Good morning, everybody. The AGM will begin shortly. The chairman will open the meeting, followed by a presentation from Marjan Mikel, outlining the achievements to date and the plans for the future. Then we will move to the business of the AGM. All questions are to be held to the end, and you'll be able to either email your questions using the investors email shown on the screen, or you can use the Zoom Q&A function to submit your questions to the moderators. Once again, we will begin shortly. Thank you, everybody. We will now begin. I'll hand over to the chairman.
Good morning, ladies and gentlemen, and welcome to the 2023 annual general meeting for Respiri Limited. My name is Nicholas Smedley, and I'm your chairman. Also welcome people attending the AGM via our webcast. Before we start the formalities of today, I'll hand over to Marjan Mikel, our CEO, who'll give a short presentation on the business.
Yeah, thank you, Nick, and hello, everyone, and thank you very much for investing your time today. Some of you turning up to the offices to say hello, and what I thought we'd do today is give you a bit of an overview of what's been a rather eventful year for us and a year, a year of achievement. So, really, the year has been spent investing in getting our access to the U.S. marketplace sorted. The investments we've made, we've acquired Access Managed Services to give us a more integrated approach to the way that healthcare is, or remote patient monitoring is delivered in the United States.
We've secured customers who have given us patients, and we've got systems in place now that allow us to be able to deliver a turnkey solution when it comes to remote patient monitoring, and in doing so, improve patient outcomes and importantly, reduce costs to the healthcare delivery. Our target moving forward is to grow the patient pool from the customers we've got, to increase the number of customers that we have, and our goal is to reach cash flow positive by the second half of 2024. That's what we will be doing for the next 12 months, and I hope that you'll enjoy the ride with us. I just thought we'd take an opportunity to revisit what has been a pretty big set of achievements that we've made this year.
We are a uniquely positioned company when it comes to the firsts that we've achieved as an organization. I'll remind us all that we were the first to actually get FDA approval for our device, wheezo, which enabled us to detect wheeze and other abnormal breath sounds in patients with respiratory disorders. There is no other device in the United States that does that. We're also the first organization whose device qualified for RPM CPT Codes reimbursement. Codes that we are currently using, or sorry, our doctor customers are currently using to reimburse, services that are being provided to their patients by ourselves. Since the acquisition of Access Managed Services, we are the first organization, Australian organization, who deliver an end-to-end remote patient monitoring service to customers in the United States.
As far as we know, we are the only RPM company, RPM being Remote Patient Monitoring company, in the United States with its own IP. That's very important when it comes to differentiation and securing broader contracts, which I'll talk to as we go through this presentation. We really have invested heavily in making sure that we have everything that we need when it comes to the tools to actually deliver a positive patient growth profile for the organization moving forward, and growing that patient base is what's going to drive us to cash flow positive. We have created an IP differentiated remote patient monitoring company that is ready to scale. We have people, we have systems, we have customers, we have clients, and it's all underpinned by a proven business model that's founded on reimbursement. In the last six months, we successfully acquired Access Telehealth.
We have integrated the RPM IT systems to allow us to integrate with platforms required to deliver remote patient monitoring to our clients, who can then utilize those data to claim CPT remote patient monitoring reimbursement codes. We've secured a number of clients over the last 12 months who are currently giving us patients. We have the clinical staff now and the infrastructure in place to deliver remote patient monitoring and are doing so as we speak. And with the last raise, we also resulted in the early redemption of the convertible note that we had as a backup for the acquisition of Access Telehealth or Access Remote Patient Monitoring, sorry, earlier in the year. So all that's been delivered.
It sets us up with a platform and a foundation for us to now springboard into growing and scaling the business moving forward in 2024. Just to remind us about Access. Really, we're in a position now where prior to the acquisition of Access Managed Services, we were an e-health SaaS company that specialized in medical devices, but only in, in respiratory disorders. The total market in respiratory disorders in the United States is about 50 million people. That's asthma and COPD sufferers. And really, we delivered solutions through partners, so our ability to be able to influence how partners were delivering our remote patient monitoring solutions were a little muted because they weren't our -- that wasn't our business. So in many ways, we were constrained in what it is we could do.
But in saying that, we made some significant progress in securing patients over that period of time. Since the acquisition of Access, that is Respiri today, we are now truly a diversified remote patient monitoring service provider, with our own IP that sets us apart from other competitors. We have other remote patient monitoring services that we now offer in addition to respiratory disorders, and no matter which way you cut it, to be able to provide a turnkey remote patient monitoring solution to patients - sorry, to customers for their patients, they're not looking for a solution for a disease state, they're looking for a solution for their high-risk patients. And to do that, you have to have a solution in cardiovascular disorder, which is what we now have.
