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Enabling better
Cognitive Intervention
for Professionals


Laura Fay, CEO
HAPPYneuron, Inc.
“GAMES
  FOR
HEALTH”
    GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   2
Agenda

 Introduction to Cognitive Intervention
 How it’s done today?

 Issues with today’s approach

 Key Success Factors

 The Journey

 Patient Cases

 Introducing HAPPYneuron PRO


GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   3
Interventions
   Cognitive Training-
        Who: healthy individuals with no brain impairments
        Goal: improve their neuron network performance.

   Cognitive Remediation -
        Who: individuals with impaired cognitive abilities as a result of
         general conditions – psychiatric, post chemotherapy, MCI, etc.
        Goal: neural network stimulation for improved cognition and
         skills development.

   Cognitive Rehabilitation -
        Who: Individuals with neurologic damage from conditions like
         TBI, Stroke, Alzheimer’s, etc.
        Goal: neural-network regeneration



GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                              4
Brain Plasticity


                  The adult brain is not fixed

                  New neural pathway creation

                 Neural network strengthening

                  Brain reserve* enhancement


GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009         5
Cognitive Rem/Rehab Programs

   Medical Professionals                 Conditions
       Cognitive                               Schizophrenia
        Psychologists                           Depression
       Neurologists                            Mild Cognitive
       Neuro-psychologists                      Impairment (MCI)
       Psychiatrists                           Traumatic Brain Injury
       Occupational                            Stroke
        Therapists                              Alzheimer’s Disease
       Language Therapists                     PTSD
       Nurse Managers                          ADD/ADHD
       Etc.                                    Chemo Fog




     GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                        6
Cog Rem/Rehab today…


      Pencil & paper exercises
      Libraries of children’s
       educational CD-ROM
       software
      Mostly ’80s and ‘90s era
       computer interaction
       methods
GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   7
Issues with today’s
approach
Issues with today’s approach



 The        Games/Exercises

   The Supporting Environment



GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   9
Low engagement effects
compliance

                      O                         X

                                      X
X
                X
                           O                O
    O


GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009           10
Patient Dignity
“But these are for kids. I am not stupid !” (cf)
“Colorful games won’t make me happy ?” (d)




     GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009     11
Audience/Conditions
not factored

      Choose Your Challenge Level

                   Easy

                  Normal
                                            Bad for
                   Hard                     Remediation
                                            Patients
                  Insane!




GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009            12
Performance Feedback?



You Pass                         WELL DONE!!             
You Fail !!                            Let’s try again   

 GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009               13
Issues with today’s approach



   The Games/Exercises


 The        Supporting Environment


GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   14
High Cost

                                         Some
                                          programs not
                                          covered by
                                          insurance
                                         Low therapist
                                          to patient ratio



GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009               15
Manual Case Management

                                            Manual…
                                             Configurations

                                             Tracking

                                            Results in…
                                             Errors

                                             Confidentiality

                                             Time




GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                 16
Installation & Maintenance




GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   17
Issues with today’s approach

   The Games/Exercises
       Low engagement and interest with current
        solutions
       Adult acceptance of kids games
       Audience/Conditions not factored
       Poor performance feedback messaging
   The Supporting Environment
       High cost of treatment delivery
       Manual performance monitoring
       Software installation and maintenance issues

GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009          18
Success Factors
The Destination - Games

 Developed with target audience in mind
 Continued, relentless positive
  reinforcement
 Engaging, non childish interactions
 Cost effective & rapid configurability
 Educational bridging to daily life activities




GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009     20
The Destination –
    Environment
   Online delivers…
     Reduces the Information Technology (IT) costs
     Improved case management
     Facilitates distance therapy protocols
     Higher patient to therapist ratio
     Enables rapid deployment of product changes
     Improved patient confidentiality and data security
     Better research tools


    GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009        21
From here  there
The Givens:
 Improved patient engagement
 Superior case management
    Personalization
    Performance monitoring


The Adjustments:
 Offline  Online
 Work style / methodology shifts
    Increased patient to clinician ratios
    Introducing supplemental distance therapy protocols



GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009              22
HAPPYneuron PRO

A brief Introduction

First previewed at the Cognitive Remediation Conference in NYC
June 5th, 2009
Product Line

