HOW do I describe you?

I was saying, entrepreneur, Dallas Maverick's owner, Shark

Tank star, you do it all Mark [laughter].

Yeah, I don't know about that but entrepreneur, that'll work.

You and I were talking earlier today on one of the panels. You made some really
fascinating points about innovation right now in this country, and all that need to
be done to encourage it, to encourage small businesses. What do you think, overall,
the most important thing for new entrepreneurs right now?

Just to go after it. I mean, the thing about being an entrepreneur is, it's just
all to you. You know, a lot of people like to make excuse, "I don't have
connections, I don't have money, I don't have this." But, if you find something
that you like to do or love to do, be great at it and see if you can turn it into a
business. In worst case, you're going to have fun doing what it is you love to do
and best case you can turn it into a business. I'm just not big on excuses, I just
think everybody has that opportunity if you go for it. You just got to do it.

Well, a lot of people say it's hard to get along right now for a small business
owner, trying to come up with an idea. How do you get the capital to start that
business?

First of all if you're starting a business and you take out alone, you're a moron
[laughter], right? Because you're, there is so many uncertainties involved starting
a business yet the one certainty that you have to have is paying back your loan,
and the bank doesn't care about your business or whoever you borrow from, unless
it's family doesn't care about your business and so it's just a complete conflict
so to--

So what--

--never.

--what's a small business entrepreneur, how do you know if--?

99% of small businesses you can start with next to no-capitals. It's more about
effort, you know? Small businesses don't fail for lack of capital. It fail for lack
of brain, they fail for lack of effort. Most people just aren't willing to put in
the time to work smart. I mean, they go for it in a lot of cases, but they just
don't recognize how much work's involve. If you start a business you better know
your industry and your company better than anyone in the whole wide world because
you're competing and to think that who ever it is that you're competing with, they
just going to let you come in and take their business. Obviously that's naive, and
I think most people don't recognize that. If you're going to compete with me on one
of my businesses, you better realize that I'm working 24 hours a day to kick your
ass.

You know a lot of companies right now are holding on to their money. They're
holding on to cash. Maybe they're doing some share buy-back but in general, they're
not putting their capital the work right now. How and when did that start to
change?

I mean, it's reflection of a lot of different things. If they're buying back shares
it means they don't see anything in their own businesses that they can invest in
and if they don't see anything in their own businesses that they can invest in,
then it doesn't matter if they're bringing back capital from elsewhere and it
doesn't matter that they can talk all they want about jobs. But, there is no good
reason to hire people because they don't have places to put capital to work and I
think that's also a reflection of the focus on Wall street. Most of the times when
we talk about putting capital to use, we talk about public companies. You don't
really see this as an issue in private companies. But, with public companies they
get such concern with shareholder value and shareholder returns that there is a
sight of trying to move the ball and to innovate and to invest on R&D and I think
that's hurt our economy and I think that hurts their company in the long-term.

So what does this mean for growth? Do you think we're going to begin this 2.5%, 2%
environment for a while?

Yeah, but I don't look it that and say, "See there is something wrong, we're not
doing something right." I look at that and say, "That's the new normal." That, you
know, when companies have their backs against wall, particularly smaller to medium
where there is a big part of the growth for jobs, we find new ways to innovate.
We're innovators in this country. We don't just sit back and say, "The only way we
can solve problem is by hiring people." We go out there and you hire smarter kids.
You hire smarter people to write software, to put things in the cloud, to find new
solutions and so we're, you're turning into an economy that is bifurcated. There's
those people who write and control and to find the software, and then there's those
people who work for the software.

Well, you're someone who's gone out and started a lot of businesses including your
own network. CBS has just purchase of minority stake in your network. What is there
intention to do it that or you think there's a chance they might buy out the whole
thing?

