Featured in CEO CFO Magazine: Digital Medicine Company QHSLab - Providing Psychological Vital Signs that Enable Primary Physicians to Manage the Behavioral Health Issues of Patients

Digital Medicine Company QHSLab - Providing Psychological Vital Signs that Enable Primary Physicians to Manage the Behavioral Health Issues of Patients

Marcos A. Sanchez-Gonzalez, MD, PhD, MSMEd
VP Medical & Scientific Affairs, QHSLab, Inc.
OTCQB:USAQ

Interview conducted by:
Lynn Fosse, Senior Editor
CEOCFO Magazine

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CEOCFO: Dr. Sanchez- Gonzalez, what is the concept behind QHS Lab?
Dr. Sanchez-Gonzalez: The concept is simple. We are a digital medicine company that specializes in what we call behavioral health vital signs. In primary care, usually physicians take vital signs, blood pressure, and glucose and so on. However, for years, accessing mental health symptoms such as depression, anxiety, burnout, has been overlooked because there is not a space dedicated to that. We have been able to facilitate that part of clinical care in which the patient can communicate from an intimate space such as their phone or computer, their behavioral or psychological vital signs, feelings of depression or anxiety or any issues that may be affecting their mental health.

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CEOCFO: Are doctors recognizing the need for this or, do they need to be educated? Are patients willing to talk about these issues?
Dr. Sanchez-Gonzalez: Not only are doctors recognizing this, there is a national guideline that emphasizes and recognizes how important it is to dedicate time to clinical affairs and the clinical practice to access mental health issues. For instance, self-harm suicide is one of the top causes of death in the nation. We are losing about 25 thousand people a year to self-harm suicide; about the size of a small town in the United States. From those patients, about 40% of the ones committing suicide, they meet with a primary care practitioner during the week before committing suicide, which has been a missed opportunity for years. These are hard topics and conversations to have because there is a stigma attached to it. People don’t know how they are going to tell their physician or healthcare provider. Finding a channel to securely communicate or start that difficult conversation is what we have been able to provide to the patients and providers. We are providing that communication channel between the provider and the patient’s symptom that may be affecting their mental health.

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CEOCFO: Would you give us an example of a few questions that might be asked of a patient?
Dr. Sanchez-Gonzalez: Traditionally in medicine, we call this measurement based healthcare. The staple here is what we call vested instruments. These are validated tools that have been clinically proven to access or to measure a psychological construct. In this case a vital sign. For example, we measure an assessment called PHQ-9 (Patient Mental Questionnaire-9), the other one is a general anxiety questionnaire, which is the GAD-20 (General Anxiety Inventory-20). We ask questions regarding your feelings, like if you feel satisfied with life, or if you have been thinking about harming yourself or others, or if you are sleeping well. Those are the kinds of questions that are asked of the patient. Also, as far as the platform and technologies that we use, we have been able to adapt those questions and adapt based on the patient’s answers. For instance, if the first question is if the patient is sleeping ok, and the patient says yes, we won’t ask too many questions about sleep because we want to move on to other dimensions. So now if the patient says they don’t enjoy being with others and they are not enjoying being socially active, then the platform will start asking questions towards the spectrum of symptoms. This might indicate depression, and then it will ask more questions. There is research to suggest that a patient is more confident in answering to phones or machines rather than talking to a person about this. That is how we have been able to use technology to give the human touch.

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CEOCFO: How do you reach out to the medical community so that they know what you have?
Dr. Sanchez-Gonzalez: We have a typical style sales, including marketing campaigns. We are a company grounded in science and evidenced based medicine. So one of our four tiers is our strong publication record, looking for different scientific studies that we can publish and we use that to showcase our findings in different scientific and medical journal publications. That is primarily the way we announce ourselves there, looking into how we can use data and technology to improve patient care. We also use social media as well and professional channels. Our primary way to approach physicians is through scientific conferences. This is not an easy product to sell as it is because it is more of a system, but when we start explaining to physicians that we are there to be a companion and your room for taking your patient’s psychological, psychiatric and behavioral vital signs; we are your partner to make that happen. This is being emphasized by different clients. Many physicians don’t know how to do it or they don’t know how to get compensated for the work they are doing. We have put a set of tools, CPT codes and strategies for the physicians as they are doing medicine and addressing those needs for the patients, so they also being compensated for their work.

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EOCFO: Do you find that smaller medical practices and larger medical practices a re paying more attention; where you are getting the most traction?
Dr. Sanchez-Gonzalez: The primary care is our staple. Primary care practices are our primary customer. We have small one or two provider practices. We have groups of multiple practices as well. For the most part, a practice is like an individual unit, it doesn’t matter if it is a five or six-practice group, verses a single practice; it is one of the interesting things that we have to play in our system and adapt to different ways for each of those practices. Even though we say it is a unique platform and system, the implementation can vary a little bit between each of the practices. Conceptually, what we do at the single unit or practice, can be applicable to various practices within groups or a large medical system. There is no difference at the end of the day, providing that we have medical infrastructure in those places to deploy our platform and system into.

