Behaivior: Wearable Recovery System

The number of deaths from opioid overdose is increasing globally due to COVID-19. Reducing addiction relapses will save lives and families and it will reduce rearrests, reincarcerations, and rehospitalizations. Over 23 million Americans are addicted to drugs and alcohol. The majority of the tools for people struggling with substance misuse/substance use disorder have low or mixed success rates. Many people in recovery end up relapsing over and over again, despite their desperate best efforts, with the heroin relapse rate around 90%. Knowing in real­ time when someone with opioid use disorder is at a high risk of relapsing revolutionizes the ability to intervene at the right moment to help people stay on track with their recovery process. Behaivior’s tool predicts and prevents addiction relapse and overdose by providing a wearable and software tool to provide people in recovery with real time detection and intervention.

The opioid crisis is the deadliest drug epidemic in American history. Drug overdose is the leading cause of accidental death in the US. It was declared a national public health emergency, and is expected to lead to 650,000 deaths over the next decade. Unfortunately, the majority of tools used by individuals to maintain sobriety have mixed success rates at best. Many people in recovery end up relapsing repeatedly, despite their desperate best efforts. Historically, the tools used to help people in recovery have been reactive rather than proactive. They take action only after people return to using again or after they overdose. The current gold standard treatment protocols are shown to have an approximate 53% success rate. Current protocols frequently include gaps in care, especially when relapse is more likely to occur. Given that only 10-20% of people struggling with addiction receive treatment, a high quality and individualized tool that can be used alone as an adjunct to treatment and as an enhancement to treatment protocols, is needed.

Behaivior has developed a wellness-focused diagnostic and digital therapeutics system to predict addiction relapse and overdose using wearables and AI to provide the right intervention, at the right time, in real time. Behaivior leverages machine learning as well as physiological and behavioral data from the wearable device to identify and stratify at-risk individuals struggling with substance misuse in order to provide just-in-time interventions. Users interact with the platform via a custom-built software that notifies the individual if their behavioral/physiological patterns resemble a drug craving state. The platform asks if they want to do anything about it and can notify their support network if that the individual is at a high risk of relapsing. 

Through our machine learning algorithms we can detect in advance that someone  is in a high risk craving state, which allows for a life-saving just-in-time intervention. Our system, which includes a wearable device and phone application, monitors biometrics and behavioral data, and has been shown through our clinical studies to significantly lower opioid relapse rates, provide greater bodily and emotional mindfulness, as well as greater focus on and response to indicators of sleep and stress states, and improved treatment adherence.

Behaivior’s system serves our end users, people in addiction recovery, with a tool that has been shown to help lower relapse rates, improve treatment adherence, and increase bodily mindfulness. The wearable system will be embedded into the person in recovery’s daily life, serving as a guardian angel on their wrist. It also serves care providers such as treatment centers and recovery homes by increasing their ability to provide high quality, individualized care, regardless of client location or socio-economic status. Care providers will provide their clients with our platform to obtain just-in-time data to reduce relapse rates of individuals with substance use disorders. Furthermore, this system can work in tandem with and enhance current recovery protocols.  

We are continuously engaging with our customer’s needs as we have completed over 200 customer discovery interviews with people in recovery, care providers, and other stakeholders through the National Institute of Health Innovation Corps (I-Corps) program and the National Science Foundation I-Corps Program. Through our multiple IRB approved clinical studies we have conducted user experience interviews regarding the needs and challenges our stakeholders (end users and customers) face and how our system, including the user interface designs and wearable functionality, benefitted them.

Despite an individual’s best efforts to stay in recovery, relapse is common. Behaivior’s relapse prevention technology is strongly aligned with the Challenge as it uses technological advancements to solve a national crisis that is frequently overlooked and limited by traditional treatment methods that are often ineffective and inaccessible. Behaivior’s solution provides a remote recovery system which has been shown to be effective both as an adjunct to other evidence-based treatment protocols or alone, as a life-saving tool for those who lack access or efficacy with existing tools.

