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Earnings Call: Q1 2023

May 11, 2023

Moderator

Ladies and gentlemen, hello and welcome to the Butterfly Network, Inc. Q1 2023 earnings call. My name is Maxine and I'll be coordinating the call today. If you would like to ask a question during the presentation, you may do so by pressing star followed by one on your telephone keypad. I will now hand you over to Heather Getz, Executive Vice President, Chief Financial Officer, to begin. Heather, please go ahead when you're ready.

Heather Getz
EVP and CFO, Butterfly Network

Good morning, and thank you for joining us today. Earlier this morning, Butterfly released financial results for the first quarter ended March 31, 2023, and provided a business update. The release and earnings presentation, which include a reconciliation of management's use of non-GAAP financial measures compared to the most applicable GAAP measures, are currently available on the investors section of the company's website at ir.butterflynetwork.com. I, Heather Getz, Executive Vice President and Chief Financial Officer of Butterfly, alongside Joseph DeVivo, Butterfly Chairman and CEO, and Darius Shahida, Butterfly Chief Strategy Officer, will host this morning's call. During today's call, we will be making certain forward-looking statements.

These statements may include, among other things, expectations with respect to financial results, future performance, development and commercialization of products and services, potential regulatory approvals, the size and potential growth of current or future markets for our products and services, and the impact of macroeconomic factors on our business. These forward-looking statements are based on current information, assumptions, and expectations that are subject to change and involve a number of known and unknown risks, uncertainties and other factors that may cause actual results to differ materially from those contained in the forward-looking statements. These and other risks are described in our filings made with the Securities and Exchange Commission. You are cautioned not to place undue reliance on these forward-looking statements, and the company disclaims any obligation to update such statements.

As a reminder, this call is being webcast and recorded, and we will be referencing a slide presentation in conjunction with our remarks. There may be a short delay between the live telephone audio and the presentation being shown. To access the webcast, please visit the events section of the investor section of our website, and a replay of the event will be available following the call. I would now like to turn the call over to Joseph DeVivo. Joe?

Joseph DeVivo
President and CEO, Butterfly Network

Thank you, Heather. Good morning. I feel quite fortunate to join the family at Butterfly Network during such a critical time in its history. I first wanna thank Dr. Jonathan Rothberg and the board for the opportunity, and also the warm welcome I've received from the whole Butterfly team. I've only been here a few weeks and have enjoyed meeting the incredible people who've brought so much success to the company, and I'm really excited about Butterfly potential. During my career, I've seen the early days of minimally invasive surgery, surgical robotics, interventional oncology, and most recently, digital health, each with the undisputed disruptors in their respective fields. It's an exciting ride, and I'm thrilled to be a part of the disruption that will be caused by the democratization of medical imaging through Butterfly one-of-a-kind hardware enabled by AI tools.

This technology will empower providers to help treat and diagnose patients where they are. In a moment, Darius will provide a business update on the quarter, and Heather will communicate the financial results. First, I'd like to share my initial perspective on the opportunities that I see. Over the past couple years, I served in the AI ultrasound field, actually partnering with Butterfly, and have seen firsthand how impactful enabling clinicians to capture images at the point of care can be. Since the inception of Butterfly, we've spoken about the importance of ease of use in empowering practitioners worldwide with ultrasound. Because nearly 2/3 of the world's population lacks access to medical imaging, and the vast majority of healthcare practitioners are not ultrasound-trained, ease of use and training are the most critical limiting factors to broaden adoption and true democratization of medical imaging.

With our Ultrasound-on-Chip technology, Butterfly has made imaging more accessible to medical professionals worldwide and frankly easier to use. This is why we've invested so heavily in the development of novel AI applications to empower practitioners wherever they may be. From our Auto Bladder Volume tool to our cardiac guidance and interpretation partnership, to our auto gestational age application with the Gates Foundation, now most recently, our Auto B-line tool. This newly approved tool makes it easier for medical professionals to capture key pulmonary scans to detect fluid in the lungs at the point of care, giving them a timely diagnosis when they need it. This B-line application is essential for diagnosis confirmation in pneumonia and many other CVDs . In fact, there are more than 1 million diagnoses per year for pneumonia alone in this country, our B-line application will make it easier.

