Connected Hearts: Exploring Loneliness, Tech, and Mental Health

[00:00:00] Joy Rios: Hello there and welcome to the HIT Like a Girl podcast. My name is Joy Rios and on the show we talk about how complicated the world of healthcare can be. I often liken it to a 30,000 piece puzzle and each one of our guests comes to share their expertise and more about the piece of the puzzle that they hold on to.

With every guest, we get to understand a bigger picture. So today's guest is very special. I'm going to give you a moment to introduce yourself, please, Cindy.  

[00:00:37] Cindy Jordan: I’m Cindy Jordan, and I'm the co founder and CEO of Pyx Health. And I know we're going to talk about it, but Pyx Health is a company that treats loneliness.

And because we treat loneliness, we often end up doing a lot of other things like helping people go to the doctor, make sure they have food on the table, that they're taking their medicine. So anything that you can think of in the social health space, we do through loneliness.

[00:01:02] Joy Rios: It's such important work. It's something that I've been talking about on a regular basis, just about the loneliness epidemic and the importance of community and thinking about stats.

It's it's almost as harmful to us as smoking. And more than anything, I would love to hear, let's start with your journey. How did you get on to this path? And was this part of your plan?

[00:01:24] Cindy Jordan: I’d be surprised if many entrepreneurs like myself, have plans like this, but I actually, my partner and I started a company and sold it, I think in 2015 and really ended up where we sold it to the advisory board and I worked for them for two years.

And when I was finished, I was finished for the reasons that you address on this podcast, Joy, healthcare is both great and also very frustrating because it's one of the most regulated industries in business, really. But in 2017, my stepdaughter, who was an adult at the time, ended up having a very bad year.

She was going in and out of the emergency room, unbeknownst to us, because she was 18. And she ended up in an inpatient facility. And when we sat down as a family and I asked her, “Hey I'm a fixer. I would really like to get ahead of having a year like this. What comes first?” And she told us that it starts with feeling lonely.

Now, she ended up being diagnosed with bipolar. So she had a serious behavioral health disorder. But the point was, is that it really was stemming from this profound feeling of loneliness. And I didn't understand that because this is pre pandemic, like you go to college, you have a roommate, you come to family dinner.

Why are you lonely? And when I started researching it at the time, we were the only developed country in the world. That didn't treat loneliness like a diagnosable, treatable mental health condition like depression and anxiety. And generally what you need to do that is you need a proven evidence based screening which loneliness has and then you need a way to intervene.

So what we've learned post pandemic. Because now there's a lot of money going to research for loneliness, is that actually when you are mid to chronically lonely, there are degrees, just like there are degrees of depression, just like there are degrees of anxiety, there are degrees, so when you're mid to chronically lonely, the brain actually starts to rewire, and it starts to believe that nothing and no one can help you. Your doctor can't help.

Your medicine won't work. No one understands. And so as opposed to depression, which is really a chemical imbalance, loneliness is rewiring the hard wires of the brain. And so for Riley, that sort of never went away. And then when the pandemic hit, she ended up losing her struggle and died at the age of 26.

And so pics has really become. Not only her legacy, but my personal journey in trying to help families not have to go through what I went through. 

[00:03:56] Joy Rios: First of all, I want to say thank you for sharing your story. I know that it is i'm so sorry that Riley's no longer with us. I'm sure it's difficult to talk about so thank you for sharing, being here to talk about the, her journey and what it had, the impact that it has had.

I'd love to learn more about, is there actually a diagnosis for loneliness? Is that what you're telling me?

[00:04:18] Cindy Jordan: Not yet. But if you've gone to the doctor, probably in the last year, you know how they'll ask you social determinants of health questions. Are you safe in your home? Do you have food? They're starting, a lot of doctors are starting to ask the three questions associated with loneliness that the evidence based screening is the UCLA screening is what it's called.

And they can tell that you're lonely, but often, and this is the fragmented system of healthcare, a doctor doesn't know what to do for you. There's not a pill that can fix it. There are very few companies out there even talking about it, let alone one like mine that actually is addressing it. And there's no billing code.

