Hello, everyone. Thank you for coming here with us today. We have Waqaas Al-Siddiq presenting for Biotricity. Thank you.
Hi, everybody. All right. Just before I jump into this slide, a little bit about the company. Actually, for that, I'll maybe go back so we're not distracted with the data. Biotricity's a smart cardiac monitoring company. We looked at cardiology as the overall market and saw that there's too many patients, it's a chronic condition, large wait times to see a cardiologist, and we wanted to kind of solve that by building a cardiac platform. We started our journey looking at diagnostics because that's where the journey for most patients begins, right? They get referred from a general practitioner to a cardiologist to try and figure out what is going on with their heart.
To oversimplify it, you know, you can kind of have two issues in a house, electrical or plumbing. Heart, electrical or plumbing. Of course, some of the electrical issues can also catch some plumbing issues. We focus on the electrical issues of the heart and that's the background of the, you know, of the company. Our core product is a smart cardiac monitoring which has cellular built in, and it's got algorithms built in. It's put onto the patient like you saw in that first picture. It's collecting your data continuously, but it's also analyzing it, and then it will transmit it in real time if it detects any anomaly, and then you can deal with emergency response.
If there is no emergency, then the data is uploaded and analyzed and available for the physician to review at the end of it. Our trailing 12-month revenue right now is $16 million. Forward-looking is $18 million. We are profitable already as of March. Our margins are 80%, well, 82%-83%, but, you know, that's we expect that to be stable and stay. Our retention rate is about 92%, what that means is it'll take us, you know, over 10- years to essentially cycle through our entire book. From a growth perspective, what that does is our last year's 12- months is always smaller than our trailing 12- months, which is always smaller than our forward-looking 12- months.
Our focus is how do we expand, and if we can continue to sell in one quarter, the next quarter is bigger. Sorry, one other thing which I'd like to touch on, which is I think very important, is as of this year, we've also achieved economies of scale. What that means is that, you know, when you think about business fundamentals and whether a business can grow and continue to sustain itself, is the question is: How did you achieve that profitability, right? Did you achieve that profitability by cutting into operations or technology or R&D budgets so you can no longer sustain your product, or did you achieve profitability with all of the departments that need that business to basically survive for the foreseeable future? We've achieved it with economies of scale.
We have our full R&D, our robust product pipeline. We'll talk about that a little bit later. We have the commercial team, and we have the profit dollars to invest. As we are scaling, the amount of dollars that we need to apply to each department is significantly less, which is why we can focus on growth. I talked a little bit about this. You know, when we talk about cardiac, why cardiac? Traditionally, it's about 30 days of wait time to see a cardiologist in the U.S. Sometimes it's even longer, up to 90 days. It's responsible for one in three deaths. The most interesting part of it is that 80% of these issues can actually be preventable if you could actually catch it early enough.
This is where our product comes in. The product, as you can see on the picture and then on the original picture, it sits in the middle of your chest. It uses some standard electrodes, but it's got cellular built in. We're a tech company, so we're vertically integrated. We actually have integrated the cellular modem inside of it, and so we have partnerships with all of the telecom providers, so AT&T, Sprint, Verizon, and T-Mobile. If Verizon has a problem, our device automatically will switch to AT&T. If AT&T's stronger in an area, it'll automatically pick AT&T. We do not have outages. In terms of how our solution works, patient comes in with symptoms. The device is placed on them, the device is analyzing and collecting that data. It brings a final report.
That report is provided to the doctor. The doctor can then review that data, make a surgical decision or a procedure, and then, if the patient needs to be managed or serviced thereafter, they will do disease management, which we'll talk about in a bit as a future of our product. How the whole system works is there's basically these three pieces, right? You have the patient with the device. You have a phone app as a companion. It's not required. Then on the clinic side, you have all of the real-time data. When a patient goes in and they have a symptom, this device is placed, it analyzes the data, and it comes in as a report.
The doctor will look at the report and look at what is the issue, what is the problem? Do I need to do a procedure? Do I need to put the patient on a medication? The device is also, and the report, this solution, as you're seeing on the screen, this is insurance reimbursable. How do we make our money? We go into a physician, and right now what they're doing is they're using technology like this as a service provider. If you get a prescription, you go somewhere else and you get a device that'll be placed on you, and then they will monitor you, and then they will send a report to your physician.
In that process, the physician will still get a report, but they'll have to wait two to three weeks to get the data because it's gotta be mailed back, and they get to make $25 for reading the report, but they then do the procedure. In our case, we provide the device and the reporting in one package. They pay a monthly fee, but now they get to bill insurance. Why that's important is because billing on a patient is about $500 on average. Instead of getting $25, they get $500. They're paying us $250 as a flat fee in a subscription model, so that's where our $18 million comes in from. They use that device on two patients a month, and the device lasts for two- years.
