Changing the world one mind at a time
Podcast transcription - 25th September
Alan Cowley: Welcome to the Invested Investor. I'm really, excited that this week I've got Keiron Sparrowhawk sat opposite me. Having had a successful career in pharmaceuticals, Keiron decided to take on a new challenge and start up a business. His first venture was as co-founder of PriceSpective, a value consultancy agency in the pharma market. The company was a huge success with Keiron running the most profitable London office. The company exited in 2012. Keiron then decided it was time to go alone, which resulted in MyCognition, and his current passion for developing digital applications for improved cognitive fitness. So Keiron there's obviously a trend here, health care?
Keiron Sparrowhawk: Yeah.
Alan Cowley: Was it a natural fit for you? Do you have a family in the pharmaceutical profession?
Keiron Sparrowhawk: No. I come from a poor family, and my dad on my birth certificate was a bus conductor. So maybe there was some intelligence there. My dad was a clever guy. My mom ... they were both from that age where they left school at 14 but they both, had they had the opportunities would have been able to go on to higher education, probably even university if they coped with it, but it just wasn't available to them.
So, I was the fifth of six children. No one that I knew in my family had ever been to university, but I just thought I didn't want to end just at finishing my secondary education and that was it. So I was young in my class. I was 17 when I left work. I joined an organisation under the idea that I would be able to do further education, and for the first 16 years of my working life, I did part-time, mostly evenings, weekends, qualifications.
That's how I sort of got my route, and choosing pharmaceuticals as a means to do that, taking advantage of my science knowledge, my science A levels. But I was really lucky because the very first job I did, I was in a laboratory where we were measuring the potency of insulin before it went out onto the market. The company was Wellcome. My dad was a diabetic and he was using Wellcome insulin, so I was working on the product that was keeping my dad alive as a 17 year old, and my career's gone downhill ever since. You can't get as good as that.
I have had those moments in the pharmaceutical industry where you do things for the masses, you hope you're doing things for the good of mankind, but you also have these personal experiences, and it's those personal experiences of course, which means far more to you than a massive clinical trial that you've been involved in because you can see personally the benefit of what you've done.
Keiron Sparrowhawk: So yes, I was sort of really, I suppose passionate about the industry. I spent the first 11 years working in R&D, although I did that work on diabetes, mostly in the neuroscience area, mostly in things like depression and anxiety, and then schizophrenia, and then the neurological conditions, as epilepsy, migraine. Then increasingly in my career, things like dementia, but that on the rise.
Moved to the commercial side of development, but still in drug development. So although I had a commercial role, and ultimately this was around the pricing of drugs, how do we price our drugs in every market? Almost like coalface type stuff. You're talking to payers, you're having to convince people of the value of your product before they'd hand over their money to pay for someone else to get the benefit of it.
That was a very good grounding I think in terms of it, because it still was able to take account of my pharmacological knowledge, background, knowing how these products worked, and with some knowledge of how they worked, you could then inject in saying, "This is why they do what they do." You explain that through to people.
It's all about capturing the measurements, doing the actual ... measuring the outcomes. So for example, you've got a product that can reduce the amount of stay in hospital. You've got to measure the stay in hospital. It's not just something that you'd say was a given that a payer will say, "Okay, we take your word for it, where's the evidence?" Now you don't need that stay in hospital to get through the regulatory requirements, so to get approval, but you do to convince payers, there's more you have to do to convince a payer, and it was that discipline I guess, that was instilled into me.
I took that into PriceSpective, it was 27 years in the pharma industry. I was 19 years at Wellcome, 19 days at GlaxoWellcome. Glaxco came along and bought them. I was in the head office, it wasn't 19 days, but it was a few months, I was kicked out with a lot of people at that stage, quite ruthless, but I had a job to go to at SmithKline Beecham, got a promotion, better role there, and a different way of looking at things.
Whereas, at Wellcome I'd been doing pricing mostly from a financial profit, tax and that sort of perspective. I was there now looking at it more from a marketing perspective, and again more deeply involved in the clinical decision making.
Then SmithKline Beecham merged five, six years later with Glaxo Wellcome, so I joined up again, back where I started so to speak. But that was quite ruthless. Suddenly it's quite an awful experience really. You had these two large companies that both had big problems, both had drugs coming off patent, dwindling sales, and that type of thing.
So, you had a merger of two weak companies, basically two big companies, but both with problems, and you got to the situation where it wasn't good enough to say, "I'm doing a good job." You knew they were going to be job cuts, you had to say everyone around you was doing a bad job, and that's just awful. Absolutely awful from a team point of view, you know you're all one company but you're fighting.
