#86: Tobias Silberzahn - What is the State of Health & Wellbeing in Europe

In this episode, Tobias Silberzahn, McKinsey talks about biohacking 101 – habits that make a difference, digital health eco-system, and much more…

Tobias Silberzahn is a trained biochemist and immunologist and works as a Partner in McKinsey's Berlin office, where he is a member of the Healthcare and Innovation Practice. His work focuses on healthcare innovation, health tech business-building, and digital transformation.

Tobias leads the global Health Tech Network, a community of 1500+ health tech CEOs/Founders, where he hosts the quarterly Health Tech CEO Roundtable. As part of his work, Tobias also hosts the MedTech R&D Industry Roundtable and publishes the "eHealth Monitor Germany," an annual book about the digitization of the German health system.

Within McKinsey, Tobias leads the Health & Wellbeing program for employees, focused on sleep, nutrition, stress management, and fitness, that was recently awarded the Brandon Hall HCM Excellence Award in Gold.

McKinsey is a global management consulting firm committed to helping organizations accelerate sustainable and inclusive growth. McKinsey works with clients across the private, public, and social sectors to solve complex problems and create positive change for all their stakeholders. It combines bold strategies and transformative technologies to help organizations innovate more sustainably, achieve lasting gains in performance, and build workforces that will thrive for this generation and the next

Youtube (Links to articles discussed in the podcast are in the description to the Youtube Video)

We were talking about:
⭐ The European Health Care System
⭐ Biohacking 101
⭐ The Healthtech Startup Eco System
⭐Small Habits – Big Changes
⭐ The 4 Pillars of Health and Wellbeing

🕛 Timestamps:
(00:00) Introduction
(05:30) The Situation of Mental Health, Health & Well-Being in Europe
(10:10) The Role of Sleep For Health & Wellbeing
(14:00) Mobility & Movement
(18:43) Why Nutrition Matters
(23:24) Healthcare and Cancer
(29:46) Digital Tools for Managing Micro Habits
(36:30) How Important are Digital Health Solutions for the Future Healthcare System – a Journey through State of the Art System
(43:40) How Can Digital Tools Increase the Level of Health Literacy in Society?
(49:30) How to Bring Health Education to all People –Solutions by McKinsey
(58:54) How to Measure the Benefits of Happiness at Companies
(01:02:38) The Cost of health deficits for the European Society
(01:08:30) The Role Different Stakeholders Play to Improve the Healthcare System
(01:16:30) Tobias Silberzahn’s Global Healthtech Network – A Community of 1,500+ Healthtech CEOs and Founders
(01:20:30) The Future of Healthcare is Full Of Opportunities
(01:21:35) The Role of Precision Medicine

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Transcript

00:00:00:03 - 00:00:17:07

Christian Soschner

What is the situation of health and well-being in Europe? In this episode, Tobias Gilbertson from McKinsey and I are talking about biohacking, one of one habits that make a difference digital health, ecosystems and much, much more.

00:00:17:10 - 00:00:48:04

Tobias Silberzahn

The factor behind the success of our Asian digital health ecosystem. The three key success factors are convenience, convenience and convenience to make the citizens as easy as possible to look after their health and well-being. Two thirds of the improvement opportunity really lies in the areas of health promotion prevention, health literacy and health environment. That is would contribute $2.5 trillion to Europeans GDP by 2014.

00:00:48:04 - 00:01:10:12

Tobias Silberzahn

Part of the ecosystem could be symptom check or medication management app that helps me manage my disease. And when I feel bad or when when something feels wrong, I can sort of engage with a very low barrier off for me one part, right, that people know more what drives the health and well-being. I didn't know that it was the past.

00:01:11:03 - 00:01:15:19

Tobias Silberzahn

It's about small and micro habits that you can integrate into your daily life.

00:01:15:20 - 00:01:49:06

Christian Soschner

Tobias Albertsen is a trained biochemist and immunologist and works as a partner in McKinsey's Berlin office, where he is a member of the Health Care and Innovation Practice. The focus areas of his work are health care, innovation, health, tech, business building and digital transformation. Tobias leads the Global Healthtech Network, a community of over 1500 healthtech CEOs and founders where he hosts the quarterly health tech CEO Rounds table.

00:01:49:07 - 00:02:22:09

Christian Soschner

As part of his work, Tobias also hosts the Met Tech R&D Industry Roundtable and publishes the eHealth Monitor. Germany Annual Talk about the digitization of the German health system within McKinsey. Tobias leads the health and wellbeing program for employees focused on sleep, nutrition, stress management and fitness. The program was recently awarded the Brampton Hall HCM Excellence Award in Gold.

00:02:22:09 - 00:02:59:19

Christian Soschner

McKinsey is a global management consulting firm committed to helping organizations accelerate sustainable and inclusive growth. McKinsey works with clients across the private, public and social sector to solve complex problems and create positive change for all the stakeholders. It combines bold strategies and transformative technologies to help organizations innovate more sustainably, achieve lasting gains in performance, and build workforces that will thrive for this generation and the next.

00:03:00:10 - 00:03:22:20

Christian Soschner

In this episode, we are talking about the European healthcare system. Biohacking 101 The health tech startup ecosystem. Small habits leads to big changes and the four pillars of health and well-being. I hope you enjoy this show the same way as I did. So it's good to see you. How is life these days in Germany?

00:03:24:01 - 00:03:52:04

Tobias Silberzahn

Good morning, sister. Wonderful to see you again. And yeah, you know, life in Germany, it's all sorts of topics going on. As you can imagine, the big and the bigger picture in in Europe with with the wild, the inflation. But also, you know, health and digitization of health is a topic. Red Corvette is still a topic. And how do we want to live with this now as a society?

00:03:52:05 - 00:03:54:10

Tobias Silberzahn

So, yeah, a lot is going on.

00:03:55:08 - 00:04:20:19

Christian Soschner

That's true. That's true. We are living in interesting times currently. I had a conversation recently with a friend from the United States. His name is Jonathan Swan. He's the CEO of Mesh Pharmaceuticals and he's doing a lot of research in mental health and research and development. Here's a thing I hope I get his age right. If he gets five decades of experience in the developing world for decades, solutions for that.

00:04:21:03 - 00:04:51:13

Christian Soschner

And he brought up at points that I found very interesting that he said he saw in the last few years. So the last three years, five years, six or seven years, a surge in mental health issues. One of the investors he's told one of his previous companies, too, is Christine. My and Christine, I may have posted recently an article on LinkedIn or let's say a letter on LinkedIn where he made the bold statements that hundred percent of the human population has mental health issues.

00:04:51:24 - 00:05:11:17

Christian Soschner

And in this conversation with tech, a lot about the situation in the United States, but not in Europe. And I'm very happy that you find some time today to come on this podcast and talk with me and the audience about the situation of health and well-being in Europe.

00:05:12:18 - 00:05:14:11

Tobias Silberzahn

Very happy to. Thanks for having me.

00:05:15:00 - 00:05:22:03

Christian Soschner

Let let me ask you the first question about is the situation of health and well-being in Europe in your eyes currently?

00:05:23:10 - 00:06:00:06

Tobias Silberzahn

Maybe. Maybe I'll start with the mental health topic and that statement that that you quoted. I it and responded from the angle of of being a sort of a bit of a biohacker myself and also leading our health and wellbeing program within our German part of the company. And and when we look at at mental health from a workplace perspective, we actually we actually see that that there are sort of three different types of of groups.

00:06:01:01 - 00:06:47:20

Tobias Silberzahn

One group is the group that is as often that is often very much in focus. That is the people that have really severe and acute needs that may require intense services and treatment. Right? That is sort of 1 to 2 people that usually in one in 100 people in an organization. And and then there is a second group that that is about a quarter when we look into into health care data they require something that we could describe mental wellness support and moderate needs towards, you know, counseling, psychotherapy, etc..

00:06:48:12 - 00:07:20:10

Tobias Silberzahn

And then there is a third group, and that's about them that the remaining 75 is employees, but they benefit from what I would now describe as support that fosters their mental well-being. Right. So they are medically, you know, if they go to a doctor. Right. They would not be diagnosed as having a condition. Right. But they still would benefit from from better mental mental health and wellbeing.

00:07:20:18 - 00:07:48:05

Tobias Silberzahn

And and then when we when we now, you know, being originally biochemists, looking at sort of the foundation read, it makes sense because because at the end of the day in our daily lives, right, there are there are there are four or five things that are really impacting health and wellbeing and and the person and that is sleep, that is nutrition, that is mobility and fitness.