Butterfly is clearly at the forefront of AI development as we seek to make our solution as easy as possible. While this approach and the importance of AI has garnered a lot of attention, investment, and M&A recently, it's been at the core of our DNA and the company strategy since the very beginning of Butterfly. Our secure Butterfly Cloud empowers our AI developers to build applications for our customers by tapping into our database, which represents the largest ultrasound image repository in the world. Importantly, this focus on novel AI tools development in our image repository is not only bearing fruit in the form of FDA approvals, but in driving the commercial adoption of our technology in ways that traditional POCUS is unable to do. Going forward, it's our intention to start monetizing our AI algorithms across our large install base.

Over the past 3 years, Butterfly has deployed more devices in the market than any other company with nearly 100,000 ultrasound probes shipped to date. Butterfly has an amazing ability to reach, deploy, and empower users virtually. I view Butterfly as a technology-empowered software company. Our chip-based hardware provides us an accessible and growing user base that our software can be sold to, providing incremental software opportunities. A recent FDA clearance has paved the way for other developed tools that are in queue for regulatory submission. Reaching more people, empowering them with intelligent diagnostic tools, and helping them with the business of medicine through enterprise software is the winning formula for our future. Being a disruptor is never easy. I've been there many times before. It's always hard to predict the timing of customer and market adoption in the face of the massive opportunity it presents.

I fully intend to lead Butterfly through this journey and capture the market for our employees and our investors. With that, I'll turn it over to Darius to comment on our commercial and business progress in the quarter. Darius?

Darius Shahida
CSO, Butterfly Network

Thank you for that introduction, Joe. We are excited to have you on board. In the last quarterly update, we shared a recap of all the progress that was made in 2022 across each of our four pillars: health systems, international expansion, path to home, and adjacent value stream on our path to democratize medical imaging. 2023 has kicked off in earnest with progress across each of these four pillars, with our team driving outcomes against our principles of easy, everywhere, and economical. With that said, let's dive into the progress we made this past quarter in more detail. Starting with our progress in health systems, this quarter kicked off with more large institutions embracing Butterfly and deploying our Blueprint solution at scale.

In fact, we are excited to share that this morning we have signed another significant deal, this time with the largest medical school in the country, to deploy our Butterfly solution to help facilitate POCUS across the continuum of education. The institution expects to use our QA and credentialing, utilization tracking, and Butterfly Academy didactic courses as a complement to its existing POCUS curriculum. This opportunity represents an important partnership to empower and deploy an exemplary medical education program across multiple specialties and to train hundreds of students, residents, and physicians. While we are introducing this meaningful partnership today, the deployment was signed in April. We look forward to sharing more details in the coming months. Another notable partnership was our multi-year rollout with HQMedEd , an internationally recognized emergency airway management and POCUS organization based in Minnesota.

This deployment will put Butterfly iQ+ probes and Compass software in over 100 rural and critical access hospitals throughout the state of Minnesota. The deployment will be paired with extensive POCUS training as part of the grants awarded to HQMedEd by the Helmsley Foundation, aiming to boost sonography and POCUS training and ultimately improve access to exceptional medical treatment for all Minnesotans. Internationally, as you'll recall, last quarter, we announced deployment with the University Hospital Bonn in Germany, in which they are deploying Butterfly in a one-to-one model across their entire medical school and Butterfly Blueprint across their health system. Great progress has been made in this area with the implementation now underway. The connectivity is in place. First students arrive later this month. Moving to our clinical progress and our path to home.

Beyond the aforementioned FDA approval we received in Q1, our clinical team continues to make progress with a number of key studies that demonstrate the value of Butterfly in a multitude of use cases and clinical settings. Our team is actively working with several institutions that have deployed Butterfly at scale and are compiling and quantifying the meaningful ROI that Butterfly is driving through encounter-based workflow. Expect more updates on this front in the coming months. Exciting clinical advancement in the first quarter is the release of the ACC Cardiovascular POCUS Workbook. Inspired by an innovation partnership with Butterfly, the ACC put together a team of experts and developed this guidance tool for Cardiologists to enhance the adoption and utilization of POCUS by Cardiologists.

Three key areas are addressed, including cardiac, lung, and vascular bedside ultrasound, as well as the value POCUS can provide in enhancing routine bedside physical exams. Now the ACC joins a growing list of professional societies acknowledging and supporting the evolution of bedside assessment to include POCUS, and we are thrilled to have been the inspiration for this publication. Last but not least, we have signed contracts with large US academic medical centers in the Northeast to initiate clinical projects that are evaluating wide-scale deployment for clinical care and training initiatives that explore the use of Butterfly as a new standard of care in hospital patient management. We anticipate initiating this in Q3 and look forward to updating you on our progress on this front later this year as well. Moving to our adjacent markets.