Some of my behaviour was terrible, and I knew the area that I was in, I knew that we were going to be done over, we were going to be sorted out for redundancy. So I had in the back of my mind, I actually spoke to my boss at the time, and I said, "We could set ourselves up. We work for these agencies doing pricing work, let's contact some of them and see if they need a pricing pharmaceutical group." We contacted this guy that I knew quite well, and his view was, "We don't want you but there's plenty of work out there, go and do it on your own."
Initially they were going to be four of us were going to do this. I had three colleagues in the U.S. and myself here in the UK, and in the end only of us went ahead and did it. But I was very fortunate, and the one guy that did it with me, Nigel Gregson, what a super guy to set up my first business with. A amazing thinker, very brilliant mind, and 100% trust in him. So that was like a blessing, so to speak, to set up with him.
Alan Cowley: So, before we move on to PriceSpective, what do you think the biggest lesson you learned from your corporate life was, taking that onto your entrepreneurial career?
Keiron Sparrowhawk: I tell people, "It took me 27 years to realise I couldn't work in a corporate." That's how dumb I am. In a sense, I was quite a disruptive person, I had disruptive ideas, which in some ways were good, and they were putting interaction both when I was in R& D and during my commercial life. But you're working in a super-tanker and it's very difficult to change that direction. You're a tiny, little cog and you can be whirling around at a million miles an hour and not really seeing much change in the organisation.
Every now and again you might hit on something, but generally, speaking you couldn't change that organisation. I wanted to bring about change, change for the better. You're not going to do that and an already well-founded organisation. They just want you to keep turning out the widgets at the right speed, in the right way, along with everyone else because that's how they will remain profitable.
It's also how if they're not careful, they would die because they continue doing the things, they're good at, rather than trying to find the entrepreneurial ways of doing different things in a better way. I learned a huge lot from working in pharmaceuticals. I was blessed at the time that I worked there. It was mostly like during the good times for the industry, and I worked with a lot of really good people, far more than I could ever mentioned. As I say, one of them was Nigel coming out of it. We came out together.
Alan Cowley: So, you set up the company, at what time was this?
Keiron Sparrowhawk: This was in 2003.
Alan Cowley: The, two of you had separated from the big pharmas?
Keiron Sparrowhawk: Yeah.
Alan Cowley: You've set up shop on your own, what were the biggest challenges that you faced early on? This is your first entrepreneurial venture.
Keiron Sparrowhawk: I think it was the fact that we'd both come from corporates and having no idea really what this world was like. So we'd made all these plans and we had all these ideas. We spent quite a lot of time, as much as we even could, we travelled, met each other, a lot of talking over the telephone, so as much as we could do in terms of the planning.
It was our view that, "Well big pharma won't want us, will they, because they've already got their pricing, market access, health economic departments?" So we want to be targeting the smaller, medium size. When in fact, that was totally wrong. In the early days, it was big pharma wanted us, they appreciated that they needed expertise, and as much as they had in-house, they wanted another view from outside, and people from outside that can link them to clinicians to pay us to talk to third parties.
So, it was a steep learning curve. But what we also realised pretty early on was that we were good thinkers, with the experience that we had, it enabled us to really get off and get some good contracts. So within three months we were profitable and we never looked back. It was a case of we were on the treadmill, we've got to increase the speed of the treadmill, increased the width, get other people to join us. It was that ability to broaden out over the next couple of years was our next main act to do.
Alan Cowley: So you had one office in London and where was the other office?
Keiron Sparrowhawk: Nigel was based in Philadelphia, and that's not a bad place. Probably within two hours, drive or Philadelphia, you've got 50% of the world's pharmaceutical headquarters, particularly in New Jersey. Then I used to say like, within London you were within two hours flight of most of the European headquarters of the pharmaceutical industry. So we were in good places to manage, and immediately we're an international organisation, just two of us. But that gave us credibility. It gave us the ability to do U.S. work, European work.
At that time, you were looking at the big markets were the U.S., France, Germany, Italy, Spain, the UK, occasionally Japan would be thrown into the mix back then, but they were the big markets that everyone, 80, 90% of your profits would come from those markets. So if you've got it right there, you were set.
Alan Cowley: So how long were you running the company, but also, you're profitable after three months? What size did you get to?
Keiron Sparrowhawk: We eventually built the company to about 80, 90 people. So 35 in London, 55, 50 odd in the U.S. We had our operations, we set that up in Philadelphia. The plan was that should have been our biggest office, but because London was so successful, we always kept ahead of it, so that was an office of about 20 to 30, we were 30 to 40 in London we grew to.
The other thing we learned was the leverage model in terms of what you do, you build yourself out. You build a pyramid, so you have as many top people as you can, but you build out strong teams underneath them, and it's your junior people that do a lot of the heavy lifting and analysis, the research and that type of thing. It's the senior people that assimilate that.
So, you don't charge out everything at the senior person's rate, but you've got a blended rate there that you can charge out at. But if you get it right, you're profitable. So to begin with, we were doing everything, chief bottle washer, toilet cleaner, everything within the office. As you built the teams out, you was able to delegate those down.