00:07:48:21 - 00:08:25:07

Tobias Silberzahn

That is stress management. And and you know, for many people also then that the topic of purpose, underlying motivation, social connections of course plays a big role. Right. And and if we just quickly look at the impact that sleep has on mental health and then the impact that movement has on mental health. Right. So if we do a little thought experiment and would say, I sleep too little and I walk to little, and both of those things just biochemically have a negative impact on my mental health and wellbeing.

00:08:25:07 - 00:08:35:18

Tobias Silberzahn

So therefore, right, mental health and mental wellbeing. Right. And those factors that we just talked about is actually something for everyone.

00:08:36:05 - 00:09:00:13

Christian Soschner

It's a great point. I would like to take a bit deeper and use your expertise as a biochemist. It was in the nineties when I started getting interested in, but as it needs to stay healthy. So back in the nineties, every time we had talked with my doctor or with other doctors and physicians in Europe, they mostly focused on treating diseases.

00:09:00:13 - 00:09:29:04

Christian Soschner

And most of the questions I had were around how can I stay healthy? How come, what do I have to do to not get sick at all? And it didn't get answers. Where I got answers was in martial arts. But unfortunately, the ways of the martial arts are great to work and there are many great masters. For example, in the Qadhi Temple in 2014, there wasn't a Shirley Temple also in Japan, but it's not very scientifically or it has not been very scientifically proven.

00:09:30:06 - 00:09:54:12

Christian Soschner

The points they brought up back in the nineties were similar to the points that you mentioned a couple of minutes ago, that in order to stay healthy, people need to sleep, need to exercise, needs to take care of their nutrition and also social connection and purpose. Can we talk a little bit further about these four topics, why they are so important from the McKinsey and the biochemist point of view that start with sleep?

00:09:54:18 - 00:09:58:14

Christian Soschner

Why does sleep play such a crucial role in staying healthy?

00:09:59:04 - 00:10:29:04

Tobias Silberzahn

Yeah, and thank you for the question. It's it's a wonderful topic and it's it's fascinating research behind it from a biochemical and also sort of how then the biochemistry of our body then affects our our feeling and mental health and wellbeing. Right. So if we start with sleep, then there are sort of two topics right there is the topic of duration and then there is the topic of do I get the deep sleep, etc..

00:10:29:18 - 00:11:02:22

Tobias Silberzahn

Why does deep sleep matter during deep sleep, which is usually the sleep that happens in the first half of the night, right? We will sleep in 90 minutes cycles and then in the early 90 minute cycles. Then ideally deep sleep takes place, right is really where the body restores and where growth hormone is secreted. Right. And the key thing is if there is no deep sleep, then there is the secretion of growth hormone, which is then helping us regenerate is is diminished.

00:11:03:17 - 00:11:29:05

Tobias Silberzahn

Let's am reduced, which then means that sometimes sleep doctors, they deal with people who would then say, well, I sleep 9 hours, but it still feel terrible in the morning. I still feel tired in the morning rather than when they do the diagnosis, etc. And sometimes they find that yes, this person slept 9 hours, but there were only 5 minutes of deep sleep.

00:11:29:05 - 00:11:51:15

Tobias Silberzahn

And if there is 5 minutes of deep sleep right when you're not, the literature usually talks about ideally, you know, 90 minutes of deep sleep. Right. Then you can imagine, right. If there is only 5 minutes of deep sleep versus 90 minutes of deep sleep, that just then, of course, the reason why people then feel tired in the morning.

00:11:51:15 - 00:12:20:18

Tobias Silberzahn

Right. And if that continues over many, many days, weeks, months and sometimes even years. But that doesn't have very detrimental effects for the body. But since it started out with mental health, but this has then also linked to what's the mental health and wellbeing. Right. And I think one of the politicians once said that after they had negotiated in Europe, in Brussels through the whole night.

00:12:20:18 - 00:12:46:20

Tobias Silberzahn

Right. They said, well if I'm massively sleep deprived, I'm I'm not a very inspirational person in mind the next day. But it pretty much means if we if we sort of are severely sleep deprived, I have these sometimes even medical problems that we don't get enough deep sleep that that means that, you know, at the end of the day we are increasing our level of anxiety via that sleep.

00:12:46:20 - 00:13:15:00

Christian Soschner

And it's very interesting. In fact, it was just this week that I read an article about anxiety, and this article stated that 90% of our fears don't come true. So when I listen to you, it now comes together in my mind. Like when people don't get enough sleep, they create them for themselves, The state of anxiety. And if they continue on this path, it might also lead to lots of depression.

00:13:15:10 - 00:13:40:13

Christian Soschner

And then their fault processes are going in a direction where it definitely don't make sense decisions for themselves. And I just imagine, I mean, when they are community leaders or leaders in a company or politicians, as you mentioned, it might also negatively impact the entire society. Is this a statement that you would say is correct, or did I miss something in the explanations?

00:13:41:06 - 00:14:15:24

Tobias Silberzahn

Well, you know, I would I would say, of course, then there are those those interconnections. Right. And the fascinating thing is that from a biochemical perspective, there are then also connections from from from mobility and movement. And so, you know, and I had that in my my life working at the desk and at the college. All right. If you do, you know, and again, there is then a body of scientific evidence, some of our cultures that that we work with in our health and wellbeing program.

00:14:15:24 - 00:14:58:02

Tobias Silberzahn

Right. He would say if people walk less, then I think the number he was a 5000 steps. Right. And he can quote a few scientific publications behind that. If they walk less than 5000 steps, then again that is a similar loop. Then the sleep blue blood you just described. We then, since we are made to move as as as an animal, as a as a being, right that then lack of movement and lack of mobility and read that if you do only add another 2000 or 3000 steps a day because to sit in front of the computer or other TV or gut knows what that is, then also something that increases your anxiety level if

00:14:58:02 - 00:15:21:18

Tobias Silberzahn

that goes on for a while, right? So if we then have a classical model, an office work out, right, you might say, oh, you know, sleep is sort of a lower priority. And I sit on the sofa or at the desk the whole day and walking, and then they increase anxiety by two means. Then anxiety is going up, right?

00:15:21:20 - 00:15:56:22

Tobias Silberzahn

And then if anxiety is going up, that then often has then connections both to the immune system and to how people then eat right. And then sometimes they gain weight and that they move even less so. So we can quickly get into, you know, what scientists then describe as vicious cycle. That's right. Well, then we are moving on several fronts sleep, nutrition, mobility, let's say, in the wrong direction from a health and wellbeing perspective, which then raises anxiety, which then sort of fuels the cycle even more.

00:15:56:22 - 00:16:08:14

Christian Soschner

Our 5000 steps are roughly a5k, so it's five K every day basically that your source recommends to to stay healthy, even assume that one step is one meter.

00:16:09:17 - 00:16:42:15

Tobias Silberzahn

Yeah, well, I like to think about it in a different way. Also, you know, as part of the health and wellbeing program, Right. You know, since many of us spent in the business world, let's spend a lot of time each day in video conferences. But when and when, for example, I personally then tried to do one video conference in the morning, half an hour, and I did one video conference in the afternoon and another half hour on the on the phone while walking.

00:16:42:21 - 00:17:04:07

Tobias Silberzahn

Right. And and I read because it when you say five K that's I was like, oh my God. Five K That was false. And now I need to put on my trainers and walking for 30 minutes during a video conference where maybe you don't need to take notes, etc. You have about 4000, 4500 steps.

00:17:04:17 - 00:17:05:20

Christian Soschner

That's a great idea. That's a.

00:17:05:20 - 00:17:29:13

Tobias Silberzahn

Code. It's it's pretty it's pretty simple. And I have people when when we do catch up calls, we already both know that we used to take that catch up call to do that. So then we both go for a walk while we chat with each other and even in in team calls and group calls. And what we what we've done has been to say, okay, who takes notes this time and all the other people can then walk.

00:17:29:22 - 00:17:35:11

Tobias Silberzahn

And then one person says, and then we rotated anyway. But that's now becoming very practical now.

00:17:35:18 - 00:18:04:06

Christian Soschner

But it's actually great that yeah, so there are some literature out there that you think philosophers said that only faults that are created during walking are of importance and you can forget all other of once sitting. So having a walk basically is a great solution. You mentioned a third pillar, so we had exercise. It's important that people stay healthy and healthy means in a way that's the come to the office in a positive mood.

00:18:04:06 - 00:18:29:02

Christian Soschner

Optimist, stoic mode that they engage with people and they have the mental capacity to drive things forward in the company. And it doesn't necessarily mean that they already know in a deep state of depression or are already severely ill. You mentioned the third pillar, nutrition wise. Nutrition so important. I mean, I live in Vienna and I think our national meal is schnitzel with French fries.

