Transforming mental health care

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Hello and welcome to the The XTech Podcast by Fox Agency. I’m your host, Debbie Forster, MBE. I’m the CEO at the Tech Talent Charter and an advocate and campaigner for diversity, inclusion and innovation in the tech industry.

Today I’m joined by founder and CEO of DOT – Mind Unlocked, Yishel Khan. Yishel, thanks so much for coming today.

Hi Debbie. Thank you for having me. I appreciate it.

Yishel, what we like to hear how people find their way into tech. Some people born ready to be into tech, they loved it from the moment that they started, others of us find our way in by side doors, et cetera. How did you get to where you are today in relation to tech?

That’s a very interesting question. I think it starts from, there’s a little bit of ethical background influence involved in decision making. In my ethnic background, I’m originally from Pakistan, and when you’re growing up, you only are given two choices, either you’re an engineer or a doctor and it’s how it is. But I wanted to do both and I was confused. I’m like, oh my God, how can I do? I was good at sciences and I found my way just trying to make a decision, got accepted in universities, in medicine as well as in engineering. And I was like, wait a minute, if I do engineering in the US, then you need a undergrad degree to go to med school, and that’s how the engineering journey of my life started. So the plan was always to do engineering. I did electrical engineering and then graduate and then go to med school.

Prior to going to med school, I stumbled upon one of those hackathon programs where you go, like a nerd, and code for 48 hours and came up with an application for children with autism. And that’s how I kind of got into the tech business world. Prior to that, it was kind of predetermined. I didn’t know better. I didn’t know that there’s other ways of influencing the world because what you’re taught is just either you’re a doctor or engineer. Unfortunately that’s still very much the case back home. It’s just something that it was easier to navigate my path because they were already preconceived notions that existed prior to even starting it.

But interesting, because through that route, not necessarily of your choosing, it really enriches what you do now. I think sometimes the most effective people in tech are the ones that have this cross discipline experience and knowledge to bring to bear rather than just that pure and narrow tech ability.

Oh, absolutely. I understand that. I come from a place of privilege in the sense that I was given the opportunity to decide. A lot of individuals from my ethnic background don’t even have that. So in that sense, I was lucky to have parents who were supporting, well, it was either of the two, nothing more than that, but they’re like, “You know what, if that’s what you want to do? Sure.”

So I love asking entrepreneurs where did the idea come from? So tell me a little bit about what DOT – Mind Unlocked is and how did you come about that?

So DOT uses a data-driven approach to mental health and mental disorders. And to be able to do so, we have developed a wearable headset that reads brainwave activity to provide diagnosis alongside therapy. And we’re starting off with a condition of attention-deficiency hyperactive disorder. This mission of ours, to help 1 billion individuals suffering from mental health issues alongside who we are, evolved over the duration of five years at this point, if not more. But the idea comes from, as I mentioned earlier, when I took part in the hackathon program, I was given a bunch of sensors and we were supposed to come up with something that was meaningful to us. My knee-jerk reaction was to gravitate towards looking at mental health issues, autism, the ADHD, schizophrenia, et cetera. And that, I guess, originates from the fact that growing up when I was in school or even when I was in university, I have taught children with special needs, specifically with mental disabilities quite a bit.

So I always knew that that is the place where I wanted to make the impact, be it through going to med school or be it through technology. And then when I came up with this application portion with autism, we won several awards. The team I had back then, it was just a project team from a university. And fast-forward several years, those awards were basically acceptance into accelerator programs and incubator programs, which are like mini MBAs. So they give you the business acumen to be building a business. And before you know it, I was building a business around the idea without realizing that that’s what I’m truly doing.

So then unpack it for me, and I’m interested to hear both about the hardware and the algorithm. So let’s start with the hardware. How did you arrive at using the hardware that you do? Were there barriers that you overcame, things that will, breakthroughs that you’re excited about?

