U.K.-based digital therapy company ieso announced a $53 million Series B round on Tuesday. The round is the funding the company needs to move in a brand new direction: creating more intuitive autonomous text therapy.
In other words, AI trained on thousands of hours of real-life therapy that can provide personalized sessions, over chat.
Ieso has been around for about 10 years, and has been running a text-only therapy service (with human therapists on one end) through the U.K.’s National Health Service. So far, the company has provided text-based therapy for about 80,000 patients — though 6,000 are actively receiving therapy, Nigel Pitchford, ieso’s CEO told TechCrunch. That’s a total of 460,000 hours of therapy so far.
“We’ll deliver some sort of 400 hours of therapy this evening, via our network,” said Pitchford.
This most recent round of funding was led by Morningside, with participation from Sony Innovation Fund. It also included existing investors IP Group, Molten Ventures and Ananda Impact Ventures
Ultimately, ieso is looking to take itself from a human-based therapist system, to a scaled-up autonomous system. The idea of AI-based chat therapy isn’t exactly unique in this space (we’ve covered other companies pursuing this) but the data behind ieso’s approach is what the company sees as its secret sauce.
Ieso’s “unfair advantage” is 10 years of real-life text-based conversations between patients and therapists, which Pitchford calls “transcripts of care.” That data set is paired with real-time data on patients’ clinical outcomes, which the company has also been collecting alongside those transcripts.
“Ieso has built one of the most impressive data assets I have seen in the space with their text therapy data set,” said Stephen Bruso, an investment partner at Morningside. The data set is one aspect of ieso he finds most attractive as an investor, and called it “unprecedented.”
This data set has been used to track how certain therapeutic conversations or techniques are linked (or not linked) to patient improvement. And, there is some evidence ieso has managed to mine that data for insight. For example, the company published a paper in 2019 in JAMA Psychiatry analyzing 90,000 hours of therapy. The paper found that aspects of therapy like “planning for the future,” or certain cognitive behavioral therapy techniques, were linked to better patient outcomes.
Overall, the data suggested that 28 minutes out of every hour of therapy contained conversations or exercises that “directly affected” the patient outcome, said Andy Blackwell, the company’s group chief science and strategy officer.
Perhaps counterintuitively, the paper also found that therapeutic empathy was negatively associated with patient outcomes — though other research has suggested clients have better outcomes when they feel their therapists understand them. Blackwell interpreted the empathy finding as evidence that empathy should be employed alongside other therapeutic techniques.
Ultimately, Pitchford sees this data set, and analysis like the type conducted in that JAMA paper as a roadmap for how the AI-based therapists will be trained and personalized.
“So essentially, we’ve been studying what the very best therapists are doing at a very high scale, and then reconstructing that, so it can reach people that are unable to access human psychotherapy delivery, which is a huge problem all over the world,” he said.
Even with this data set, ieso does seem to be working in an increasingly crowded space. Funding for mental health startups is anticipated to crack $3 billion in 2021, per a Q3 Silicon Valley Bank Trend report. That means there are a lot of minds focused on the problems associated with traditional therapy right now.
Bruso sees ieso as one of the few mental health companies that can point to real-world health outcomes, at least using their own data set.
“We believe that there is a unique synergy between ieso’s digital products built on real-world data, and their ability to trial these products in their existing user base to generate outcomes data from day 1,” he said. “At the end of the day, the products that will last in the space will be those who can demonstrate a measurable impact on both individual health and societal outcomes.”
Blackwell is also aware of how packed this space is — in fact, he sees it as a problem for consumers. These apps, ieso’s leadership figures, are often designed for either self-help, mindfulness or patients with non-severe mental health diagnoses.
Though ieso can treat people with non-advanced mental health struggles, the company also has a focus on moderate-to-severe diagnoses. It’s not, to use his words, a “wellness solution” — and can be used by groups who might require more intensive care.
This focus means that safeguards for self-harm need to be especially strong. Blackwell says the company has risk escalation protocols in place for its human-based therapy model that have been honed over the course of 10 years as one of the largest mental health providers in the U.K. The company has plans to incorporate those programs into the autonomous therapy product in the future.
Right now, Blackwell doesn’t anticipate a harder regulatory path because it’s looking to deal with higher-stakes mental health diagnoses.
“The good thing is that there are precedents and predicates that we can use as we come to market. But the key thing will be about having, you know, demonstrably safe and effective products,” he said.
The high volume of data the company has already collected will allow it to collect insights into efficacy and safety “many times faster” than you’d expect under regular clinical trial circumstances, Blackwell argued.
Going forward, ieso plans to use this round to build out its AI based therapy arm, and shore up a presence in the U.S. The team is expected to grow to about 200 people by next year, which will set up a push to go to market over in the next two years.