Executive Summary
Digital health platforms that offer personalized support are gaining traction in the market, both from patients and investors. Trellus Health is connecting IBD patients with resilience methodologies that enable disease management at lower healthcare costs. Its co-founder Laurie Keefer talks to In Vivo about scaling up the business for greater reach within the market.
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In Vivo Rising Leader Laurie Keefer is co-founder of Trellus Health, a company that has created a connected digital health platform designed to help those suffering from inflammatory bowel diseases (IBD), which includes the chronic incurable conditions of Crohn’s disease and ulcerative colitis, using positive psychology methods.
Keefer’s methodology, the patent pending Gaining Resilience Through Transitions (GRITT) assessment and personalized skills-based solution, was developed and validated at the Mount Sinai Health System to build resilience and wellness for improved outcomes at lower healthcare cost. Trellus uses its technology platform, TrellusElevate, to coordinate and deliver personalized clinical and behavioural support remotely via digital solutions and access to an expert resilience team via telehealth.
Trellus is one of several growing connected health offerings for patients using medical and behavioural science together to understand, accept and manage disease. Digital apps and therapeutics that apply mindfulness and a scientifically proven psychological approach, such as weight loss app Noom which received $540m in 2021, have been the apple of the investors’ eye for the past few years. Digital therapeutic companies such as Pear Therapeutics, Click Therapeutics, and Akili Interactive have brought products to market that treat and manage behavioural health conditions and represent a new wave of therapy management that does not involve swallowing a pill. Keefer, however, is no opportunist. Her methods have emanated and developed from her work as a gastrointestinal (GI) psychologist at the Icahn School of Medicine at Mount Sinai and the Feinberg School of Medicine at Northwestern University. She talks toIn Vivoabout her journey so far and how she, and her other female leadership team, intend to scale up their offering.
Tell me about your career path up to the point of establishing Trellus? “My career has been both accidental and intentional. Now, I can scale what I’ve been doing my entire career spent in that brain-gut axis, beginning in graduate school. I was first exposed to the concept of the’ brain gut’ connection as a doctoral student. There wasn’t such a clear path for health psychology at that time, where psychologists working in medical settings. My PhD was in clinical psychology, and as much as I liked doing traditional clinical psych work, what I really loved was working with physicians, and particularly with gastroenterologists. What I’m scaling at Trellus is something that I’ve been just doing as one person for all these years. I’ve had the pleasure to train students in the idea of being a gastro psychologist, right. When I started, there weren’t gastro psychologists, they were not embedded in GI departments. I was at Northwestern for many years, and when I left there were four GI psychologists, so it became a trend. This was the first innovative step in my journey – integrating, for the first time, psychology into a gastroenterology setting. That led to research on the patients. I wanted to make a difference in these patients lives through behavior change. No matter what GI condition the patient had, there was an associated set of behavior changes that kind of had to happen. I created this methodology that identified patients that are going to adjust to their diagnosis, who are going to make whatever lifestyle changes they need to make take whatever medicines they have to take, and who are the ones that are going to need that extra support? Because I’m one person, I can’t see everybody.”
How did you make the leap from academia to a commercial entity? “I’ve always seen myself as creative and disrupting the field in what I do, but never in an entrepreneurial way. Mount Sinai, which promotes faculty entrepreneurship, took notice of my work, and put myself and my co-founder, Marla Dubinsky, a gastroenterologist and IBD specialist also committed to whole person IBD care, through its innovation accelerator program. We spent two years working out the business model, how would we get paid for it, and who would be our customers. Sinai provided us with Monique Fayad as a business consultant, to serve as our first CEO, she was instrumental, too, in putting Trellus together.”
And because Trellus is classed as a health and wellness app it doesn’t have to be FDA regulated… “And that was a conscious business decision that we made because what we offer is so personalized and promotes these positive psychology concepts of resilience and improving the patient-provider relationship. We don’t want to take patients away from their trusted doctors. We’re not an app or a solution that replaces any kind of care. We help the doctors, and the patients manage outside of the office visit, because most care happens outside of the office visit. You see your gastroenterologist twice a year, but what is going on between those visits? That’s where the health and wellness part comes in.”
