People behind healthcare innovation: Interview with Hagay Levy, CEO and Co-founder of Iluria Health

As part of our work, we have the privilege to speak with many inspiring innovators. Although the business community usually focuses on companies, pitches, and valuations—and less on the innovator—we thought it would be interesting to learn a bit more about the people behind healthcare innovation. In this series, we’re sharing some of our conversations with innovators in a condensed format to gain insights into their experience, their opinions, and their learnings.

This latest conversation is with Hagay Levy, CEO and Co-founder of Iluria Health, a digital-health company that targets the trial-and-error treatment process in ADHD patients.

Gila: What is your story, and how did you become an innovator in healthcare?

Hagay:?As in many cases, I’m here because of my wife. I’m 53 years old. I started my career many years ago in the Israeli capital markets, and then I spent some years as a financial analyst. In the last 20 years I’ve held several positions in the Israeli high-tech industry.

I am also a father and, as of this morning, all four of my kids have been diagnosed with attention deficit hyperactivity disorder (ADHD). That was actually the motivation for starting the company with my wife four years ago.

At the most basic level, we wanted to provide assistance to parents and better identify what treatment is effective in managing their children's ADHD. We are developing a remote-monitoring solution to improve the entire treatment ecosystem, including managing side effects. We are not involved with the initial diagnosis, at least in the MVP (minimum viable product), although we train the algorithms to analyze, monitor, and technically mimic the diagnosis. The basic idea is to mathematically analyze changes in physiological markers to determine whether we see an effective or ineffective treatment. We’re also looking to improve adherence, reduce unnecessary visits to clinics and, overall, cut down the trial-and-error elements of medication. ??????

Our overall goal is actually to look beyond ADHD, and we have secured the IP for anxiety and depression as well.

Gila: Where do you see healthtech, specifically in ADHD and mental-health monitoring, moving to over the next ten years???????

Hagay: We have some real traction in ADHD but we also have a pretty solid understanding in some other disorders such as anxiety, depression, and bulimia.?

With ADHD (and here I’m talking about kids and adolescents), the best current approach uses manual subjective questionnaires. It’s very subjective; false positives account for a quarter of diagnoses; the false-negative element is unknown but also huge. So, it’s super problematic in all aspects. If you look at all the stakeholders, parents, providers, pharma, pharma distribution companies, all of us are suffering from the trial-and-error elements of the process.

There are many methods by which startups are trying to move forward and illuminate the mental-health ecosystem. Addressing specifically what we actually understand, which is analyzing markers, I have to be optimistic because this is where we are deeply invested; we are all-in on that.

But we truly think that the ecosystem will significantly change because, in multiple mental health disorders there is a very clear association between changes in, say, marker A, marker B, or a combination of them, and the patient’s wellbeing attributes: side effects, risk element, medical-treatment effectiveness, and so on.

There is currently a lot of activity now because everything is newly developed: the wearables weren’t accessible, let’s say, five years ago, but now with $150 you can basically get a hospital on your hand. You have a lot of data you can use, and I hope, even as a father, that we would see a dramatic change because the data are real. The clinical association is there, at least in ADHD, and I think that walking blindly and guessing subjectively what would happen if you were to change the medical treatment, should be upgraded.

The clinical association is there, at least in ADHD, and I think that walking blindly and guessing subjectively what would happen if you were to change the medical treatment, should be upgraded.

Most patients leave treatment because, if you cannot measure anything, why tolerate the side effects? Leaving treatment is not a solution. It’s just sticking your head in the sand. There is some pretty distinctive research showing the long-term implications of ADHD if it’s not properly treated.

The same goes for anxiety and depression, for example. With anxiety and depression, the patient knows whether he or she feels better or not, but you cannot really, for example, mitigate the overdosing. So, I think there will be a significant impact on the patients themselves, again, in some different attributes. In ADHD, maybe it’s adherence; in anxiety and depression it’s maybe preventing overdosing.

There are some other technologies that are super interesting: measurement of eye movements, a lot of brain research. Everything will be dramatically changed via out-of-clinic monitoring, I think the watches will do a very, very good job in future. ???????????

Gila: Looking more broadly, what do you think are the biggest opportunities and obstacles to innovation within healthcare generally????????????

Hagay: There are several obstacles; as for all startups, obviously, proper funding. I do hope to see a more supportive regulatory ecosystem in the sense of analyzing mental health. Also, the regulatory environment, at least in the EU, is somewhat challenging. ?????????????

Regulation varies along a spectrum: nothing is a disaster because technically we are monitoring patients; we are not curing them; we are not doing any surgical element; nothing is invasive. But still there is a distinct difference between getting classified as a decision-support tool and being able to, let’s say, utilize the reimbursement element such as DiGA in Germany tomorrow morning versus doing additional clinical trials on US or German soil and being classified as a Class II medical device.

Regarding the opportunities, I think it goes without saying that there’s a lot of money being currently spent on ADHD treatment. A lot of it is electrodinal-based. Many patients are hospitalized, maybe not in ADHD but in anxiety or in bulimia and some other disorders because you cannot really manage it.

There are many attributes that could be better mitigated by raising awareness in the ecosystem, starting from caregiving for us as either parents or patients, reducing the number of unnecessary visits to clinics, and probably adherence (not only from a pharma perspective but also for us as parents).

So, there’s a lot of money being spent, and the prevalence is very, very high in most of these disorders, and I do see a huge opportunity in that.????????????????????????????????????????????

Gila: Has COVID-19 affected receptiveness towards innovation in health care?????????????

Hagay: Yes, definitely. COVID-19 assisted in promoting remote activity, like Zoom that we are using right now. Also, the notion of understanding what’s going on with the patient when the patient is not at the clinic was actually pushed forward by COVID-19. I think the impact of COVID-19 is super clear but not only digitally, even tactically. I mean the openness of doing things remotely is super welcoming right now. Currently, we are in the middle of a clinical trial in Italy with the second-largest child development center in the country, and we’ve never met them. We have made many Zoom calls; we have a protocol and everything there; we are also very good friends but we’ve never met them physically. So even on a tactical level, the entire ecosystem is much more welcoming.??????????????????????????

Gila: What do you know now that you wish you had known when you were starting out as an innovator or entrepreneur??????????????

Hagay: It sounds very na?ve, but knowing where to raise money. Going to generic VCs wasn’t too helpful for us, but the second we started focusing on strategic players, with a distinct interest in mental health, the entire discussion became completely different. Being focused is important, not only in the sense of knowing what to build and which problem we’re trying to solve, but in the context of how to establish the company, who to partner with as co-founders, and where to raise money.

Bio

Hagay Levy was born and raised in Tel Aviv. He worked as a financial analyst for five years and, in the past 18 years, has held managerial positions (all business development or finance related) in several high-tech companies. He is married with four kids, who have ADHD. As a consequence, he encountered the trial-and-error monitoring process for those diagnosed with ADHD and established Iluria. He holds a Master’s in Finance and Accounting from Tel Aviv University.

Disclaimer: The views and opinions expressed in this article are solely those of the author and guest contributor and do not reflect the views of McKinsey & Company.