Yeah, so initially when I started off, it started off with just using sensors followed by just using the wearable consumer devices that could read brainwave activity that were available in the market. And that’s where the whole idea began. We’re like, okay, we don’t need to do our own hardware. There’s several of them available, which we can go along with. And we decided to just pick one and stick with them. But these are multinational corporations and they constantly change their scope of who they want to collaborate with. So at one point they were collaborating with startups. Down the line, they shift their focus to being more B2B.

And then we were left in a little bit of a flux because the core of our technology was based on a product that was not ours. And then I had to go back to the drawing board and I was like, okay, now what are we going to do? Should we contact other? I did actually end up contacting many other companies. We needed specific customizations because we’re, A, dealing with children, the size of the headband, the filtration, the data that we required needed to be a little bit cleaner. And the price tag that were associated with doing this customization through companies that are available, it was exorbitant. It was something that, as a startup, we couldn’t afford.

And if I say to you, and for the audience listening, this is something always to remember because there is the attractiveness of just grabbing what’s already out there and innovating on it, but when it isn’t proprietary, you are at the mercy of however good that relationship is. And there is a point where I think there is that calculation that you have to make as a tech entrepreneur on ease versus long-term control and averting risk in that respect. So what decisions did you take from there?

Yeah, no. And I second your point. I think it’s so important. So if anyone’s even starting out in this area, there are two things to keep in mind. Either, A, make sure the core of what you’re doing is not contingent upon another company, and if it really has to be, then have a signed contract in place because that’s the only way you can protect yourself.

It is just so often what goes wrong in entrepreneur is, oh no, we didn’t need anything written down. That sentence rarely ends with, and they lived happily ever after. Having things written down, however good things are at the start, is crucial.

And so learn the hard way, but thankfully, I think everything happens for a reason sometimes. And when you look back in hindsight, in retrospect, it just makes sense. So electrical engineering wasn’t really, I just did it for the sake of doing a degree and then going to med school. But then that came into play a little bit over here because designing hardware, which could read EEG data, but it comes back to my field.

Not that I designed the chips entirely myself, but I could understand what’s happening and I knew what was needed to get the chips fully developed, which to a person who has no background in electrical engineering might seem really intimidating. Chip designing, that’s the green little thing inside the phones or whatever that you need to essentially code to be able to read EEG data.

So I ended up hiring PhDs, professors at universities to assist with designing the chip, and we basically designed the headset from scratch. So it sounds more intimidating than it really was, but that was the case for me because I have a background in electrical engineering and we were able to quickly produce the hardware, the chips that is, within less than six months. The manufacturer was a little bit of a challenge because we had to order them to one of the companies in China because that’s one of the places where they come from and that’s right before COVID hit. So that was a challenge for us.

And that never shows up in our business plans, global pandemics, does it? But again, if I go back thinking about within that startup context, you had those skills, but it is important to remember having the great idea is not enough. Making sure you have those skills. And I like, as well, that you have the confidence, but also the common sense to draw on your expertise, but then to hire in some expertise because, again, while it may feel quite scary, that outline of your revenue to be putting those things in, you need that expertise and, again, somehow captured on paper.

So this is just not a friend, this is not somebody doing a favor, but bringing in that expertise. I think, you getting burned by that being in China, you and every company worldwide, and it is, again, always things that we would not necessarily have said three or four years ago. Thinking about that kind of turbulence, what happens if, is vitally important, and having your supply chain close and understanding where that is, is vital. Okay. So the hardware you were able to design, you were able to build. Talk to me about the other side, the algorithms, how did you make that work and did you, from the very start, look at the ADHD or were you going more broadly and hone in on that?

