really focused on howcan we better integrate with
in-person care moving forward.
And the last bit is around AI.
Ai is permeating tech right now,but for healthcare it could
serve a really great purpose ofhelping personalize programs
better for you, helping to speedthe convenience of information
back to you as a member andwe're investing very, very
(26:58):
deeply in the AI and also toscale our care team to allow
them to reply much more quicklyto our members, to give them a
snapshot of every member whenthey're interacting with
somebody.
If they have a panel of 150members, how could they know
about John Smith, who they'reinteracting with now, and could
the AI help summarize?
This is his condition.
This is how he's been over thelast two weeks.
(27:19):
This is how engaged he's been,and here are some challenges
he's faced, to help give you aleg up as you're trying to wrap
your head around this particularclinical case.
So we are investing in AI.
So those are the three thingsDigital physical therapy we're
not done yet.
How do we interact within-person care and how can we
weave AI through our program tomake sure that the end user has
(27:39):
a phenomenal experience?
Lacy Wolff (27:40):
That's amazing.
I am so honored to get to spendtime with you and hear directly
from you about this incrediblecompany that you've built and
that we are able to offer thissolution to our members.
Is there anything else that you, that I missed, or that people
should know about Hinge Health?
Daniel Perez (28:00):
Well, first, of all, just I am so grateful to be
able to work with ERS andmembers here in Texas.
It's been really exciting tosee just how committed your team
is to getting the word out, butalso how committed your team is
to just healthcare innovation.
Healthcare is really tough totackle.
That's the reason why it's soexpensive in America and it's
(28:21):
going to take creativity, and sowhat I want your members to
know is that when they joinHinge Health, whatever they see
today is going to be even bettertomorrow.
We have 500 people on our R&Dteam, and every every week we're
pushing out new updates, and soit's going to be radically
different even six months fromnow and 12 months from now.
So we commit to you know,members here in Texas, is that
(28:43):
it's going to get better andbetter every time you interact
with our program, and that'swhat we're committed to never
being satisfied with.
Lacy Wolff (28:52):
I love that.
It's great today.
It's going to be bettertomorrow.
Yeah that's wonderful.
Well, thank you so much, daniel.
I really appreciate your timeand your innovation, and we look
forward to great thingssupporting our members.
Daniel Perez (29:03):
Thank you, Lacey.
Lacy Wolff (29:05):
Thank you so much for tuning in to this episode of
the ERS Walk Talk podcast.
I hope you enjoyed ourconversation with Daniel Perez
and learn more about how HingeHealth may be able to help you
with managing chronic pain andimprove your overall well-being.
If you're ready to take thenext step in your health journey
, be sure to check out our shownotes for details on how you can
enroll in Hinge.
(29:27):
This is a fantastic benefitthat's now available to Health
Select of Texas andconsumer-directed Health Select
participants at no cost.
If you enjoyed this episode,please don't forget to subscribe
.
Leave a review, share thepodcast with your coworkers,
your family members that mayalso be eligible for this
benefit.
Your support and feedback helpsus to continue to bring
(29:48):
valuable health and wellnessinformation to you.
Until next time, keep walking,keep talking and stay well.
Take care everyone.
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