Who knows? But I think they're recognizing that we took a network, HDNet, which was
the first all high definition TV network, grew it and then two years ago I
recognize that being HD obviously is not enough and so I said, "After in the media
landscape, what opportunities are there? What creates a unique scenario that would
be good for a network?" And, if you look at what's happening with social media, and
in particular real-time social media, it's very obvious and you guys notice as well
as anybody, real-time social media drives real-time viewing on TV and live events
on TV drives social media. It's a very symbiotic relationship, and so with AXS TV,
we had been doing live events as HDNet, and we just amplified that. So we, from
concerts all over the globe to live interview shows to live fights. Whatever type
of event that we can do live, we want to do--.

Live is what people will tune in for?

Live is what differentiates television from the internet. You know, the internet
was designed for everything but video and televisions designed specifically for, to
deliver video, and that's a huge differentiation.

And how does the internet, I mean, when you think about content now being so much
on-demand. Live obviously different because you have to tune in specifically for an
event.

Right, but Gangnam Style video, billion people watch it. You couldn't find any two
people who watched it and talked about it at the same time. It's just completely
different. By the time you watch it on YouTube, you've already missed it, you've
missed the conversation. YouTube's not about conversation. On-demand is not about
conversation. It's about catching up. It's about killing time and vegetating.
Watching a show all day long, whereas watching this live, hopefully, there's people
online talking about it, "Cuban's an idiot," or "Cuban's smart," or whatever,
"Trish knows her stuff," or you know, whatever it may be. But, that's a, that's a
holistic conversation that happens in real-time that creates a unique experience.
THANKS, while we're actually talking about telehealth, these are just few more
specific questions for anyone on the panel. So, what actually qualifies us
teletherapy? That's one question. And also, what does the law tell us about
telehealth? A lot of people have concern about crossing state lines and other
things. And, how do families and practitioners work through reimbursement related
issues? So that's yet another policy or inter-question. I think these are all
perceived barriers all of these, the law, reimbursement. And, also I think people
have some confusion about, what exactly is teletherapy if we're talking about
delivering interventions? So for anybody, who wishes to address?

There are broad spectrum of teletherapy. There is face-to-face, pretty much a

precise imitation of what would happen if some of us were in the same room. There's
synchronous passive of messages so people could in fact do texting, do texting
related therapist. There is asynchronous where in fact one can either send a video
messages back and forth in terms of response to various or intervening synchronous
passion but with video present. There is audio teletherapy which existed just for
telephone before we had smart phones and continuous to exist. And, anything that
uses those tools in the broadest possible spectrum would allow back-up
intervention.

Thanks for that, and that actually speaks a little bit to the asynchronous and
synchronous use but, yes Oliver.

So Charise thank you, so just to cover up the [inaudible] upon us from the other
countries we're on the wall. Swirzerland was one of the first adaptees of telecare
and not just for mental health disorders but for range of medical disorders and its
very very common now I think maybe becoming more common than a primary care
consultation face to face. There is also a telecare service which covers most of
Latin America and send it on Brazil, [inaudible] spot which has 20 million patients
and 30 thousand positions on the back hand. So, more driven by necessity, largely
the long distances to travel and the dirt of practicing connections. A lot of other
countries believed in the developing world kind of lead for [inaudible] existing
healthcare system in the west and have adapted telecare kind a wholeheartedly.

So thank you for that, okay.

State lines is a thing, right? So if you're seeing a kid at Duke you're technically
practicing medicine in North Carolina. So, I think the professional societies have
to figured out how to help people with that barrier. It is actually a true barrier.
It is like all these other equations, solvable. It takes clarity of purpose to
states what have to collaborate. I know, there is some knowing one's state activity
in the social work field to think about that differently. And until that happens,
national companies are coming in with people that are licensed in their mistake,
which is another way to do it. It's another disruptive idea. It's a field that
could use a little disruption. And that's an interesting, I think potential
opportunity.
I took a look at the one of, several of the online platforms prior to this
conference, and the subscriptions services for therapy are quite interesting
because they have also different billing practices depending on how long the
session. If you decide that you will have three pack therapy, package that you'll
purchase and so forth. So, as we get into this disruptive technology, its also the
case that it may be disruptive to our customary practices around billing, in our
way that we think about what constitutes a session and what kind of commitment a
patient might need to make.