Yeah, no, so initially when we started off, it was more focused towards autism. And then after I connected with neuroscientists, so my partner at that point, Dr. Rasheda Arman, she is a PhD neuroscientist at McGill University. So she and alongside of the doctor is kind of navigated what we were doing more into the ADHD space. And that’s how we, with a little bit of handholding, we decided to change directions and go into ADHD market because it turned out what we were trying to do is more closely focused on ADHD and there’s a lot of preexisting literature which helped us build upon. Whereas with autism, it’s a spectrum, it’s much more difficult. There are much more visual cues, but in the brain signaling, you are looking at a, sure, you can still diagnose it through brain patterns, but to treat it is not as simple. Not that ADHD is simple, of course it’s not, but there’s more clear-cut, it’s more binary, it’s more one and zero versus it being a spectrum. So we decided to look at the ADHD market first.

And developing those algorithms, did that go smoothly? Did you hit some walls? What were the key learnings that you had, and if you were going to go back and do it again, might you have done differently?

That’s a good question. Oh, lots of key learning. Like I said, everything was done through trial and error. And I feel like if I am to do everything a second time round, I would be way more polished and be able to take these decisions upfront. So once again, when we were initially collecting data, it was very haphazard. The right thing to do would have been to reach out to universities, get some sort of, once again, contract in place, get some sort of external funding in place. And there are resources, I didn’t know there are resources available. And specifically in Canada, there’s Mitac, there’s IRA, there are all these government-funded programs which help you conduct these research. So you just need to be connected with the right people. So they give you that.

We were in a situation where we’re like, okay, well, now we need data. So now we’re going to put out ads, call people who have children who have ADHD, do some volunteer, do some paid trials. So that’s how we build our algorithms through volunteer, through paid ads, through going to conferences and doing live demos. Not the most strategic way to do things, but it got us the data we needed. While that was good enough for us to just build the basis of the algorithm, that’s where another hurdle came in. Once again, in the North America, you’re looking at very sensitive data. This is healthcare data, this is individuals who have ADD, who’ve been diagnosed. So then you enter the realm of the healthcare industry. And back in 2017 and 18, they were not entertaining startups, at least not to my knowledge, maybe they were. But from what I know is specifically the Canadian healthcare, even today it’s very much protected and it’s a very difficult barrier to cross.

We had this data, we wanted to be a B2B product that exists in healthcare settings, but no hospital, no clinic was willing to entertain us or to take us seriously. And as a result, I had to hop around quite a bit. So my first hop was to Texas and I was there working in the Texas Medical Center Accelerator for a year, collected enough information, hardware, software as well, for the algorithms. And then the second hop was back to my home country, Pakistan, which was almost driven by lack of funds because, once again, funding was running out. I was running out of time. I needed some major milestones to be hit for the company to actually go to market. And I ended up just going back living with my grandmother. And then I found a bunch of developers over there, realized there’s no healthcare rules and regulations around mental health. People are doing anything and everything, unfortunately. But fortunately for us, because we were able to collect ADHD, autism, all sorts of patient data without the barrier of regulations or rules. So that just turned out to be a blessing in disguise.

But that’s something to really think about, I think both in terms of ensuring you’re getting the right sort of strategic growth of your user data, but then really understanding that is the gold dust as well of what you’re doing and keeping that protected, making sure you’re using it ethically, et cetera, is quite a hurdle to jump over in that respect. And so where is it now? You’ve got some hardware that’s starting to work through, you’ve got the data to start developing these algorithms. Where are we today?

Yeah, so after flip-flopping and basically going all across the globe, we launched overseas, we collected enough data and COVID hit. And now at this point I was back in Canada and now I was kind of stuck here. So I’m like, oh my god. Now the clinics, most of the clinics that we were sort of collaborating with, they ended up going under. So they couldn’t pay us, all the contracts were null and void. And once again, sitting in this part of the world, you can’t really do much. So I had to go back to the drawing board. And then during that time, I was obviously, there was a lot happening in my personal life as well with my parents immigrating to Canada.