           HAPPYneuron                    HAPPYneuron PRO
  Target   Healthy Adults,          Depression/         TBI / Stroke /
             Children &            Schizophrenia /       Alzheimer’s
              Seniors                   MCI
Function     Stimulation /           Remediation        Rehabilitation
               Training
  Where        At Home             Doctor’s Office /   Doctor’s Office /
                                      At Home             At Home
    How      Self Service               Guided             Guided



      GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                     24
Patient View
Happy Neuron PRO Exercises




GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009   25
Customize and
  Prescribe


                                      HAPPYneuron PRO
                                         Cognitive            Patient performs the
                                        Rem / Rehab             assigned cognitive
                                                             stimulation activities at
                                          Program           Medical office or at Home




 Compliance &
 Performance
   Review


                GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                       26
Independent Researchers

Psychiatry, Neurology, Geriatrics, Occupational Rehab
 Johnny Orr Memory Center, IA
 Lyon Hospital, France
 Queens University, Toronto, Canada
 Hartford Hospital, CT
 Veteran’s Administration, PA
 Pierre&Marie Curie Hospital, Paris France
 Memory Training Center of America, NJ
 Columbia University, NY
 UCLA, CA
 Lausanne Hospital, Switzerland



 GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009              27
Patient Progress

With Interactive Games for
Cognitive Remediation…
Life Changing Rehab
                                            Chris Bowie, PhD
           Joe – Severe Depression          Research Professor
                                            Queens University,
                                            Toronto,
                                            Canada
1 year progression
Energize  Motivation
Train       Cognitive Remediation
Practice  (higher order) Skills Training
Generalize  Bridge to Daily Activities
Apply       Vocational Services and
              Case Management
Progress  Employment!


GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                29
Games make the start…
                                                              Dona Bellucci, PhD
                                                              Clinical Instructor,
Clementine @ Essex County Hospital, New Jersey                Department of
                                                              Psychiatry,
                                                              UMDNJ-Robert
   Before…                                                   Wood Johnson
      Hospitalized 5 years with schizophrenia                Medical
      Minimal human interaction
      Staff not optimistic about remediation possibilities


   Then…
      “Come to the lab with me to try a game or two...”


   After 5 months…
      Goes to ‘work’ each day at the computer lab
      Takes outdoor exercise
      ‘Chats’ with all the staff
      Starting more progressive therapies


     GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009                              30
Thank You

Laura Fay, CEO
HAPPYneuron, Inc.
+650-776-4352
Laura.Fay @ Happy-Neuron.com

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HG4H - Cog Remediation For Professionals