00:18:29:07 - 00:18:32:10

Christian Soschner

So what's your opinion on nutrition.

00:18:33:14 - 00:19:02:12

Tobias Silberzahn

And what nutrition is? A is a wonderful and fascinating topic, right? Because it's both related to health and wellbeing. Right. And with wellbeing, I mean, that, you know, ideally it tastes well and it's a great experience and we do social bonding over good, right? So nutrition is completely multi effects, right. And the other fascinating part is if we quickly go back to the biochemical side is that nutrition is also very individual, right?

00:19:02:12 - 00:19:26:03

Tobias Silberzahn

There are fascinating studies where nutrition researchers gave 100 people the same to eat and then they measured the blood glucose response and and they found very different responses from different people to exactly the same food fat. So that's that for me being a bit of a biohacker, as mentioned. But for me it was fascinating to try out different things.

00:19:26:09 - 00:19:47:05

Tobias Silberzahn

And the coach that I have been working with, she encouraged me to say to me, Why don't you why don't you 2 hours after you've eaten something, why don't you sort of quickly think, do I have now more energy than before? Do I have the same energy? And it didn't change on Do I have less energy? And maybe I feel tied up, right?

00:19:47:14 - 00:20:17:04

Tobias Silberzahn

And then I came to that conclusion, which, you know, from a scientific perspective, it's not very surprising. And so I feel a little bit embarrassed that I didn't realize it earlier and that, you know, when I love animals as well, anxious. So when I have my Venus suit with with French fries or with pasta or or a couple of friends, I love potato salad, etc., then I feel really tired in the afternoon.

00:20:17:18 - 00:20:38:20

Tobias Silberzahn

So then I did the experiment of, okay, I still eat my Wienerschnitzel, but I eat it this time with it with salad or with some vegetables, and I leave out the carbohydrates. Right. And and again, you know, every one is a little bit different in terms of nutrition. For me, that had the effect that my afternoon tiredness was gone.

00:20:39:12 - 00:21:11:18

Tobias Silberzahn

And really so I still I still eat what I like to eat, but not my personal one of my personal micro habits is that sort of from Monday to Friday. Then I try to be a good with my nutrition and I would I would focus on salads and vegetables as side dishes. I still eat my salmon on my chicken, you know, whatever as the main writer, but I would try to reduce get rid of for some of the people who are more into it.

00:21:11:18 - 00:21:40:14

Tobias Silberzahn

Right. That is then doing a bit more of what what some people say a ketogenic diet, right, where you try to reduce sugar and carbohydrates to you know, and for me that then has just the personal benefit often of being less tied up during the week. And then Saturday and Sunday are my Cheetos with and I eat lots of chocolate and ice cream and all sorts of other things with my kids, with my wife.

00:21:41:12 - 00:22:20:10

Christian Soschner

Yeah, I was in the Shirley Temple in 2014 and the abbots there said it's really easy to live a clean life when you are in a monastery, so working out meditation and vegetarian lifestyle. But she said it's really tough when you're out there in the world. I mean, just look at Vienna. You mentioned the vicious cycle before, so getting up in the morning, going to a Starbucks, for example, and having a coffee platter and a delicious cake, and then during lunchtime schnitzel with French fries.

00:22:20:10 - 00:22:51:18

Christian Soschner

So we have some rice. And so to overcome the afternoon tiredness, a can of coffee again. So I could just sort of push that is nutrition really has to have so heavy impact on on health, not only mental health but health generally. I mean, I read an article recently on the Internet where I said didn't believe it, and Talib, a writer who promotes also a keto diet because lifestyle slash reading lifestyle.

00:22:52:02 - 00:23:13:20

Christian Soschner

And he mentioned that patients with stage four cancer, when they stick to a routine, that they get enough sleep, enough exercise and patrician showed signs of remission with that. Now does it really have such and such a heavy impact on how they feel? And over decades how illnesses evolve? So nutrition, sleep and exercise?

00:23:15:06 - 00:23:42:23

Tobias Silberzahn

Well, I think there's lots to unpack now, except maybe if we start with the cancer patients that I've you know, I feel very, very close to this kind of topic. But there is there's a body of scientific evidence, for example, that shows that that a cancer patients who have anxiety, depression. Right. And of course, it's a very natural thing.

00:23:42:23 - 00:24:16:04

Tobias Silberzahn

Right. That given the fear and of dying, etc.. Right. That that one gets into that anxiety depressed state during cancer, but that there is a body of scientific evidence saying that cancer patients who are able to keep a more, let's say, positive state of mind versus the people that go into sort of anxiety and depression during cancer, they have the people with a more positive state of mind, have better patient outcomes at the end.

00:24:16:04 - 00:24:54:13

Tobias Silberzahn

Right. So in terms of the cancer. Right. So does that mean now that that so I think that is a nice example and that is also a very proven example of how our mental wellbeing but then has also implications on other diseases etc.. Right. You know the other Bob is an and and of course with cancer too to finish that topic, there is then a genomic component there is a behavioral component, there is then you know what type of medicines etc. do you get.

00:24:54:17 - 00:25:19:08

Tobias Silberzahn

There is the mental health component, right. So, so this is something where, you know, let me put it like that. I'm always a bit suspicious that in such a multifactorial world, if someone says, oh, you're you're just to do this one thing and then you'll go cancer. And in the instances then from a biochemical and medical perspective, right, there are several factors that that come together.

00:25:19:09 - 00:26:06:16

Tobias Silberzahn

Right. And and, and mental health and sleep and nutrition and and and whether one moves or not. Right. These behavioral things, they they have been they have an impact not only on your wellbeing but also on your health. And if we maybe took for a second example in addition to the cancer example switched to chronic diseases. Right? Many of the chronic diseases come from our metabolic system, you know, beat diabetes, hypertension, etc. and if I don't sleep well, if I don't walk, if I eat too much food and gain lots of weight, and if I'm not in a positive mental state, then it's sort of something where we we see the diabetes type two numbers

00:26:06:16 - 00:26:33:10

Tobias Silberzahn

rising in this world, but then people are sort of getting into chronic diseases, into that vicious cycle, which then, you know, they overweight and then they eat the overload of carbohydrates and sugar, right Then diabetes type two likelihood increases and on the other type. Right. Then the impact off of having good micro habits, that is is then also shown.

00:26:33:10 - 00:27:01:09

Tobias Silberzahn

Right. So so I think that's that's an important point. Right. And the final thing I I'll say is that, you know, in that respect why I also find digital health a promising thing. Right. Is it's no tools have it right We've seen with social media and and apps and mobile phones right that digital tools can help change human behavior quite a bit.

00:27:01:09 - 00:27:27:21

Tobias Silberzahn

Right. And I would say not always to the to the better. Quite a lot. Also to the words. Right. When you spend lots of time in front of screens and you're looking at other people that are much more beautiful than you yourself, right. And then you get into a negative body image, negative mental state that's at red. But what I'm excited about is using digital tools to help people towards positive, sustainable behavior change.

00:27:27:21 - 00:28:02:06

Tobias Silberzahn

Right? And that is since you mentioned prevention earlier, Christian Right. In a world where our health systems are often designed to deal with acute sickness. And so I'm very well treated if I'm run over by a car. Right. And and then if I break my arm right there, then I'm sort of back to normal. But at that point around, as you said, with the martial arts and medicine, at the point of getting towards positive behavior changes, then a different topic and how often our health system are less good, right?

00:28:02:06 - 00:28:26:03

Tobias Silberzahn

Because you spend maybe 10 minutes with the doctor. What if you are a patient the 10 minutes per year? Right. And are of course then that the micro habits are harder to do that because that changes heart rate and therefore it is. That's why I'm positively excited about digital tools not seeing as sort of towards better micro habits, more on a daily basis.

00:28:26:03 - 00:28:29:10

Tobias Silberzahn

Instead of speaking with the doctor once a year for 10 minutes.

00:28:29:10 - 00:28:49:11

Christian Soschner

Yeah, it's good that you mentioned that. That reminded me of a conversation I had 20 years ago when it came from a seminar and also proudly presented that you can do a lot that people can do a lot to stay healthy themselves with micro habits and eat their own nutrition. But 20 years ago the response was, let's say mediocre to not very positive.

00:28:49:19 - 00:29:18:00

Christian Soschner

And it's good to hear from you. Now, that's the understanding in our society evolved tremendously in the last 20 years towards these micro habits. I think our health care system is great when it comes to treating illnesses and sicknesses, and it's really evolved after 50. I think it's it's one point in time people ever had a chance to get sick, but I didn't really know before I started with martial arts that people can do so many things.