And as you and I both know, the minute a billing code comes for loneliness, this whole landscape is going to change.

[00:05:00] Joy Rios: Of course. Okay, what are those three questions?

[00:05:01] Cindy Jordan: Oh my gosh, I actually couldn't say them to you off the top of my head. What I can tell you is that they're not, they never ask, are you lonely?

They'll ask about feeling does anyone in your world, do you feel like people understand you? Have you felt like you've been able to engage? Those kind of questions. But the way that mental health conditions get found is through evidence based screenings because they've been proven through clinical trials to actually diagnose a condition and we've had that for loneliness for a long time.

It's just that nobody, until we all experienced it as a collective population, actually believed that loneliness was a killer. And in fact, then I bet you a lot of people who are listening to this, they'll say “Yeah, my grandma's lonely”. We then pigeonholed it into a senior problem, but the AARP did a huge study.

I think it was two years ago now that said that found that. The most lonely population in the world is 13 to 24 year olds.

[00:06:01] Joy Rios: And of a specific demographic or just in general 13 to 24 year olds?

[00:06:05] Cindy Jordan: I mean there are demographics that influence. If you live in a rural area that obviously leads to more actual physical isolation which then of course can impact loneliness.

Living at or below the poverty line can impact, but it does not have statistical differences between men and women, between race, nationality. It is one of those very very sneaky conditions that doesn't really impact folks differently. You can be a multi billionaire. And still be chronically lonely.

[00:06:36] Joy Rios: Sure. I think about Taylor Swift and they're, “Oh, having no one to call at that. You've made it to the top”. And then who do you call? And you've made it to your, to the top by yourself. But when I think about this, I'm thinking about several things. If tech, do you believe that in the statement that technology has actually contributed to the loneliness epidemic? The use of phones and social media and like the feeling of closeness without really having a relationship to be close with somebody and then counter question, is there a possibility that technology is also part of the solution?

[00:07:14] Cindy Jordan: Thank you. You set that up beautifully for me, but the truth is, of course if you look at 13 to 24 year olds. I'm 52, right? When I grew up, I had four friends and we fought and we made up and we loved each other and we had this what I call a mile deep relationship. I learned things about engaging with people like forgiveness, like gratitude, like the whole cycles of interacting with humans.

Now you have a hundred friends. But it's a mile wide in an inch deep it's very we've, I'm sure you've talked about this before, but it's very easy to be a keyboard warrior, even if you're someone's friend you'll say things that you would never say if you were in person. The flip side of that is you don't get any of the real benefit of being close with a community or friends that through social media that you do when you when it's in person. So the answer is unequivocally, yes. I have a 15 year old son in this I we I literally just gave him one social media app this year because he's a freshman. There's no reason for it really, there's very little that's accretive.

Joy Rios: Do you mind my asking which one did you give him permission?

Cindy Jordan: Instagram, mostly because I can follow him. Secondly, because just looking at the stats, it's one of the fewer from a what I would call a detriment side for teenagers in particular. And then lastly, because that's his friends are on that the other thing though.

 I'm going down a rabbit hole here and then we'll talk about how technology also has to be a part of the solution. We as parents give our teenagers phones and then talk about privacy with them. There's no privacy on that phone. He doesn't get to keep a single thing. I can take it at any point and it's not because I don't trust you It's because I love you.

It's because I want to protect you. There's this idea that there's somehow a stigma attached to looking at your kid's phone. It's quite the opposite.  

[00:09:10] Joy Rios: The creative and multiple ways that they can get, find themselves in trouble or even adults, we're all at risk.

[00:09:16] Cindy Jordan: And unknowingly, we see what happens to seniors all the time through technology but the reason it has to be a part of the solution is that phones are here to stay.

So when you said phone and social media, I separated them in my mind, right? We're not going backwards on accessibility. We're not going backwards on easeability. We're not going backwards on any of that stuff. Information at our fingertips. So when you talk about addressing a problem as pervasive and big as loneliness, you have to have a technology presence.