But it did mean that even to the most junior person in the company, I could say to them, "I'm not asking you to do anything that I haven't done myself. So some of this is going to be tough, but it's good to learning, you're going to learn a lot." In consulting, because of a number of projects, the number of different projects you work on, you see and assimilate a lot of knowledge.
So, whereas my background had been in the past, mostly in the neuroscience area, the neuroscience drugs, I was now looking at cancer, diabetes, anti-infectives, a whole range of different drugs, and they're fascinating areas. It was interesting because it made me reflect more and more just on how poor the drugs in the neuroscience were. As good as they were, they leave a lot to be desired.
We don't really know how they work. We've just got hypotheses as to the mechanism of action. They don't work in every one. You're guessing as to who you're ... you're going to try a number of them out. Antidepressant, try this one, it doesn't work. We try this one, try this one.
They always come with side effects, and I suppose increasingly particularly because of the personal situation I was in, and again, on reflection, you can't give these to prevent depression. You don't take an antidepressant to prevent depression. You don't take an antidepressant to build resilience. You take it when you're very sick. So you have to wait till you've fallen off the edge and hope someone catches you, and then you take these terrible drugs.
That just made me keep thinking, "Is another way of looking at it? Looking at this area?" I did have a view in terms of, again looking down the drug route, but in about 2008 I came across this video, I was doing some research, and I came across a video of a functional MRI scan.
So it's a scan and it was taken while someone was playing a computer game, and as they were playing this computer game, various parts of the brain were lighting up, so as they did different activities, specific areas would light up, which is indicative of additional blood flow going to an area of the brain, really strengthening it, taking more blood, more nutrients, more oxygen, and taking away the toxins.
It sowed the seed in my mind that if that was happening by chance, could we direct it, could we do anything with that? So could we direct it towards areas of weakness? And really that's how MyCognition have come about. We don't use the scans, we use another means to understand your brain health. We use psychometric tests. But we use that as a recipe to direct your training.
Alan Cowley: Okay. Let's just go back to PriceSpective actually.
Keiron Sparrowhawk: Yeah.
Alan Cowley: So, you had an idea for MyCognition here with the video, but did you anticipate and plan the exit because of this? Because you're thinking about something next, the next part of the journey?
Keiron Sparrowhawk: No, not because of that. PriceSpective was really successful. Gosh, we were earning lots of money, and the company was growing. In 2006, we brought on two other partners in the U.S. Nigel won't mind me saying this, but he was fantastic, but one of the things he wasn't good at was managing. He didn't want to build a team around him, and we definitely did need to start building a team.
So, I brought on two senior people in the UK. We needed to expand now in the U.S. and it was a case of, "Well, let's bring on board another U.S. partner." So we put out feelers saying we wanted a U.S. partner. And we got to two, two for the price of one. We got Steve Slovick and Ted Sweeney, who in their own ways are both brilliant people.
They came on board in 2006, and we grew to six. Then once we went from there, we built out the Philadelphia office. We ended up with offices in Boston, North Carolina, San Diego, Los Angeles. So covering the breadth and width of the U.S. and strengthen the London office. So London was still a main international centre. I had 34 people at the end in the London office, 20 nationalities, an amazing mix of people. And as I say, we were really successful. We were gaining projects, growing, but there was increased tension amongst the four of us.
Alan Cowley: Because you were looking in different directions, different end points of the business?
Keiron Sparrowhawk: Because we were so successful, we were becoming like that organisation where we didn't want to change just churn out the same as we had done, because that was successful. So, for example, I had this plan and said, "Why don't we set up an office in Singapore?" Having mentioned before, it was Europe and the U.S. Now Asia, China, Japan, we're coming. They were important markets. If we have an office, Singapore, Hong Kong, even Shanghai, somewhere in that part of the world we could operate out of there. And there was a lot, "No, it's too risky, we don't want to do it."
So, anything where I was pushing to bring about change, I had three U.S. business partners, and I wouldn't wish that on anyone, sort of thing. They were great people, but I felt as the only Brit, I was like the grit of sand again, I was the disruptor that was probably annoying them most of the time, a lot of the time. And we did have plans. We always had this plan of like a five year exit. But because we were fortunate we'd never took on board any investment. We didn't need it. We grew organically. We put the money back in.
Alan Cowley: Did you have any advisors?
Keiron Sparrowhawk: Financial advisors, no.
Alan Cowley: Not financial, just advisors on a sort of board or anything?
Keiron Sparrowhawk: No, we didn't and again, I wish we had because it would have given us a different way of looking at things. And the fact of the matter is it was almost like spike, I suppose a little bit of arrogance, we didn't need it. We were doing that well, we didn't need it. We knew the area very well. But I think it would have helped just in terms of giving us a different way of looking at things, and particularly because I suppose financially it was going that well, never got any experience.