They're generating about $1,000, so $500 per patient for every patient that they screen. They pay us $250, they net $750, and they do this for two- years. This is where that annuity comes in for us. To be a cardiologist, you have to identify cardiac risk, and we are the tip of that iceberg, and we are a key product associated with identifying the issues. We now bring that in an insource model so that they can get reimbursement for it. That's where our retention rate comes in because we are one of the most profitable technologies that a cardiologist is using in their day-to-day practice. What happens after they diagnose that patient. They, you know, that's great. They get a study.
They get to bill for it. They collect revenue. Now the patient has to be managed, right? If you do a procedure on that patient, you're gonna see them once every year if they're stable. If they're not stable, you're gonna be supplementing them with medications. Maybe you install a pacemaker. Now you gotta manage that data. There's these other markets that come after diagnostics, which is what we're focusing on for the next two to three years. One is disease management. There's reimbursement around managing patients and their medications, especially if they're cardiac. We are right now in that ambulatory cardiac monitoring market of I think there's a laser here. This is the market that we live in, the $5.5 billion market.
Once you diagnose here, you go into disease management, or you go into implantable management if you got an implant. Our focus is to now take the patients that we're screening, now we know what their problem is, and we built disease management software and analytics and reporting to enter into those markets. The idea isn't to shift our sales focus. We will still always sell ambulatory first. This is about upselling our existing customers. We have 2,500 physicians that use our product in 35 states. We will go in and say, "Hey, you're using our ambulatory cardiac monitoring. We've shown you how it's better for the patient. We've shown you how it gives you better clinical data, and it generates revenue for you." We're doing the same for disease management and implantables.
The idea is that we are combining this concept of saving time and doing faster diagnosis with revenue generation, and the three together gives us stickiness and retention. To give you an idea of how, you know, our growth over the last five years, we've always grown, but what's interesting is our gross margin has been improving. We do have a hardware, you saw that device, but it's a very small piece of our revenue. In the beginning, obviously, it was a higher percentage, but as we get more devices out into the market, most of our revenue's actually getting coming in from that $250 a month subscription.
As 99% of our revenue becomes subscription SaaS, hardware becomes 1%, and that's where our margins kinda get steady state around 84%-85%. In terms of revenue mix, we talked about those programs. We have invested in them, and we're gonna be launching them later this year and early next year, but we've already piloted with existing customers. You know, if you talk about, you know, last year, we already saw about half a million dollars showing up in our platform Disease Management Program. This year, we expect that to be about $1 million, and about another $100,000 or so in the implantable side of things.
These divisions will basically grow to be about the same size as our ambulatory. Where we're doing $18 million today in ambulatory cardiac monitoring, we expect to do $18 million in disease management and, you know, $18 million in implantables. Of course, it's gonna take time to do that, and that is our focus of investing in the commercial team. You can also see here the device sales as, you know, becoming a smaller and smaller percentage of our revenue, which is why the margins keep improving. In terms of whether or not we think users are gonna be compliant, right?
We're very methodical about how we commercialize at Biotricity, one of the things is that disease management only works if the patients can be engaged. One of the things that we did was we introduced a companion app, not for the purposes of the device, because the device doesn't need it's cellular enabled itself, but to see are patients actually going to engage? Are they actually going to ask us questions? We do surveys.
What we're seeing is that, over the last three years since we, since we launched it, we have about 70,000 people that have just on their own downloaded our app because they've saw it in our book or they got a text message about it when they, when they got their study assigned by the doctor. They're actually asking us questions about, "Hey, we need some information about our condition. We need these tips and tricks." What that tells us that disease management is gonna work, and which is why we invested in our disease management program, and then we took it to our doctors to see, hey, are they gonna adopt it?
Our KOLs have adopted it, and it's generating revenue, we think it's gonna be a great strategy over the next 18 months. Another reason, like, you know, talk about why do providers adopt us and why do we have stickiness and why are we continuing to grow, because we've always grown. If you think about our revenue, in our last 12 months, we did $15.6 million. Our cardiology customers generated $62 million. They paid us $15.6, they generated $62 million. That's dollars they were not earning, they were earning $4.2 million before Biotricity showed up. What's the result of that? More patients are being seen. Many of our practices have expanded. They have now multiple sites. They're servicing a lot more patients.