Now, Pyx's business model is the technology is important because it serves people 24/7. We do not use any kind of AI interaction with humans. We're not relying on a robot to have a conversation to help solve loneliness, right? We're giving people self management. There is a bot in there, but he's more a directed conversation.

You can't free chat with him. But what happens on the technology is within three interactions, we can tell you who's in trouble. And when they are in trouble, a flag gets thrown and I have a whole staff, hundreds of them across the country, literally that we call Andy. And that stands for authentic, nurturing, dependable, your friend.

And when you are suffering from loneliness or you don't have food on your table or you don't have transportation or daycare for your kids, Andy is going to call you and Andy's going to help you through it. So Andy is a peer support model. All of my folks are certified. All of them are employed, but they're not physicians, they're not psychiatrists because there is no way to address the pervasiveness of that problem through nurses, doctors, and psychiatrists.

We've got to start leveraging models like ours, a peer model.

[00:10:59] Joy Rios: Actually, I'm so heartened to hear that there's not an AI aspect of it because I feel like there's so much bias in the current versions of AI, that if you're trying to train a model on human behavior in such a way, it just feels like a recipe for disaster for now, maybe it won't be like that forever.

[00:11:18] Cindy Jordan: We use AI on the back end, right? We'll analyze the things we do to be better. But really the AI just helps our humans be smarter when they're on the phone. We don't let the AI have the conversation. Plus if you're lonely.. 

[00:11:33] Joy Rios: You can go talk to chat GPT, but that's not the thing. That's going to be heartwarming or really like scratch that itch.

Is it addressing mostly with a phone call? Is there ever any face to face, either virtual face to face or in person, face to face? And I guess I'm curious about, how you would implement a community for somebody because ultimately like community is what we're all lacking in many ways and is one of the ways to address it?

So I guess that's open ended, but I'd love to hear your thoughts.

[00:12:01] Cindy Jordan: I totally agree with you. But the way I look at the continuum is. we find these folks that are, like I told you, in the mid to chronic phase. So that means they are really either like already very sick with comorbidities both physical and mental health comorbidities or they're on what we call a rising risk. They're getting there, they've stopped taking their medicine if they're a chronic diabetic. They've started using the emergency room in ways that they don't need to be they've pulled away from their family. So when people are there, we call them stuck in mud, right?

 You can't engage in community until we get you through that. Think of it as the episode, right? Whereas engaging in community is the long term self management. The answer to your question is, I really do believe that an in person solution is important. And frankly, Pyx is looking at growing into that space, but right now, everything we do is telephonically or through the platform.

[00:12:55] Joy Rios: Okay. And then what's the experience of the platform? How did they engage?  

[00:13:00] Cindy Jordan: The bot really is again, not AI, he's machine learning. So we program what he says ahead of time. But he acts like a friend in a coffee shop. He tells jokes. He like, he asks all of the important questions without being like what I call health care greedy.

If the last piece of technology that all of us have used for health care, I bet you 99 out of 100 of us will raise our hand and say that we were told to answer 700 questions. It gave nothing to me. There was nothing. That platform did nothing for me. And so frankly, I'm just, forget it. I'll just, I'll fill out the paper forms when I get in there or there's nothing helping me here.

What the bot does is ask about sentiment. How are you feeling today? So while I may be diagnosed bipolar and I may be suffering from chronic loneliness today, I feel good. I'm happy. I'm happy in my space. And so the bot will celebrate that. And, but what the bot is doing is developed as a capturing information, important information, particularly around social health and loneliness.

[00:14:03] Joy Rios: And then what the Andy aspect of it do, did people engage with the same Andy over and over again?  

[00:14:10] Cindy Jordan: We definitely tried to do that. The only time you may get an Andy, that's not your Andy is if you dial into the hotline and your Andy doesn't happen to be on that day. Because if you think about the pure model and when I say peer, because this, people get confused, it doesn't mean we have to look like each other. It doesn't mean we both have to be 52 year old women. It means we have to have a shared experience. We take a lot of great care in pairing people with shared experience.