But we're still in a wonderful position because we're the only RPM company that really delivers a solution for the other 15% of patients who have got respiratory disorders. And as I've said in the past, one of the reasons that we're in discussions with some of the larger capitated risk share model providers that we are at the moment, is on the back of the wheezo device. We were invited to speak to them as an organization with Access on the back of wheezo, and been able to expand the scope of those discussions to include all their patients, not simply their remote patient monitoring place, high-risk patients in respiratory disorders. So when you talk to an insurer, they want a one-stop shop. We know the people that we've purchased in Access provide world-class care when it comes to remote patient monitoring delivery.
We know that we are significantly better than the average RPM provider in the United States. We know that we've got programs that work, and we know that those programs deliver, physiological measures, parameter measures, that basically reduce risk of high-risk patients down to a normal level. And by doing that, we anticipate keeping patients out of hospital, and no one, none of our clients argue that point. We've got the platforms in place now that allow us to deliver the solutions immediately, which we didn't have in the past. So today, we've gone from a respiratory organization to an organization that specializes in delivering remote patient monitoring solutions for all high-risk patients, which is what our clients want. And we are differentiated on a device, wheezo, that nobody else has.
To remind us about a few details around why the Access acquisition was so important to us, I've spoken about the end-to-end remote patient monitoring solution that we can now deliver. The dollars and cents also make enormous sense for us. We've gone from making $10-$20 a month per patient, to up to $100 per patient per month with the acquisition of Access Telehealth. Reminding us all that we are underpinned by reimbursement in the U.S.. The increased or improved financials see us now only require 9,000 active remote patient monitoring patients across all disease states to hit cash flow positive on a monthly basis, down from 30,000 under the old model. We've got a scalable infrastructure now.
We've got devices, systems, processes, and people in place now that allow us to deliver remote patient monitoring solutions to our existing and new clients for thousands of patients. So scale is not a problem for this organization, which is pretty important, given that our objectives over the next 12 months is to grow our patient bill from existing clients and also new clients. Important to note that a clinical staff member, which we call a patient advocate, who engages with the patient, costs us somewhere between $50,000 and $70,000 per annum. That's U.S. Each one of those people generate about $250,000 in revenues. Now, there aren't too many businesses in the world where you're actually making an 80% gross margin on human investment. So it is a very profitable business to be in and a huge marketplace.
Data really is the basis under which we will be moving forward, our value proposition with our clients. Artificial intelligence remains an important part of everything that we're doing. AI, as I've said many times over, is inherent in the way that we operate our algorithms in our devices for wheezo and future devices. We also use AI to analyze data to give us a better understanding of what our clients' patient pools look like and where the opportunities for RPM exist. We're doing that now, we're doing it differently to anybody else, and we're getting great traction with the clients that we've currently got. We're imparting more insights into what it is they could be doing to improve their situation and for new clients.
We've used it internally with regards to our own productivity when it comes to IT development and infrastructure development, and as I've said in the past, we've had an uplift of over 50% when it comes to productivity. I've spoken about the data sets that we have available to us that allow us to get a much better understanding of the opportunities that our client's patient base provides to us and how we can address those, and importantly, what programs they should be on. So there are, as you know, we now are in a position where we have a choice of RPM therapeutic solutions that we can deliver, and as is the case with many high-risk patients, they have comorbidities.
They have three, four, five things wrong with them, and we need to work out which of those we need to target to improve their outcomes. Because the solution isn't, we're gonna target them with everything, because they won't do anything. So it's really important for us to be in a position where we can analyze what is keeping patients or putting patients in hospital, and address that particular issue as a point of urgency and priority for us. So we're really in a position where AI, analytics, and the like, are important for the way that we, we deliver solutions, but as importantly, managing existing clients moving forward so they understand and appreciate the value that we're bringing them, and provide us with more target patients.
For new clients, have discussions with them about their patient bases and provide insights without actually touching their data, and being able to give them a good level of comfort around what it is we do at our own competency levels. The full RPM suite is certainly something that appeals to a broad array of customers. I've spoken to clients that we've signed up and are currently onboarding patients as we speak. Taylorville Family Medicine in Alabama, they've already got about 100 of the 500 patients enrolled in our programs. It's up from 50. The Kahuku Medical Center in Hawaii is also on board now, and we're currently working on making sure that we streamline that whole process.