So thanks for these comments. I want to shift focus just a little bit and maybe
have Kim and Gareth from your perspectives. Talk a little bit about the impact of
stigma in cultural barriers about accessing mental health care globally, and I know
Kim some of your comments leaded to this, how are we going to overcome those in
terms some our digital and technological applications to delivering mental health
care.

So, its both the medium as well as the content. So, you have a way to deliver care
at scale and remotely but if the care package is not culturally sensitive, I think
that level of engagement will be much decrease. So, I think about some of the work
of a Maggie Alegria who has pioneer to use of short-term CBT approach specific to,
or taking into consideration the interests and needs of Latina women. It's been
delivered over the telephone, over cellphones. I don't know if there is a video
version or not but its proving to be just as effective as in-person treatment. But
the, it's not the medium that is really driving the outcomes exclusively, it's the
treatment itself has been designed for the population that she's most trying to
reach.

So in the developing world, first the, it's not just the societal and logistic and
local stigma but also a policy stigma and the isolation of people with mental
illness from mainstream towards a decision making impairment. At the same time, the
lack of services causes such tragedy to families, such families become [inaudible].
So many places of which we are, there are very very small, centralized,
extraordinarily, inhumane and frightening mental institutions that keep people in a
circumstances worst than that alone and without any hope of real therapy treatment
intervention.