Their programs have expanded. We're, we're a catalyst for growth in cardiology. Today we've recorded over 2 trillion beats. Why that's important is we're constantly improving, the more data that we collect, the better we get. We do, we've done about 400,000 patients since we launched our product. We will do about 200,000 patients this year. We have over 2,500 physicians, as I mentioned earlier. With that, I'll turn it over for questions. Yes.
Does this apply to post-surgery? For example, my cardiologist put more stents in my heart.
Yeah.
A lot of monitoring goes on, and I have to go back and forth to his office. Would this help in that regard?
Yes.
Also, does it increase his capacity to build his practice?
Yeah. on both fronts. When you stent somebody, and I'm assuming, did you do it in the hospital setting or in the ambulatory surgery center, like in outpatient settings?
After the hospital.
Okay. At, yeah.
Yes, I'm home, and so, but I need to be monitored.
This would be a great addition to your cardiology practice. For post stenting, they can put it on you, and they can monitor you for two weeks to see how you are stabilizing. When they're bringing you back in for your post-op visit, they'll have a lot more data. Because it'll generate revenue for them as well, as well as improving outcomes, it will allow them to grow their practice. That's exactly our idea. One thing is that stenting is now happening where you're doing same-day discharges for, you know, simpler procedures, and a big part of that is, "Okay, I'm gonna discharge you in two hours, but I'm gonna put a monitor on you to make sure everything is good." Sir?
Great product. How soon till break even?
We are profitable. We're break even, cash flow positive, EBITDA positive. DSO are 22 days. We have incredible DSO.
Have you discovered new data, or are you using data that's been there that is now digitized?
We've discovered new data. Most people don't have such large datasets on such a wide population set. We are also sampling at a very high rate. There's a couple things that we did which is very different. If you go to a hospital, everybody was sampling and looking at the heart 200 x a second. We look at it 1,000 x a second. What we've been able to figure out is we are seeing underlying sleep issues. Some patients are going for cardiac, but they are undiagnosed sleep apnea patients. We're now doing clinical studies with ResMed to pull that data out and actually be able to do a cardiac and a sleep study simultaneously.
Are you public?
Yeah, we're public.
What do you trade for?
Not very much. I think, like, less than $1. Like, I think $0.30, $0.25. Huh? $0.16. There you go. Yeah.
I know you focus a lot on software, but, how heavily or involved are you with the hardware that, I mean, I walked in maybe 10 minutes late to this, so I'm just curious?
Yeah
Like how involved you are with the hardware stuff.
We're vertically integrated. I'm personally a specialized chip architect, we know hardware very well. We use hardware and we built hardware simply because there's no hardware in this space that was capable to meet our needs and to do it in a way that was cost effective. It doesn't mean we will always be a hardware company, I think that adding multiple biometrics, collecting data, and getting a more holistic picture of the patient does require you to be kinda hardware light.
You know, think of us as a technology company that happens to be in software or in healthcare. If you look at Biotricity's employees, they're not a bunch of healthcare people that came out and tried to fix a broken healthcare system. They're a bunch of ex-Googlers and Intel and NVIDIA guys who are like, "Hey, we should probably utilize this technology to drive better outcomes.
Do you have any partnerships with, like, healthcare providers or something so that, like, if a patient uses this, they sort of get, like, a deduction perhaps on their premium or something that sort of gets, sort of incentivizes them to sort of take on and use this product?
We sell through and with providers. Our technology is reimbursable, we go to the provider. The provider's prescribing this and utilizing it. It's really driven from the provider. Our next product, which is in disease management, that is the one that is going to be, you know, a partnership between the provider and the patient, and it will do exactly what you're saying, that if the patient utilize it more, their premiums go down. Doctor has an incentive to read the data because it's reimbursable, and we're sitting at the background providing all the data in a nice, you know, clinical context.
Thank you.
You have such a good product. This is very positive. What is it gonna take for you to take off? I mean, just looking at your numbers, you still have losses and a little, You're still burning cash flows from operations. There's still losses. I mean, you're still negative on that, and you're saying you're profitable. The question is, what is it gonna take? Are you a hidden gem for what you have? Is it something unique? Has the market yet to discover you?
Yeah. Few different things. I'll answer them each. The reason the operations are showing negative is because you're looking at historical. We're profitable as of March. Forward-looking, we're profitable. The next quarter should either be operational positive or be right on the edge. If you look at it quarter-over-quarter, it's going down, down. I think the year before last year, our net operating was, like, - $2.5, and our trailing 12 is - $0.7. It's edging down. What's gonna help us to grow is we need more feet on the ground. We're in 35 states, we did an analysis on You know, I talked about the $5.6 billion market, right?
