Elaine Taylor-Klaus: Welcome back to another episode of Parenting with Impact, everybody. We're thrilled to have you back and really excited to have this conversation with Zack Booker from ADHD Online. Zack, thank you for being here.

Zachariah Booker: Thank you for having me. 

Elaine Taylor-Klaus: We are so psyched. We were introduced to this amazing new resource just this year in 2021 I think. We kicked off the year meeting each other. And I'm excited to hear more about what's going on with ADHD Online. It's definitely kicking off. But we're going to start by talking about you and how you got there. Just for people listening, we'll have all these resources in the show notes. ADHD Online is an online resource to get evaluated and assessed for ADHD using artificial intelligence. And Zack is going to correct me if I got that wrong, right? 

Zachariah Booker: Yeah.

Elaine Taylor-Klaus: Is that a good nutshell? Is that what it is? 

Zachariah Booker: It's a dynamic assessment. Yeah, 

Elaine Taylor-Klaus: Dynamic assessment. Great. And we've used it. We've referred it to a lot of people, and it's a really great way to fill the gap in services in our country. So we're really excited about it. But let's start by talking about like what got you here because this was not what you expected to do in your life, as I recall from our conversation. So how did you get to be doing this?

Zachariah Booker: Right. It's a great question because I was not in healthcare previous to this. I've been on other industries as a business owner and entrepreneur, and just passion filled for helping the community at large. And I was introduced to Dr. Duthler, who is my business partner and co-founder alongside me. And we struck up a friendship and decided that we should make a go of something that we're passionate about. And he being a full-time physician, has been experiencing the bottleneck that diagnoses the diagnosis of ADHD has on children. And specifically, children they're going a year without school, sometimes longer, without the correct treatment and management of their mental health, and they're struggling. And it was pulling at the heartstrings of both of us, saying there's got to be a better way. The traditional model is just too slow. The kids should not be waiting that long, be able to understand [inaudible]

Elaine Taylor-Klaus: And let's back up because a lot of parents listening to this have already been diagnosed. Some are trying to figure it out. A lot of us have been struggling for years around it. But part of what's happening here is that ADHD, in particular, is a very complex diagnosis. It's not a simple one. So it's not something like you can go into your pediatrician's office and in a 15-minute visit, they can say yes or no, you got it. So let's talk a little bit about what has created the bottleneck before we talk about how you have resolved it.

Zachariah Booker: Yeah. So with what we're seeing with hospital systems, it's demand. So a lot of people don't necessarily know what's going on with their mental health, and they need to be able to see a psychologist to fully vet that and to understand that. So that may take multiple visits. That may take the psychologists to be able not just to be able to sit down in one hour and fully understand in a synchronous nature because these questions that are being asked are required to have an answer immediately face to face, not giving the patient may be the opportunity to go seek other resources, like a teacher's perspective in the immediate. Also, the patient may feel rushed because they only have an hour. And they know that if this is going to take multiple visits, they're going to want to say as much as possible and maybe not try to dive into the true issues of what's going on with them with their selves or their children. So that develops this cadence of maybe multiple visits with a psychologist, and these psychologist appointments are getting packed, and there's maybe not enough resources of psychologists out there within certain regions of the United States. So that's where we started to just think there's got to be a better way. So that's when we developed the asynchronous dynamic assessment called Acorn, appropriately named [inaudible] closer associated with ADHD.

Diane Dempster: I love that. So part of what I'm curious about, and this may not be the place to talk about exactly, Zach, but the difference between the type of diagnosis you're talking about versus what parents are told a lot of times to do, which is get a psych ed evaluation for your kid.

Elaine Taylor-Klaus: Gold standard.

Diane Dempster: That's like this gold standard. So can you talk a little bit about the differences and when a parent might seek one versus the other? That sort of thing.

Zachariah Booker: That's a great question. That's where I would lean on Dr. Duthler. He would be the best resource to be able to explain me because he sees it. So when he has his patients, he's the first entrance to understanding that there's something wrong, or not necessarily wrong, just something difficult. So it's something that we see from a physician's standpoint because that's where people start. And then physicians then refer, and physicians will refer to psychiatrists, psychologists, and all the like. They're really who they've developed a relationship with clinically, to be able to trust and be able to treat from their diagnosis.

Elaine Taylor-Klaus: And let's look at that for a second because once a kid is referred for diagnosis, there are a number of different ways that diagnosis could take place. As Diane has pointed out. Typically, we've been taught the gold standard as a psycho-ed evaluation, which usually takes about two days. It's eight-plus hours of testing.