So I was a little distracted, truth be told. And I think that’s a part of life, which is why I’m bringing it up right now because people think it’s just when you’re running a business that should be your sole focus, which it was for a good four years up until family came into the picture, and then I kind of got distracted. And then 2020 I was like, well, now what am I going to do? And then I really started looking into the Canadian system and healthcare and started reaching out to people over here. And it took maybe a good year, but if you’re consistent, I feel like things do come through.

Oh, I’m completely agreeing and I’m going to say the reason I’m so pleased you’re talking about this, Yishel, is I’m forever trying to explode the way that we have fetishized this idea of the entrepreneur and the overnight success. And you have the idea there’s a little fail, and by the closing credits you’ve made your millions and you’re sitting on that. Whereas I think some of the survival instincts for a good entrepreneur is that resilience, that ability to respond to the barriers, to the things to overcome and to know that you are, time and again, sometimes through your own mistakes, sometimes because the world breaks, you have to go back to that drawing board, refocus, understand what’s the key, the core MVP of what you want to do.

Absolutely. And I think that’s where a lot of people, right when they’re at that point, they tend to give up. This whole entrepreneurial journey has been fantasized so much. And I suffered from that too, because when you see people, so there were people in my cohort which in year three had made it, they had funding. I wouldn’t say they made it big, I would say they had funding. And I still did not receive a million dollar check at this point. So I would really think, am I not cut out for this? Am I doing the wrong thing?

But even if you get that million dollar check, if you don’t have the experience, which takes time, and I wasn’t a believer of this, but today I am, I’m like, it takes time, you can blow through millions of dollars that investors have given you and you’re back at square one, be it one year down the line, three years down the line. You need that skill set to be able, resilience is what you need to be able to carry it forward. What would happen when the investors back out? Are you generating enough funds? So fortunately, I didn’t have the opportunity to blow through millions of any investors because we were.

And I think we are hearing more and more the day of the unicorn is possibly, thankfully vanishing. And because, like you said, a lot of times that led to some really bad habits, some poor business models, some bad tech. The idea of not getting that check, of having to bootstrap for a while to bring those things through doesn’t necessarily, in the long term, end up as a bad thing. And I’ve worked with more entrepreneurs who have their head and in their hands because they got the money too fast or they got the wrong funders, those sorts of things. So today, what’s happening? Where is it?

Yeah, so just about six months ago, we ended up signing a contract with the largest children’s hospital in Canada, one of the largest children’s hospital in Canada called Children’s Hospital of Eastern Ontario, CHEO. And it is a Canadian healthcare hospital, so the progress is slow in the sense we’re still trying to find a clinical champion, but that’s expected. But we had our foot in the door and we made it through and we signed a contract, and now we’re just waiting to find a clinical champion to do a validation study because that would be the next step for us to, A, launch in North America and, B, be fundable to begin with. So that’s just what where core focus is on, where we put blinders on, we’re not looking at anything else, and we’re just focusing on getting done with this validation study because that would determine where the company is headed, and this is a critical milestone for us.

Fantastic. Congratulations. And I think to have achieved that on the back of the world has broken. And I think the impact, not just on the business world and the world, but on individuals, on people, is so to be here at that point is fantastic. If I’m interested in the space, this MedTech space, it’s starting to really show, and I think COVID gave a lot of attention, again, to this. If I’m interested in MedTech, what should I keep my eye on, do you think?

Today the world is very different from, I would think, when I started off. And it’s not been that long, if you think about it’s only been like five, six years, but still it’s such a different landscape. And I say that because I’m sure you’ve heard of all the craze around AI and ChatGPT and just there’s a immense focus on that. So anyone starting out today in the healthcare realm, you really need to incorporate, think about where the world is headed in the next five years because this technology that’s come into the consumer hands has changed the landscape forever. So you need some element utilizing AI technology into the healthcare. Well, people, the healthcare industry is a little bit more receptive to this as well. And just see how you can collide these two worlds of tech, AI, and healthcare and bring value to the consumer at the end of the day.