[00:14:38] Joy Rios: How does somebody become an Andy?

Because I would also imagine that it's probably just as important for the people on the other side. You're creating community in both ways and connection. How did you open that up and who are these folks? And if somebody wanted to be one, how would they sign up?

[00:14:56] Cindy Jordan: What we actually with our growth, because right now we're in 83 markets and cover almost 7 million people.

So we hire Andy all the time. We take very good care in reaching out to people. through like traditional employment, like LinkedIn and Indeed, but actually mission forward so we tend to pull folks in who may have been like retired school teachers or social workers or something like that. And then we will then, once we hire you, we'll get you certified and trained because we serve a lot of CMS business, meaning Medicaid and Medicare where we're of the utmost when it comes to compliance.

So we go on. The search of finding folks that can be mission driven in their work. And to be totally candid, our number one referral for hiring Andy is Andy. It's something like 87 percent of all of our hires come in from a referral of a current Andy.

[00:15:53] Joy Rios: I can imagine that it gives them a lot of I have the word I'm searching for.

It's not pleasure. It's just satisfaction. And then it's got to feel good to be able to support somebody in that way, especially if they're reaching out for help and don't have anywhere else to go and you get to be their lifeline to a degree.

[00:16:09] Cindy Jordan: And generally, if you look at other companies in healthcare, because everybody's about the margin and the bottom line and everything else, and don't get me wrong, I run a healthy company, but you can do that.

Generally, these folks are treated as 1099s or they'll be given 32 hours worth of work or 31. So they don't have to get what we offer full benefits 401k, we give every other friday off. We have a full time therapist on staff only for our Andy’s because imagine what you hear on a daily basis.

Yeah, so I actually think that we're doing something like that is breaking the mold on how to serve these folks.

[00:16:49] Joy Rios: It sounds like it. That's what I mean. You're not only helping the technical demographic, but even the people that are supporting it. I'm confident that they get support as well.

It's gotta be self fulfilling in some way. And so you're doing good on so many levels. That's amazing.

[00:17:04] Cindy Jordan: If you've been in this business long enough, you have to believe in like the tailwinds, right? Why does one company that has an amazing idea supersede the other company that has an equally amazing idea?

And then, so the first thing you do is look at people. And that's important. Who's running the company? Where are they? What's their motivation? And then the next thing you look at is like that untangible, the thing that you can't see or put your finger on, but it's the tailwinds. And that has to come from being like, from being good employers.

From doing business fairly and from not always just chasing the dollar. I like to tell my staff, it's one thing for us to be a company that's doing well and making money, but it's another thing to punch a hole in the earth in a good way. And so that's first.

[00:17:50] Joy Rios: I love that. I was listening to a podcast over the weekend and it was talking about touching our heart and how much of like our heartstrings are actually tied to our health in some ways and how like you actually might get more benefits from listening to a song that makes you feel something or like taps into an emotion that you might otherwise have a hard time tapping into. And that might be better for your health than taking a pill, right? Or a vitamin.

And that's not the kind of thing that in our healthcare system is set up to measure, but those intangibles of heartwarming things that make you feel connected and just like on a human level feeling deeply and with somebody else as having that shared experience has got to be part of our wellness culture.

[00:18:39] Cindy Jordan: No doubt. If we don't understand the value of social health at this point if you look at the new CMS guidelines for 2024, what they do is they send out like not only the things that got new billing codes, but like things that are, can be reimbursed in different ways. And I won't get into all of that.

And the majority of them are around social health. Because there are not enough doctors in the world, there are not enough nurses, and there are not enough therapists to treat this pervasive problem, this huge gap that we're creating around social health. The more we advance in technology, the wider the gap gets.

And there's gonna have to, it's not just Pyx of course, I'm shamelessly promoting and believe in my company, but there are companies like mine, and these are models that are gonna have to be embraced as a part of care. 

[00:19:29] Joy Rios: I totally understand where you're coming from. I feel similarly in like in my mission of trying to tip the scale of like people at positions of power and who gets a voice and all of that.