You know you mentioned your father has written this book about the Invested Investor it talks about investors on the other side of the table. I know nothing about that side, so now I'm in the situation where I need that, I read this book, I need to understand that more carefully. We were in the situation where growing well, doing well, having this plan that we should be thinking of a five year exit all the time, and in the end we went nine, 10 years. And it really was a case of, I think the strain was showing then, we either exit or we're going to... They probably would have put together some money and got someone to kill me or something, I think that might have solved the problems to some degree. And in fact, Steven Ted they've gone again, and they've set up the same organisation again.
Alan Cowley: Same name?
Keiron Sparrowhawk: No, Jupiter is the name of their organisation. I think they're doing well. We don't really keep in touch. I keep in touch with Nigel, that's what I heard from him over the weekend. But yeah, I think it was right that we should go our own way. And for me personally as well, I mentioned this thing in terms of I wanted to bring about changing and I thought that Prospective could be a force for change.
It's a bit like the area we're in, drug pricing, highly controversial. People could look at me and say, "Well you're just one of those price gouging bastards in the industry that's making money out of people dying." Well, we're trying to make money out of the value of life. So if you can prolong life and if you can improve their quality of life, then you should get rewarded for doing so.
And I think my view was that we were trying to hold the mirror up to the industry and say, "If you really want that price, you're really saying you've got the evidence to procure that price." And I think in some ways we weren't successful in what we did because there was integrity within the organisation, we're people of integrity. But you are battling again, against this huge industry that where in some instances there's still some companies saying, "We will have that price because we can. We've got some that have saved lives so we're going to just push it through. We don't care about affordability," and that type of thing about whether everyone will get access to this.
So we have that in the UK now where you've got companies selling life changing products, but they're so expensive the UK, so we can't afford them. So okay, you as the UK, you can't have them. And we're not even interested in doing a deal with you. You're tiny market now. So that leaves not such a good taste in the mouth. And I think one of the things we did alongside that, I mean I was lecturing at Cambridge, and I suggested to Cambridge that... But then they set up a diploma in drug pricing, basically, what it was. So we ran that for a few years and again, that was very successful. But it's almost like within this five day diploma course there was element here is that at the end is nigh for the pharm industry.
Look, it's gone through all these transitions, really, successful starting out, less than 100 years ago really to get to where it is now. And its hay day was the eighties, nineties, early two thousands when blockbuster after blockbuster was coming out and it was double digit growth. Well, it's bled healthcare systems dry to some extent, even to the extent now they're talking about price controls in the US, which you'd never thought would've come about. But the pressures are there because you can only expand an ecosystem so far before people say, "Well, where's the money coming from? We can no longer afford of these extortionate prices." And particularly because we're not seeing the same value increases that we were seeing previously.
A cancer drug which extends your life for three months, important to the person with cancer and important to their loved ones around them to have another three months out of their family member, but for $100,000 a year, for many years to get that extra three months, are you sure? That type of thing.
So, I had that feeling within what we were doing that we were helping that to continue. So being able to hold the mirror up and say, "Look at this in different ways, find different ways." In fact, it's very difficult for the industry to do that because it's cost specs. So a billion, $2 billion to get a drug to market. Look at the returns that you need to be able to do that. And hence, again, this is where I do think that med tech is the future. But let me talk about MyCognition for a second.
Now we change behaviour, we change the physiology of the brain. I'm sure that we also change the biochemistry. I'm sure that we normalise cortisol levels. We normalise downstream cytokines, which are little proteins that go around destroying dead and dying cells. We change those with a piece of tech, for goodness sake. So tech can do this safely, sustainably and in a way that's going to promote good habits, good lifestyle habits.
So, a much more effective and sustainable way of not prolonging life but enhancing the quality of our life and at a fraction of the price, fraction of the cost that you get from using pharmaceuticals. So I think there is going to be a big transition to med tech.
Alan Cowley: So, we've heard about the video that you watched. It gave you that spark and then obviously, the blockade that you were seeing with the pricing of drugs. Did you have any other motives deciding to go at it alone then?
Keiron Sparrowhawk: It was much about going at it alone, but I had this motive in terms of I wanted to get back to making my own products again, to do my own development. I'd worked for a number of companies as PriceSpective where we, they give us their baby to look after. Sometimes the babies, they're not that beautiful, pretty ugly. You're glad to give them back. But other times you think it's actually a beautiful baby and I'm giving it back to somebody who doesn't appreciate how beautiful this baby is. You're not looking after this baby the way you should be.
And there was this in terms of the success around a product, I wanted to own that success to some degree. So it wasn't as much about going at it alone, but wanting to get back into drug development. But it wasn't drugs. One of my companies I'm involved in, we are developing a drug and if we have time I'll talk about that. The company's high pay stream. We've got this fantastic product where we double the survival in severe burns, but I'll leave that there for now.