There have been issues, obviously, with the fires in Maui, which have slowed progress with those moving forward, but we are back on track and moving forward with onboarding patients there as well. The other three contracts that were announced in the second half of this year are VDO Cardiology, Angelic Health, and our existing partners, MLC, that's Minnesota Lung Center. All these three organizations have started significant recruitment of patients that we are currently delivering remote patient monitoring solutions for. The annualized revenues for that, for those opportunities, are in excess of $1.1 million, and we're growing that patient base to the initial patient numbers as we speak. So we are currently at around about 500 patients in total on program. Near-term catalysts, and I'll make this short, sharp, and sweet.
We, as you know, are involved in significant and advanced discussions with insurers in a capitated model, not a fee-for-service model, where we're looking at 4,500 patients, where we won't get paid for the services that we provide, but we'll get paid per member, per month for managing a patient pool on behalf of the insurers and an independent physician association, to target those patients at highest risk and reduce the cost of managing that cohort of patients over a period of time. And we will get paid $40 per patient, per member, per month in for the initial contracts, excuse me, with a total revenue stream per annum of about $2.2 million.
Most importantly, though, is a clear line of sight contractually to 40,000 patients that these organizations look after on a broader perspective across other states on the mainland. Now, we need to deliver on the solutions that we are engaged with for the initial 4,500 patients to get there. But assuming that we do that, and the beauty of that is that's completely in our ballpark, there is a clear contractual line of sight to the 40,000 patients. Now, there's no contract until there's a contract, and we're in the final throes now of finalizing those contracts moving forward, and I hope to be able to provide the market and the shareholders with an update on that over the coming weeks and months.
The total opportunity that offers us when we get to the 40,000 patients are recurring revenues of $20 million per annum. It is important to note also that the MSO, the Medical Services Organization that we're dealing with, who is sort of an agent for the insurers that we are that have a national presence in the United States, obviously have a direct line of sight to the insurer they're working for, on behalf of, I should say. Now, these insurers have a 1 million-plus patients that fall into the same category. Now, the 40,000 patients is a 12-month timeline. The million-plus, well, that's probably two-three years away, but it's not 10 years away.
Assuming that we continue to deliver value and on the value proposition that we've been contracted to do, we have a very positive and confident scenario when it comes to rolling it out to the broader organization, 1 million patients. Now, to give you an example, half of those 1 million patients would generate $250 million per annum in recurring revenues. Now, again, I'd reinforce that's not something that's gonna happen next year, but it's something that we can see happening in three-four years' time. We're also working with three Accountable Care Organizations who have contracts that are risk-share with insurers as well. The initial contracts are for 2,000 patients, so roughly $1 million in recurring revenues, but a clear line of sight to more than 30,000 patients.
In fact, I can say now that one of the ACOs we're working with has just topped covering 45,000 patient lives themselves, so that number now is closer to 50,000. So again, assuming we roll it out to the entire patient pool, that's in excess of $14 million in recurring revenues. There are also some traditional, I'll call them, clients, that we're working with, where the scenario is a fee-for-service setup, and again, that's up to $2 million in revenues. All these things, of course, mean that we need to onboard these patients to recognize the fee-for-service revenue streams, but the other five opportunities are a fee per member. So as soon as we sign the contract, we start getting paid. It's predictable, and our job is to make sure that we deliver on the savings that we're contracted to deliver.
It has been a very, very successful year for us in 2023. I can say that our capital program, which I hope to be making public in the next few weeks, I should say, is well advanced, and we hope to be able to finalize those over the next few weeks to give us a clear line of sight to cash flow positive in the second half of 2024. You've all got my contact details. There's a lot more that I can spend time talking about, but I think we should throw it back to Nick now to the business side of the AGM. But you've got my telephone number, you've got my email address.
If people have got questions that don't get answered in this particular forum, don't hesitate to reach out, and I promise to get back to you with answers, as soon as I possibly can. So with that, I'm going to hand over to Nick to continue to the business side of the operations. Thank you.
Thank you very much, Marjan. Ladies and gentlemen, I advise that there is a quorum of members is present. I therefore declare the meeting legally constituted and open. Before proceeding with the formal business of the meeting, I'd like to introduce the directors of the company. You have Marjan Mikel, who you've just heard from, our Managing Director and CEO. Mr. Brad Snow, Independent Non-Executive Director, who'll be joining us from the United States. Also present today, virtually, is Mr. Sam Claringbold, our Chief Financial Officer. And physically, we have Andrew Metcalfe, our Company Secretary. We also welcome B.Y. Chan, representing our auditors, RSM. Brian Leedman resigned as a director on the third of November, 2023, and therefore, Resolution four is withdrawn from today's annual general meeting. This is a hybrid meeting of shareholders.