[1 00:05]
[music] MY name is Jacob Morgan, the author of "The Employee Experience Advantage,"
and you are listening to Paycom's HR Break Room.
[2 00:18]
[music] Hello everyone and welcome to HR Break Room! The podcast dedicated to
having quick conversations on the hot topics in HR and HR Technology, one cup of
coffee at a time. I'm Caleb Masters.
[3 00:28]
And sitting in for Chelsea Justice, I'm Braeden Fair. As always, HR Break Room is
the podcast of new discover how far your workforce can go. Caleb what's on top for
today's episode?
[2 00:38]
Today we'll kick off 2018 by talking with Leigh Stringer, the best selling author
of the book "The Healthy Workplace. Going to be talking with her about the hot
wellness and ergonomics trends we can expect to see in 2018. We will talk with this
about the rising investment and mental wellness programs and how they relate to the
growing millennial workforce. And, she also talk about the important role physical
space plays in creating a healthy productive work environment. And, how sustaining
a great wellness program starts with changing your organization's culture.
[3 01:07]
What a way to kick off 2018 and it sounds like Leigh has a talk full of great
information and actual advises to workforce.
[2 01:13]
Absolutely Braeden. I think we're looking at 2018 we just started the new year. I'm
sure HR personnel are, just like me and you, we've got new year's resolutions we're
thinking about. I'm going to drop about 10 lbs off the scale and will live a little
bit healthier this year.
[3 01:25]
Yeah, I love the phrase, "New year, new me". And I'm sure that a lot of
organizations are probably approaching that as well. You know, according to
Workplace Wellness Trends 2017 Survey Results report, among employers that are
offering and measuring their wellness efforts more than a half have found a
decrease in absenteeism. 63% are experiencing financial sustainability and growth
in their organization and then 66% reported increase per activity and then 67% said
employees are more satisfied over all.
[2 01:54]
I mean it sounds like, at this point, why not at least consider, I'm looking at new
wellness initiatives or new wellness programs within your organization. And you
know it, this is not something that just benefits the organization, also like you
said, it leads to employee satisfaction because actually I cross the stat the other
day from United Healthcare states that 70% of employees are interested in taking
corrective steps to improve their health.
[3 02:13]
I'm sure Leigh has great examples on what that looks like.
[2 02:17]
Yeah absolutely Braeden, I can't wait to talk what there more. Do you want to get
ahead and take a step into the Break Room to find out what she has to say out of
the subject?
[3 02:23]
Let's do it.
[silence]
[2 02:35]
It is always great to be back in HR Break Room especially for New Year Braeden and
I'm really excited about today's guest. Can you introduce us today?
[3 02:42]
Of course Caleb! Leigh Stringer is a workplace strategy expert and researcher whose
work has been covered recently by BBC News, The Globe and Mail, Fortune, CNN and
Good Morning America. She works for EYP, an architecture and engineering firm, and
services client including Google, Under Armour, LG, Johnson and Johnson, Ernst and
Young and the architect of the US Capitol. She is the author of two best selling
books, including "The Healthy Workplace: How to Improve the Well-Being of your
Employees" and "Boost Your Company's Bottom Line." Leigh welcome to HR Break Room.
[4 03:16]
Thanks so much for having me.
[2 03:18]
Alright, well Happy New Year by the way. First show of the year, we're really happy
to have you on.
[4 03:22]
Happy New Year to everybody else. This is-- it's gonna be a good year.
[2 03:25]
You know as with the New Year, it seems like New Year's resolutions and trying to
take steps to get healthier always seems to be a front scene of everyone's minds.
And I think it-- that rings through for a lot of organizations around the country.
So, I just wanted to kick our conversation off today by asking the question, "What
are some new wellness strategies that you saw in-- last year in 2017 that are
actually gaining even more attractions we had further into 2018.
[4 03:48]
Well to think when in list top of mine, for me and all of my clients is mental
health. We're really taking care of mental health. It's something that has been
under cover or not brought to the fore fronts for a long time. If ever, and it
really is emerging and is so important. All this talk about mindfulness and
meditation and yoga and talking about that in the same conversation were talking
about work, would it seem crazy just a couple of years ago but it really is taking
off and their is so much evidence around that critictivity becomes-- from the
stillness of your mind and the quieting of your mind getting stress and all the
rest. So, I think that one is for sure, and if continue it grow exponentially as we
learn more about the human mind and what we can do to calm it and keep it at its
most productive best.
[3 04:43]
Yeah I thinks that's a great segue into my next question for you Leigh and we're
talking about this new found emphasis on mental health. How is this perception and
the emphasis on mental-- maybe in emotional wellness shifted as millennials are
becoming large working group in today's workforce.
[4 04:58]
It is! It's funny, one of my colleagues was mentioning a study, I need to get my
hands on it where she was shocked. We do a lot of work with higher education and my
design firm, and so obviously, paying attention to what student's want and then
what happens when they have best prepared them for the workforce and one of the big
steps that came out was something like seventy, 7-0 percent of students come-in to
college with things are the issues. They come and stress out to begin with. And
then they leave even more stress, I assume, because they've been working so hard at
school. And now, a lot of colleges are really addressing that head on and looking
at how to present mental health in a way that is, it doesn't have any stigma and is
part for the sweet of services that they offer students [inaudible] everybody else.