So, I still, keep an eye on pharmaceuticals, but I wanted to get into production, and I thought this idea around using tech. And being a person who had no idea of tech at all, that was quite scary, that was quite risky, but thinking there's something in this that's worthwhile exploiting, that's worthwhile putting some time and effort into. Let's see how far we could push this new boulder about this new hill.
Alan Cowley: Obviously your first company, PriceSpective, you used a lot of the learnings you had there to push forward with MyCognition, or was it just so different tech compared to consultancy?
Keiron Sparrowhawk: It is quite different. Yeah. I mean, I should've gone back into consultancy again, some form of having learned all the lessons from that.
Alan Cowley: Where's the fun in that?
Keiron Sparrowhawk: Exactly. I've done that to some degree. Loved it, loved the people I worked with. I worked with some fantastic people and I miss them. We still get together now and again, one way or the other. A real good family there. But this yearning to want to do something different, want to, be able to say do this production, I hadn't have any of the learnings in terms of getting investments on board, of building a advisory board around what we were doing, so lots of new learnings to do.
Well into my 50s, so I'm 60 now, but still learning, which is good. It's a fantastic thing. It's a much better place then thinking you want to decline. Not sure that I'm in the ascendancy, but maintaining my brain health personally is a good thing by having these challenges, having these new mountains to climb.
Alan Cowley: What do you think the biggest ones you've faced with the new company, a start up in med tech?
Keiron Sparrowhawk: I think definitely this would not have taken off if I had not had the personal means, the personal financial means to push this along, because the idea that I clasped onto quite early on was the fact that we could use a video game as an intervention, a video game to supply medication to people. And trying to convince other people or that early on, I think most people just thought, yeah, go ahead and have some fun if that's what you want to do, and not taking account of the seriousness, because immediately we pushed a game into clinical trials, because that was the main approach that we were going to take was a huge risk.
Those early games that we built then screwed up, threw away, the earliest one 150,000 pounds during something like that. So taking a huge risk around these things, but seeing enough in it to know that there's something there that we can build upon, and the beauty of working with tech. And like a drug, with a drug, once it comes out the laboratory and goes into clinical trials in man, there's not really much you can do with it. That 20 milligram of substance, be it a molecule, be it a piece of protein, you can change the formulation but you can't really change its inert activity that it has, and there's not much you can do about the side effects.
Keiron Sparrowhawk: With a piece of tech, you can tinker with it. You can constantly say, what can we do to improve it, improve the engagement we see with it, to improve the skills that we're enhance in people, the benefits. So tech is absolutely fantastic for that. Sometimes you tinker, you go the wrong direction, but you can learn relatively quickly from that. So the fact that we have something today where I say we know we can see benefits in psychiatric, neurological patients, in the workplace, in schools and the community, across all ages.
The fact that we can see that with what we have today, imagine what it'd be like in 10 years, time if we're allowed to let rip with this. Just amazing. So that's why this is going to take off, this will take off in a big way. And not necessarily replace the drugs, it will work alongside the drugs, but I just think from a sustainable point of view, we've got something that's a lot more meaningful.
Alan Cowley: Okay. So, you've had no fundraiser at all so far?
Keiron Sparrowhawk: Zero to date. Even though I've been out with my begging bowl for quite a few years, I must be bad at it. I've got to read your dad's book. But no, that part of it's been difficult because it means that the whole weight's on your shoulders and for the good that I can see in all the reaching new horizons and enjoying the view and enjoying lots of the journey, there are parts of the journey which have been torturous. And maybe it's a facet of my life that I do these...
Going back, when I first started working in the pharmaceutical industry, I put myself in night school, all, of those types of things. There's a sacrifice to yourself, but there's also sacrifice your family. So yes, if you take it on board, you're personally, you're definitely going to do this, but you end up sacrificing or hurting others if you like as well. They're bought into it. That preys on your mind as well. Yeah, so I've had mental health problems myself. Mental illness and that's something that never quite goes away.
Alan Cowley: Have you ever heard of founder's fatigue?
Keiron Sparrowhawk: Oh, I can certainly appreciate it. Yeah.
Alan Cowley: I was listening to a talk recently and the lady that was giving the talk was talking about founder’s fatigue and recognising it. And founder's fatigue is not just tiredness, it's everything. It's mental strength of dealing with a task or anything, not just looking tired.
Do you think that your second company and how you run it is very different from how you run the first company? I know obviously, the industry is different, but I mean actually the actual running of the company?
Keiron Sparrowhawk: Not really. I think we've ran PriceSpective well, we rewarded people well, but we did work people into the ground. I mean, in the London office I would say to people after a certain time of the evening, "Look, if you're going to stay any later I'm going to charge you rent, and I'm going to charge you electricity, for staying here. Go home for goodness sake." And they say, "But we've got to do this." There was a culture of working very long hours, sometimes I'm sure some people did work 24 hours on pieces of work. Whether it was necessary...