Diane Dempster: It's expensive.

Elaine Taylor-Klaus: It's expensive. It's time-consuming. And as you say, there's a long delay in many parts of the country for people to get a psych evaluation psych-ed. One of the things that makes it a gold standard, I want to be really clear, is that it screens for a lot of other things. Because to diagnose ADHD, you have to show that it's not this and that and the other. So it screens for learning disabilities. It screens for other neurological disorders and screens for other mental health disorders. So it's a very, very thorough assessment. Not all ADHD is diagnosed that way. Sometimes ADHD is diagnosed with multiple appointments to a psychiatrist or a pediatrician with conversations and some histories, as you say. When it's diagnosed that way, it doesn't screen out all these other issues. It just identifies that that's here, and we still need to look to see if those others exist. So that's an important context, I think what you're what you've created.

Zachariah Booker: Yeah. So right, great segue. That's what we have created. We understand that ADHD may be masked by other symptoms of maybe more predominant comorbidities like anxiety and depression. So we have that GAD and PHQ, along with the DSM built into that assessment to be able to draw out a lot of what's going on. And what our psychologists in our network are finding is that the answers from our long-form questions are actually more in-depth than they would receive face-to-face in their clinical room. Just because the patient has all the time in the world to be able to answer the question in the safety and security of their home, they can start and stop the assessment whenever they want. In one sitting, the assessment can take 60 to 90 minutes if they wanted to just sit and just dive right through it. Now it being dynamic as well, the questions change based on some answers given, so not everybody necessarily follows the same path. And we also have some other suicidal mania stopgaps built into that, just to be able to make sure that if patients are answering questions with suicidal tendency, we can be able to trigger an event where a pop-up comes up and tells them to seek psychiatric help immediately with suicide hotline, and then also pings our clinical staff to call that patient and contact them and make sure that they're safe. So we're one of the first barriers for suicide as well. And we really pride ourselves on the ability to help, and it wasn't our direct vision to do that. We just know that that was the possibility and capability of what we were doing, and just really proud to be able to help on that. 

Diane Dempster: Absolutely. And I just want to back up for a quick context because I want to make sure because a lot of our audience's parents have complex kids. And your services are designed not just for diagnosing kids but also for diagnosing adults who are, hey, what's going on with me? I might have something. I might have ADHD. I'm not sure. And I don't know what percentage your audience's each of those, but it sounds like, particularly for the piece you were just talking about with the suicide awareness, that would be something that would show up more in an interview, likely with an adult. Not that it wouldn't show up with a child, but that's really kind of the context of that.

Zachariah Booker: More of an adult. Yeah, teenagers go through a lot, especially now. I mean, teenagers are going through a different time than then we did, and it can be stressful, and the road is unknown. And they need a little guidance. So we want to make sure that we're making sure we can help. 

Elaine Taylor-Klaus: So when you and I first talked, and just so everybody, I want to be really transparent, I am earning nothing by sharing this. We have no financial relationship at this moment. And I was just really excited because when Diane and I created Impact Parents at the time, Impact ADHD, what we were trying to do was to make support accessible and affordable because we knew there were millions of people that weren't getting access to services. And so when I heard about ADHD Online, I was very excited. One of the things you told me when we first spoke was that the surprise of it all is that not, not everybody is diagnosed with ADHD. So talk a little bit about how effective this system is at screening out and identifying or not identifying ADHD.

Zachariah Booker: So yeah, another great question. So we get a lot of people that feel like this is a potential rubber stamp, and it's not. This is a true depiction of what's going on in their mental health. And a lot of people will get a diagnosis that excludes ADHD may include other things. But when they get this diagnosis, we help them by facilitating the next step. So a lot of people will have seen this in the past where it's a dead end. No, it's not ADHD.

Elaine Taylor-Klaus: Well, now what? 

Zachariah Booker: Well, now what? Where do I go? So what we want to do is we want to give the ability to the patient to choose what path they want to do, whether it includes or excludes ADHD. So for our efficacy, we've been seeing in floats between 60, 65% are actually inclusive of ADHD.

Elaine Taylor-Klaus: Which is higher than it was at the beginning of 2021 when you and I first talked which it's interesting because you've got more volumes, so you have more data.