Our veterinary team is excited to announce that a seminal paper was published in the JVME , which demonstrates the feasibility and benefits of implementing a self-driven POCUS program in large animal teaching hospitals using Butterfly iQ+ Vet. This randomized controlled trial found that by equipping students with Butterfly iQ+ Vet and providing simple, self-guided digital materials for device use and key clinical applications, it is feasible to implement self-motivated POCUS training even in large animal teaching hospitals amid heavy caseloads and time constraints. Moreover, the self-driven program increased POCUS knowledge in students that have lower test scores. 94% of students found the Butterfly useful in their education, and 95% reported they would like a device during all their clinical rotations.

This Penn research corroborates our belief that by empowering students with Butterfly's easy-to-use portable POCUS system, academic institutions will greatly enhance training efficiencies and knowledge outcomes in their programs. Supporting ultrasound education and training is core to our veterinary team strategy, as it is with our broader company strategy. The vet team continued to expand existing relationships with academic institutions and strategic partners this past quarter. As you'll recall, in Q3 of 2022, Butterfly announced and entered into a collaboration with a third-party training platform that connects veterinary hospitals with professional sonographers in real time using the Butterfly iQ+ Vet device. In Q1 of this year, we expanded this relationship, and they now offer a more comprehensive package that includes Butterfly program tablets with educational offerings for all their customers. With all this progress in mind, I will now turn the call over to Heather for the financial results.

Heather?

Heather Getz
EVP and CFO, Butterfly Network

Thank you, Joe and Darius. Revenue for the 1st quarter of 2023 was $15.5 million, essentially flat compared to the prior year period, and within our guidance communicated on the year-end earnings call. Looking at our sales channel, we saw a 15% increase in our US. direct business, driven by higher subscription revenue and increases in our global health business, which includes our deployment in Africa with the Gates Foundation. This growth was offset by softness across our other channels, including e-commerce, international distribution and vet. Breaking our revenue down between product and software. Product revenue was $8.8 million, a decrease of 20% versus Q1 of 2022. This decrease was driven by lower volume across all segments, with the exception of global health.

Software and services revenue was $6.6 million in the first quarter, growing by 45% over the prior year period. Software and services mix was 43% of revenue, an increase by approximately 15 percentage points versus Q1 of 2022. This increase was due to a higher installed base of product with the accompanying subscription software, renewals on the existing base of software users and software implementations completed during the quarter. Turning now to gross profit. Gross profit was $9.1 million in Q1 of 2023 compared to $8.3 million in the prior year period. Gross profit margin was 59% for the first quarter, which compares to 54% in Q1 of 2022. This increase was primarily due to a higher average selling price in addition to product mix, reflecting a higher proportion of subscription revenues.

Also contributing to the increased margin was improved manufacturing productivity and other efficiencies. Offsetting these benefits was higher amortization of internal use software, which reduced margin by 560 basis points. For the first quarter of 2023, adjusted EBITDA loss was $22.3 million, compared to a loss of $39.7 million for the same period in 2022. The improvement in adjusted EBITDA loss was driven by the increased gross margin dollars as well as the implemented cost reductions, which led to lower payroll, consulting and other outside services. Moving to our capital resources. As of March 31st 2023, cash and cash equivalents, including restricted cash, were $198 million.

Our monthly use of cash, excluding bonus and severance, was $11 million in the first quarter of 2023, compared to $18 million per month in the first half of 2022. Before I turn the call back to Joe, I would like to touch on 2023 guidance. It has been less than a month since Joe joined the Butterfly team, and we need to give him an opportunity to evaluate the company's strategy. As such, we cannot affirm full year guidance at this time. We will revisit our guidance on our second quarter earnings call.

That being said, we are committed to providing as much near-term direction as possible. Considering the greater than expected disruption we experienced in the first quarter resulting from the change in leadership and reduction in force, as well as the longer than expected launch time with our distribution partners, we are expecting Q2 revenue to increase sequentially, but still be flattish to last year. Breaking it down, we believe our US direct channel will continue to show strength and as we recently signed a deal with one of the largest medical schools in the country and have visibility to another in the near future. We also expect our distribution partners to gain traction as we progress through the quarter. Our vet channel will see expansion, albeit at a slower pace than expected.

