April 25, 2025 • 9 mins
In this episode, David Zakariaie, Founder and CEO of Senseye, joins Scott Becker to share how his company is transforming mental health care through objective, eye-based diagnostics using just a smartphone. He discusses the founding journey from a high school science fair to FDA-bound innovation, and how Senseye is tackling the mental health crisis with neuroscience and computer vision.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
This is Scott Becker with the Becker's Healthcare
Podcast.
I'm thrilled today to be joined by the
founder of Sensei,
David Zachariah.
And David's gonna tell us about the founding
journey, what they're doing, trends he's watching, and
a lot more.
David, can you take a moment and introduce
yourself and tell us a little bit about
Sensei?
(00:21):
Yeah. Absolutely. And, thank you very much for
having me. I'm David. I'm the CEO and
founder of Sensei.
And, essentially,
the problem that we're trying to solve at
Sensei
is the fact that there's really no objective
way to do anything within the
behavioral health space today. The way that we
think about the mental health space at Sensei,
and kind of the existing standard of care
(00:41):
is that it's essentially the equivalent of if
you were to diagnose a patient with diabetes,
but you never measured their blood or if
you were gonna, you know, diagnose them with
a heart attack, but you never took a
EKG. And as ridiculous as that that sounds,
that's essentially
the way most behavioral health takes place in
America right now. About seventy five percent of
(01:01):
all mental health, is occurring, you know, inside
of primary care, and that's because of the
major shortage of psychologists and psychiatrists.
And And it's basically the equivalent of you
show up at a doctor's office. They ask
you a couple of questions. They call it
anxiety. They call it depression. They probably get
it wrong. You get a prescription for Xanax
or an SSRI, and that's kind of the
end of the road for the overwhelming
(01:23):
majority of patients. And so what we're really
trying to do at Sensei is build the
first
diagnostic and severity monitoring platform for mental health
with an initial focus on anxiety, depression, and
PTSD.
And and and talk about because your your
point is still well taken. So much of
mental health diagnosis is is
(01:43):
subjective
versus, like, if you break an arm, you
do something with an elbow, you get an
x-ray, they could see what's actually happened. And
you almost think about surgeons that did surgery
before these tools as it must have been
impossible to do it, how you wanna do
it. Talk about what Sensei does.
Yeah. Absolutely.
So the way the product works, it's essentially
(02:04):
a app on a mobile phone.
The first time a patient interacts with it,
it's about a ten and a half minute
test. And we've gone to phone to solve
a lot of distribution challenges, but at the
point that we're approved by the FDA, we
are still a regulated medical device.
And whether in person or through telehealth, it
does require a approved
clinician,
to essentially be a part of the process.
And so the first time a patient interacts
(02:26):
with it, it's about a ten and a
half minute test. We show different types of
ocular stimuli on the screen while we videotape
your eye's response to it. And then on
the other side of that, we spit out
a binary diagnosis and a severity score.
And we are spitting out that diagnosis and
severity score essentially on whatever the standard scale
currently for that indication is. So, for example,
(02:47):
if you're being diagnosed with PTSD correctly right
now, you'll probably take an assessment called the
CAHPS five. What we're spitting out is the
equivalent to that. And then there's a a
shorter version of the test,
that we're still kinda tweaking,
on our clinical trials, but, it's gonna end
up somewhere around four and a half to
five minutes that you can take as often
as the clinician wants you to to a
(03:08):
max of once a week,
as a way to see how that severity
is changing over time in response to treatment.
So it's a more objective way to understand
if the patient's actually getting better or not,
instead of what we do right now, which
is kinda just ask them every week, well,
do you feel any better yet? And then
in terms of what we're actually measuring,
in response to the ocular stimuli that we're
showing, there's three main categories.
(03:29):
The first is all of the conventional,
ocular metrics that you normally think of, things
like pupil size, blink, saccades, gaze, eye movement,
essentially kind of all of the normal things
that you think of when you think of
the eye tracking space. The second is slightly
more novel. We measure changes in the dilator
and sphincter of the iris.