Because you get to the state where some people are saying if you can't do this within a normal range of hours, are you at the best place to be doing this? How much of this are you keeping for yourself at that you shouldn't be delegating? You should be asking for help. It's hurtful to say that to people because they're saying, "I'm giving you my heart and my soul and then you're slapping me in the face over it." But you're trying to do so for their good.
Bad thing in terms of that fatigue and that pain you go through, I'm sure I entered PriceSpective in not good mental health, and I was in complete denial all the time that I was with PriceSpective, that there's anything wrong with me despite that I had colleagues and other people saying to me, saying "Kieron are you sure you're all right?"
And I was like, "Well, I'm running a company, how can I not be?" And it was like a long slow car crash in a sense in terms of the descent. Destroyed my marriage, 25 year marriage, almost destroyed my family, last and least almost destroyed me. But I survived it. It's still there and elements of it are still there.
And I think this is where, if I come around to MyCognition, you mentioned that that person is saying about, it's not just fatigue, it's the inability to do certain things. Well, when we look at ourselves through cognition, we look at five domains and one of the domains, working memory's your ability to make decisions. That's an innate thing that we do all the time, but when your, working memory's in a poor state, you're paralysed. You can't make decisions.
So, do you want tea or coffee? Even that's difficult. White or brown toast? Even that. Those emails which you'd normally get flying a couple of minutes, you're spending hours trying to think, well, how do I reply to this? So you become paralysed. You can't make decisions, you're stuck. Your ability to your wisdom, your past recollection of events in terms of any new tasks that you're doing to help you get out of a learning curve, accelerate up the learning curve, suddenly your memory is vague, foggy, so you can't remember those events and so you have to start every new task at the bottom of the learning curve.
And that's your episodic memory. Attention, your ability to focus on something. So there's lots of distractions. You're just clear in terms of, I've got to get this done. Suddenly you don't get anything done. The three things that you knew you had to do at the beginning of the day, they're still there at the end of the day, at the end of week, you've got 15 things to do. You just don't get around to doing it. Processing speed, your ability to switch tasks, to keep a lot of plates spinning. And not that you can multitask, but each one you can attend to in time with speed and accuracy, that goes. You can't even keep one plate spinning. It's like you're wading through syrup.
And then the overarching cognitive domain executive function, your ability to plan, to organise, be creative and control your emotions. So you've got something to do in a months, time. You can think of various ways, use your creativity saying there's four routes I can achieve that. So you go down route A knowing that if you hit a roadblock route, you've got B, C and D to fall back upon. You're in control, so you don't get angry, you don't get upset, you control your emotions.
When that goes, you're well stuck in a rut because wherever you look, it looks awful. Whilst I may as well just stay here and then you do get angry and you do get upset with people. So if you look at it from those five cognitive domains, that's our lives basically, that's how we live them, and what we've done with MyCognition is that we can assess each of those five domains. You can do it in 15 minutes on your phone, on your laptop, on your iPad, any device download the app. So 15 minutes, you've got an overview of your brain health across those five domains and if you're in a good state, well then great, that means you're operating at a good level and all the things that you're doing to maintain that, keep doing it. Many of us, we find that we're in the middle, we're round the mean and we may be good in three or four of the domains, but we've got weaknesses in one or two.
Alan Cowley: When you do the 15, minute check, how often are you meant to do it?
Keiron Sparrowhawk: Once you've got the app, you can do it as often as you like.
Alan Cowley: How often do you advise people to do it, is that different question?
Keiron Sparrowhawk: Try it two or three times to begin with and maybe try it in different circumstances and always try it when you're not in a good state because we tend to say "I'll wait till I'm in a really good state before I do this because I want to do my best." It's a bit like sports day, well no, you can do it whenever you like, do it in all different times. Do it in a noisy situation, do it in a cafe, do it on a bus, but once you've got it, do it monthly, every other month because what you want to be looking at is the trend.
So, once you're in a good state, you want to be saying, "Am I trending upwards? If I'm in a good state, am I trending ... plateauing?" What you don't want to be doing is seeing a trend going down because then you can intervene. Because jumping to one of the things that ... Cognition is about our performance, about our behaviours, which lead to habits, about how we perform, how we control our emotions, all of those things but in a chronically bad state, if our cognition is impaired in deficit in a chronic state, that's mental illness. Whereas some years ago it was a case of people thought you were mentally ill and then your cognition fouled, increasingly we're realising that your cognition in a deficit state brings about the mental illness.