We are, however, expecting continued softness in our international distribution as well as lower global health revenue as we anniversary the Gates Foundation deployment. As for EBITDA, we are expecting some improvement versus the first quarter of this year, with higher sequential revenue and the full realization of our reduction in force. To close, while we saw strength in our U.S. direct and global health channels, we experienced higher than expected disruption and softness in our other channels. We believe we can navigate this disruption we are seeing while still realizing the vision and mission of Butterfly. Under all scenarios, we have a solid cash position. We continue to evaluate and find opportunities for efficiencies, and we will continue to invest in our current and future growth while closely scrutinizing our investments to ensure that we pick the maximum ROI projects and carefully evaluate the trade-offs.

Meanwhile, we will give Joe the opportunity to assess our strategy. With that, I will turn the call back over to Joe for closing remarks.

Joseph DeVivo
President and CEO, Butterfly Network

Thank you, Heather. My last prepared remark will be on the incredible opportunity Ultrasound-on-Chip technology provides. As I mentioned earlier, I believe we are a technology-enabled software company. We have many opportunities to monetize our broad and growing base of hardware with new software applications. I don't believe it ends there. I believe the proprietary Butterfly chip can be leveraged in more form factors to empower even more patients to be treated in more automated and intelligent ways. I'm excited to share with you our vision before the end of this year. Thank you. I'll now turn it over to the operator for questions.

Moderator

Thank you. If you would like to ask a question, please press star followed by one on your telephone keypad now. If you do change your mind, please press star followed by two. When preparing to ask your question, please ensure that your line is unmuted. Our first question today comes from Joshua Jennings from Cowen. Please go ahead. Your line is now open.

Joshua Jennings
Managing Director and Senior Analyst, TD Cowen

Hi, good morning. Thanks for taking the questions and congratulations, Joe, on joining the Butterfly team.

Joseph DeVivo
President and CEO, Butterfly Network

Thank you. Happy to be here.

Joshua Jennings
Managing Director and Senior Analyst, TD Cowen

Absolutely. Great. Good morning, Heather and Darius. Wanted to just maybe just review, I guess, the details on the US commercial team and maybe just to remind us of the US sales infrastructure. Sounds like, Joe, you may be reevaluating the commercial strategy in the US and globally. Just have a better handle on kind of the combination of direct sales reps and distributors. Anything incremental or sorry, you get detailed you can share, would just be helpful to understand where that commercial team sits and how that could evolve over the course of 2023.

Heather Getz
EVP and CFO, Butterfly Network

Yeah. Hi, Josh. If you look at our direct sales force, as we mentioned on the year-end call, when we restructured it, we did reduce some of our direct sales force and focused them specifically on the hospital systems, which has been successful in Q1. As I mentioned, we were up 15% year-over-year, which is a great result with that reduction. On the distribution side, we had expected to onboard third-party distributors at a faster rate, and that did not occur. You will start to see that benefit in Q2. As we mentioned, Joe will be evaluating that go-to-market strategy, and we will revisit it on the Q2 call.

Joshua Jennings
Managing Director and Senior Analyst, TD Cowen

Understood. No, thanks for that. was hoping to also just get an understanding of the hardware and software pipeline initiatives. Anything you can share to what investors should be expecting in 2023 in terms of new capabilities, features, through software or also the next gen Butterfly IQ system.

Joseph DeVivo
President and CEO, Butterfly Network

Well, so, this is Joe, Josh. First of all, you know, historically, when we would sell software, we would sell it in a bundle in a subscription package. What we are doing is we're in the process of coming up with different levels of bundles and being able, as new capabilities come out, to be able to monetize them with a different pricing strategy. We are working on that today, and I'd expect, you know, in the year, near the end of the year, to start going with new capabilities to customers and be able to monetize them. When we do that, we'll let you know. I think we are gonna be releasing the B-line algorithm sometime in the second quarter.

That'll be, you know, an ability to kind of reinvigorate our subscriber base and find ways, you know, ultimately to upsell. I think 2024 is the year where you're gonna see a lot of incremental software and also some hardware come out. We'll certainly update that more specifically a little bit later. I have to say, you know, coming in as a new CEO and learning what's in the pipeline, I feel like a kid in a candy store. There is so much this team has done, and I'm actually stunned it hasn't come to market yet. There are AI applications, there's excuse me, software improvements, hardware. It's gonna be a lot of fun.