  • 1. Enabling better Cognitive Intervention for Professionals Laura Fay, CEO HAPPYneuron, Inc.
  • 2. “GAMES FOR HEALTH” GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 2
  • 3. Agenda  Introduction to Cognitive Intervention  How it’s done today?  Issues with today’s approach  Key Success Factors  The Journey  Patient Cases  Introducing HAPPYneuron PRO GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 3
  • 4. Interventions  Cognitive Training-  Who: healthy individuals with no brain impairments  Goal: improve their neuron network performance.  Cognitive Remediation -  Who: individuals with impaired cognitive abilities as a result of general conditions – psychiatric, post chemotherapy, MCI, etc.  Goal: neural network stimulation for improved cognition and skills development.  Cognitive Rehabilitation -  Who: Individuals with neurologic damage from conditions like TBI, Stroke, Alzheimer’s, etc.  Goal: neural-network regeneration GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 4
  • 5. Brain Plasticity  The adult brain is not fixed  New neural pathway creation  Neural network strengthening  Brain reserve* enhancement GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 5
  • 6. Cognitive Rem/Rehab Programs  Medical Professionals  Conditions  Cognitive  Schizophrenia Psychologists  Depression  Neurologists  Mild Cognitive  Neuro-psychologists Impairment (MCI)  Psychiatrists  Traumatic Brain Injury  Occupational  Stroke Therapists  Alzheimer’s Disease  Language Therapists  PTSD  Nurse Managers  ADD/ADHD  Etc.  Chemo Fog GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 6
  • 7. Cog Rem/Rehab today…  Pencil & paper exercises  Libraries of children’s educational CD-ROM software  Mostly ’80s and ‘90s era computer interaction methods GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 7
  • 9. Issues with today’s approach  The Games/Exercises  The Supporting Environment GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 9
  • 10. Low engagement effects compliance O X X X X O O O GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 10
  • 11. Patient Dignity “But these are for kids. I am not stupid !” (cf) “Colorful games won’t make me happy ?” (d) GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 11
  • 12. Audience/Conditions not factored Choose Your Challenge Level Easy Normal Bad for Hard Remediation Patients Insane! GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 12
  • 13. Performance Feedback? You Pass WELL DONE!!  You Fail !! Let’s try again  GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 13
  • 14. Issues with today’s approach  The Games/Exercises  The Supporting Environment GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 14
  • 15. High Cost  Some programs not covered by insurance  Low therapist to patient ratio GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 15
  • 16. Manual Case Management Manual…  Configurations  Tracking Results in…  Errors  Confidentiality  Time GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 16
  • 17. Installation & Maintenance GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 17
  • 18. Issues with today’s approach  The Games/Exercises  Low engagement and interest with current solutions  Adult acceptance of kids games  Audience/Conditions not factored  Poor performance feedback messaging  The Supporting Environment  High cost of treatment delivery  Manual performance monitoring  Software installation and maintenance issues GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 18
  • 20. The Destination - Games  Developed with target audience in mind  Continued, relentless positive reinforcement  Engaging, non childish interactions  Cost effective & rapid configurability  Educational bridging to daily life activities GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 20
  • 21. The Destination – Environment  Online delivers…  Reduces the Information Technology (IT) costs  Improved case management  Facilitates distance therapy protocols  Higher patient to therapist ratio  Enables rapid deployment of product changes  Improved patient confidentiality and data security  Better research tools GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 21
  • 22. From here  there The Givens:  Improved patient engagement  Superior case management  Personalization  Performance monitoring The Adjustments:  Offline  Online  Work style / methodology shifts  Increased patient to clinician ratios  Introducing supplemental distance therapy protocols GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 22
  • 23. HAPPYneuron PRO A brief Introduction First previewed at the Cognitive Remediation Conference in NYC June 5th, 2009
  • 24. Product Line HAPPYneuron HAPPYneuron PRO Target Healthy Adults, Depression/ TBI / Stroke / Children & Schizophrenia / Alzheimer’s Seniors MCI Function Stimulation / Remediation Rehabilitation Training Where At Home Doctor’s Office / Doctor’s Office / At Home At Home How Self Service Guided Guided GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 24
  • 25. Patient View Happy Neuron PRO Exercises GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 25
  • 26. Customize and Prescribe HAPPYneuron PRO Cognitive Patient performs the Rem / Rehab assigned cognitive stimulation activities at Program Medical office or at Home Compliance & Performance Review GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 26
  • 27. Independent Researchers Psychiatry, Neurology, Geriatrics, Occupational Rehab  Johnny Orr Memory Center, IA  Lyon Hospital, France  Queens University, Toronto, Canada  Hartford Hospital, CT  Veteran’s Administration, PA  Pierre&Marie Curie Hospital, Paris France  Memory Training Center of America, NJ  Columbia University, NY  UCLA, CA  Lausanne Hospital, Switzerland GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 27
  • 28. Patient Progress With Interactive Games for Cognitive Remediation…
  • 29. Life Changing Rehab Chris Bowie, PhD Joe – Severe Depression Research Professor Queens University, Toronto, Canada 1 year progression Energize  Motivation Train  Cognitive Remediation Practice  (higher order) Skills Training Generalize  Bridge to Daily Activities Apply  Vocational Services and Case Management Progress  Employment! GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 29
  • 30. Games make the start… Dona Bellucci, PhD Clinical Instructor, Clementine @ Essex County Hospital, New Jersey Department of Psychiatry, UMDNJ-Robert  Before… Wood Johnson  Hospitalized 5 years with schizophrenia Medical  Minimal human interaction  Staff not optimistic about remediation possibilities  Then…  “Come to the lab with me to try a game or two...”  After 5 months…  Goes to ‘work’ each day at the computer lab  Takes outdoor exercise  ‘Chats’ with all the staff  Starting more progressive therapies GAMES FOR HEALTH, BOSTON. Jun 11-12, 2009 30
  • 31. Thank You Laura Fay, CEO HAPPYneuron, Inc. +650-776-4352 Laura.Fay @ Happy-Neuron.com