But when I see other people doing the same thing that I'm doing, I don't 0 percent feel threatened. I'm just, good. We need more of that. If there are more people out there that are after a similar mission, then we all win because it probably would be impossible if you were able to tackle every single lonely person in the world with your business model.

[00:19:59] Cindy Jordan: It is important that we one of the things like prepping for the podcast is some of the questions that you've asked before and one of them was like what would you change in health care? And the short answer would be I would have a billy coat around loneliness. But the longer answer would be that right now the way that we incent folks to provide care it needs to move you. It's disparaging, firstly.

Number one, hospitals get paid a lot of money when people show up at their ED, but health and plans aren't incentive to send people to the ED. The ED is really supposed to be for emergencies, right? Incentives are not aligned and fee for service just has to go away. It can't just be, I did something so I should get paid.

Outcomes should be a part of everything that we're doing. And when you talk about outcomes there's no more powerful model.

[00:20:46] Joy Rios: And the one of the things that I've always had a hard time understanding how to measure is prevention, because you want, how do you have a way to do it? Because it's that would be the best outcome is somebody not getting sick or not needing to use the system in the first place.

But that's a really hard to put on a spreadsheet and say I saved you X amount of dollars insurance company.

[00:21:08] Cindy Jordan: The only way really to do it is self reported, right? You ask the member, “Hey, do you feel better? Did it stop you from using a higher level of service?” We actually do that. But is that valued? Cause all pretty much all of my clients are health plans.

No, it's not. That's not something that an actuary can put into an ROI calculation and say, “Oh look what this”. Look, you have to follow the money in healthcare very unfortunately we've got to start putting more value on, to your point if I got you into the doctor and I made sure that you were back on your medicine, I probably stopped you from six months from now having an expensive emergency room or God forbid, inpatient admission.

But how do you quantify that?

[00:21:49] Joy Rios: Okay. So I love everything that you're doing. How do people get involved if they want, if they are feeling lonely or, and we addressed the Andy aspect, but if somebody wants to be involved in your sphere, where do you direct to them?

[00:22:02] Cindy Jordan: We do have a free version of pics on the, on the stores, the Google and the Play store and the Apple store.

Admittedly, it doesn't have the Andy’s attached to it. Like one of the things I'm doing is like growing up as a company is my goal is that a consumer will never pay for this. So going through health plans is an insurance is one of the ways that I'm doing that.

[00:22:25] Joy Rios: But that's great. Cause you said earlier that you're tied to Medicare and Medicaid.

So for the populations that are. in probably in need of your services most are, how many states have you been able to tackle through Medicaid?

[00:22:38] Cindy Jordan: I think we're in at this point, 37 or 38, December is our biggest month. So we've closed like a lot. So we're in, and if you look at the map, guess what states we're not in? Fee for service states.

[00:22:51] Joy Rios: Oh congratulations on that. That's massive. There's an, okay, we're approaching time, but I actually have another set of questions if you are available and it has, it has to do with entrepreneurship. And I'm wondering if you have any advice for others.

And I'm just going to say I'm like other entrepreneurs who are LGBTQ plus do you have any advice for them? Because I imagine that navigating healthcare as a business person and all of what is available and not available. All of the whole landscape is intimidating. Do you have advice for folks?

[00:23:27] Cindy Jordan: I think that my advice is probably not earth shattering, but I, and the other reason I can give this advice is because I did it wrong. I think in my first company in the very beginning, but part, Of, I think being a successful LGBTQ entrepreneur is to be LGBTQ. But I used to worry when I was pitching investors that if they knew I was a lesbian, then they wouldn't give money to me.

And the truth is those are folks. I don't want their money. There is a lot of about being out candid. There's not enough of us that are being represented in the entrepreneurial space to begin with debunking some of the stereotypes around what LGBTQ entrepreneurs look like. And frankly, I don't even know what those are, but it's blonde, wears glasses, just did a private equity recap in July and we ended up getting quite a bit of interest.