00:29:18:00 - 00:29:32:07

Christian Soschner

You meant so many things themselves in a daily life to stay healthy longer. You mentioned digital solutions that can help people. Can we take a little bit deeper into that topic? Which digital solutions do you have in mind to help to create micro habits?

00:29:33:07 - 00:30:06:03

Tobias Silberzahn

Yeah, I'm a wonderful question. Maybe just to what you said earlier, I would just make a distinction between acute illnesses and chronic illnesses. Right now, our health systems are good at dealing with acute illnesses, but having an infection or having a broken bone, they are generally less good in dealing with chronic diseases like diabetes, cardiovascular diseases, etc.. And then the question becomes how can we how can we actually better deal with chronic diseases?

00:30:06:09 - 00:30:49:07

Tobias Silberzahn

And and that's where often cognitive behavioral therapy comes in, which then since it's it's cognitive behavioral therapy and has to do with your practices. Right. It's ideally done more often than less often. Right. And then we we we move into a now a a situation where then digital tools could two or three things for if we assume that I'm a chronic disease patient that digital tools can do do three things say they make it more convenient for me to manage my chronic disease you know, online appointment booking, tailor consultations, right?

00:30:49:07 - 00:31:21:22

Tobias Silberzahn

So that that I just have an easier access and more convenient access to it to manage my disease. Then there is the second part around around sustainable behavior change, right? Most chronic diseases benefit from sustainable behavior, change of the patient in terms of better nutrition, better sleep, better stress management and better mobility, let's say. So then the question is how do we get it down?

00:31:21:24 - 00:31:45:21

Tobias Silberzahn

And so my my doctor, my doctor, he he looked at my my values and I think it was two years ago. Right. And that one one value was higher in my in my blood diagnostic. And then he just he just smiled at me and said, next year you'll need to eat a few cookies less. Okay. Did that, you know, wasn't funny?

00:31:45:22 - 00:32:05:09

Tobias Silberzahn

Yes. Did it help me with sustainable behavior change? No. But because, you know, I usually go to the doctor a little bit before Christmas, and so then he tells me that I should eat less cookies. Well, then Christmas comes, and guess what? That's when I eat the most cookies in the whole year. And then sort of New Year starts.

00:32:05:09 - 00:32:24:09

Tobias Silberzahn

And then that is already four weeks back. Right. And in my day to day life, it just doesn't help me that much. If someone has told me sort of what I should do instead of how to do it and how to integrate it into my life. Right. And that is sort of one wonderful point that a health coach told me.

00:32:24:09 - 00:32:46:22

Tobias Silberzahn

If you have all of those things that you know, I don't you and you have all of those things that you're that you could do, and then life gets in the way right. I couldn't agree more. And then sort of the question is, how can we actually use digital health and talk to a sustainable behavior and try and trade?

00:32:46:22 - 00:33:18:20

Tobias Silberzahn

And that is that not saying personalization, gamification, having stuff on the phone being prevented and then also having tools and cognitive behavioral therapy is shown to do that and can be delivered by digital to try to get into a more positive frame of mind, etc.. But and the third part, why I am quite positive and excited that digital tools have the potential to help chronic disease patients is they can also make it more fun to improve health and well-being.

00:33:19:00 - 00:33:44:05

Tobias Silberzahn

Because if I'm a chronic disease patient, that's hard enough, right? But do I constantly want to remind that I'm right? So in that sense, there is that fun component that we see with social media and various apps, right, where people actually willingly spend time watching videos and and posting stuff and reading what other people have posted. So that sense and make it read.

00:33:44:13 - 00:34:00:00

Tobias Silberzahn

So health is sort of one of the things I'm I would love to sort of future over the next decades right make it health and well-being less of a sort of dry and hot and or I should add a topic that's more of a fun topic.

00:34:00:18 - 00:34:23:23

Christian Soschner

Let's stay a little bit, which is digital health and what you would like to do in the future. And maybe I can add one story from my life. But when I think about solutions, the health care system, the first thing that pops up in my mind is track development and complicated development processes that take years tech. It's just emergent biotech.

00:34:23:23 - 00:34:50:19

Christian Soschner

For example, when they started with their marinade technology, I think the company started somewhere in 2008. But the scientific roots go back to the sixties. When we talk about lifestyle change in chronic diseases. What helped me in the last year were very simple apps. In 2010, I wanted to run a marathon and I was looking for a solution to measurement distance.

00:34:50:19 - 00:35:18:22

Christian Soschner

And what I found was running cheaper in the United States. And I think a year later Runtastic started in Austria and it was really helpful to measure distance. I mean, the technology was not as advanced as it is now today, but it worked basically. And one day I forgot to check that my progress is shared on Facebook and then a couple of weeks later I found out that every run that I did went directly to Facebook.

00:35:19:11 - 00:35:40:16

Christian Soschner

And the response was quite interesting. Instead of being offended or getting a lot of hate mail to something, people were really motivating. They admired me that they get up every day today to my runs, the distance are covered and they send positive messages. And this helped me to train for my first marathon in my life and move forward with that ambition.

00:35:40:16 - 00:36:05:22

Christian Soschner

This is the positive side of digital digital solutions. Now I have this talk about Zimmerman, so it is easy small solutions that I would not really consider therapeutics or therapeutic solutions. And then from my professional life, I notice scientific sound solutions like marinade technology that really help people but cost a lot of money. The digital have solutions that you have in mind.

00:36:05:23 - 00:36:21:15

Christian Soschner

Are there more on the side of the hardcore pharma industry with a lot of these long development cycles? Or would you also consider this that these small lifestyle apps that don't really look like much going on and you also had four, in your opinion, I wonder.

00:36:22:00 - 00:37:01:08

Tobias Silberzahn

So and one what we've what we've seen over the last few years is that those individual apps and and software pieces that they have been marching into into brought up digital health sort of multi service offerings, you know that we could call it digital health ecosystems Right? Well, at the end of the day, we are now then moving towards a situation where we have several service offerings that help me along my customer journey of making, journey of citizen journey to the to better health and well-being and make it as convenient as possible.

00:37:01:18 - 00:37:34:17

Tobias Silberzahn

And so for, for example, that could start if we go and take an example of me being, let's say, a chronic disease patient right then. So the first part of the ecosystem could be any sort of symptom check or medication management app that helps me manage my disease. And when I feel bad or when when something feels wrong, but I can sort of engage with a very low barrier of the threat and then that gives gives me the first indication of what might be going on.

00:37:35:04 - 00:38:23:00

Tobias Silberzahn

Then I could move on to an online appointment, booking a piece in the same digital health ecosystem to then schedule a virtual consultation with maybe Dr. Christian on on the video call. And I'm still in my home and it's still 10 minutes after I have the problem. And then I'm speaking with the doctor, and then maybe we find out that, that there is something that's even more serious, etc. and then we can move towards disease management programs that have been developed for chronic disease patients, where I would then maybe as a as a chronic disease patient, go through a structured guided program towards better habits and moving and dealing with my disease pattern.

00:38:23:00 - 00:39:00:09

Tobias Silberzahn

And often this is then accompanied with medication as well, so that ultimately medication and digital tools come together in an integrated treatment path at and other paths are patient remote monitoring, which is a whole body of scientific evidence around it, where then Doctor Christian automatically gets my values of blood glucose, for example, or blood pressure, etc. once a day or once a week or three times a day, etc. and like that, Right.

00:39:00:10 - 00:39:27:18

Tobias Silberzahn

We have a much closer bond than me showing up at your doorstep of the doctor's office once a once a month or once a quarter. Right. Because then you'll see my cups and how things are developing. And if you see that my let's say my weight curve is sort of steadily increasing week by week, if you see that my blood pressure is steadily increasing, if you'll see that my blood glucose levels are going in the wrong direction.

00:39:27:18 - 00:39:57:16

Tobias Silberzahn

Right. And you can coach me and that and and we can just intervene early on. Right. And with chronic disease patients, get people back onto the right track earlier rather than later. But if I can share one example, even with an acute disease like COVID 19, but there's been a fascinating project with the university clinic I did back during COVID.

00:39:58:17 - 00:40:33:22

Tobias Silberzahn

They asked a patients who had tested positive, How would you like to be part of a patient remote monitoring program, which means that you will get a blood oximeter to measure the oxygen saturation at the fingertip and and and submit your body temperature and and how difficult you'll find the breathing several times a day. And then the idea was that they pretty much offered patients like that, that a doctor can pretty much watch over their shoulder and sort of follow them as they now isolate at home.