CEOCFO: As more and more practices implement your program, what have you learne d and what has changed in your approach?
Dr. Sanchez-Gonzalez: Going back to one of these pressing issues with suicide prevention, at the beginning were very apprehensive about using some of the tools because they had the fear about liabilities and the fear of the patient having a disorder and wanting to commit suicide. If that happened and the patient expresses that they want to self-harm, I am going to be liable. So we have prepared a system with very strict rules, to provide both the patient and the physician, a series of guides or steps. An organization would gather information and basically dump it into the EHR. We collect information from the patient and if that information is an emergency, the patient will see immediate feedback. Many of people dodge that, so typical tools are used where they collect patient information and then they are basically putting it into the EHR for review. We don’t do that, we collect information from the patient, provide the patient with self-feedback. If it is an emergency we will direct them towards resources to take care of that. At the same time, the physician is being alerted. One of the things familiar to many people is where the office will send them a bunch of papers to fill out. What happens after that? It is very rare to see someone giving feedback, education and so on, so we provide that at the first point of contact. So when the physician starts finding out that the patient is informed about what is happening with them, it is a meaningful conversation with the physician, and now the patient is ready to make a change in their life. This happens when the patient is ready to have a conversation with the doctor about depression and signs, other issues that may be affecting their diabetes or hypertension. We have also been providing some evidence-based guidance and education to the patient before they come to the clinic. Initially, there was some apprehension by the physician, but now they really appreciate it and can really focus on being a doctor to their patients because that information has been summarized and the patient already knows what is going on with them and can take full advantage of the clinical. It quickly gets traction once they know there are safeguards for the patient, education and clear instructions. Not long ago one of the practices called us to thank us because one of their patients activated the Eminent Risk Alert tool that we have. Our tool gave the patient instructions to immediately call 911, so they were in a psychiatric emergency, while the practice was contacted. It is one of those stories we are glad to hear.

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CEOCFO: There a number of other initiatives on your website. Is the mental health a focus today, and is there anything else you are providing that you would like to share?
Dr. Sanchez-Gonzalez: Mental and behavioralhealth, is our main focus today but it is not the only focus. We are also looking to a holistic array of symptoms for the patient. This also depends on the different practices services of that practice. One of the things we have been working on through the years is allergies and allergy related disorders. Specifically, we are working on respiratory allergies. Allergies can affect your sleep and your mental health, so we are basically looking at the difference in methodology and we put that together in our tools. Yes, behavioral and bioscience is our primary focus but we also for some practices that are conducting allergy medicine, we provide tools for them so they can identify more patients in that specific area. We also provide resources for patients if they want to make some lifestyle changes and modifications such as diet and exercises in the control of their anxiety, using medication. So we have this array of services and modules inside our platform, which may be applicable for certain practices.

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CEOCFO: QHS Lab is a public company, what has been the interest from the investment community?
Dr. Sanchez-Gonzalez: Last year, we were able to get off the debt that we had and now we are running into more revenue because we don’t have to worry about paying that debt. We are more focused now on increasing sales, and more than that is scale. One of the ways we are doing that is putting an emphasis on our sales force, so now the investors are coming in after we pay our debt. They are finding out how we are going to be able to scale the products and sales. We want to achieve a number of practices across the land. We are focused more in Florida right now. There are some practices in the Northeast also. We are looking into the state of Texas as the next frontier for us in terms of us expanding. Number one is our sales and services and a line of products.

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CEOCFO: Why Texas?
Dr. Sanchez-Gonzalez: We are doing an analysis in terms of growing population, healthcare needs, and payers. Some of the models that we use to work on our business model, is a model where we provide the service to the practice, and then they qualify for reimbursements. So there is a line of insurance that pays for these services, where other lines will not pay. So we primarily focus more on those regions with a more robust and higher volume of qualifying patients, to be provided these services.

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CEOCFO: We reach people in healthcare, potential patients, and the investment community. Why is QHSLab important for all these groups?
Dr. Sanchez-Gonzalez: We cannot see the important things in life or touch and smell them; many things are physical and have been physical for many years. There is an aspect of mental health that affects the physical, and outcomes. Up until now, they have been doing halfway there medicine. We are that other half. We are the perfect pair to what primary care medicine is doing. We can be the perfect partner for your patient, for your practice, for your system, to identify and manage patients who may have behavioral health issues. We are basically the facilitators. We can be the ears of the physician in a way that normally cannot be heard. We are that solution to start a conversation about better mental health and overall better health. We would love to partner with governments, agencies, counties cities. We look to be part of the solution for identifying people that need help, provide initial tools through our platform that help them get the help they need.