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Mainul Mondal: “Being authentic and truly working hard day-in and day-out is essential”

For communities, they should invest and foster nonprofit organizations that work directly with their own community members and support a network connecting them all together. These organizations should have formal agreements with the local healthcare organizations to aid in outreach, in home support and mental health advocacy (e.g. community mental health workers) to address social […]

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For communities, they should invest and foster nonprofit organizations that work directly with their own community members and support a network connecting them all together. These organizations should have formal agreements with the local healthcare organizations to aid in outreach, in home support and mental health advocacy (e.g. community mental health workers) to address social determinants of health and factors affecting the health of community members. Communities should also offer free Wi-Fi to enable telemedicine for all.


As a part of my interview series with leaders in healthcare, I had the pleasure to interview Mainul Mondal, founder and CEO of Ellipsis Health.

Mainul I Mondal is co-founder and CEO of Ellipsis Health, a Bay Area health tech startup. Ellipsis Health has pioneered the first artificial intelligence-powered, speech-based-vital sign to quantify and manage depression and anxiety symptoms. By inventing scalable mental health tools, the company is democratizing emotional wellbeing for people across the world.

As a skilled healthcare IT business leader, Mondal has deep experience in the tech, healthcare, pharmaceutical, retail and defense sectors. In 2020, he was selected as a Milestone Maker by the Nasdaq Entrepreneurial Center. Mondal started his career in management consulting focused on market-entry strategies for innovative technologies.


Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

I have always had two passions. The first has been to address healthcare disparities, which I have seen both growing up in Bangladesh but also here in America. Healthcare is a human right, and untreated diseases, especially mental health issues, causes untold suffering. Since the early days of my career, I have believed that this is a cause that can create the most value for the most people.

My second passion has been the revolution in technology. I remember a statistic that there was only 53 kb of RAM in the world in 1953. The computing revolution has truly transformed the world, and now we are in the midst of another revolution as machine learning advances. The technology that we use at Ellipsis was not possible even 10 years ago.

Starting Ellipsis Health has always felt like the inevitable meeting of these two passions.

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

I was attending a Super Stars Literacy board meeting in the Kaiser Permanente building, when I happened to meet Bernard Tyson, who was the CEO of Kaiser at the time, in the restroom. He looked at me and said, “What do you think of my tie? My son picked out this one, do you think I should wear it?” And I told him to go with the tie his son picked, and since I was in their building asked, “Do you happen to know anyone at Kaiser?” When he handed me his card, I was obviously embarrassed, but he listened to what I was working on and promised to connect me with people.

He was truly a man of his word, and he had followed through on connecting me with contacts in his network. That interaction really taught me a lot about appreciation and the importance of collaboration in this industry. If someone like Bernard would take the time to listen to me and help me try to solve pain points, then we all can come together to advance healthcare and promote innovation from all corners of the industry.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

In summer 2017, we sent our first employee her offer letter with our old office address (we had moved one week earlier). I had spent hours going over the nitty gritty details of the offer — equity, role, how we described Ellipsis, but I did not pay attention to the address on the letterhead.

Of course, our new team member wanted to stop by the office the week before she started, and all she found was an empty spot where the company name should be and an abandoned office. I got a panicked call asking if Ellipsis was a real company or some type of complex prank. Needless to say, it was not the onboarding I was hoping for.

From that point on, I learned that no detail is too small when you are the CEO.

What do you think makes your company stand out? Can you share a story?

Depression and anxiety symptoms impact one third of Americans and cost the global society over $1 trillion dollars each year. The onset of COVID-19 has highlighted this epidemic that is occurring underneath the pandemic. We need bold, scalable solutions to address this epidemic — beginning with tools to scale quantifying symptoms. Ultimately you cannot manage what you cannot measure, and today providers alone do not have the bandwidth to solve this problem at scale.

Ellipsis Health’s technology represents a breakthrough as the first scalable, consistent AI-powered, speech-based vital sign for depression and anxiety symptoms. By leveraging the ubiquity of smartphones, our cloud-based machine learning algorithms democratizes emotional wellbeing by making health measurement available anytime, anywhere. For the first time, providers and payers will have longitudinal visibility into depression and anxiety symptoms, so that they can better manage care.

What advice would you give to other healthcare leaders to help their team to thrive?

Being authentic and truly working hard day-in and day-out is essential. For a healthcare organization to succeed, it must be built around a genuine mission that people feel connected to in order to drive the business forward. The power of a group is much larger than the power of one person — especially when you are addressing mental health conditions that impact our society on a massive scale. You will need all the help you can get, so prioritizing recruiting and retaining talent must be a top priority.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

There are quite a few factors driving why the US is ranked unfavorably for its healthcare system, which generally all stem from healthcare provider reimbursement. First, fee-for-service has long been a broken model that puts the patient second. Incentives among the patient, the provider and the payer are not aligned. As we continue to shift into value-based care reimbursement models, Americans are receiving improved quality of care. That is because the Centers for Medicare and Medicaid Services is now measuring healthcare organization reimbursement against patient health outcomes and hospital readmissions.