00:40:34:01 - 00:40:56:04

Tobias Silberzahn

And, you know, most of them at the time went at it for the first time. Right. Then the question then becomes, will it be mild? Will they have complications? So the idea was then with that, a remote monitoring program that the patient submits measurements three times a day and then the doctor would within two or 3 hours be able to spot that.

00:40:56:04 - 00:41:41:05

Tobias Silberzahn

Now, complications have started, but first of all, the question is will there be complications and then usually complications with COVID, Right? When we when we look at the crops usually stop on day seven on their aid, on day nine or ten, 11 or 12. And and they recently published the results. So spotting complications within two or 3 hours in all patients in that program and then intervening early with the often, you know, medication or sometimes hospitalization reduced the mortality of that cohort of patients by a factor of three fold to fourfold compared to the other municipality around TIDAL.

00:41:41:17 - 00:41:42:12

Christian Soschner

That's amazing.

00:41:43:13 - 00:42:05:15

Tobias Silberzahn

And that is for me, one of the most powerful examples how pretty simple digital tools can actually have an impact, because with acute diseases like COVID, it it allows you to intervene much earlier than having the patients sit at home and wondering they have complications and often coming two or three or four days too late to the hospital by themselves.

00:42:06:05 - 00:42:15:14

Tobias Silberzahn

And even with chronic diseases. Right. You sort of get them coached and sort of put back on a more positive track than on the track that you might be on.

00:42:16:01 - 00:42:34:11

Christian Soschner

Do you like this episode? Then please, please subscribe the channel to get a notification whenever I publish a new one. That's amazing. Parents, I mean acute diseases. They also think about the secret households where people are not the problem. The trend, how the patients who are at risk for heart attack, for example, of stroke when they are severe.

00:42:34:11 - 00:43:00:03

Christian Soschner

So nobody nobody watches them. But with modern technology, many understand your right. You can also monitor them. And if there is a serious episode, we have the potential theoretically to fix that in future. Then the second you mentioned is are chronic diseases where digital solutions act more like coaching in time coaching, helping people to stay on track with lifestyle changes.

00:43:00:03 - 00:43:24:03

Christian Soschner

What about the healthy population? I mean, sometimes I'm now close to 50, I'm 48 and I wish so my biggest regrets is I wish I have known what I know now 30 years ago. So especially when it comes to lifestyle, when it comes to nutrition and have a coach will say, don't eat a cake, don't go to the party and difficult to the party, don't stay until 4 a.m. in the morning.

00:43:25:18 - 00:43:35:04

Christian Soschner

Would it make sense to also consider such digital solutions to use to bring more healthcare information to people to educate them earlier in life?

00:43:36:20 - 00:44:06:09

Tobias Silberzahn

Yeah, I wholeheartedly agree. Right. You know, being here in Germany and Berlin when I've got the feeling that every German knows more about how their car works and how their body works, the right, which is a fascinating situation. But joking aside, you know, in the last W.H.O. country comparative study of a country like Germany in terms of health competency was right at the bottom.

00:44:06:16 - 00:44:33:16

Tobias Silberzahn

So so I think it was like 58% of the people in the survey had low health competency. Right. Which then means that they might take choices that seem maybe logical of maybe to do, but then they have a certain medium term to long term effect. And so I think they are again, my conviction is that we make we need to make it fun, right.

00:44:33:17 - 00:44:56:11

Tobias Silberzahn

Because if we print brochures that sit somewhere in libraries and, you know, and they tell you what are the 37 things that you shouldn't do, like six out of those 37 things are fun to do. But, you know, it's pretty foreseeable, Right? And we've had that over the last decade. It's right that that it it doesn't have sort of a big impact.

00:44:56:11 - 00:45:22:05

Tobias Silberzahn

Right. So I think there is a big part about health competence issues and digital health competencies that that actually can be fun and actually can help people feel better and beat better. But it doesn't have to be that you now suddenly live a little bit like a monarch and don't do anything that is sort of your normal daily routine, right?

00:45:22:05 - 00:45:42:07

Tobias Silberzahn

So the the you know, that would be for for me one part, right, that people know more. What drives the health and well-being. Right. I didn't know that it was the pasta in at lunch time for many years despite, you know, maybe I should have known as a biochemist that you know. And then I just leave out the pasta at lunch.

00:45:42:20 - 00:46:14:24

Tobias Silberzahn

So then I and then it's a very simple decision that is a personal decision. Does pasta at lunch bring me more joy or does being less tired in the afternoon makes me? And then I can take the informed decision that for me personally, but I'm happy to get rid of the pasta at lunch and I prefer to be alert and full of energy and not tired for 3 hours in the afternoon.

00:46:15:09 - 00:46:52:02

Tobias Silberzahn

But there might be people who love pasta. I would say I love pasta and I, I think for me the important point is that people know what the implications are, right? And often there are certain behavioral patterns where then there are detrimental consequences and the implications are not clear. I think the I'm just quickly is that that, you know, in our health and wellbeing program, first of all, we we we think about what is sort of the purpose and the inspiration and the motivation.

00:46:52:02 - 00:47:16:21

Tobias Silberzahn

But this is not about sensible self optimization. Just because we can. And why do I want to do that right? You you mentioned you are 48 and you still still look much younger, but you have a certain purpose and motivation behind it that you, you like to maybe increase your health and you like to maybe increase your your wellbeing, right?

00:47:16:21 - 00:47:38:23

Tobias Silberzahn

So I think there is one component around what is my underlying purpose or motivation and what do I really want? What is really important for me? And and I think then based on that, right then there is a bit what does set the health competence? You can then help and then ultimately you can get to a few micro habits that move you then in the right direction.

00:47:38:23 - 00:48:04:17

Tobias Silberzahn

And that's our experience. Having done the program for many years, it's about small and micro habits that you can integrate into your daily life instead of the radical changes. And then it's also about not beating yourself up that you need to now do this 100 of the time. All the time. Perfect, right? But it's more like am a sort of 80% mindset.

00:48:04:20 - 00:48:22:14

Tobias Silberzahn

If I do my micro habit, 80% of the time, that's totally fine. And I don't and especially I don't need to get stressed about it for the 20% where I don't do it. So Saturday and Sunday can be cheaper. Is where you do all of the things that you crave and might not be that right. But if you are really good from Monday to Friday, why not?

00:48:22:24 - 00:48:26:13

Tobias Silberzahn

And so in the end of the day, it's a personal decision. What is important to people?

00:48:27:11 - 00:48:55:07

Christian Soschner

Yeah, I completely agree to what you say. I think it's necessary also for social and mental health. Just imagine, I mean, when you go to a base shop with your friends and you start then lecturing them about the healthy lifestyle and like this is best for them. So having a cake is a good thing sometimes. And when I think back, one of the questions I had to one of my slides trainers was like, it's like this character could lose a sense of what can I do to stay healthy?

00:48:56:06 - 00:49:39:09

Christian Soschner

And his response was very surprising to me. So I expected a long lecture and a list of 100,000 things that I need to do. And the only thing he said was drink water, green tea, sleep more and eat your vegetables. That's it. So I said, okay, Is it really that simple? And I used the opportunity in 2008 between two chops to take a few weeks off and really try this lifestyle and wake up early in the morning, meditate, go for walks, eat only vegetables, water and green tea and read motivating books for a couple of weeks.

00:49:39:12 - 00:50:04:20

Christian Soschner

And the difference was really huge. And I wasn't aware until that point in time. I did this weeks of reducing my life to what's necessary and leaving out everything else that it wasn't until that moment that I realized what a difference to is. The question I have to you now is, I mean, taking a few weeks off. If you have people have children, have families, have jobs, have to responsibly.

00:50:04:20 - 00:50:21:04

Christian Soschner

It is it's almost next to impossible for the entire society. How would you tackle the problem of bringing health, education to people on a systemic everybody's what's what's what's the McKinsey is working on in theory. What's your recommendation.

00:50:22:05 - 00:50:50:06

Tobias Silberzahn

Now? Well I want what we do and what what we what we are building out is to do this on several levels and to to integrate that also into the daily lives off of colleagues and people. Right. But of course, first of all, this is sort of voluntary, right? This is for people who actually want to to improve something.

00:50:50:08 - 00:51:15:18

Tobias Silberzahn

I didn't. And interestingly, there are then different different groups of people like that that I've been dealing with. There are some people who are in the segment of saying, oh, you know, maybe I've I've gained weight and I have the feeling that I now should do something to improve my my health as a sort of health driven segment of people.

