Flowly (YC S21) – Manage pain using VR and biofeedback

Hey HN! This is Celine, Julien, and Narae of Flowly (https://www.flowly.world/). Flowly is an app that combines VR and biofeedback training to help people manage pain, reduce anxiety, and increase relaxation (we send every member a VR headset and Realtime HR Sensor to use). We started this company to serve the 1 in 3 Americans who suffer from chronic pain and we’re now backed by the NIH and National Institute of Drug Abuse.

The opioid crisis has exposed how prevalent chronic pain is and how inaccessible and limited pain management solutions are today. Many pain management tools don't address all aspects of pain because pain encompasses more than physical pain: the top symptoms of chronic pain actually include anxiety, depression, and feelings of social isolation. In other words, chronic pain is a bio-psycho-social condition. It is important to us that we address it as such and this comprehensive approach is one of our core differentiators.

I (Celine) started the company because I grew up around pancreatic cancer patients, who were experiencing excruciating pain. People close to me passed away from morphine overdose and not even the cancer itself. I saw how pain affected someone not just physically, but also psychologically and socially.

Later when I was developing interactive content at DreamWorks, I got involved with VR and biometric feedback for entertainment experiences. At a certain point, I realized that all this cool tech had actually been studied since the 80s for pain management. This resonated strongly with me because of my personal experience. I brought in my best friend from Yale, Julien, who was at Hyperloop One doing controls on their Transponics team, and then Narae, an internationally recognized designer and animator from Broadway and California Institute of the Arts. Together we convinced the Chair of Anesthesiology at UCLA to come aboard and design the Flowly prototype together.

When we developed Flowly we were adamant about two things: it has to be accessible (needs to be easy to use at home) and it has to be science-backed. Our NIH grant cites over 300+ studies using VR and biofeedback for pain and anxiety management. We've conducted case studies, Phase I clinical trials, and have more trials coming up. Our Chief Principal Investigator is the Chair of Perioperative Medicine at UPMC and our Director of Research is at USC.

Another aim we have is to make Flowly reimbursable (covered by insurance so people who can’t afford it can use it too)— as you may know, that is not an easy journey, but we are working on it. In the meantime, we provide it direct-to-consumer for those who do have the ability to pay for a subscription which is $30/month. We are acutely aware this price point privileges certain populations to Flowly and that’s why we are working hard to get Flowly to be reimbursable. If you have experience with this or have advice we would love all the help we can get to make Flowly as accessible as possible.

The Flowly we've launched today works like this: you receive a kit with your subscription that includes a mobile VR headset and real-time Heart Rate Sensor that work with our iOS App. You enter a Flowly session in VR which helps to tackle pain in a few ways. First, you enter a beautiful immersive VR world that can work to distract you from existing pain or anxiety (called Gate Control Theory). Second, in each session you are guided to autoregulate and control your nervous system, which is where much of the body’s pain response is modulated. You learn to control your nervous system through biofeedback training which is the ability to see your realtime biometric data (Heart Rate, Heart Rate Variability, respiration) and then through calibrated breathing guides, voice-over, and light gamification, we teach you how to control those metrics and shift your body from fight-or-flight mode (your sympathetic nervous system) to rest-and-recovery mode (your parasympathetic nervous system). Third, we incorporate voice-overs in every session that focus on different therapeutic approaches like Acceptance and Commitment Therapy, Value Affirmation exercises, etc. Afterwards, you can track your progress through a personalized data analytics portal. You'll also get access to a text/call line with our Health Coach for questions or help getting set-up.

We're partnered with University of Pittsburgh Medical Center, USC, US Pain Foundation, and other institutions to provide Flowly to those who need it. Surprisingly to us, this past year many people we didn't expect to need Flowly also came to us for help— folks like therapists who needed anxiety management themselves, or families dealing with pain and stress at home.

We have a long way to go, but we feel passionate about creating an opioid-sparing tool for pain management. Check out our iOS app here: https://apps.apple.com/us/app/flowly-relaxation-training/id1.... We're working on an Android version. We welcome your feedback, questions and advice. Thank you for reading!



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andrey azimov by Andrey Azimov