Another funding model is a capitation system, where a set amount of money per patient is paid in advance to the healthcare provider for medical services. However, there are many permutations of this model, such as a proportion of the reimbursable money being part of a risk pool that is accessible for good performance or the healthcare organization taking a straightforward risk on all expenses. However, most of those models do not pay for a full range of care, which include mental health patient needs as well as screening for social determinants of health. This is the legacy of the fee-for-service model, which lends itself to favored reimbursement of tangible and easily auditable tasks, such as procedures, rather than preventative care, such as health education and screening. This is especially critical for primary care providers that work with underserved patient populations, who are disproportionately affected by both physical and mental health conditions.

Another reason for our poor ranking is that there is significant disparity in both healthcare access and treatment to these very populations. Right now, unfortunately, a significant predictor of your health in this country is the zip code you live in. The issues of poverty, systemic racism and a healthcare provider population that does not reflect the general population all further contribute to this disparity. The US ranks poorly because of the profound inequities in the US healthcare system. The highest risk patients –underrepresented minorities — are the least likely to get access to care, testing and costly treatments and therapies.

This brings us to the final point, addressing and destigmatizing mental health in America. Mental health conditions often impact other chronic diseases but can be overlooked and go unaddressed for years. It is critical that healthcare providers and their patients make time to talk about their behavioral health concerns or integrate health IT solutions to help them manage symptom identification at scale.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

I mentioned some of the major issues preventing our healthcare system from being a high performing system in the previous question, like providing value-based care rather than fee-for-service, but those changes are high level and cannot occur overnight. However, there are some powerful steps we can take to nudge the existing infrastructure in the direction of those high-level changes.

First, we should mandate complete price transparency in the healthcare market and make this easily accessible to all. As more and more costs are shifted to the patient, they become the biggest payer in the country and can have the most influence. Right now, costs are abstracted through payer-provider and other contracts that do not involve the patient, which leads to significant price variation. For example, Safeway determined that colonoscopies around their East San Francisco Bay headquarters ranged anywhere from $900 to $8,000.

Next, we must enable easy and complete access of patients to their healthcare data. While one might say this is already realized, it is more in theory than in practice, and there are still many changes that need to be made. Many times, one patient’s data is siloed in different healthcare organizations’ Electronic Health Records (EHRs), and those EHRs are at times from the same vendor or at times from competing vendors. It is difficult for a patient (and providers) to aggregate all of this information into one longitudinal, cohesive record, the creation of which has documented benefits to quality and cost of care. Without strong mandates for data sharing, interoperability and cost-free access, this will never happen. Additionally, access to patient data includes what is termed “Open Notes”, which provides access to the actual narrative entries recorded by the providers within the EHR, which has been shown to increase patient engagement, health literacy and recall of critical information from the clinical visit.

Another change, of which we have had a taste of due to COVID, is the promotion and reimbursement parity of telemedicine with face-to-face encounters. While this level of reimbursement is currently temporary, it should be made permanent. The advantages of telemedicine are evidently clear: improved access and convenience for patients, which leads to improved care. In many cases, no show rates have decreased, and many studies have shown decreased costs and improved outcomes with its use. While there are limitations with virtual encounters, such as inability to get vital signs or do a physical exam, there are many startups (including Ellipsis Health) who are addressing these limitations to narrow the use cases where telemedicine is not applicable.

Rewarding patients for maintaining or improving their health is another powerful way to affect patient engagement and behavior change. While there are several examples of this, like gift cards for completing Health Risk Assessments or decreasing premiums for elimination of behaviors such as smoking, it is not a widespread and comprehensive practice. Behavior changes for health are one of the hardest tasks in healthcare and one of the most critical to affect meaningful change in a person’s health status. Patient rewards for favorable health practices need to become common practice.

Finally, make screening for the social determinants of health reimbursable. It has been clearly shown that issues such as food, transportation and housing insecurity, education and other factors directly contribute to a patient’s health. Incentivizing healthcare organizations to reveal these factors with all of their patients will lead to better care and lower costs. For example, discovering that a patient has no car and must take three buses to visit the clinic and therefore miss a whole day of work can explain their high no-show rate and lack of insight into their medical condition. With this knowledge, the patient could be offered a telemedicine visit, thereby decreasing their no-show rate and giving them the opportunity to ask questions of the care team.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

At the end of the day, individuals are the ultimate customers of healthcare, and they need to always ask for access to all of their lab, pathology, diagnostic procedure and radiology results as well as provider notes at every visit and for these to be delivered using accepted national standards, so this data can be shared easily with others. They also need to request quality information on the performance of the organization for whatever services they are being provided. They can also demand culturally competent care in the form of interpretation services and training for providers and a care team that reflects the diversity of their population.