00:51:16:03 - 00:51:41:07

Tobias Silberzahn

And then there is a segment of people who who, you know, that so many of the biohackers. Right. They would then say, oh, you know, if I optimize sleep nutrition, fitness stress management, then I'm more productive and etc.. All right. That is, of course, a typical segment that we as we see it everywhere in in sort of the health and wellbeing community.

00:51:41:14 - 00:52:06:14

Tobias Silberzahn

And then there is this segment of people saying, well, actually I'm I'm medically healthy and I'm I feel I'm productive enough and I just want to feel better. I'm I'm personally in that cycle. And then there is a segment of people that was like, oh, you know, I've I've tried this and I've read that and I've tried this diet and nothing has worked and and I to fight this really hard.

00:52:06:15 - 00:52:38:08

Tobias Silberzahn

Right? And so there is already a threat this and this is a simplified version. So it needs to be getting it needs to take people where they are from based on that motivation or that need or that desire, aspiration that they have instead of doing one size fits all stuff. And the second experience that we've made with our programs is that that it needs to be integrated into the daily life of people.

00:52:38:08 - 00:52:59:01

Tobias Silberzahn

It needs to be impactful, it needs to be fun. And if you don't integrate it well in the daily lives of people, and if it's not fun and if and of course impact, it needs to be there. Otherwise people wouldn't do it right then. So there is then a very question sort of how do you design it to achieve those objectives, Right?

00:52:59:01 - 00:53:21:18

Tobias Silberzahn

Because if you give me a 200 page book and say everything is in there now, you just need to read it and you do it right, not a lot will usually happen right? And so so yeah, we designed the programs and we, we work with coaches that then to put this in bite sized man that supplements videos some misreadings, some as noxious, etc..

00:53:21:18 - 00:53:47:19

Tobias Silberzahn

So then we offer those programs several months programs for people that they then can work and then sustain hybrid programs with a coach plus digital tools that work very well. We also have some programs that are digital only. And then the third part is that we found is important is to do it also on the team level, right?

00:53:48:09 - 00:54:13:14

Tobias Silberzahn

So that it's not just like Christian going through his six month program. Right. But you might be working in a team with three or four other people and then this is then less about health and wellbeing. This is the framing as often then more around way of working, way of collaboration. And and then and then if we if we then just, you know, play through hypothetically, right.

00:54:14:04 - 00:54:51:15

Tobias Silberzahn

If we, if we are now in the team and we will be working together over the next 12 weeks on a project. Right. Sort of what would we like, Do we want to work like, like crazy and our 12 weeks of sleep deprived, right. Or do we might want to integrate our fitness routines into now the 12 week so that that sort of if I know that you like to go running on a Tuesday evening, but maybe I come on Tuesday evening so that you can do your run and maybe I like to do swimming on a Thursday morning and then maybe you come out on Thursday morning so that I can go swimming.

00:54:52:02 - 00:55:20:23

Tobias Silberzahn

So then we we elevate this from individual norms and agreements to actually team agreements. But then some of those agreements, some teams that have a lot of energy around, you know, having better nutrition together because they all like to eat and they they really like like that. Right. And some people are like, okay, I would like to optimize sleep and therefore we get to a few agreements how we help each other on that.

00:55:20:23 - 00:55:41:05

Tobias Silberzahn

Right. And then we get to also the situation that you described with you on social media profile like that. Then actually people help each other achieve that and spur each other on, right? So in that sense, that is another experience that we've made that it's sort of both. Ideally, it's the individual level and the team level.

00:55:42:09 - 00:56:12:11

Christian Soschner

I completely agree. I mean, it's it's extremely helpful for me when I post a picture from Iran for my documentation and then friends encourage me to do more of it and congratulate for the effort it's really motivating. So it's it's great to to hear that. Also your company integrates that into the daily life also managing expectations that it's very important that people can speak openly about their wishes and desires and that's the card.

00:56:12:11 - 00:56:21:12

Christian Soschner

It's also supports them that to some extent they are integrated in into work life. This is really great development now.

00:56:21:12 - 00:56:47:13

Tobias Silberzahn

Thank you. And you know, people people just generally like it. Right. And and and also, you know, if we if we think about it from you know, from also from a work perspective, if you sleep well and if you are able to integrate your fitness into it, into your your work life, you are just more a more creative and more inspirational and more happy person.

00:56:47:13 - 00:57:10:20

Tobias Silberzahn

Right? So if we take my own journey right, I started sort of with this whole biohacking stuff about, you know, eight years ago, right? I have I've I've lost more than than ten kilos, right? I, I now do more 12,000 steps a day than 4000 steps a day. And I now sleep on average more than that in 7 hours.

00:57:10:20 - 00:57:32:19

Tobias Silberzahn

Right. And I'm about three times as happy as I was ten years ago. And then a lot of that is then, you know, it's then fun when you are that journey and and then you get into a positive cycle, right? Because when you when you feel it and you it and and you feel more positive, then it's easier to continue on the path.

00:57:33:22 - 00:57:54:00

Christian Soschner

Let me ask you one question to what you just said. I mean, it was too fast to a free whereas this attitude that they were too focused on training because I realize that it makes me happier. And I also thoughts that when I am happier, I come to the office with a positive attitude for positive more to make more compliments.

00:57:54:06 - 00:58:14:06

Christian Soschner

And that's also has that an impact on people in the office are leaving the office. However, at 6 p.m. in the evening when our colleagues were working until late in the evening and then went to the next stop for a drink and stand by, told me about 11 p.m. and came back at 7 a.m. in the morning, was a little bit tense.

00:58:14:13 - 00:58:37:17

Christian Soschner

So we had a discussion and I also made a statement and say, Look, when you do more exercise, remote is better, I'm happier and more productive. And then came those finance guys who said, where can you measure it and how can you measure that? We can measure the time that you spend in the office, but not how happiness impacts the productivity in a company.

00:58:38:16 - 00:58:49:22

Christian Soschner

Are you aware of any measurement tools for CEOs? So when they wants to implement such measures that they also can then demonstrate to the owners or to the employees the difference it makes?

00:58:50:17 - 00:59:23:05

Tobias Silberzahn

Yeah, yeah. So there are there are various tools and also that can be used on company levels and then designing health and wellbeing programs on an company level that are then, you know, fact based and you know, depending on how much tech based metrics or so the company wants, right, then you can do that. You can do that on the one hand with, with with surveys and and also then with some of the metrics that you want to measure.

00:59:23:22 - 01:00:11:05

Tobias Silberzahn

But, you know, if we and again, many companies like to do that, but if we just go back to the basics and look at the scientific that scientific literature, they're just picking again, the sleep example and there is a whole body of evidence where they show they have cohort one sleeps, I think 7 hours or 8 hours cohort to sleep, 6 hours, cohort three sleeps 5 hours for several days and they get cognitive tests to do and this has been shown years and years ago that the cohort that sleeps 5 hours a night will, depending on what study you read, that productivity the next day is 60% or 70% of the productivity of the cohort

01:00:11:05 - 01:00:12:21

Tobias Silberzahn

that sleep seven or 8 hours.

01:00:13:01 - 01:00:14:02

Christian Soschner

That's your difference.

01:00:14:10 - 01:00:48:23

Tobias Silberzahn

So yes, of course you can now develop and design dashboards and and think about how you now measure that exactly. Is now also having that effect, too. Right. But but on the other hand, it's there are just a few fundamental ills, right? Because you are a human being that has a human biochemistry. And therefore, do I now need to know whether you are productivity was 60% or 66% after you slept only 5 hours in your case?

01:00:49:05 - 01:01:23:13

Tobias Silberzahn

And so in that sense, I am not saying anything against that. Right. I think I think that the important bit here is that and that's also an important framing how we frame our health and wellbeing program, right, that it helps people be at your best and and and yes it it if done well it of course has massive positive benefits on a company level as well in terms of you know, how creative people are, the problem solving capacity, the productivity, etc..

01:01:23:13 - 01:01:49:00

Tobias Silberzahn

But but this is actually this is actually something where we're framing it more from a, you know, helping people be at their best kind of perspective instead of, oh, we have now, I don't know, 17 levers to increase productivity by 7%. Kind of stating right, that that is sort of often not that the smartest way to design that.

01:01:49:01 - 01:02:11:16

Christian Soschner

Great right so completely accurate to what you say when people exercise regularly get enough sleep, it makes a huge difference. For example, focus just picking the right points to work on that drives the company for I mean, comes much easier with enough sleep and the right nutrition and enough exercise or meditation.

