Health Tech: David Bates On How Linus Health’s Technology Can Make An Important Impact On Our Overall Wellness

An Interview With Dave Philistin

You need to know how to work hard. Let your work speak for you. Never let yourself take on the mentality of a victim because it leads to entitlement, which causes you to excuse yourself from being responsible and accountable, and no high performer wants to work with such a person. Like I tell my kids, “Less squawking, more walking.” At Linus Health, we are committed to living out our values, which are to be real; be wise; be noble; be a team; be a master of your craft; and think big and act bold; all of which take hard work and applying yourself.

In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing David Bates.

David Bates, PhD, is a scientist, engineer, inventor, entrepreneur, and investor and is the CEO and co-founder of Linus Health, a Boston-based brain health company that offers a digital platform for multimodal brain health assessment and precision care beginning with cognition and motor impairments in seniors. David is a founding partner of Tamarisc Ventures and co-founder of Bode, a tech-enabled hospitality company for group travel. He is on the board of several technology companies, as well as the philanthropic TMCity Foundation.

Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?

I grew up in a semi-rural/suburban area outside of Atlanta, Georgia with three brothers. A lot of my time was spent outdoors, exploring and building things. As a child I was curious and innovative, which motivated me to discover and problem solve and set my course to become a scientist engineer. I knew very early that I would be an inventor and I especially wanted to invent things to help people heal from afflictions and better their lives.

Can you share the most interesting story that happened to you since you began your career?

I think Linus Health is the most interesting story that happened to me since I began working professionally. It’s the first time I truly experienced the “stars aligning”; it was incredibly fortuitous to come across the right people, in the right place, at the right time. It’s also as if everything I’ve learned and experienced to date was tailormade to build a company whose value proposition meets a massive global market demand at a time when both the understanding and technology are advanced enough to address it. For example, I met my co-founder, Dr. Alvaro Pascual-Leone on the same day I first came across Digital Cognition Technologies (which Linus ultimately acquired in 2020) at an investment pitch event organized by Brown Advisory in Boston for TMCity, a foundation I am on the board of that has a venture philanthropy model focused on mental health. Alvaro and I started talking and it was one of those intellectually stimulating conversations that keeps me in Boston, despite the cold. His understanding of the brain and its functional intricacies and how to approach treating individuals, not diseases, was so inspiring. I recall him saying, “People always talk about treating disease; I’ve never seen a disease walking down the street. We have to treat people. We do that by trying to understand their life, their disabilities, and what matters most to them. Then work with them to chart a path to become the best version of themselves.” Alvaro and I spoke for an hour, then parted ways with no further discussions. A little over a year later he reached out to me out of the blue and said, “I’m still thinking about our conversation and believe it’s time to do something about it.” My colleagues and I had already started working on a concept that was inspired in part by serendipitously meeting digital biomarker pioneer, Dr. Rhoda Au from Boston University while we were visiting Hong Kong in early 2019. A few months later, Linus Health was incorporated. This is just an example of many such fortuitous encounters with incredibly smart, mission-aligned, and motivated people who truly want to make a difference for millions of people all over the world in both quality and accessibility of care. This has been the story of Linus to date and is why I believe it is destined to achieve its mission and I’m so honored and excited to be part of it.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

If I have achieved anything in life it is due to the generosity of so many people along the way. Professionally speaking, Dr. Gerald Chan has probably impacted my life the most. He has been successfully doing business all over the world in science, technology, media and real estate for decades as well as being personally very active in philanthropy. I’m still not sure why he decided to take any interest in me, but I am humbled and forever grateful that he did. Gerald is a fellow scientist engineer and I recall him telling me early in our relationship, “business is how you can make science scale and have an impact on the world.” He trained me to get to the bottom of things and seek to understand the people involved: what is motivating them, what is their capacity, how can you help them, and to what extent can you count on them. I’ll never forget when I was thirty, he said, “your natural talent has gotten you this far, you won’t be able to go much further unless you learn how to dig deeper, work harder, and execute more effectively.” Over the next decade I took this exhortation to heart and grew to appreciate the value of execution, oftentimes even more than great ideas. I was incredibly honored when Gerald agreed to become Chairman of Linus Health and I continue to learn from him and frankly enjoy working with him to build an amazing and impactful company that will benefit so many people around the world.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I have three:

Theodore Roosevelt — “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

The Stockdale paradox — “You must never confuse faith that you will prevail in the end — which you can never afford to lose — with the discipline [and courage] to confront the most brutal facts of your current reality, whatever they might be.”