Because unfortunately, the healthcare industry is one of the lagging behind places where things have not taken off. Especially, I’m not sure about the UK, but in Canada it’s a welfare state and when you go to a hospital, you’re waiting over there. I just had a very recent experience with my father and he knew when he was in the hospital, I had to wait there for about nine hours before anyone even saw him. And I was sitting there, I’m like, why is this a thing in the healthcare industry today when there’s so much advancement happening in technology? Why is the healthcare system lagging behind? And if there are people out there who are interested, the first and foremost step I would say, is just to go to your local clinic, hospital and observe. You’ll find, if you don’t have an idea, you’ll find tons of ideas just while sitting there to be able to better. Focus in on that. Use AI to your leverage because you need that moving forward, you need that to be fundable, and then just keep at it.

And from what you were saying as well, so often we’re only looking at and talking about who’s going to fund you, getting out to the investors, et cetera. But from what you were saying, it was also important, those relationships with the actual ecosystem that have been transformational for you. That it’s true of most sectors, but I think more so than most in medicine, those relationships with the experts, with the champions, with your clinical champion to put those things together and rather than those bold and will be in every hospital, starting with that first hospital, et cetera, is really important.

And I like what you’re saying, don’t just look at what’s here. And I think I like what you say about getting in the hospital, understanding tech today, even if it ever was in the past, you can’t operate in isolation, you have to understand what the environment is, you have to understand what is or isn’t happening in terms of tech. And tech is now so cross-pollination, is based on cross-pollination, bringing those things in. Is there anything in terms of MedTech and what’s happening there, do you think that might help businesses in the future? Is there anything that we could be learning from what’s happening in MedTech?

Specifically for MedTech companies, once again, having the ecosystem, you exist in, support you becomes a crucial pivoting point or a make it or break it situation. Now, the receptiveness of hospitals and clinics to startups and technology, I think this was not there five years ago, and it’s beginning to come up. People are now starting accelerators focused on health tech so that you understand the rules, the regulations, because there’s a lot of regulatory observance in this field, so you need to be familiar with what that is. You need to be familiar with what the compensation for doctors, for hospitals looks like. And this information, it’s not available on the, for most part, sure, you might be able to find some information about the US, but overall you need to be connected with experts. So it starts on the expert side. Now there’re experts, being hospitals or government systems in healthcare, that are giving you this information.

And I think that’s a very crucial point to being a MedTech company where you need that support because you might think what you’re doing, which is what was our case as well, we thought what we’re doing is great, we’re just going to use third party consumer data in terms of just calling them in, do volunteer work and we’ll sell to a hospital. No, you need to be connected with the hospital system. You need to understand what are their rules, regulations, requirements for you to be deployed in such a setting. And you can’t get that information when you sit by yourself or you talk to other business people. You need to be in the healthcare environment. And I think, so my advice to companies or individuals who are interested in the MedTech space, is connect with these individuals, reach out to them on LinkedIn, go to your local hospital, ask them who you can connect with to understand the framework better, because without their support, you might have a great thing, but it’ll never get deployed.

So what we try to do is also look at some horizon gazing. Now you’re very much in MedTech and you know what’s coming and what’s coming through. But either there or more broadly, is there anything on the horizon that you are particularly worried or concerned about? And then we’ll go on. I’ll give you a chance to think about what’s exciting, but is there anything coming on the horizon that you’re worried about, that’s concerning you?

So one of the things that comes to mind is what we already faced, and maybe I’m being too specific, and as we talked about earlier, the supply chain issue, that’s something that we need to keep in mind moving forward, because if our chips are being manufactured in China and say there’s a lockdown, say there is a global pandemic, and moving forward as we hear these pandemics would become more frequent than not. And if we have a hardware component and we’re dependent upon countries halfway across the world, what does that look like for us when we get orders in the scale of thousands? Can we replicate that locally? Can we set up an industry over here? What would the cost of that look like? So these are just questions that I’m beginning to think about because just because supply chain is now, and with the world economic situation, you never know. So you need to take what’s happened and just try to prepare yourselves to the best of your abilities.