Joshua Jennings
Managing Director and Senior Analyst, TD Cowen

Well, that's great to hear. wanted to ask about the home opportunity and I know the team has been working on regulatory pathways with the FDA to open up that home indication for either patient self-scanning or even, you know, provider scanning in the home. Any progress there? Anything you can share just from the timeline front. When do you think that work with the FDA will be done, and you'll kinda have a defined pathway forward in terms of what's gonna be required?

Joseph DeVivo
President and CEO, Butterfly Network

Well, that's a part of things that we're revisiting. I think there may be opportunities to get there sooner, and it may not be as complicated as we thought about in the past. Just give me a little time so I can piece it together for you. The home and alt site is gonna be a, you know, a massive opportunity for us. I'm just thrilled, you know, to update you. I wish I could tell you what I know right now. What I want right now is dates and deliverables so, you know, when I tell you, I can, I can tell you with certainty on timing. Our, our... I have a very strong desire.

You know, when I've looked at this business from the outside in, the hospital business is very important and very strong. It's also filled with some incredible incumbents who, you know, are gonna fight us tooth and nail to cede market share, although they have been, fortunately for Butterfly. There's an even larger opportunity outside the hospital. You know, in my time in digital health and virtual, we've all seen how payers, providers, employers are all trying to find ways to reduce the cost of care and help treat or manage and maintain patients in their home. Given the lens that I'm bringing from my time at InTouch and Teladoc, I think there's gonna be an enormous opportunity, and I don't see it as a science project.

I see it as connecting some dots internally and packaging things in a way that can create value for this company. It's, it's a little too soon for me to, you know, to connect those dots for you, and I can't wait until I can.

Joshua Jennings
Managing Director and Senior Analyst, TD Cowen

No, understandable. Thanks for that. Then last question, wanted to just ask about the Blueprint software package, enterprise software, and the software revenue line is performing very nicely since it was introduced, I think, last year. Can you just help us understand? I know part of the strategy is in the facilitating deployment, but also Blueprint could act as a Trojan horse, and there's some hospital systems that are adopting Blueprint in front of the Butterfly IQ+ handheld devices and all the capabilities there.

maybe just help us better understand that opportunity in the United States, just Butterfly Blueprint as a standalone software solution, for hospital systems exclusive of the devices and how it's been contributing to the software and other services revenue growth over the last couple quarters? Thanks for taking the questions.

Joseph DeVivo
President and CEO, Butterfly Network

Sure, Josh. I'll do my best, and if I have any holes, I'll let the team help me. Our enterprise software is called Compass, and Compass plus Butterfly IQ+, meaning our enterprise software plus our hardware in a wrapped bundle, is called Butterfly Blueprint. The Compass software has been a pleasant surprise to the team. I think, you know, we do a lot in software. We are using software to tune our chip to get the appropriate images. We're using software to create AI algorithms to make image capture more successful, and then we're using software with Compass to make the business of medicine and the business of ultrasound more efficient.

A lot of people take scans, but they're not documenting those scans, and then they're not billing for those scans. When they don't bill for those scans, that's revenue for health systems that they're foregoing. There really isn't, I guess to the team's surprise, there really isn't an enterprise management software that ties the scan, the ID and the record of the scan to the EMR and then to the billing process to ensure that these scans are paid for. As our team approaches hospitals, regardless of who the incumbent, imaging company is, they pretty much all are excited about the fact that Butterfly's solving a pretty major problem for them. The early signs are we're seeing in a few of our early sites. Capture simply more reimbursement.

The ROI is very immediate. Literally, being able to see what the baseline in reimbursement for imaging was the prior month and then after Compass seeing that go up materially. It's a big positive for us, and we're gonna continue as we market Compass to make Blueprint and the bundling of the entire solution, a priority. I think our team has been... I think the prior management team, prior leadership were very visionary and did a great job in this area. I think, you know, I feel blessed to have a product like that with everything else that's in the pipeline.

Fantastic. Thanks a lot, Joe.

Thank you.

Moderator

Thank you. The next question comes from Suraj Kalia from Oppenheimer and Company. Please go ahead. Your line is now open.