The dilator is innervated by the sympathetic nervous
(03:50):
system and the sphincter by the parasympathetic. And
so we,
are able to essentially get a bit more
granularity
into what part of the nervous system the
stimuli we're showing is actually activating. And the
third is heart rate and heart rate variability
off of the face. And so across these
three categories,
we're measuring about 45 individual metrics. We feed
those into our models, and then that's what
(04:11):
we're using to deliver a diagnosis and a
severity score. And from a neuroscience standpoint, what's
interesting is there's actually very little of what
we're doing that is actually new. Almost all
of this has been established in the scientific
literature now for about thirty five years.
And the problem has been, in order to
make any of this work, you have to
take the multimodal approach of measuring all these
(04:33):
ocular metrics
simultaneously.
And that's traditionally required a lot of very
expensive eye tracking equipment because there's no such
thing as an eye tracker that's able to
actually measure all of these things simultaneously.
And so our breakthrough has less to do
with,
the raw fundamental neuroscience,
and it's more that we have built the
(04:54):
ability,
or we've built the computer vision to do
a lot of this to do a lot
of this eye tracking work with essentially the
front facing camera of a cell phone. And
that new technology that we've built is what's
allowing us to kind of operationalize a lot
of the existing neuroscience.
And and and talk about, just a moment,
your journey as a founder and how you
(05:15):
got here and what a what an amazing
thing that you're doing.
Talk about your your founder's journey.
Yeah. Sure. Absolutely. So the kinda the backstory
behind Sensei,
the, like, original
idea behind Sensei, which had nothing to do
with mental health,
started off actually as my tenth grade high
school science fair project.
(05:35):
And so this was this was 2012.
It was the year that Google Glass came
out.
And for folks who remember
Google Glass,
as amazing as it was, the one thing
that I thought was really stupid about the
whole thing was that they got essentially, you
know, a very powerful cell phone,
into the form factor of a pair of
glasses.
But the best idea they had for how
(05:57):
to interact with it was to basically slap
a mouse pad on the side of your
head. And so that got me really interested
in kind of the evolution of interface technology
over time. So how we went from a
keyboard on a typewriter to a mouse on
a PC to a touchscreen on a phone
and kind of that very natural
evolution.
And, naturally, because Google Glass was a pair
(06:17):
of glasses, it got me interested
in the
eyes as kind of a potential to serve
as that next interface device. Now, obviously, Google
Glass didn't really go anywhere, but that kind
of process of discovery
is what kind of got me to stumble
upon all the scientific literature that was out
there that talked about all these different ocular
(06:37):
metrics and their correlation
to arousal and changes in light, you know,
and mental health indications and all of that.
And so while the interface idea didn't really
go anywhere,
it seemed very obvious to me that there's
a lot of very powerful eye tracking applications
that could become commercially feasible if we could
just figure out a way to, you know,
a, be able to measure a whole bunch
(06:59):
of additional metrics
beyond just pupil size, which is what a
lot of eye tracking work was kind of
solely focused on. It was either pupil size
or gaze. And then, b, if we can
do it with kind of commercial off the
shelf equipment instead of these very, very expensive
large and traditional eye trackers. And so that
was kind of what led to the idea
of ResensaI.
I, you know, I kinda spent four, five
(07:21):
years just trying to figure out a proof
of concept, then we chase different applications
while we were trying to build out the
core technology.
And then once we got the core technology
built and it, you know, and it worked
and the science was valid, we decided to
kinda figure out what the best place to
apply it would be, and we ended up
settling on mental health as kind of that
that that perfect use case for us.
That's fantastic. And and talk about what you're
(07:43):
most focused on and excited about this year.
Yeah. So I think our the the biggest
focus for this year is our our phase
three clinical trial,
starts August 18.
And that trial being successful
and occurring on schedule is kind of the
the biggest project or milestone between where we
are now in getting FDA approval next year.
(08:05):
And so there's there's a lot of interesting
things that are going on and a lot
of stressful things that are going on, but
that that's kind of the number one focus.
As long as that goes off without a
hitch, everything else will kinda slowly fall in
place.
David, that's fantastic. Congratulations.
Tell people where they can learn more about
Sensei. Where could they learn more about Sensei?
Yeah. Absolutely. So, if you're interested in learning
(08:26):
more about Sensei, or perhaps if you want
to enroll in our trials,
our website is, senseye.co.
Thank you very much. Again, it's Sensei, not
Sensei.
Sensei,
s e n
s e y e, like I, dot co.
Sensei. You got it.
(08:47):
David, it's great to visit. We I've heard
a lot about your bachelor in origin story.
You you very, very impressive.