01:02:12:14 - 01:02:52:10

Tobias Silberzahn

Now and circle. Just one other thought. We we also looked into that extensively on country level, right? So so for example, if we take Europe as an example, right before the pandemic, the cost for the European society and economy, the cost of a poor health was about was about 2 to $2.7 trillion per year. So about 15% of GDP in Europe was the cost of poor health and lost economic opportunity.

01:02:52:18 - 01:03:30:15

Tobias Silberzahn

So that's equivalent to about $5,000 per person. If we break that down. Right. So then the question is sort of what are the drivers of these poor health costs, right? And then musculoskeletal disorders. So that would mean lower back pain, neck pain. They account for 24% of the total economic loss from poor health overall. And then the mental health disorders with which we started our conversation, such as depression, anxiety, they account for 18% and neurological disorders such as migraine, headache, etc. They account for 13%.

01:03:31:11 - 01:04:07:15

Tobias Silberzahn

And now we come back to the one what what we can do if if we would apply it in a more consistent way. The different health and medical tools that are at our disposal in our societies right. In a more consistent way, we could reduce that health burden without any innovation that is in the pipeline of companies. We could reduce the health burden by about 30% in Europe over the next two decades, just with a more timely and consistent application of the interventions that are available today.

01:04:07:15 - 01:04:35:20

Tobias Silberzahn

And what does that mean? Since you mentioned your age, that would mean from a society perspective that an average 65 year old person in Europe in the year 2040 would be as healthy as a 55 year old? To date? And then if you do the full health economic calculation, it would also mean 11 million more people would be alive in Europe by the year 2014.

01:04:35:20 - 01:05:11:15

Tobias Silberzahn

And then and this is now, if I if we talk briefly from a health system and country perspective, the the the the most positive message is that that, you know, two thirds of the improvement opportunity really lies in the areas of health promotion prevention, health literacy and health environments. And then the question is, so what would be the benefit and the impact and the business case if we did that as a European society or a sort of a European set of countries?

01:05:11:15 - 01:05:45:07

Tobias Silberzahn

Right. And and if we would go in that direction, that would mean that this would contribute $2.4 trillion to European GDP by 2040. So that would be a sort of a 10% boost above projections. All you can also say if, you know, GDP is multi annual, but it could be 1.5 percentage points of annual growth for Europe. So that's a big deal, right, Because that that pretty much is the size of the demographic that we have.

01:05:45:07 - 01:06:10:07

Tobias Silberzahn

Right. So this would be almost to a positive magnitude to counter the negative impact of the demographic problems that we have in Europe. And then the other part is then often when often we have the mindset in in European countries, all our health system, they are very expensive, right? That we in Germany we spent more than €300 billion a year on our health care system.

01:06:10:18 - 01:06:38:14

Tobias Silberzahn

And and in many European countries and I guess in many countries across the world, right then there is a notion of we need to to keep our health care spending under control. But that is sort of a mindset that has been there for decades and which means that we treat health care and health as well-being, as a cost bucket that needs to be controlled and managed down.

01:06:39:09 - 01:07:18:08

Tobias Silberzahn

And what I find fascinating and why I'm fascinated working in health and wellbeing is that actually what if what if we would treat health and wellbeing as a positive investment case on our country level or on our company level? I don't know. On the country level, we've done the research, our economics and understand the research depending on what country you are in and what your starting position is across the world, you get either $2 back for each dollar that you invest strategically in health and wellbeing on a country level or up to $4, right?

01:07:18:08 - 01:07:41:09

Tobias Silberzahn

So on average, I think it's 2.7 or so. If we look at across countries. So you get $2.7 for every $1 that a country would strategically invest in health and wellbeing on a sort of health promotion prevention type topic. And I think that is a a very promising and a very positive message and it will sort of move in that direction, in my opinion.

01:07:41:09 - 01:08:13:14

Christian Soschner

That are excellent points. Thank you. Thank you for making time at the podcast. I always liked the data and I completely agree to what you say. Seeing helps us in investment is is a great shift in mindset. I also think that, for example, when we look at viral diseases and think when the population is healthy and the risk of getting this severe disease and severe outcome is less than when people have less health on a on a population level.

01:08:14:13 - 01:08:40:10

Christian Soschner

At this is is a study that you cited, statistics that it's publicly available. If yes it would be great if you could add it the to the podcast to the description we should bring to the study. One question popped up video by speaking. You mentioned some players on the market already. So we have politics, politicians who direct tax money into the system and make sure that it's used properly for society.

01:08:40:10 - 01:09:11:05

Christian Soschner

Then we have the large corporations. We were talking about pharma. Then we have the new startup ecosystem that gained popularity in my eyes since 2000, 14, 15 in Europe. And then we have the NGO readouts and the families. What are the roles of these different players when we just make your mind game and say, Let's assume we go together on this journey and wants to change the European society in the direction you proposed a couple of minutes ago, what roles do you see for the different players in this system?

01:09:11:19 - 01:09:44:08

Tobias Silberzahn

Yeah, now a fascinating question and and and also complex question, right? Because it's we are living in the multi-factorial world, right? And health and wellbeing is is impacted by many, many different things. Right. So if we maybe for a moment zoom in to digital health. Right. That we don't have the full health system, right? So digital health is pretty much a set of 25 different categories of offerings, right?

01:09:44:11 - 01:10:19:14

Tobias Silberzahn

And about ten of them usually are citizen facing, right? Online appointment booking, teleconsultation diagnostics at home, online delivery of medications and and and so on. And then we have big more than ten not citizen facing right that sort of clinical decision support systems form for doctors and nurses and workflow automation, etc. And then on a country level, there are two foundational elements.

01:10:19:14 - 01:10:53:15

Tobias Silberzahn

There is the electronic patient record that is then being used or not used in that country as well as the E prescription. Right. And often when we look at countries health system, often these two foundational elements that e prescription and the electronic patient record, they are often sometimes even run by a public sector agency. So we could say, or at least there is a very clear set of regulations and standards around it.

01:10:53:15 - 01:11:27:15

Tobias Silberzahn

Right. Because of course, in a in a platform economy and digital economy. Right. If everyone has a different app. Right. It's slightly less powerful than if everyone has the same app or the app on the same standard. And of course, that is important when you do in prescriptions and electronic patient records, right. That that right. If you go to the doctor and I go to the doctor, that our electronic patient records are following the same logic in the country and that it's linked with our health insurance, etc..

01:11:27:24 - 01:11:58:15

Tobias Silberzahn

And so there is a role there is the role that then the public sector plays and in that regulation. But if we take the U.S. as an example, which is also a very multi dimensional example, because they have very high health care costs, but they are also doing an interesting and interesting initiative by moving towards value based healthcare.

01:11:59:04 - 01:12:28:23

Tobias Silberzahn

And they they try to manage it in a sort of, you know, almost say, a two track process where they put sort of that classical fee for service health system and then they are shifting towards value based contracts. And every year over the past few years already, and it's projected to grow by more than 10% over the coming five years every year they have a slightly higher number, slightly 10% more patients under value based care contracts.

01:12:28:23 - 01:13:00:03

Tobias Silberzahn

And these value based care contracts mean that it's sort of capitated models where then the person leading that program, right, they get a capitated payment and then they manage that program. And the idea and that and and the hope is that this is better suited to manage people with chronic conditions, right? Because then there is one actor who then designs the overarching program, and that is then usually a hybrid program, sometimes a partly digital, partly in person, etc..

01:13:00:11 - 01:13:25:24

Tobias Silberzahn

And that is, I think, you know, a nice way to also effect change, right, from a conceptual level. Because if we now say we have a health system, that is the way it is. Right. And has evolved over 100 years, right. It's very hard to shift that from one year to another, you know, fee for service health care to a maybe value based health care.

01:13:26:00 - 01:13:46:06

Tobias Silberzahn

I do not think it's pretty accepted globally that value based care is is something that has prominence. But the question is how to do that change. Right. So so that is sort of a bit like the framing, right. Do we if we take Europe as an example of European countries, why do we actually want to go to that change?

01:13:46:06 - 01:14:17:20

Tobias Silberzahn

And then do we find mechanisms to actually gradually shift in that direction? It's a little bit like the energy and sustainability, right? We try to phase out certain energies and we tried to increase certain energy use and you have sort of the general framework that sort of provides incentives and and budgets to to have a few things increase and a few other things that we maybe think will serve us less well for the future to decrease.

01:14:18:10 - 01:14:58:14

Tobias Silberzahn

And and then the other part, the broader digital health ecosystem, what are those offerings and how are those multi service offerings being integrated? And when we've studied digital health ecosystems across the world, right, and in Asia, that they are much higher degree, but that the the factor behind the success of Asian digital health ecosystem, right? We look at some ecosystems that are having more than 400 million citizens in it, and the three key success factors are convenience, convenience and convenience, and to make it the citizens as easy as possible to look after their health and well-being.