Winston Churchill — “…never give in, never give in, never, never, never, never — in nothing, great or small, large or petty — never give in except to convictions of honour and good sense.”

These quotes are meaningful to me because I had many setbacks and challenges to overcome and things to escape, especially in my adolescent years. By God’s mercy I was armed with a resilience and determination that, combined with the care and support of family and loved ones, enabled me to change my life trajectory away from self-destruction and toward a path of contribution for humanity.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

In addition to having vision:

1. Creativity — I have a robust imagination, so much so that I never had the desire to read fiction. I’m as entertained in my head as I could be in front of any movie screen or watching sports. The universe, the world, and people are amazingly interesting. As a leader, you have to see the world for what it could be and question the norms that cause it to be the way it is. Creativity is necessary to solve complex problems, to do new things or do things better, to find ways to motivate people and set them up for success. Creativity takes courage, a pioneering spirit. You can’t figure it all out at once–perfect is the enemy of good–sometimes you just have to start with the plan you have and trust you’ll be able to figure the rest out as you go. There is risk to try something new, to do something different and you must be creative and bold to make something meaningful happen.
2. Resilience — Leadership is a lonely road with many critics; your mettle is tested. Headwinds and setbacks are a regular occurrence, and strong fortitude has to be complemented with informed and unwavering optimism. As a leader, your team gets its cues from you.
3. Collaboration — The greater the challenge, the greater the need to work together effectively with many different people and that means different personalities and opinions, the magnitude of which is oftentimes directly proportional to each one’s talent and/or expertise (but if the former is greater than the latter, you should find a new teammate). At Linus Health, we have brought together experts in neuroscience, data science, computer science, clinical science and medicine, engineering, healthcare, enterprise software, and business expertise to build a single platform that seeks to help providers optimize an individual’s brain health.

Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?

Amyloid beta plaques associated with Alzheimer’s disease can appear in the brain as early as 15 to 20 years before clinical symptoms manifest. Early detection of cognitive impairment is a key step towards enabling disease modification — from implementing timely lifestyle changes to discovering new disease-modifying targets to expanding treatment options. Current methods for testing for dementia include pen-and-paper tests, up to eight hours of clinical assessments, and PET scans which cost $6,000. Most of the time, these costly and time-consuming options are only ordered when clinical symptoms are present in an individual, which in most cases, can be too late for intervention.

These standard “office” test methods, whether paper and pen based or computerized versions of them, are not sensitive or specific enough, and the pricey and invasive tests that are impractical for use as a screen to detect the onset of the disease before greater impact on memory, language, or visuospatial problems occur. Physicians, clinicians, and researchers need a test method that can be administered regularly in their office or even in a patient’s home so impairment can be detected at the earliest sign. Early detection allows for intervention via treatment plans at the earliest onset of impairment rather than when symptoms are present, at which point it may be too late to create and execute a successful treatment plan.

How do you think your technology can address this?

Our technology is a next generation approach to detecting functional impairment, administered easily on an iPad. We have combined the use of digital sensors, machine learning, and clinically-established and familiar neuroscience to provide assessment and monitoring capabilities so sensitive and precise that they can detect signals of impairment before they are even perceptible to humans. For example, Linus Health’s digital clock-drawing test (DCTclock™) was designed to provide a highly sensitive brain vital sign at a low cost and in just three minutes. Based on the 50-year-old standard pen-and-paper cognitive assessments, the DCTclock assessment goes beyond simply digitizing the clock drawing; it captures the entire process of drawing a clock, sampling at 120 times per second and tracking hundreds of digital biomarkers along the way which are then analyzed with artificial intelligence. In a study in Neurology by Massachusetts General Hospital researchers, this assessment was shown effective in identifying individuals with dementia before symptoms appear. Invented to deliver a quick, yet highly sensitive brain vital sign, the FDA Class II medical device can be easily administered at a lower cost and time burden than traditional methods of measuring cognitive impairment, such as a PET scan.