So, this gives us a means by which we can monitor mental illness. You can monitor how mentally healthy you are and if you are in decline, you can do something about it. So going back to when I was at PriceSpective and in denial, I didn't have anything, any way by which I could do that. I was going to see people because I knew I had something wrong with me but it came out are you depressed. Of course not. Give me the depression scales, I'm fine, fine, fine. You can do those. You're asking, "What's your beliefs?" I believe I'm fine. I wasn't. Do this other test, actually, don't you think you've got a problem here?
Well we can do those. Now the great thing is that once you identify those issues, those problems, you can do something about it. If we were in the situation where we said she was ... "Oh, you've got poor cognitive health, poor brain health, that's a shame, go away." No, if you can do our assessments, you can get better. Here's the protocol.
So, we devise the training to go in parallel with the assessment and the training trains you in all five domains, but trains you more intensely in those where you have a weakness. So the best place we've seen that is in a school setting, where we've got a whole class of kids who are in the computer room, they're all looking round. They all around and there's a game called Aquastat and they all look, they're all playing the same game.
So there's no stigma, totally inclusivity but actually they're all playing a version of the game that's linked to their needs, linked to their situation. So it's perfect. So they've got loops of training. So if you've got attention problems, you've got to have more loops of training around attention. If it's executive function, more of those loops and they are automatically linked into the game. That's how they're fed through the game and that's one of the reasons why we think that we see such great results with it because it's like physiotherapy for the brain.
So, we target the areas where you've got a weakness, so that ... You go to see a physiotherapist complaining of a bad back, the physio is going to give you an assessment and at the end of the assessment the physio says, "Yeah you have got a bad back, but actually it's a result of your ankle, your ankle's out, your knee's out, your hip's out, that's causing your bad back. So I will give you some exercises for your back, but I'm going to do most of it on your ankle." You think, "Okay, well that's a bit painful but I will do it." So you do it and actually within three months your back's fixed.
Same with us. We have a lot of people my age, middle age, got memory problems and actually their memory is not bad. It's in pretty good nick but they've got attention problems. That old thing, "I can't remember where I left my keys." Well, remember you got keys, don't you? That's one thing. When you've lost your keys, where do you look? Well I look? I look on the hook, I look in my pocket, I look at my purse, wherever it is, where I normally leave my key. So you remember where you normally leave your keys, so what's happening is that you're putting your keys somewhere that you don't normally put them. You're not paying attention. So they end up in the sock drawer, in the fridge, just because you're not paying attention. You're stressed and stress will eat at your tension. It will eat at your working memory, your ability to make decisions, it will eat ultimately, at your entire cognitive fitness but because attention is an energy consuming part of us, we don't realise how much energy we do consume to pay attention to something.
That's one of the things that can go early on when we are stressful. So you're just not thinking, so you put them down, you can't remember where you put them, you go back to where you want to find them and they're not there and they end up in a place where you ... last place you would have looked. But it's not memory, it's attention. So again, we'll give you some training for memory but more so we're going to give the training around attention.
Alan Cowley: So, what are you most proud of with the company, MyCognition?
Keiron Sparrowhawk: I think I'm proud that, despite, the fact that particularly in the early years when we were doing this work, we were told basically by most people you're wasting your time. "What are you wasting your time and money and energy on that?" I think we've come through. So we're now NHS-approved, the NHS approved us when the NHS Digital Health Store. ORCHA, the biggest reviewer of health apps, they've given us a good review. Most recently, we were approached by a company doing work for the Bill and Melinda Gates Foundation and they were viewing the area of executive functions, basically your cognitive area, the cognitive function. The area that we're in. They said we were one of 20, 30 companies they were reviewing, would we take part? We said, "Yes, of course we would." In the end, we were one of about half a dozen that they took to the leadership team of the Gates Foundation, and they spoke about us and what they said then was that with their other companies say that they're assessing and training cognition, MyCognition, the most comprehensive.
Furthermore, they put their training into a gamified way for stickiness, for engagement. Furthermore, when they train you, they train the area's not where you're good, but the areas where you're not so good to enhance your overall health and then the Gates Foundation, just in the last few weeks, we've got to make a lot of noise about this. They produced this report, which they've made public and they go into that, especially around the education area, the importance of cognition for academic performance, but also for health. They touch a lot of the boxes that we touch upon and then when they get to the companies they say, There's not that many companies are doing this well, but among those that are doing it well are ... " And we're the first company they mentioned and there's only three that they mentioned there.
Alan Cowley: This is globally? This is globally, yes.
Keiron Sparrowhawk: So I'm getting all excited, even talking to you about it because this is an independent review that's been done by one of the most renowned organisations in the world and they're basically saying we're the best, for crying out loud in terms of our approach to this. We're tiny. The companies are ... one of them is ... We'll mention them, Cambridge Cognition, a great company, they do most of their work in clinical trials. They're listed on the stock exchange. They're doing really well, but they do clinical trial work, not much on the training side. The other company, Eckley Interactive, I bow to that company in terms of what they're doing in this area. They've developed games for different disorders. So they're waiting to get FDA approval for their gain for ADHD in children, but their approach is to look at each indication and make a game that indication. Our smart way is to say for all these indications, all of these areas, ADHD, other attention deficits, dyslexia, dyscalculia, autism, they've all got problems in terms of cognition. Let's assess the cognition and then we are a single game that then is interactive and all of those.