Zachariah Booker: There's more volume. Yep, and we're growing tens and thousands all the time. And it's really. Our patient panel is really great. It's just we want to make sure that that we're appropriately managing the growth because, like you mentioned before, it's a big responsibility. There's an opportunity that's ahead of us.

Elaine Taylor-Klaus: So let's talk about the 35% who don't get a diagnosis of ADHD. At this point, 35 to 40% of people are not getting a diagnosis of ADHD. What information do they get because they're not getting a diagnosis of anxiety or depression? What are they getting?

Zachariah Booker: So some of them actually do.

Elaine Taylor-Klaus: Do they?

Zachariah Booker: Yeah, we have society and Ph.D. level psychologists on our staff and in our network across the nation that covers all 50 states. And these psychologists are comfortable enough within their clinical judgment to be able to diagnose outside of the ADHD spectrum. So it's really great for us to be able to portray what may be going on. Because of the assessments, asynchronous nature, and the questions that are answered sometimes, our psychologists need a little bit more info. And we have the ability, through our proprietary messaging system for the patient and the provider, to discuss things a little bit more in-depth to try to drive out what's really going on. And that's all included, just to be able to make sure that we can help as much as possible.

Elaine Taylor-Klaus: So that so so if I recall, what happens is once somebody completes the online assessment, a psychologist reviews it, and then that person has the capacity to then check back in with the patient to ask further questions-

Zachariah Booker: Yes.

Elaine Taylor-Klaus: -in one of the reports. So I've seen it didn't diagnose ADHD. It what it said was you should consider getting screened for anxiety. It didn't say to this person, yes, you have it. But it did say go get this checked out.

Zachariah Booker: Yeah. And we leave that clinical judgment up to the psychologist because they're the expert when it comes to their focus and their education on what they've learned. So we don't direct any which way. We just let the clinical judgment happen within the psychologists and the physicians that we employ.

Diane Dempster: So Zack, I want to take us back up to, I don't know if it's 30,000 feet or however many feet, but AHDH Online was created to solve a problem in the audience that the mental health community serves.

Elaine Taylor-Klaus: And particularly ADHD.

Diane Dempster: Particularly ADHD. So let's talk a little bit about that problem and put it in the context of the parents that might be listening, who are wondering, do I get my kids diagnosed or not get my kid diagnosed? How do I get my kid diagnosed? That sort of thing because I know that could be a helpful conversation.

Zachariah Booker: Yeah. I mean that with our platform, it's completely confidential. So it's cash pay. Right now, it's only $149. And you get to understand what's going on in your child's mental health. And for that, I mean, you can't put a price on that.

Elaine Taylor-Klaus: So let's pull this out of the context of your product for just a minute. because while we think it's great, we support what you're doing not everybody listening is going to want to make that choice. A lot of people want to walk into a provider's office. What I think I hear you asking, Diane, is a more contextual question about how, when, and what you're looking for in a diagnosis. Correct me. Diane, is that accurate?

Zachariah Booker: Yeah. So it's a good question. Myself, I have ADHD, and my son has ADHD. So as a parent of a child who has ADHD, I've have always wanted to know what's going on with all three of my children. And for me to fully understand that, it puts me at ease to know that there's some level of treatment plan set forth that I can help facilitate alongside my child and their provider, and it helps me myself because I have ADHD. So I use some of us things for myself. And for friends of mine that have children with ADHD, they may not have it, but they have sought things and good things that have come from the treatment of their children and the resources that are available. So resources like Impact Parents is a great opportunity for somebody who needs that direction that doesn't necessarily want to go find all of the things on the internet and try to piece it together. It's something that gives you a formal direction to be able to help facilitate the growth of your child and their mental health.

Elaine Taylor-Klaus: So this is all happening at a time when telemed has shifted the landscape in health care. Let's talk a little bit about it. But you started this before the pandemic so long before because I imagined it took a few years to develop just a few, right?

Zachariah Booker: It did, yeah.

Elaine Taylor-Klaus: So when you look at the context of how people are accessing health care via technology, what's what do you anticipate? What do you see shifting and not so much about the assessment you're doing, but you're about you have moved into a healthcare realm that wasn't your realm 10 years ago? So from that entrepreneur and technology lens, what are you seeing?