Suraj Kalia
Managing Director, Oppenheimer & Co

Morning, everyone. Can you hear me all right?

Heather Getz
EVP and CFO, Butterfly Network

Yes.

Joseph DeVivo
President and CEO, Butterfly Network

Yes.

Darius Shahida
CSO, Butterfly Network

Good morning, Suraj.

Suraj Kalia
Managing Director, Oppenheimer & Co

Perfect. Joe, Darius, Heather. Joe, welcome aboard. Pleasure to connect with you over the phone today.

Joseph DeVivo
President and CEO, Butterfly Network

Thank you.

Suraj Kalia
Managing Director, Oppenheimer & Co

Joe, lot of commentary, you know, you have provided, and I appreciate the fact that, you know, you're just getting your feet wet, and there are a lot of unknowns out there. Totally understand. Joe, one of the things you mentioned is repositioning the company, I'm paraphrasing here, as a technology-enabled software company or AI-enabled something you had said. Moving forward, Joe, would you advise us to start looking at the software component of the business, you know, that line item specifically in terms of the ROI on these strategic initiatives rather than the handhelds being placed per se as an ultimate driver of software? How would you advise we'd start looking whether Q2, Q3 onwards in terms of these two line items?

Joseph DeVivo
President and CEO, Butterfly Network

Thank you for the question. It's an incredibly lucid question. I look forward to when I feel comfortable providing guidance, and I feel we have initiatives in place that are driving revenue, to help at that time, help you know, forecast and see it, you know, and peel it out in the right manner. The reason, you know, while I have not been inside the operation long, it's only been, you know, a couple weeks of meeting people, but I have been studying the business from afar. I have been thinking about the business and I had a thesis on the business, you know, before I took the job.

In thinking about the business, what I'm seeing is that we are having an ever-increasing install base, and our capabilities and our software are becoming more sophisticated. The way to look at it simply is every quarter we're gonna increase our install base. We are not in any way, shape, or form de-emphasizing hardware. I see an opportunity that as new capabilities come out and those capabilities are creating value for customers, instead of just adding them into a package for free, for those customers who will see value in that additional software, they could pay for it. That means that we have to create an enterprise system that allows a customer to go to a site, and actually increase their package and their capability and buy more software from us.

A, we wanna increase the breadth of our business by placing as much software as possible, or I'm sorry, placing as much hardware as possible. Second, as our R&D continues to be productive in creating new solutions, that's not just increasing the ASP on the new sales, it's going back to the base business, reinvigorating them and selling them software. It's not really a pivot, but it's a different way to monetize the business. I think what that'll do, you know, you've seen in the quarter, I think we were 54% gross margin going to 59% or I don't know if that's exactly right. We've seen an increase in gross margin, you know, and I'd like to see this business with much higher gross margins than we're at.

If we can do, if we can keep our hardware at an appropriate price to create market access, but we can monetize our software at very high gross margin, I think you'll see the profitability or at least the contribution profile of the company increasing, you know, over time as we execute on that strategy. I'm very happy to unpack it for you when we get closer to guidance, but at least that's how I'm thinking.

Suraj Kalia
Managing Director, Oppenheimer & Co

Fair enough. Joe, again, maybe a preemptive question, so please forgive me for that.

Joseph DeVivo
President and CEO, Butterfly Network

Sure.

Suraj Kalia
Managing Director, Oppenheimer & Co

Our math is, you know, the rough software revs per handheld are, like, $400-ish. I don't have it in front of me, somewhere in that ballpark. I guess let's say it's X revenues, software revenues per handheld. Let's assume a metric like that. Joe, as you think about the remapping the company, right? Whether it's 12- 18, 24 months hence, how much do you think is the additional leverage you have? Can X go to 1.5X? 2X? How do you think about, you know, this is the target where we have to get basically to monetize or upsell, like you had said, you know, with all these new apps, the B-line and presumably others coming online shortly?

Joseph DeVivo
President and CEO, Butterfly Network

Thank you for the question, and I'll caution myself not to get ahead of myself. I think your question is going in the right direction, where first of all, you know, Butterfly is leaving a lot of price on the table. If you look at our total cost of acquisition from a customer side and what it costs in its entirety, you know, we're 1/3 of what the market is charging today, maybe 1/2 of what the market is charging today. Even just to get to parity, with enhanced features, we have a lot of pricing upside. The way I look at it though is I would like to keep our handhelds and our hardware price competitive, and I see, you know, upside in selling more software.