01:14:59:10 - 01:15:36:24

Christian Soschner

They the creation of the sort of travel to Asia into the world. It looks like they're living in the future. So it's the from the European standpoint, Korea, South Korea, I mean ultimately it's temperature measurement when you go into elevators so the elevator doesn't open and tells you you're sick, please go home. So it's also very convenient, in my opinion, here in Europe to have such a level of support or in 2017, I think it was also in South Korea, we traveled to a hospital that was fully automated it was really interesting to see that the patient came into the hospital just in time to enter.

01:15:36:24 - 01:16:00:05

Christian Soschner

Logistics was organized automatically. There was no waiting time for a patient. A cab picked him up, brought him to the hospital. The doctor was waiting. The team was prepared to went through the procedure and then could go home. But the upsides, the downside was, of course, I mean, he comes barcodes. So that's the contract logistics chain. There's a lot of possibility.

01:16:00:16 - 01:16:24:23

Christian Soschner

One thing that I find particularly difficult, especially for startups that want to help in that space, is to connect to the right people. You also mentioned that the system has its specialties. It's different in each country. I know that you run a lot of initiatives in that area and one of the super connectors on LinkedIn and in the European society.

01:16:25:06 - 01:16:33:08

Christian Soschner

Can you can we talk a little bit about your initiatives that you brought to life to move the health care system for both and how people can connect to you?

01:16:34:20 - 01:17:11:12

Tobias Silberzahn

Yes, very, very happy to read. I think, you know, ultimately, but ultimately, I've dedicated the second half of my career to health and well-being and to improving health and well-being in the world. But and and when when I spoke with innovators and health tech CEOs and founders a few years ago, I didn't then they said that they would find it helpful to have an informed community on the CEO level to sort of exchange what life really is like.

01:17:11:12 - 01:17:39:09

Tobias Silberzahn

Right? Because often, often we have pitch events with the innovators, right? That they are very competitive and there are prizes and and every innovator tries to pitch that they are the best. Right. And and so so we started we called the health tech network as a as a very different informal friendly health tech CEO community. And to be honest we didn't really think about it that much.

01:17:39:09 - 01:18:08:00

Tobias Silberzahn

We set it up as a global network right from the beginning. But then it turns out that those two factors have resonated The health tech CEOs and founders and friendly CEO community and the global network. Because the Europeans are interested in you as the patient and vice versa. So that that health tech network grew to get more than 1500 health tech CEOs globally, across 25 regional chapters from Canada to Australia.

01:18:08:00 - 01:18:40:06

Tobias Silberzahn

And then when when that was, there were several hundred health tech CEOs and founders in that community and lots of other leaders that are working in the health check space also got interested in that. And with that, I mean, leaders of pharma companies, of medtech companies across the roles of health insurances of some public sector agencies, investors, etc. Right now there's actually a second sort of community we could say that that we call the friends of the health tech network.

01:18:40:06 - 01:19:18:12

Tobias Silberzahn

Right. So in total is now two community 1500 health taxi or some 500 friends of the network that all then all you know like that community on the one hand I would say one reason they like that community is that many have the aspiration of improving health and well-being in the world. Right. And they increasingly see that, you know, that it maybe is not only that, it's not only helpful, but it's also fun to do it and a bit of a community instead of everyone trying to do it to do things on their own.

01:19:19:11 - 01:19:23:00

Christian Soschner

That's that's great news. What's the best way to get in touch with these communities?

01:19:24:14 - 01:19:47:22

Tobias Silberzahn

Well, I think the easiest would be to try to connect by a linked in There is more information on my on my profile including sign up link. But you're know I'm very passionate about this topic and so you know very happy people connect with me and on LinkedIn on Twitter and we we take it from there.

01:19:48:15 - 01:20:08:22

Christian Soschner

The the problem that I have with complex topics is that that I mean, I'm curious so we could go on with this conversation for another $5, I guess. And you mentioned already a couple of times that these topics are very complex. So it opens the space for me to ask a lot of questions. Is there anything at the end of the episode and the end of the recording?

01:20:08:22 - 01:20:18:03

Christian Soschner

Is there anything that you would like to say in this episode that I didn't ask in the last one? And to far, is there anything that I missed that you think is important to mention?

01:20:19:08 - 01:20:57:17

Tobias Silberzahn

But I think I, I think there is if we look the big picture, but at the end of the day, we have we have health systems today. But that that and the question is how do we want to have health care and how do we want to improve health and wellbeing and 2013 and 2014. So I think we have here a massive opportunity where we have our traditional medical interventions, medications, medical devices, but we now have about 25 digital health solutions at our disposal.

01:20:58:04 - 01:21:20:21

Tobias Silberzahn

We have the whole prevention topics that we've talked at length about sleep nutrition, fitness, risk management and and we didn't talk about that at all. We have genomics and precision medicine as well. Maybe we have cancer and then we see what is the mutation. And then we look at can I actually have medication that is personalized to my mutation, right?

01:21:20:22 - 01:21:49:08

Tobias Silberzahn

Instead of saying, Oh, Tobias has, I don't know, prostate cancer and we just do the standard prostate cancer treatment that we've done with 10,000 other people and we hope for the best. Right? So in essence, we have now the opportunity to rethink how we want to do health and well-being. Bringing those four puzzle pieces together, the classical interventions, the 25 digital categories, the preventative type stuff, which we talked about, and precision medicine.

01:21:49:08 - 01:22:08:16

Tobias Silberzahn

And I'm very hopeful that that is actually it is then has then a dual effect, right? It increases health and well-being of us as citizens, but it makes our health systems futureproof and maybe even fun and it even has positive economic benefit.

01:22:09:12 - 01:22:26:19

Christian Soschner

Now, I completely agree to what you say. What role one more question would like to ask. You mentioned precision medicine. What role does it play in your opinion? Why is it so important? There's this term on the Internet genomics, for example. What's the novelty of of of this area?

01:22:27:21 - 01:23:01:02

Tobias Silberzahn

Well, it allows personalized medicine, right, so that we don't have one size fits all medicine. Right. So if we if we, for example, take Germany as an example, we have 500,000 new new cancer diagnosis per year and we have about 35,000 patients, sorry, parents who will have a baby with an unclear, unknown, potentially rare disease situation. And and and and of course then the people with cancer.

01:23:01:02 - 01:23:23:03

Tobias Silberzahn

Right. That triggers the whole anxiety and all of that. And and then genomics can then help to understand what what is that cancer in detail and to what is the most promising way of treatment do we have medication that goes against that gene, that mutation that the patient has or is radiology or something else at the most promising path forward?

01:23:23:11 - 01:23:54:19

Tobias Silberzahn

But and then, of course, with the parents, with babies, with potentially rad diseases like day to day in a non genomic world. Right. And there are studies about if on average this diagnostic journey takes seven years, but it triggers an enormous amount of pain, anxiety and suffering for those patients and parents and families to go through that and then maybe finding out five year, 60 or 78 years spent on average, years after birth, what's wrong with the child?

01:23:54:19 - 01:24:19:05

Tobias Silberzahn

Right. So I think even if we take those two citizen segments, right, there is a case. And then in Denmark went in that direction with their National Genome Center, they designed the National Genome Center to provide these precision medicine services to the Danish citizens at scale on a national level. But having especially those two customer segments in the citizen segments in mind that I just mentioned.

01:24:19:24 - 01:24:40:05

Christian Soschner

And I agree to everything is safe, think the the human to human society can achieve so much when people work together. And as you mentioned, there's so many great developments that started a few years ago and now come to fruition. We just need to pick it up and move it forward together and can create a great society in future.

01:24:40:05 - 01:25:01:14

Christian Soschner

In 20, 30 years, two years. Thank you very much for for this amazing conversation. I really enjoyed getting so much new information from you that I wasn't aware before. It would be really great to stay in touch. And if you want to share future studies, future information on the podcast, feel free to reach out.

01:25:02:14 - 01:25:05:02

Tobias Silberzahn

Wonderful. Thank you for the invitation. Thanks for having me.

01:25:06:11 - 01:25:08:00

Christian Soschner

Have a great weekend. Bye.

01:25:08:13 - 01:25:09:11

Tobias Silberzahn

Thank you. Bye bye.

01:25:09:21 - 01:25:25:16

Christian Soschner

Do you like this episode then? Please, please subscribe to the channel to get a notification whenever I publish a new one. Have a great week.