And I was meeting with a private equity firm and the gentleman sitting across the table from me said, the majority of your management team is women. Do you hire men? And I firstly said no human ever has that comment ever come out of anyone's mouth, but I'll entertain it anyway. Is that we just hired the best people for the job and what he was in effect doing was being, do you like men? Are you a man hater? And in his like stealth way and so my point to him was like we're not meant to do business together

[00:24:55] Joy Rios: Yeah, and that's okay. There's plenty of business out there to be had. And I guess given the fact that there's so much so few people that are out. I think that there's a connection between this conversation around loneliness because I think people on the queer spectrum feel there's a shame, unfortunately, still for a lot of people and stigma.

And I'm just, how do we take this away? How do we make the that's not an easy question to answer. I don't expect you to have the answers because I think that when you see the onslaught of bills being presented that are countering people's existence, it's really hard to just see that, to say “Oh, just let it go. Just be yourself.” And there's not any consequences to that because unfortunately there are, but it's a tough space to navigate. And I love to be able to bring our audience to something that is hopeful. And so if you have any words of encouragement for people that it's worth it to be authentic and be themselves out in the world. I would love to hear it.

[00:25:58] Cindy Jordan: I can tell you that the most encouraging thing is that it feels better for you. It feels better for me to walk authentically through this earth. And then secondly, I know that, and oftentimes, like particularly when we think about politics and stuff, we can feel insignificant.

We always talk about one vote or one. I know for a fact that in the two businesses I've done, in the investors that I've interacted with, in the people that I've employed, that being an out lesbian has changed people's minds. And maybe it was ten people, maybe it was twenty, maybe it's a hundred, I don't know the number, but those ten will affect another ten, who will affect another ten, and that's the best way I can, is it easy?

I feel bad for my son because he's like when they make Mother's Day gifts at school, like he's there the longest but also like we also gave him permission to be proud about his family. And I know that has impacted his little group of friends. And so I guess what I'm trying to say is, it might feel inconsequential to, if I'm on an airplane and someone asked me where my husband is, I correct them, “Oh, my wife?” And that small one thing can make a difference. And you just never know where it's going to go next. And so I'm not trying to say that this is easy. It's not. I grew up in the 80s. That wasn't easy. But it is impactful.

[00:27:20] Joy Rios: Yeah, I 100 percent agree with you that every single one of us, like what we do matters. And even if it doesn't feel like it at the time, but it absolutely does.

And even if you can affect one person in the form of being empathetic, being a good listener, accepting, being true to yourself, being a good example or showing kindness and supporting a friend in need, those are the types of things that connections and relationships and ways of walking through the world that even if it's a small circle, it matters a lot. The whole starfish theory, right? You're a hundred percent. I just want to say thank you for what you are doing in the world because it, and thank you for opening up and talking with me about this, and I'm excited to share your journey and all you're doing with our listeners.

[00:28:10] Cindy Jordan: Well, thanks for having me. It's wonderful to be invited. I've done a lot of podcasts in the last however many years and not all of them are as encouraging and open as you are. So thank you for letting me be me.

[00:28:25] Joy Rios: My pleasure. So can I, if people want to find you online, if they want to work with you, if they just want to follow you and admire you, where would you send them?

[00:28:32] Cindy Jordan: LinkedIn is probably the best. Although you can always reach out to me directly. I'm Cindy@Pyxhealth.com.

[00:28:41] Joy Rios: I will include that in the show notes. Thank you for everything that you're doing and I appreciate you as well.

[00:28:46] Cindy Jordan: Thanks, Joy. Thanks for having me.

[00:28:49] Joy Rios: Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle hit like a girl pod.

Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle HIT Like a Girl pod.

Thanks again. See you soon.

Again, thank you so much for listening to the HIT Like a Girl podcast. I am truly grateful for you, and I'm wondering if you could do me a quick favor. Would you be willing to follow or subscribe to this podcast or maybe leave us a rating or review? Or if you're feeling extra generous, would you share this episode on your Instagram stories or with a friend?

All those things help us podcasters out so much. I'm the show's host, Joy Rios, and I'll see you next time.