Zachariah Booker: We're seeing a lot more companies come in and try to somewhat shift the models around, and for us, we want to uphold the highest standard of care. So we include psychologists, where you're starting to see some telehealth companies come in and bypass a psychologist, which we don't feel is appropriate. We feel like a couple of providers involved in a patient's health care are important because they have specific focuses. They have specific experience and understanding, and helping the trajectory of that patient in their future. So with the telehealth space, we were pre-COVID. And it was, in a sense, disruptive. We were disrupting an industry that was not used to having an assessment that was accessible 24/7, and that was asynchronous. Who ever heard of an asynchronous assessment where a provider was not present during the time of questioning? That was [inaudible] pre-COVID.

Elaine Taylor-Klaus: We understand. We've did the same thing about 10 years ago in terms of parent education. 

Zachariah Booker: Yeah, so you get it. I mean, it was disruptive, and we got challenged a lot from some large organizations. But as COVID hit, it just accelerated our effort. And in showing in a transparent way of how influential a company like us could be. And as you guys have experienced as well, the ability to add more horsepower behind you to help more of the community and more of the market. Yeah, it's just been it's been a wild ride.

Diane Dempster: I'm curious because you were talking about the fact that you guys have not yet started partnering with insurance companies and things like that, and this may not be an area that you feel like you have expertise. But the future of telemedicine in the mental health industry is something that's really fascinating. We were at a conference last night talking to some folks specifically about this. It's going to be really interesting to watch how delivering care, particularly mental health care, where you're connecting to someone differently kinesthetically, you don't need to touch them as often or in as many situations as you do with some of the other medical interventions.

Elaine Taylor-Klaus: They don't have to say open your mouth and say, ah, right?

Diane Dempster: Right. There are some times you do that, but anyway. But my point is, I mean, what, let's get out our crystal ball here for a minute and see what doors are getting open by the kinds of services you're providing and the things that we're experiencing right now in terms of telemedicine.

Zachariah Booker: Yeah. So another great question, the insurance companies on that side, although we don't par with insurance, we do offer reimbursement on behalf of the patients. And we're noticing that they're being reimbursed up to 100%. And most of them are all that way, and it's great. It's great to see because these insurance companies understand that due to the times, this is how it has to be during this window. What we're noticing on the regulatory side is that it's transitioning to telehealth is forever because telehealth is easier, faster, less expensive. So when you have those three paths, why not? It offers a better experience and entrance point into facilitating the patient's health. Yeah, again, why would you want to restrict that and go backwards? So we're noticing, on our end, a lot of hospital systems are wanting to partner with us because they see these things on our end. We can diagnose way faster and knock that six-month bottleneck, in our area, it's six months, knock that six-month bottleneck into less than a week. And it's really great. So these hospital groups are aligned with these payers. But because of resources like ours, we can just plug and play and be a snap-on resource to these large hospital systems too.

Elaine Taylor-Klaus: Yeah, and they're so busy they really are looking for ways to decrease the cost, bottom line, whatever you want to call it, to increase efficiency and delivery of services. 

Diane Dempster: So I'm watching our time a little bit. And Zack, we want to make sure that you do have an opportunity to tell people how they can find out more about ADHD Online, and then we'll ask a few more questions and wrap up.

Zachariah Booker: Yeah. I mean, you can visit us at adhdonline.com, and it's free to set up a portal.

Elaine Taylor-Klaus: So bottom line, what do you want parents to take away from this? I heard you say find what's going on.

Zachariah Booker: Find what's going on, yeah. There's easier, faster, less expensive ways like AHDH Online and Impact Parents to be able to help facilitate a better future for you and your child.

Elaine Taylor-Klaus: So you said you've got a great final motto. We always like to end with a motto word or a quote, and we always let them know in advance when possible. And you said you had a great one. So we're excited to hear it.

Zachariah Booker: Yeah. So I've got a great one. It's, again, simple as nature. Don't talk about it; be about it. So it's something that I live by every day because we can talk and talk and talk in circles. But to actually show and execute is something very much more powerful and influential for the community. So that's what we did with ADHD Online. We didn't want to talk about it; we wanted to be about it.

Elaine Taylor-Klaus: Be about it. I love it. I think we can really relate to that. It's beautiful.

Diane Dempster: Zack, thank you so much for being with us today. This has been a great conversation about telehealth about ADHD Online and about parents taking action to really figure out what's going on for their kids. So thank you so much.

Zachariah Booker: Absolutely. Thank you. I appreciate your time, and it was a pleasure talking with you, Elaine and Diane. Thank you.

Elaine Taylor-Klaus: Always. So to those of you who are listening, thanks for being here. Thanks for what you do for yourself for your kids. Remember, at the end of the day, you make a difference, and we will see you in the next episode. Take care, everyone.