With Linus’ digital assessments like the DCTclock, providers and researchers have a simple, fast, and affordable method for making the earliest detection of impairment possible to determine a next step for diagnostics, treatment, and intervention. With a low-cost and short test duration, Linus assessments can be taken on an annual, monthly, or even daily basis to also assess improvements in lifestyle changes and other personalized interventions.

Can you tell us the backstory about what inspired you to originally feel passionate about this cause?

I’m sure almost everyone who has lived a decade or more has a story of someone they loved affected by brain-related disabilities. I’m no exception. I prefer not to expound the personal tragedies and sufferings I’ve witnessed, but I will say that brain ailments are among the cruelest of diseases. For any person, especially a young person, to take their own life, whether by drug overdose or suicide, is beyond words. And watching someone have their very person slowly eroded away because of Alzheimer’s or some other dementia is crippling. Disorders like these are tragic for the afflicted and devastating for their loved ones. Knowing that the expertise, technology, and opportunity to prevent such suffering exists and I can do something about it, to me, is as much a responsibility as it is a passion.

How do you think this might change the world?

Linus Health is dedicated to radically improving brain health outcomes for people across the world. By transforming how we detect, diagnose, and treat cognitive impairment and other brain-related disorders and disease, we envision a future where people everywhere can live longer, healthier, and happier lives — one in which brain disease not only has less of an impact on individuals, but also on those who love them.

To that end, we’re taking a global approach; our assessments are already available in multiple languages and in use in studies throughout the world, including in countries with limited access to traditional cognitive screening. Mobile devices such as iPads and smartphones have high adoption globally and dramatically simplify access to cognitive health assessments. The practicality and convenience of our platform, combined with its low cost, facilitates broad accessibility, as well as the inclusion of large, diverse populations in clinical studies. Coupled with its role in these critical clinical studies, the Linus platform’s use in clinical settings, senior care facilities, and even at home stands to enable a fundamental shift towards more proactive, technology-enabled brain health assessments and personalized interventions that can change the course of people’s brain health and their lives. Today there is no solution that has the sensitivity and specificity that the Linus Platform can provide, and we hope to revolutionize the approach to brain health care worldwide.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?

Data privacy and security are of the utmost importance to Linus Health, and we are fully committed to respecting patient privacy and safeguarding sensitive health information. Our platform maintains technical, administrative, and physical security measures designed to protect against unauthorized access, disclosure, misuse, alteration, accidental loss, or destruction. And we will never sell patient data.

While we seek to expand access to brain health assessments, it must be done under physician direction. We don’t recommend making these technologies available to consumers widely outside of a healthcare setting, as detection is just the first step toward diagnoses and treatment. Our assessments should only be taken under the direction of a provider, who remains involved during test administration, diagnoses, and monitoring treatment plans. All patient information and data is secured as Linus Health complies with HIPAA, GDPR, and FDA-mandated standards.

Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)