Explain the concept of Resilience-Driven Connected Health and the GRITT Method? “Every patient, to be able to effectively be called resilient in our methodology, needs to have five core character strengths. And these are all modifiable, they’re built, we can build them, we can teach them. They’re not related to things that the patient can’t change. Those are: disease acceptance, hope and optimism, social support, the ability to self-regulate, do hard things, and self-confidence. If you have those five things, then we can call you a resilient IBD patient, a warrior. And we know that whatever gets thrown your way down the road, you can be resilient through transitions, such as pregnancy or career change. If you have those five resilience characteristics, we’re confident that whatever comes your way you’ll adapt. And if you don’t have those five things, then we’re going to make sure you do, so that the next time you must transition into something you will be prepared for the changes that need to happen. I have a lot of conversations with patients, both with irritable bowel syndrome (IBS) and IBD, explaining to them that accepting that you have this disease doesn’t mean you approve of it, it doesn’t mean that you’re just giving into it. It’s just a way of accepting that you must attend some of your brain power to this problem over time.” There are many large teletherapy providers on the market such as OmadaHealth and ResMed, do you have ambitions to develop Trellus to be as big as them? “Our goal is to democratise access to mental and physical wellbeing in one location. That’s a huge problem in society, that we separate the mind and body. We can’t keep doing that. The whole is greater than the sum of the parts. Being able to look at all of that together in the context of a person’s life; what their values are, what their goals are, not just what their A1C is. Are they meeting their goals in life despite having adversity? inflammatory bowel disease is our passion, but this methodology applies to any chronic condition.”
Will you be developing the technology or method to cover different chronic conditions? What conditions could this method apply to? “This is where that resilience framework is helpful because resilience can apply to any adversity. Resilience is going to going to teach you how to adapt to whatever that is. We do have some very disease-specific content, but 80 to 90% of the methodology is disease transdiagnostic. Trellus licenced the GRITT methodology from Mount Sinai for seven disease states. In addition to IBD, we’re going to be going into irritable bowel syndrome (IBS) as early as 2023. But that methodology can apply to different types of cancer, diabetes, or really any chronic conditions that patients around the world face.”
How else do you plan to grow the platform? “We are moving toward launching potentially in Canada, or the UK, but the biggest barrier is data security. There are places all around the world that could benefit from that solution and access to care. In the various parts of the world, the incidence of IBD is rising, particularly in Southeast Asia and other regions where there’s a lot less specialty care, and certainly a lot more stigma around mental health in the context of mental illness. The more we can expand, the better, but we’re trying to stay disciplined, perfect the solution in the US and in IBD, before we scale to the next level. That is the one of the strengths of Trellus and the strengths of having an all-female leadership company, with two female founders and a female CEO. We have discipline but also flexibility. We maintain focus on our goal. How we get there? We might have to pivot quite a bit. But we know where we’re going. We know what our North Star is. We know what our values are, what we are willing to compromise, what we’re not willing to compromise. That’s where Trellus itself is a very resilient company.”
How does it feel to be known as an innovator?
“I’ve always been very intellectually curious as a person and as a kid. I was fascinated by the bookThe Secret Gardenwhen I was in elementary school. But the curiosity wasn’t so much about the garden, but around why the character Colin was in a wheelchair for no clear reason. The curiosity surrounded that mind versus body story, I didn’t know at that time that that was going to end up being the profession where I’m doing my body of work.
That innovative spirit has always been a part of who I am as a person. But what I find different is figuring out where your innovative spirit fits within the current needs of the world. That’s why I joke about being the accidental GI psychologists, because no one knew that’s what the world needed. But as the needs became more and more obvious, I became more and more innovative. To be able to say that all these little moments have accumulated into an innovative company or a healthcare shift – that’s the really exciting part.”
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Published July 7, 2022