Every time we sell more software, we're gonna have to cost justify the value of that software. It's not like we're just gonna be increasing prices on existing customers. That's not what we would do. What we would do is we would launch a new AI algorithm that enables people to capture, bill, serve in an entirely different way. Then just as any software does, you calculate what is the net value and ROI of that software, and you make it available. They can buy it or they don't have to buy it. I think what we'll find is, first of all, we'll probably sub-specialize.

We may be doing something in cardiac, then we may be doing something in OB, and then when another thing might come out in for bowel, and then those subspecialties will see that opportunity, and then we'll increase the capability. It may not stack up, you know, for one customer constantly with the software that comes out, but it'll allow us to increase the amount of value we are getting per customer. I think given our current price position, we have a lot of upside, and the only thing that we would be doing is selling something that the customer values, and I think there's headroom.

Suraj Kalia
Managing Director, Oppenheimer & Co

Got it. Thank you for taking my question, Joe. Welcome aboard.

Joseph DeVivo
President and CEO, Butterfly Network

Thanks, Raj.

Moderator

Thank you. The next question comes from Neil Chatterji from B. Riley. Please go ahead, Neil. Your line is now open.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

Hey, good morning. Thanks for taking our questions, welcome Joe, and congratulations on the new role. First off, just, yeah, curious with ChatGPT and just generative AI, just curious if you could just talk about, you know, how the AI in your platform and with your various tools, you know, maybe reflects any of that and the potential to leverage that on the Butterfly Enterprise software platform. You know, whether it's diagnostically or with, you know, ultrasound workloads or billing.

Joseph DeVivo
President and CEO, Butterfly Network

Yes, that's a great question. Thank you. First of all, most of the AI focus to date has been on how do we make it easier for a medical professional that is not trained in imaging, how do we make it easier for them? That's what we've done historically. The team has been cycling... You know, we have a We're launching a project now on our entire business reinvention at all levels, whether it's current, you know, whether it's in development or whether it's in customer service, or whether it's in, you know, direction. We are looking at all ways to optimize our business with this new level of intelligence. You know, what I've learned in my time in digital health, and I think it's a, you know, pretty basic fact in AI is...

It's actually, it leads to one of the greatest frustrations I have with healthcare is 80%-90% of healthcare data is not accessible to AI. It sits in thousands and thousands of small databases across the country. Even the largest EMR Companies, the customers themselves encapsulate their data, so there's no mass national database to learn from. AI is, it's not just about the algorithm, it's about the access to the data to be able to learn, and then create the appropriate outputs. That's where I think, you know, we have a distinct advantage. You know, this company was architected correctly from the beginning. Our Founder's vision was dead on.

In my last company, we had a closed, secure private cloud that all of our transactions went through, and we leveraged it extremely well to be able to deliver telehealth across enterprises. Butterfly was architected in a very visionary way, where we capture massive amounts of data. It allows us to learn on our customer behaviors. It allows us to learn not just in clinical image interpretation, but it allows us to learn what they're using and how we can serve them better. Our founder personally challenged me to look at business reinvention to ensure that we're on the cutting edge using these tools, and I can assure you we will do it.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

Great. Thanks for that. Just on the pilot programs with the large medical centers, you know, just kinda curious how that compares to past strategies and how that might be a new model to replicate. You know, I think in the past you've had kind of physician champions that helped sort of run device pilots in certain departments. How might this be different with Blueprint, you know, versus just a device deployment?

Darius Shahida
CSO, Butterfly Network

This is Darius. Thank you for the question. If you're referring to the medical school focus that we mentioned on the call, that's actually very consistent with the strategy that we prosecuted in the past, it's just another proof point of how Butterfly is really transforming the way that medicine is being taught from the very get-go. The medical schools remain a key focus for us because obviously strategically they're empowering the next generation of students with Butterfly. Is that what you're referring to?

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

I was talking about the large medical center.

Darius Shahida
CSO, Butterfly Network

Oh.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

We talked about-.

Darius Shahida
CSO, Butterfly Network

The $32.7 mark.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

Some clinical projects.