Addiction is a lifelong, chronic disease that affects at least 30 million people globally, opioids being most deadly. Knowing in real-time when someone with opioid use disorder is at high risk of relapsing or has overdosed revolutionizes the ability to intervene at the right moment to help people stay on track with their recovery process and connect individuals to life-saving services. The relapse rates for our IRB approved clinical research participants who utilized our Behaivior system was far below 50%, significantly lower than the relapse rate for the “gold standard” treatment protocol (CBT + MAT). Significantly, our system can work in tandem with and enhance current care protocols for people in recovery, used alone, filling the gaps in care where relapse and overdose mostly occur, and solving serious issues such as care access for individuals in rural communities and those needing to rely solely or primarily on telehealth options by providing convenient, HIPAA compliant remote monitoring, notification, and digital intervention. Using a wrist-worn device and smartphone application we can monitor things such as heart rate, stress levels, and GPS location to identify high risk craving states and intervening in real time with customized responses. While academic research is being conducted in this space, we are not aware of any commercially available tools that are significantly similar. Furthermore, Behaivior’s system has the opportunity to make a greater global impact by adapting this solution beyond addiction, to help those struggling with other mental health challenges such as anxiety, PTSD, and suicidal ideation.

Our methodology and app-infrastructure for collecting and processing physiological and behavioral data and crowd-sourcing signals and their corresponding labels as well as our existing infrastructure for developing time-series data-driven AI for classification of categorical states (i.e. disease, emotional states, etc) allows us to rapidly adapt our solution to help mitigate the worsening impacts of Covid-19 on those struggling with addiction. This includes incorporating fully digital onboarding and creating a clinician/care provider dashboard to help remotely monitor and serve patients who are currently unable to access in-person services. Behaivior is utilizing evidence-based techniques such as cognitive behavioral therapy, behavioral economics, and motivational interviewing to nudge people towards positive behavior change. 

Wearable devices are used on a daily basis and are widely available to the general population (Pew: 1 in 5 Americans owns a smart watch). Behaivior has validated our system through the completion of multiple IRB approved clinical research studies and through the integrating the team with data scientists at the top of their field from Carnegie Mellon University, the University of Washington, Stevens Institute of Technology, and clinical addiction researchers from the University of Pittsburgh and experienced clinicians working in the field. The purpose of the IRB approved clinical research studies conducted have been to identify digital biomarkers associated with reinitiating drug use and relapse, and developing machine learning models and a system able to provide Just-In-Time interventions (JITs) that connect people in recovery to the supports they need, at the exact moment they need it. Since this product demo was released (), we have completed the clinical studies and have developed an MVP system application to be released this summer.  

Immediate outputs for target population:

Our initial contribution during the performance period of this award will be to release a globally available addiction prediction and response platform using time-series physiological and behavioral data to reduce relapse and overdose. 

Longer-term outcomes for target population:

Fewer overdose deaths, Improved health, improved relationships with family and friends. Reducing relapse and overdose saves lives and families and reduces rearrests, reincarcerations, and rehospitalizations. 

Logical links between activities, outputs, and outcomes:  

Our revenue model numbers below are focused solely on an OUD focused tool. We plan on quickly expanding our tool to help those struggling with other issues as well. We plan to expand our tool within the first year of a product release and these numbers will then increase accordingly to service the 30 million people globally who suffer from substance use disorders and a deficit of tools. 

An MVP system has served almost 100 people in early recovery with opioid use disorder.

1. In one year we will be serving 126,000 people

2. In five years we will be serving 2,016,000 people

Our impact goals within the next year include servicing the 16 million citizens worldwide who have opioid use disorder, and 30 million people globally who suffer from substance use disorders. Making a global impact is achievable thanks to our development of a digital onboarding process. Our system has applicability for any country and the iPhone app can be downloaded from any country.

While the Behaivior platform has thus far been designed with Opioid Use Disorder in mind, this process is generating and logging data on the activities, health, and behaviors of patients. Within the next five years, our goal is to use the platform on patients who are not battling addiction issues. For these users the platform would not calculate the risk of overdose, but would instead monitor health outside of the hospital or clinic. Our platform also enables care providers to access this data in real-time, and review it even when the patient is not physically present. This allows care providers to provide services and better care to those in rural areas that have limited access to needed services. Alerts for elevated stress levels, unhealthy heart rate, and other metrics can also be implemented, per care provider needs. This puts health and wellness organizations in a position to be proactive and more prevention focused.

Within the next year our greatest barrier will be funding to support the commercialization of this solution. Behaivior also faces the need to expand its team to find additional talented individuals. As Behaivior moves beyond its initial-use case of OUD, additional funding is required to enter those particular markets including other addictions, PTSD, and suicidal ideation within the next five years. Market entry also requires industry expertise and connections, and further research and development which Behaivior currently has comprehensively completed for OUD but not yet for the additional markets previously mentioned.

Currently we are addressing the financial barrier through application to grant funding opportunities. We are also exploring opportunities for investment. We will continue to reach out to our network to seek the connections and expertise required to move into each new market.