So, we've reverse engineered it. So our way is much more cost effective because we've got a single game or a single series of games that could work in all of these disorders, rather than a particular game for each one. So we've actually done it the smart way and the most comprehensive way according to Bill and Melinda Gates Foundation. So that's recent but it's been a journey and each year of this journey we've learned a little bit more that's pushed us on. I mean, we're not making any money yet. Hopefully that will come about because I think we've got something very special to bring to the market with the need. Recent report saying that by 2030, mental illness will cost the planet $16 trillion. So this is a huge economic, but also huge social, burden that we're facing and I think we've got something that can work in children, preventing, treating mental illness in children.
50% of mental illness emerges by the age of 14, so lots of need there. The workplace, a huge burden. Just the UK economy up to £80 billion as the impact of mental health on the UK economy and in an ageing population where it's not just mental illness, it's not just psychiatric neurological conditions like dementia. We're living longer with a whole series of those physiological conditions such as diabetes. That condition that my dad died of when he was 70, people are living long with that, but in poorer and poorer health because of the poor habits they have, they're actually driving themselves in the ground, but the drugs are keeping them alive.
We do work with the NHS in diabetes and the idea there is to change those habits of those people. So to get them to do a little bit more activity, getting them to have a better diet, so they'd be working with their drugs, with good habits, and those habits come from changing their cognition.
We've got to change their cognition before we can change their habits, so we can have people ... We're not saying to people, you're going to live longer as a result of taking MyCognition, but you'll have a better quality of life if you follow this protocol and that's good for the person. It's good for the health system, it's good for society. So our tagline is "Changing the world, one mind at a time." I want to think about change and I think I'm bringing about the best change through MyCognition.
I used to say to people, I didn't know what I wanted to do when I grow up. I think I do now.
Alan Cowley: Now, the work you're doing is absolutely, fantastic and vital. What else are you curious about in the world of cognition and the future of the human mind?
Keiron Sparrowhawk: The really, interesting thing about cognition is that there's two sides of the coin. So spoke a lot about the mental health, mental illness sides of it and when it's in deficit but once we get to a certain level of fitness, once we get to a certain level of cognition and continue to improve it, we're going onto the performance side. We are going on to, this will help our thinking. I think, what I've discovered now is that, we've been able to look at cognition from as young as six to as old as 103. We've got these lovely trajectories so we can measure cognition at all of those stages. So cognition improves in the early years to the early 20s, plateaus to 50s, 60s, then declines. If you add on the weight of the population across all of that and then you look forward actually our cognition is in a state of crisis and overall is in decline because we've got more and more people in poor health states, living longer in a poor health states and an ageing population.
So, if we take the average weighted cognition, it's going south. As a species, we've been around 200,000 years and we've not always used our cognition to the best. We think very short term, this instant gratification that we go for. So if you look at something like climate change now, take that as one aspect of it. A lot of short-term decisions are brought to the stage where we could be killing the planet that supporting us because we're not doing enough of the long-term thinking. So this again is part of the hope of the changes that if we can enhance our thinking amongst our leaders like that politicians, look at the parliament, it's like a just an emotional maelstrom of shouting at one another. If we have the leadership that can cut through that, we have clear thinking, we have a means of maybe saving ourselves and that again, it's about that enhancing cognition about us, particularly that domain executive function where we look at our planning, our organising, our creativity and our ability to control our emotions.
We need people with that, to be able to think ... to paint a picture for the future that isn't about we've got to go back to living in caves in order to save the planet. There must be other ways that we can do that, but it does require us to change and again, our tagline, "Change the world one mind at a time," we've got to think about that change quite quickly to save ourselves, so that's something else that turns me on.
:: Well Kieron, it's been absolutely fascinating to hear all about your journey through pharma, PriceSpective consultancy, but now what is quite clearly a huge passion and it actually reverts ... One of the first things you said was talking about the interest in clinical trials when you're 17, 18, 19 saying it comes around.
Keiron Sparrowhawk: It does.
Alan Cowley: Thank you very much.
Keiron Sparrowhawk: Thank you Alan I really enjoyed it.
Peter Cowley: Thanks for listening to another Invested Investor podcast. You can subscribe to all future podcasts via our website, investedinvestor.com or via a number of podcast platforms online. Remember, you can order our book online and be sure to follow us on Twitter, LinkedIn, and Facebook to get the most up to date, interesting and insightful content from the Invested Investor.