And, of course those students are now or these millennial are now fully in the
workforce. A lots of them really entering and we're seeing the stigma of mental
health while on a way, it much more so, that it has been as I was mentioning. But
also, a fact that they've expect to see an addressing of mental health and physical
health and emotional health and financial health, all these things need to be part
of the package that we're offering them.
[1 00:00]
ALRIGHT, so why don't I start with this question, I think maybe I will direct this
towards, Sarah I'll start with you and if others want to chime in. So, older adults
are not digital natives, doesn't that make it more of a challenge to develop
technology for therapeutic health versus younger people with the various or lower?
[2 00:23]
Absolutely it does, but you'd be surprise at how adaptive people are. We have found
that its less must of the barrier all the time. They, making universal design
available and principles in either a smartphone or on the web is critical to making
things usable. But, I think as Dilip showed, people are very willing to adapt to
technology and are interested in what the new tangled thing is. So, its less of the
challenge I think than you would think.
[3 01:03]
Making a case for using the technology is critical. I think, older adults are less
likely to have exploratory use of technology but if its critical and you can make a
use case for it adaption there, it's fairly comparable to younger adults.
[4 01:21]
In my experience, that critical component for us to go opinion, smart phones apps
was to focus perfect with these participants. We learned a tremendous amount.
There's just a few characteristic things that older folks don't like. They don't
like surprises on the devices while they're using them. That's a big no no, so we
had to pretty much start over from scratch. Wait, we thought we're very clever and
had this figured out but actually sitting down and testing out with old people was
a huge critical step for us.
[ 2 01:49]
Yeah, I think that testing that part is actually a really good point. Some of the
games that people assume are engaging for younger people may not be so engaging.
I've, researcher out of Florida was evaluating, whether older people like the games
of violence. The "shoot'em up" games, they hate that. Finding more socially
nurturing kinds of engaging games are much more likely to be successful.
[1 02:22]
Great, thank you guys. Thanks for the question. So, Dilip if I ask you this
question, if you can hear me, okay? Seniors are awfully concern with privacy and
security and how do you get the script to adapt, adapt digital health when they're
so worried of these concerns?
[silence]
[1 02:44]
Why don't one of you guys answer that question [laughter]?
[2 02:46]
It's very interesting because Air Peace, of very aware that older people are
subject to scums and we're trying to balance, making people aware of some of the
privacy concerns when dealing with technology. But, it's about creating trusted
information making sure that people are understanding who is reaching out to them
and building that level of trust overtime and making sure that the, what you do
with their personal information you're letting them know, they're seeing it and you
were treating it with respect and confidentiality.
[3 03:37]
And now we're at transparency and control, to that, we found an armor that you can
convince people of the value of continuous monitoring. For example, if you give
them the ability to turn it off. So if people have control over when they are
monitored and when they are not, they're much more have to go with it. And I think
transparency is the second thing, knowing what's being used, where the data are
being stored, who is keeping the data has crucial if you did a little project.
Looking at privacy apps for the mention, that's a serious issue there with lack of
clarity of what's actually happening with these information. Transparency are then
giving the people being monitored to control over what's being monitored and how. I
think it's crucial.
[1 04:23]
So Jason here's a question for you but I'm going to add a second [inaudible] part B
to it as well. So, one is do you have any independent validation that day-to-day
fluctuations that you were mentioning are clinically meaningful. And the part B of
that question is, do you think that some of the really disappointing negative
clinical trials if you will and mild to moderate AD with some of the amyloid
targeted therapies are actually related to some of these issues we've mention at.
[4 04:51]
So the answer to the first question is, that's one of the aims of our grant that
we're looking at, is to determine what are disease effects are underlying the
variability that we see. But right now we don't have a lot of evidence to support
that. There are other things that we're considering to, like time of the day
effects. And the answer to the other one is yes, I think a lot of the trials have
missed precisely because they were under powered. To, in order to get a drug
approved in Alzheimer's disease you have to show a cognitive benefit depending on
what the indication the disease. If it's for secondary prevention you have to show
a cognitive benefit, and there the number of trials that you've just missed because
of unexpected variance that occurred in the placebo, for example. So they're
probably are working but they just didn't detect it because they were under power.
[1 05:41]
I'll just reinforce that last point about how these trials just missed. We've been
involved in the number of these really lengthy secondary prevention trials and also
some of the trials that patients with disease. And, the clinical benefit, of
course, you don't know what patients are on, both had people are in open label
treatment for up to five or six years with relatively remarkable stability of
symptoms and insignificant change after drug was withdrawn because the trial
failed. So, I think we need to do, I mean the work you're doing today is soon going
to really have a huge impact in terms of our ability to interpret these trials. I'm
going to ask one more question--.