As of 6/17/2020

Full time: 2

Part-time: 3

Interns: 5

Mentors/Advisors: We have multiple advisors and mentors who join us as needed on relevant projects

Behaivior is comprised of a diverse team of experts with professional backgrounds including business, design, software development, machine learning, addiction science, wearables and consumer technology in addition to others. The team features individuals with roles including founders and leadership, specialists, advisors, and interns.     

Ellie Gordon, Founder and Chief Executive Officer of Behaivior LLC, is a behavior change technologist, designer, and biotech entrepreneur. For more than 13 years, her work has primarily focused on improving people’s lives through technology. She has successfully created, organized, led, and managed teams for everything from hackathons and codefests, to other science based startups and initiatives, to community development and research projects. She did a TEDx Pittsburgh talk as a behavioral technologist speaking about the design elements of what Behaivior is developing.
 

    Behaivior LLC’s CTO, Prahlad G Menon, PhD, has extensive experience with regard to commercialization of medical device technologies. He has spun off technologies from his academic research program as an Assistant / Associate Professor of Electrical & Computer Engineering (Carnegie Mellon) and Biomedical Engineering (University of Pittsburgh), which resulted in QuantMD LLC and CerebroScope (Science Plus Please LLC) - each entities focused on biomedical device areas based on granted patents. QuantMD LLC was focused on clinical efforts relating to image based diagnostics for cardiovascular disease, and image guided surgery for cardiovascular interventions.     

Doug Wolf is a project advisor and executive advisor to Behaivior. Doug will provide monitoring and guidance in the areas of financial performance, research & analytics, business development & strategy, and marketing.

Behaivior has partnered for technology development, research, initial piloting, and applying/receiving opportunities with many different organizations. These include, but are not limited to:  

• University of Washington, Carnegie Mellon University, and University of Pittsburgh on technology development and a broader research partnership. 

• National Institutes of Health (NIH), and NIH through the National Institute on Drug Abuse, the National Science Foundation, Innovation Works, AlphaLab, Ascender, Pittsburgh Veterans Administration, and Jade Wellness Center on solution pilots and research efforts using their capital and resources to support the deployments.

Through a SAAS B2B model we serve people in recovery as end users and their care providers as customers. Over 23 million Americans are addicted to drugs and alcohol, which is roughly equal to the entire population of Texas. In the US there are 14,000+ treatment facilities and growing, and they are often filled to capacity and unaffordable. Insurance typically only covers 28 days while research shows that the longer the stay is, the greater the chance of a successful recovery. According to the US Surgeon General drug and alcohol addiction in the United States in 2016 costed $442 billion per year, and research suggests that at least 80% of people who need addiction treatment do not receive it (Vivek Murthy, M.D., 2016). With that being said, our solution is to not only reduce relapse rates, but also minimize the negative impact on the entire network of stakeholders who are directly affected by the opioid crisis. This includes the higher costs several groups face due to addiction relapse, including inpatient and outpatient treatment programs who lose reimbursement money when people leave treatment early against medical advice and families who lose money and peace of mind worrying about the safety of their loved ones who have SUD. As previously outlined, Behaivior’s technology has been shown to both enhance and work in conjunction with current treatment/care/social support protocols and also alone, to provide care during gap periods when individuals are not receiving active care.

Our funding goals within the next year are to be awarded multiple grants to fund R&D, outreach, and marketing, and to explore opportunities for a 2M seed round. Additionally, we plan to have a commercializable MVP available by summer 2020 and hope to start generating initial revenue through pilots. Behaivior has a detailed revenue model plan developed.

Behaivior is at a critical stage in which it needs an expanded resource network to successfully enter the commercialization stage. MIT’s network can take our massively scalable, science and technology-based company and provide the needed funding, and employ an objectives-based mentoring process with the goal of maximizing equity-value creation. We look forward to acquiring crucial funding (particularly given the huge negative impact of the Covid19 on those struggling with addiction) and refining our product and startup through the access and mentorship provided. 

1. Talent Recruitment: We would like to expand our team to find additional talented team members who are passionate about helping others. 

2. Solution Technology: Given the opportunity to expand the capabilities of the system through the development and employment of additional foci (i.e., additional physiological and behavioral metrics), assistance with expertise and person-power to expand this solution would be of great value to our team. 

3. Funding and revenue model: We have conducted some initial customer discovery research. Due to time constraints and the changing landscape, further guidance regarding our funding and business model plans would be beneficial. 