In addition to the company representatives and shareholders in Melbourne, proxy holders and guests are participating in the meeting virtually and can submit their vote by Computershare's online virtual meeting platform. Virtual attendees can listen and view the live webcast of the meeting and see the slides as we prepare, as we are presenting today. In addition, shareholders and proxy holders have the ability to ask questions and submit votes. If we experience technical difficulties during the meeting, we will assess next steps, and we'll update you via a posted message in the Zoom webcast, which may include proceeding with an in-person only meeting. For those attending in person and who wish to ask a question, you may raise your blue attendee card to ask a question when called upon to do so. For those attending online, you can type your question.
Written questions can be submitted online at any time during the meeting. I ask that you provide your name and identity, the capacity in which you are attending the meeting, and when asking a question. Please also note that your questions may be moderated or, if there are multiple questions on one topic, amalgamated together. If you have a question that does not relate to the AGM agenda, these questions will be held over and answered after the AGM is officially closed. The voting today will be conducted by way of poll on each item of business. To provide you enough time to vote, I will shortly open the voting for all resolutions. For shareholders and proxy holders who are attending in person, you will have been issued a blue attendee card with the voting details on the reverse side.
For those attending virtually, if you are eligible to vote at this meeting, a vote icon will appear. Selecting this icon will bring up a list of resolutions and present you with voting options. To cast your vote, simply select one of the options. There is no need to press a Submit or Enter button, as the vote is automatically recorded. You will receive a vote confirmation notification on your screen. You do, however, have the ability to change your vote up until the time I declare voting closed. For further details on how to log on and vote online, please refer to the online user guide. I now declare voting open for all resolutions. Please submit your votes at any time. I appoint Michael Stretton of Computershare Investor Services to be the Returning Officer and conduct the poll.
As chairman, I intend to vote undirected proxies in favor of all resolutions, as outlined in the Notice of Meeting. Your board also strongly recommends that shareholders vote for all resolutions. During the meeting, we'll display slides of each item of business and the number of proxy votes received for each resolution. Ladies and gentlemen, as the notice of meeting has been made available to all shareholders, I will take it as read. I now explain the format of today's meeting. Marjan and I have already made a presentation to shareholders, which will be published on the ASX platform, and will be published on the company's website. These presentations, among other things, will attempt to cover questions that you may have. We will then proceed to the formal resolutions and considerations of the 2023 financial statements, and reports as outlined in the notice of meeting.
Shareholders will have the opportunity to ask questions on each resolution before they are put to a vote. Please keep your questions specific to the resolution at hand, and further, please note that during consideration of the financial statements and reports, shareholders are given the opportunity to ask questions of a general nature if not covered in earlier resolutions. Ladies and gentlemen, we now move to the formal business of the meeting. Each resolution will be voted on by a poll. As I mentioned earlier, resolution four is withdrawn from the voting at today's meeting. The persons entitled to vote on the poll are all shareholders, representatives, and attorneys of shareholders, and proxy holders who hold a blue admission card. A person holding a yellow card are shareholders, representatives, and attorneys of shareholders, and proxy holders who have already voted.
The persons holding white voting cards are visitors and may not vote or ask questions. On the reverse of your blue admission card is your voting paper, which details all the resolutions being put to the poll. If you require any assistance, members of Computershare are here to assist you. Please raise your hand at any point if you require assistance during the voting process. Proxies have been received from 87 shareholders, representing 72 million ordinary shares, of being approximately 7% of Respiri's issued capital. Results of the polls will not be available until after the close of the meeting, and will be announced on the ASX and posted on the company website. If you need to leave before the close of the meeting, please complete your blue voting card and give it to the registry representative as you exit the meeting.
All shareholders and proxy holders may choose to vote on each resolution as they put to the meeting or all resolutions at once. First item of business is consideration of the 2023 financial statements and reports. The company's financial statements for the year ended 30 June, including the director's report and the report of the auditor, were provided to shareholders in the 2023 annual report. Shareholders are now provided the opportunity to ask questions regarding the financial statements and the report, the operations and management of the company, or questions to the auditor in respect to the audit report. Mr. B.Y. Chan, representing the company's external auditor, RSM, is present to respond to any questions in relation to the conduct of the audit, the preparation, and the content of the auditor's report. I now invite shareholders and proxy holders who are attending the meeting in person.