In the 35 states that we're in, we're not in 50 states, but 90% of the market of all cardiac ambulatory is in those 35 states, so that's a pretty good. Like, we're in the right area, right? If you take the top 20%, it's about 1,300, like offices, and we have eight sales reps.
That's
So the-
Yeah.
It is interesting, right? We've been doing two things. We've been partnering with, like, complementary partnerships. Like, we made a partnership with ResMed, which is doing really well. We just did that this year. That's growing. Now that we're profitable, that's why I talked a little bit about economies of scale, like, we've achieved economy of scale. $100 comes in, the next two- years for me is $100 comes in, $20 goes to your COGS, $80 is left. We put $20 on the balance sheet. The rest goes into sales. We need to expand the commercial team. As we expand the commercial team, what we're also finding is that your doctors are giving us referrals.
They're like, "Hey, my buddy who I went to medical school," or, "My buddy down the street." The problem is that there's so many buddies, and there's just not enough people to call on them. We need more bodies.
Makes sense. Thank you. What about GPO affiliations?
We are partnered with all of the GPO. We have HealthTrust, Vizient, and Premier, which cover 90% of the hospital market in the U.S. What that means is that you don't have to go through this, a process of supply chain or vendor qualification. We're a qualified vendor in all, in 90% of hospitals. That doesn't mean that they suddenly just start buying from you. You still have to physically go in there and sell them, but it removes the six-month process of saying, "Let me qualify you as a vendor. Let me qualify your cybersecurity. Let me qualify your clinical effectiveness." We've done all of that. Now it's really about investing in the commercial team.
Can this device help a patient find a cardiologist?
No. We haven't done that yet. That's something that we should probably work on.
Yeah.
Yes, sir.
Can you talk about your competition a little, a little bit?
Yep
Your competitive advantage?
Yeah. Great. I'm gonna oversimplify just, you know, because there's a bunch of different people in the room. In cardiology and ambulatory cardiology, you have three different types of technology that's primarily used today. One is traditional Holter, which is, like, a GE device. It's actually not GE's device. A German company that they white label, GE. The reimbursement is $85, and the doctor gets to bill the $85 in general, and he's got, like, a device which uses two double A batteries. Got to bring it back, download the data, and the nurse has to read everything, and that's for 24 hours. The next device is an extended Holter device, which iRhythm uses, they invented that, and which is a seven-day patch monitor.
You put it on, you wear it for seven days. There's no connectivity. You peel it off. You mail it back. You wait another week for them to process then another week for them to get it back to the doctor. Three weeks to four weeks, hopefully nothing happened to you. The reimbursement there is $250, the doctor only makes $25 . It's outsourced. The third product is a patch monitor with a cell phone, a locked cell phone, and that's what Philips has. They bought a company called BioTel. This one will transmit the data. You still have to mail it back, you get the report faster. Philips bills $850, the doctor makes $25 . Okay. A doctor, you usually have all three solutions.
We walk in there, and we're like, "This is complicated. Take all of this off and replace it with one device. You can use it for all the modalities you want, and you get to, instead of making $85, $25, you get to make $85, $250, $850." The blended average, that's why I was saying $500. They are making $500 per patient, and they rotate that device, and it sits on their shelf, and they don't have to worry about all of these other, you know, dealing with three different technologies in one office. Our competitive advantage is simplification of workflow. We are the only three-channel device, so better clinical data, and revenue generation. Yes.
Do you have to have a cardiac event before they use the monitor? Do you have to think, you know, I've had a heart attack, visit the cardiologist, and then they put it on you? There's nothing before that you're a high-risk person to monitor you?
Yeah.
In case
This should be used for those high-risk patients. If you go into a general practitioner, you have high lipids, for example, or high cholesterol, it's continuously staying, they should refer you to a cardiologist, this would be something that they would This would be the number, the first thing that they would do, right? They would do this, they may run an echo. There's two basic things that they would wanna check immediately, and for sure, electrical is the number one thing that they would wanna look at.
The GP could prescribe on the spot before your cardiologist appointment.
The GP can, we do not target general practitioners because the volume is very low. We focus on cardiology because we have a small sales force. Ideally, it should be, like, you don't wanna wait for the heart attack, right? Actually, we save patients from getting heart attacks and strokes because our device will detect it, then it will transmit it, and it'll notify the physician that or whoever's on call, "It's 3:00 A.M. The patient has a 6-second pause. You need to have an emergency procedure." We've actually caught patients that were, like, remarkably leaving a cardiologist office in the parking lot and, like, pulling out, and the device goes off, and it turns out they went into emergency surgery because they were gonna have a heart attack in, like, 10 hours.
Thank you so much. We'll take further questions outside. Thank you.
Thank you.