For corporations, they can negotiate care for their employees based on transparent costing and quality analysis and promote value-based care with downside risk. They can also educate their employees on unconscious bias, equality and equity and be proactive about mental health monitoring (in a way that respects individual privacy).

For communities, they should invest and foster nonprofit organizations that work directly with their own community members and support a network connecting them all together. These organizations should have formal agreements with the local healthcare organizations to aid in outreach, in home support and mental health advocacy (e.g. community mental health workers) to address social determinants of health and factors affecting the health of community members. Communities should also offer free Wi-Fi to enable telemedicine for all.

Lastly, leaders need to promote a precision-based health approach, using data and measurement based care to guide prevention, diagnosis and treatment, which includes embracing AI technology that is created based upon datasets free of racial and cultural bias. They need to develop standards so consumers can accurately compare performance quality at different healthcare organizations and make an informed choice about who should provide their care. Leaders need to prioritize and promote diversity, income equality and eliminate the stigma of mental illness by directing funding and legislation in these areas.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

Mental and general healthcare have come a long way towards working together, even though they still run on somewhat parallel tracks. Integrated primary and behavioral health clinics are becoming much more common, but workflow integration is still a challenge. That is why digital tools are providing pathways for integration like Ellipsis Health’s Rising Higher app, which makes screening, monitoring and alerting for depression and anxiety symptoms much easier. This technology can then be leveraged to provide the right care at the right time in the right place. Digital tools can also be leveraged to provide custom care pathways based upon assessment and symptom severity. These tools need to be used more widely to address the severe shortage of mental health providers in this country.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider is someone who is skilled at their profession while also being caring and loving and showing that they are there for patients to listen to them and help. I believe all providers have good intentions and want to provide the best care possible. However, our current healthcare system has made it more difficult with disparate solutions and incentives. To help all providers excel, our system must enable them to take better care of patients, and technology solutions provide an opportunity to free up their time and enable clinicians to take impact actions instead of being bogged down with other tasks.

For example, Ellipsis Health’s Rising Higher app, a clinical decision support tool, enables healthcare providers to remotely monitor depression and anxiety symptoms in high-risk patient populations. There is often little insight into a patient’s life outside of a clinical encounter with few early warning signs of deterioration or relapse. Ellipsis Health’s behavioral health vital signs detect anxiety or depression symptoms via dual acoustic and semantic-based assessments of patient speech — providing critical monitoring between clinical encounters, so providers can identify the people that need assistance much sooner and gain visibility into their mental states over time in a consistent and scalable manner to improve health outcomes.

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

I always think of the quote by Elon Musk: “When something is important enough, you do it even if the odds are not in your favor.” Frankly, when we started Ellipsis Health, depression and anxiety were not sexy problems to go after in the minds of VCs — the exception has been some of our early investors. They include Khosla Ventures, Generator Ventures, Springtide Venture, Luminous Ventures, Collier Fund, CityLight Ventures and angels including Divesh Makan, Richard Socher, Marie Hurabiell, Ram Reddi, Matt Salmonson, Helmy Eltoukhy and Akhil Paul. But my co-founder, Dr. Michael Aratow and I had the conviction that it was important. We decided that we would dedicate this part of our lives to tackling this problem.

Are you working on any exciting new projects now? How do you think that will help people?

While we initially focused on the adult (>18 years old) population, Ellipsis Health is starting to organize studies in the adolescent age group, where depression and anxiety can initially present. By identifying these mental health issues earlier, we can get people into treatment sooner and reduce severity. We are also partnering with a company to get physical vital signs using just your cellphone with no additional equipment, which will answer a significant need for telemedicine sessions, since not every patient has a tool to measure things such as pulse, respiratory rate, blood oxygen content and blood pressure.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

One of my favorite books is Good Economics for Hard Times by Abhijit V. Banerjee and Esther Duflo. This book is a very timely read, given that it takes on inequality and political divisions.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I love that you used the word movement. At Ellipsis Health, our vision is to create “a movement that democratizes emotional wellbeing.” We were very intentional when we chose the word “movement” because, ultimately, when we wake up each day, all of us do not want to build just a feature, a product or a business. As humans, we want to spend our life doing something bigger than ourselves, and we want to build movements.

We chose democratizing emotional wellbeing as our movement because negative mental health not only impacts the person but also ripples out to impact families, communities and societies. This is more than economic costs. It is human costs. Every day, billions of people are prevented from flourishing because of stress, depression, anxiety and poor emotional health. To us, there is no better way to impact the universe in a positive way than to play a small part in alleviating this suffering.

How can our readers follow you online?

Readers can connect with me on LinkedIn and Twitter. They can also learn more about Ellipsis Health by visiting ellipsishealth.com and following us on Facebook, LinkedIn and Twitter.

Thank you so much for these insights! This was so inspiring!

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