If you have any questions or comments, please raise your blue or yellow attendee card. I now move to resolution one, which is to adopt the 2023 remuneration report. Details of the resolution and proxies received for this resolution are on screen. I now invite any questions or comments from the floor. Andrew, do you have any virtual questions?
Virtual questions received.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. I now move to voting of the affirmation of Mr. Brad Snow as a director. Details of the resolution and proxies received for this resolution are now on screen. I now invite any questions or comments from the floor. Andrew, do you have any questions virtually?
No questions received on this resolution.
Okay. As there are no further questions, I put the resolution on the screen to the meeting. I now call upon Marjan to chair the next resolution.
Next resolution's on the screen, the re-election of Nicholas Smedley as a director. I now move to voting on the re-election of Mr. Nicholas Smedley. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. Andrew?
No questions received on this resolution.
Great. Now, I now put the resolution on the screen of the meeting. I'll hand back to Nicholas.
Thank you, Marjan. Resolution four, as previously mentioned, is withdrawn. Resolution five, the affirmation of Marjan Mikel as a director. I now move to voting on the affirmation of Mr. Mikel. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. Andrew, do you have any comments virtually? Questions virtually.
Questions received virtually.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. I now move to ratify a prior issue of 24,787,942 shares, pursuant to placement. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. Andrew, do you have any virtual questions?
No virtual questions received.
I now put the resolution on the screen to the meeting. I now move to ratify a prior issue of 12,393,971 options. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. And Andrew, are there any questions virtually?
No questions received virtually.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. I now call upon Marjan to chair the next resolution.
Next resolution: approval of the issue of shares and options to Nicholas Smedley, pursuant to placement. I now move to approve an issue of 800,294 shares and 400,147 options to Nicholas Smedley and related party, pursuant to placement. Details of the resolution and proxy received for this resolution are on the screen. I now invite any questions or comments from the floor. Andrew?
No questions received virtually.
I'll now hand back to Nicholas.
Thank you. Thank you, Marjan. Resolution 7-B. I now move to approve an issue of 882,353 shares, and 441,177 options to Brian Leedman, a related party at the time, pursuant to placement. Details of the resolution and proxies received are now on the screen. I now invite any questions or comments from the floor. Andrew, do we have any virtual questions?
No virtual questions received.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. I now call on Marjan to chair the next resolution, resolution 8-A.
Approval of issue of options to Nicholas Smedley. I now move to approve an issue of 30 million unlisted options to Nicholas Smedley and a related party. Details of the resolution and proxy received for this resolution are on the screen. I now invite any questions and comments from the floor. Andrew?
No questions received on the resolution.
Great. I'll hand back to Nicholas.
Thank you, Marjan. Resolution 8-B, approval of issue of options to Marjan Mikel. I now approve, move to approve the issue of 30 million unlisted options to Marjan Mikel, a related party. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. And Andrew, anything virtually?
No questions received virtually.
Okay. As there are no further questions, I put the resolution on the screen to the meeting. Approval of Respiri share option plan. I now move to approve the Respiri share option plan. Details of the resolution are on screen, and proxies received are now also on screen. I now invite any questions or comments from the floor. Andrew, do we have any comments virtually?
No questions received virtually.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. Resolution 10, ratify prior issue of options under additional placement. I now move to ratify the issuance of 19,117,647 options, listed options to sophisticated and professional investors. Details of the resolution and proxies received for this resolution are on the screen. I now invite any questions or comments from the floor. Andrew, do we have anything virtually?
No questions received virtually.
As there are no questions, I put the resolution on the screen to the meeting. Resolution 11, approval of 10% placement capacity. I now seek approval for the 10% placement capacity permitted under Listing Rule 7.1A. This is a special resolution and requires 75% approval of votes received to pass. Details of the resolution and proxies received are now on screen. I now invite any questions or comments from the floor. Andrew, do we have any virtual questions?
No questions received virtually.
Okay. As there are no further questions, I now put the resolution on the screen to the meeting. Thank you, ladies and gentlemen. That completes the discussion of the formal parts of the meeting. I will close the voting in approximately one minute. Please ensure your votes are recorded and according to your wishes. For shareholders in the room, please raise your hands if you need any more time to complete your voting card. Yeah, good. Thank you. I now declare the poll closed, and Computershare representatives will collect voting cards. Thank you, ladies and gentlemen. There is no further business to be conducted. The results of the poll voting will be announced to the ASX as soon as possible after this meeting, and will be passed on, posted on the company's website.
I now declare the meeting closed, and in doing so, I thank you for your attendance today.