4. Marketing, media, and exposure: As a small health tech startup we have a limited budget for marketing; any assistance in that realm through promotion or media opportunities would be greatly appreciated. 

We would like to partner with national addiction services care providers to provide this solution to the individuals they serve. We would also like to partner with any MIT faculty and initiatives or Solve Members who have any related expertise and would like to join us in expanding our tool through research and development to better serve those who are experiencing barriers in access to services due to the Covid-19 pandemic.

Our team is working hard every day to help stem the tide of the opioid epidemic, which affects millions of people globally. Deaths from drug overdoses are now higher than the combined death rate of car crashes and many wars, and are increasing due to the Covid-19 pandemic. Our goal is to help people live better lives by reducing relapse and overdose, and to better support individuals struggling with addiction who are now, due to Covid-19, frequently separated from or experiencing reduced access to both clinical and peer support services. We are elevating humanity by using our novel detection and intervention system and adapting evidence-based solutions using human-centered design principles and UX testing for digitized, personalizable, real-time interventions, empowering people in recovery and their loved ones and care providers to more proactively and effectively stay on track with their recovery process, regardless of their location.

Our team will use the Elevate Prize to advance our solution and support our team who are putting their health and safety at risk to save the lives of and care for those who are affected by drug addiction through funding a collaborative development and outreach effort. This would include hiring a community outreach coordinator to connect our tool to those who need it most, a developer to implement additional personalizable interventions into the application, and a collaboration with local addiction support services to provide our system to those who are economically and socially disadvantaged including due to their racial and ethnic identities.

Our tool uses novel pattern detection machine learning algorithms to detect and intelligently respond to craving states in individuals struggling with opioid addiction. Using strong data science, artificial intelligence, and machine learning, our technology combines both physiological and smartphone sensor data that provides indicators such as stress, changes in behavior, and triggers, and then serves an alert and intervention options to the end user and pre-approved trusted support network members to provide the right intervention, at the right time, in real time. Supported by funding from the National Institutes of Health through the National Institute on Drug Abuse we collaborated with AI and machine learning experts at Carnegie Mellon University, the University of Washington, and the University of Pittsburgh, including Dr. Anind Dey, Dr. Grace Bey, and our CTO, Dr. Prahlad Menon using data we collected from IRB approved clinical research studies. 

Our team will use the AI for Humanity Prize to advance our solution that is dedicated to improving the lives of individuals and our global community through neuroscience research and information technology through funding a collaborative development and outreach effort. This would include hiring a community outreach coordinator to connect our tool to those who need it most, and a developer to implement additional personalizable interventions into the application. 

The People’s Prize, which celebrates and crowdfunds innovative achievements for the UN Sustainable Development Goals, will help advance our solution to help mitigate the opioid drug epidemic, now worsened by the impacts of Covid19. The UN broad goals of Good Health and Wellbeing and Reduced Inequalities are supported by our innovative achievements of our solution, which reduces drug relapse and overdose, and empowers people with the information and ability to take charge of their own wellbeing and can improve their ability to stay on track with their recovery process, regardless of income or background. Depending on the award level, we will use the People’s Prize funds for a collaborative development and outreach effort. This would include hiring a community outreach coordinator to connect our tool to those who need it most, a developer to implement additional personalizable interventions into the application, and a collaboration with local addiction support services to provide our system to those who are economically and socially disadvantaged including due to their racial and ethnic identities.

Our team is working hard every day to help stem the tide of the opioid epidemic, which affects millions of people globally. Deaths from drug overdoses are now higher than the combined death rate of car crashes and many wars, and are increasing due to the Covid-19 pandemic. Our goal is to help people live better lives by reducing relapse and overdose, and to better support individuals struggling with addiction who are now, due to Covid-19, frequently separated from or experiencing reduced access to both clinical and peer support services. We are elevating humanity by using our novel detection and intervention system and adapting evidence-based solutions using human-centered design principles and UX testing for digitized, personalizable, real-time interventions, empowering people in recovery and their loved ones and care providers to more proactively and effectively stay on track with their recovery process, regardless of their location.

Our team will use the Future Planet Capital Prize to advance our solution and support our team who are putting their health and safety at risk to save the lives of and care for those who are affected by drug addiction through funding a collaborative development and outreach effort. This would include hiring a community outreach coordinator to connect our tool to those who need it most, a developer to implement additional personalizable interventions into the application, and a collaboration with local addiction support services to provide our system to those who are economically and socially disadvantaged  including due to their racial and ethnic identities.