And I think that’s genius. I mean, I can’t agree with you more because that is something for companies of every size. So there are certain industries, certain businesses that they sort of shake their head as of how were you not thinking about that before? But that’s not something that in tech we had to grapple with in the same sort of way of other sectors. But now really thinking about what does our tech rely upon? What is that supply chain? And really understanding whether we are a big multinational or a startup, but understanding that is a way that we’re trying to avert risk in future. I think that’s fantastic. Is there anything coming up on the horizon that you’re quite excited about? That as someone in tech feels like that I want to know about that, that’s got real potential?

Yeah. And then I think I touched upon this earlier as well. It’s this whole, I knew about, I knew of AI, that’s the field, we have AI in our technology as well. But the ease of accessibility of such a technology into the consumer hands. I know a lot of people are fearing it because they think that it’s going to replace, it’s going to take over jobs, and that’s one way to look at it. And definitely there would be a shift in the type of jobs that come out. So the traditional job that we’ve been doing would be changed, for sure. But it’s, at the same time, very exciting because when you look at technology, if I backtrack a little bit, ever since the dot-com bubble, everything, the technology development rate just went exponential. And if it’s already gone exponential, now you have this little tool in front of you, which is going to just, what we experienced in the last 10 years, that’s going to happen over the next two years.

Using that to your benefit. And I’ve already started using tools like ChatGPT, I don’t know when they’re going to start to put a price tag on it, but for now, it’s brilliant. When you have to make social media posts, you have to sit there, think about what you’re going to write, which I’m not saying you shouldn’t, but if you have an idea and you can just delegate. Now you just need to know how to manage these machines, these systems that are being built. And the sooner you get into it, the more easier your life would be, the easier your company would be able to leverage from these opportunities. Because I think there’s always resistance to change within everyone, within myself as well, but when you start to see how you can use it in your own personal day-to-day as well as in your business, it has so much potential, which is just extremely exciting for me.

Fantastic. And then the last thing I will do is if one of our listeners is someone who’s thinking, I think I do have a great idea, I would like to be that entrepreneur and, in particular, if that’s a woman or a woman of color, anyone of color, do you have any advice on what they should remember or do?

So from my personal experience, I think this is one thing I still suffer from, and it’s called the imposter syndrome. That plays into your behavior, into how you approach fundraising, into how you present yourself. It’s when you start to spiral into the thought process of, A, you’re not good enough, you’re not equipped enough, you don’t know enough about this industry. And in that moment in time telling yourself that it’s okay. It’s okay if you don’t, you’re learning. And showing that vulnerability to other people. So if you just keep that to yourself, you will feel like an imposter. But when I go into investor meetings and if there’s a subject that I don’t know about, maybe it’s foolish of me, but I say it, I’m like, this is not my area of expertise. I don’t have a business background. I’m learning. So some investors will be put up for that. But then those are not the investors you want on board to begin with.

Exactly. And I think that’s powerful as well. I think for entrepreneurs to really start understanding the different ways that people get their products or services to market, it’s not always the perfect investor coming along. And always understand this is somebody you’re going to work with for a long time and, agreed, if they’re not happy with your answers, they’re probably not going to be happy with your product and you’re not going to be happy working with them. So super. Listen, Yishel, thank you so much for joining us. I know it’s really busy. You’ve got a lot on. Congratulations on getting so far. Thank you for joining us today.

Thank you, Debbie. I thoroughly enjoyed it.

Thank you for listening. If you’re a tech innovator and would like to appear as a guest on the show, email us now at xtech@fox.agency. And finally, thank you to the team of experts at Fox Agency who make this podcast happen. I’m Debbie Forster, and you’ve been listening to the XTech Podcast.

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