The the person who referred me and introduced
me to you just raves about you. Thank
you for joining us today on the Becker's
Healthcare Podcast. Thank you very much. You very
much. Appreciate you having me.
This is Scott Becker with the Becker's Healthcare
Podcast.
I'm thrilled today to be joined by the
founder of Sensei,
David Zachariah.
And David's gonna tell us about the founding
journey, what they're doing, trends he's watching, and
a lot more.
David, can you take a moment and introduce
yourself and tell us a little bit about
Sensei?
(00:21):
Yeah. Absolutely. And, thank you very much for
having me. I'm David. I'm the CEO and
founder of Sensei.
And, essentially,
the problem that we're trying to solve at
Sensei
is the fact that there's really no objective
way to do anything within the
behavioral health space today. The way that we
think about the mental health space at Sensei,
and kind of the existing standard of care
(00:41):
is that it's essentially the equivalent of if
you were to diagnose a patient with diabetes,
but you never measured their blood or if
you were gonna, you know, diagnose them with
a heart attack, but you never took a
EKG. And as ridiculous as that that sounds,
that's essentially
the way most behavioral health takes place in
America right now. About seventy five percent of
(01:01):
all mental health, is occurring, you know, inside
of primary care, and that's because of the
major shortage of psychologists and psychiatrists.
And And it's basically the equivalent of you
show up at a doctor's office. They ask
you a couple of questions. They call it
anxiety. They call it depression. They probably get
it wrong. You get a prescription for Xanax
or an SSRI, and that's kind of the
end of the road for the overwhelming
(01:23):
majority of patients. And so what we're really
trying to do at Sensei is build the
first
diagnostic and severity monitoring platform for mental health
with an initial focus on anxiety, depression, and
PTSD.
And and and talk about because your your
point is still well taken. So much of
mental health diagnosis is is
(01:43):
subjective
versus, like, if you break an arm, you
do something with an elbow, you get an
x-ray, they could see what's actually happened. And
you almost think about surgeons that did surgery
before these tools as it must have been
impossible to do it, how you wanna do
it. Talk about what Sensei does.
Yeah. Absolutely.
So the way the product works, it's essentially
(02:04):
a app on a mobile phone.
The first time a patient interacts with it,
it's about a ten and a half minute
test. And we've gone to phone to solve
a lot of distribution challenges, but at the
point that we're approved by the FDA, we
are still a regulated medical device.
And whether in person or through telehealth, it
does require a approved
clinician,
to essentially be a part of the process.
And so the first time a patient interacts
(02:26):
with it, it's about a ten and a
half minute test. We show different types of
ocular stimuli on the screen while we videotape
your eye's response to it. And then on
the other side of that, we spit out
a binary diagnosis and a severity score.
And we are spitting out that diagnosis and
severity score essentially on whatever the standard scale
currently for that indication is. So, for example,
(02:47):
if you're being diagnosed with PTSD correctly right
now, you'll probably take an assessment called the
CAHPS five. What we're spitting out is the
equivalent to that. And then there's a a
shorter version of the test,
that we're still kinda tweaking,
on our clinical trials, but, it's gonna end
up somewhere around four and a half to
five minutes that you can take as often
as the clinician wants you to to a
(03:08):
max of once a week,
as a way to see how that severity
is changing over time in response to treatment.
So it's a more objective way to understand
if the patient's actually getting better or not,
instead of what we do right now, which
is kinda just ask them every week, well,
do you feel any better yet? And then
in terms of what we're actually measuring,
in response to the ocular stimuli that we're
showing, there's three main categories.
(03:29):
The first is all of the conventional,
ocular metrics that you normally think of, things
like pupil size, blink, saccades, gaze, eye movement,
essentially kind of all of the normal things
that you think of when you think of
the eye tracking space. The second is slightly
more novel. We measure changes in the dilator
and sphincter of the iris.
The dilator is innervated by the sympathetic nervous
(03:50):
system and the sphincter by the parasympathetic. And
so we,
are able to essentially get a bit more
granularity
into what part of the nervous system the
stimuli we're showing is actually activating. And the
third is heart rate and heart rate variability
off of the face. And so across these
three categories,
we're measuring about 45 individual metrics. We feed
those into our models, and then that's what
(04:11):
we're using to deliver a diagnosis and a
severity score. And from a neuroscience standpoint, what's
interesting is there's actually very little of what
we're doing that is actually new. Almost all
of this has been established in the scientific
literature now for about thirty five years.