1. You need to know who is on the other side of all of your work. I’ve told our team that we can never forget that at the other side of our work is a person in need. Someone who may be confused and scared. Someone who loves and is loved. Someone who is suffering. And there are family and friends distraught and exhausted, desperately trying to understand, relate, and help. Everyone matters. Everyone deserves dignity and comfort from an awareness of themselves, their life’s journey, and of their loved ones until they take their last breath. Our solutions help all of these individuals as they traverse the many challenges of cognitive diseases.
2. You need to know what technology is for. Don’t just build technology for technology’s sake or spend your days developing a solution in search of a problem. My good friend and former business partner Ed Walters and I developed a technology thesis that guides our investment decisions, and that is, technology — at its highest and best use — should help shape an environment that informs and supports a better, more noble human experience. It should satisfy and meet psychological, physical, and social/health needs at scale in repeatable and sustainable ways. It should help us to make more efficient use of what we have already built through sharing, reuse, and repurposing. It should soften and enhance our relationship with our environment, react to our behavior, and anticipate our intent to engender interactions so seamless that we’re almost unaware that the technology exists.
3. You need to know your market. What are the inputs and outputs? How are things currently done? Who are the stakeholders — decision makers, payors, and ultimate beneficiaries, and what are their drivers? Who is left out and why? Who will benefit from your innovation and who or what could be harmed? At Linus Health, we studied every stakeholder in patient health, the Ecosystem of Care, which is composed of patients, providers, payers, suppliers, researchers, regulators, and caregivers (e.g., family, loved ones). We tried to understand each one’ experience, drivers, challenges, and frustrations. We surmise in order to benefit the patient most we need a platform that delivers value to each one. Furthermore, we sought to understand what the fundamental limitations were to enable equal access to quality healthcare. Some were obvious, some were not. For example, it’s obvious there is a shortage of specialists (e.g., neurologists, psychiatrists, neuropsychologists) that will never be met, especially outside of the wealthiest countries. To help address that limitation, we utilize ubiquitous sensors embedded in all mobile devices or personal computers to deconstruct human behaviors (e.g., drawing, talking, watching) into signals of interest as determined by machine learning and expert clinicians. These can then be fed into artificial intelligence models to enable real-time specialist insights for providers and, in turn, help people take agency over their brain health. That is powerful. On the other hand, one of the less obvious limitations we found was the homogeneity of the datasets. The majority of health data used to train machine learning algorithms is collected from educated caucasians. When it comes to data, especially brain health data, diversity is not a political matter, it’s scientific. Without datasets that are reflective of the population, care cannot be equal. Furthermore, assessments have to take into consideration cultural, educational, socioeconomic, linguistic, and environmental factors. All of our new assessments are designed to be agnostic to these factors and we are teaming up with experts from around the world to help generate the largest, most diverse database in existence from which data science can be used to finally provide equal insights for everyone.
4. You need to know that doing the right thing is always the right thing to do. When working toward something that can benefit society, you cannot think or operate in a way where the end justifies the means; otherwise, you could justify almost anything. In business, you will be tested. You will face hard decisions: Do you violate your ethics “just this once” or “just a little” to get ahead? It’s a slippery slope. Do you try to excuse, justify or vindicate an unethical or illegal action in the name of correcting past wrongs, personal or societal, or by telling yourself you’re working toward something that’s “right”? Do you discriminate in the name of anti-discrimination? Do you mislead or lie to customers, investors, the board for the “survival” or betterment of the business that is out to do good? Leaders may face all of these things and more and we need to know where we stand before such a time comes and have the courage to maintain that stand when indeed it does come.
5. You need to know how to work hard. Let your work speak for you. Never let yourself take on the mentality of a victim because it leads to entitlement, which causes you to excuse yourself from being responsible and accountable, and no high performer wants to work with such a person. Like I tell my kids, “Less squawking, more walking.” At Linus Health, we are committed to living out our values, which are to be real; be wise; be noble; be a team; be a master of your craft; and think big and act bold; all of which take hard work and applying yourself.

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

We all should consider and choose what kind of person we want to be and not just live our lives reacting to circumstance while chasing riches. My father-in-law once told me, “In our professional lives, we are always working on two things: our CV (resume) and our eulogy.” Too often the latter is neglected. Each of us has less than 10,000 workdays in our entire professional career. How will you spend yours? I encourage you to make your days count, find something that you’re passionate about that benefits others and harms no one, and apply yourself to be a real contributor in that area. I’ve heard it said, “count the cost, pay the price, and live a life of no regrets;” I think that’s sound wisdom to live by.

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)

I’d say either Elon Musk, John Mayer, or Kanye West. They are all creative geniuses, independent thinkers, and brilliant masters of their craft who are a bit mysterious, can be controversial and, I believe, are often misunderstood. They are just a little older than me, so I’d love to learn their perspectives on life, people, innovation, and views on the world situation. It would be a fantastic conversation.

How can our readers further follow your work online?

You can learn more about Linus Health on our website: www.linushealth.com or follow us on LinkedIn.

You can learn more about the Linus Health DCTclock here: https://linus.health/blog/digital-clock-drawing-test-can-detect-alzheimers-biomarkers-in-individuals.

Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.