And the problem has been, in order to
make any of this work, you have to
take the multimodal approach of measuring all these
(04:33):
ocular metrics
simultaneously.
And that's traditionally required a lot of very
expensive eye tracking equipment because there's no such
thing as an eye tracker that's able to
actually measure all of these things simultaneously.
And so our breakthrough has less to do
with,
the raw fundamental neuroscience,
and it's more that we have built the
(04:54):
ability,
or we've built the computer vision to do
a lot of this to do a lot
of this eye tracking work with essentially the
front facing camera of a cell phone. And
that new technology that we've built is what's
allowing us to kind of operationalize a lot
of the existing neuroscience.
And and and talk about, just a moment,
your journey as a founder and how you
(05:15):
got here and what a what an amazing
thing that you're doing.
Talk about your your founder's journey.
Yeah. Sure. Absolutely. So the kinda the backstory
behind Sensei,
the, like, original
idea behind Sensei, which had nothing to do
with mental health,
started off actually as my tenth grade high
school science fair project.
(05:35):
And so this was this was 2012.
It was the year that Google Glass came
out.
And for folks who remember
Google Glass,
as amazing as it was, the one thing
that I thought was really stupid about the
whole thing was that they got essentially, you
know, a very powerful cell phone,
into the form factor of a pair of
glasses.
But the best idea they had for how
(05:57):
to interact with it was to basically slap
a mouse pad on the side of your
head. And so that got me really interested
in kind of the evolution of interface technology
over time. So how we went from a
keyboard on a typewriter to a mouse on
a PC to a touchscreen on a phone
and kind of that very natural
evolution.
And, naturally, because Google Glass was a pair
(06:17):
of glasses, it got me interested
in the
eyes as kind of a potential to serve
as that next interface device. Now, obviously, Google
Glass didn't really go anywhere, but that kind
of process of discovery
is what kind of got me to stumble
upon all the scientific literature that was out
there that talked about all these different ocular
(06:37):
metrics and their correlation
to arousal and changes in light, you know,
and mental health indications and all of that.
And so while the interface idea didn't really
go anywhere,
it seemed very obvious to me that there's
a lot of very powerful eye tracking applications
that could become commercially feasible if we could
just figure out a way to, you know,
a, be able to measure a whole bunch
(06:59):
of additional metrics
beyond just pupil size, which is what a
lot of eye tracking work was kind of
solely focused on. It was either pupil size
or gaze. And then, b, if we can
do it with kind of commercial off the
shelf equipment instead of these very, very expensive
large and traditional eye trackers. And so that
was kind of what led to the idea
of ResensaI.
I, you know, I kinda spent four, five
(07:21):
years just trying to figure out a proof
of concept, then we chase different applications
while we were trying to build out the
core technology.
And then once we got the core technology
built and it, you know, and it worked
and the science was valid, we decided to
kinda figure out what the best place to
apply it would be, and we ended up
settling on mental health as kind of that
that that perfect use case for us.
That's fantastic. And and talk about what you're
(07:43):
most focused on and excited about this year.
Yeah. So I think our the the biggest
focus for this year is our our phase
three clinical trial,
starts August 18.
And that trial being successful
and occurring on schedule is kind of the
the biggest project or milestone between where we
are now in getting FDA approval next year.
(08:05):
And so there's there's a lot of interesting
things that are going on and a lot
of stressful things that are going on, but
that that's kind of the number one focus.
As long as that goes off without a
hitch, everything else will kinda slowly fall in
place.
David, that's fantastic. Congratulations.
Tell people where they can learn more about
Sensei. Where could they learn more about Sensei?
Yeah. Absolutely. So, if you're interested in learning
(08:26):
more about Sensei, or perhaps if you want
to enroll in our trials,
our website is, senseye.co.
Thank you very much. Again, it's Sensei, not
Sensei.
Sensei,
s e n
s e y e, like I, dot co.
Sensei. You got it.
(08:47):
David, it's great to visit. We I've heard
a lot about your bachelor in origin story.
You you very, very impressive.
The the person who referred me and introduced
me to you just raves about you. Thank
you for joining us today on the Becker's
Healthcare Podcast. Thank you very much. You very
much. Appreciate you having me.
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