Darius Shahida
CSO, Butterfly Network

Yeah. If you're referring to our focus on large health systems, for example, with URMC, which we've announced in the past, we've continued to make key progress there. In fact, we went live in 15 new departments this past quarter, including ED, anesthesia, the PICU, NICU, adult ICU, and many others. That remains obviously a focus, as Heather and Joe mentioned, and we continue to focus on that area as we deploy Blueprint, which is our Compass software and hardware in more large health systems.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

Got it.

Darius Shahida
CSO, Butterfly Network

So continuing-

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

All right. Sure. Then just one other follow-up here. Just in terms of the, you know, I think last quarter you talked about adding, you know, 12 new Blueprint accounts. Just kind of curious how that tracked in the first quarter and how that activity is looking kind of going forward, you know, including with the recent, you know, Cloud 2.0's launch.

Heather Getz
EVP and CFO, Butterfly Network

Yeah. Directionally, we continue to add new customers. Q1 does tend to be a little bit lighter than Q4. Sequentially, it was lower. We continue to add more customers.

Neil Chatterji
Senior Analyst and Equity Research, B. Riley

Great. That's it for me.

Heather Getz
EVP and CFO, Butterfly Network

Thank you.

Darius Shahida
CSO, Butterfly Network

Thanks.

Moderator

Thank you. As a reminder, if you would like to ask a question, please press star followed by one on your telephone keypad now. Our next question comes from Danielle Antalffy from UBS. Please go ahead. Your line is now open.

Danielle Antalffy
Senior Analyst, UBS

Hey. Good morning, everyone. Thanks so much for taking the question. Joe, congrats on the role in joining the team there.

Joseph DeVivo
President and CEO, Butterfly Network

Thank you.

Danielle Antalffy
Senior Analyst, UBS

I'm curious, Joe, given your background in this industry, as we think about the goal of Butterfly and eventually, you know, home care and things like that, how you think about the competitive barriers to entry here. You know, GE HealthCare did recently buy Caption Health. Just curious about how you think about the competitive moats and where Butterfly can sustain a competitive advantage in that regard.

Joseph DeVivo
President and CEO, Butterfly Network

Oh, boy. I wish I could answer that question today. I'll answer it for you in the future. I think First of all, I was with Caption, and I'm a big fan of Caption and a big fan of GE, to be quite honest with you. It's an incredible team of great people, and I consider them friends. I personally believe Butterfly will be able to show some pretty tangible advantages in access to the home market. You know, personally, I think the big four in imaging have advantages in the hospital market. I think there are, you know, contracting, leveraging. They can give away handheld ultrasounds to protect the rest of their business.

I don't think that leverage exists in the off-site channels and in home, and I think some of our software and some of the new capabilities I'll be sharing with you know, I think my belief is we have the advantage.

Danielle Antalffy
Senior Analyst, UBS

Okay. Okay. Yeah. No, that's great. Then, just Heather, maybe this is a question for you, just as we think about the models. Appreciate, you know, pausing, giving guidance for now, but, just from a capital needs perspective, how we should be thinking about where Butterfly is as you're reevaluating the strategy here?

Heather Getz
EVP and CFO, Butterfly Network

Capital referring specifically to fundraising.

Danielle Antalffy
Senior Analyst, UBS

Yeah.

Heather Getz
EVP and CFO, Butterfly Network

Capital referring to cash.

Danielle Antalffy
Senior Analyst, UBS

Yeah.

Heather Getz
EVP and CFO, Butterfly Network

We're in great shape from a cash perspective and I figured that's what you meant. Just wanted to make sure.

Danielle Antalffy
Senior Analyst, UBS

Thank you.

Heather Getz
EVP and CFO, Butterfly Network

We're in a great place from a cash perspective. Plenty of runway into 2025. We're continuing to look for additional efficiencies, and so stay tuned on that.

Danielle Antalffy
Senior Analyst, UBS

Okay. Thank you guys so much.

Joseph DeVivo
President and CEO, Butterfly Network

Thank you.

Heather Getz
EVP and CFO, Butterfly Network

Thanks, Danielle.

Darius Shahida
CSO, Butterfly Network

Thanks, Danielle.

Moderator

Thank you. As a final reminder, if you would like to ask a question, please press star followed by one on your telephone keypad now. This does conclude our Q&A session for today, so I'll hand back over to the management team for any additional or closing remarks.

Joseph DeVivo
President and CEO, Butterfly Network

Great. I wanna thank everyone for joining the call this morning. Please give me some grace on my excitement, but it's real. You know, we have, you know, we have to get through getting the organization, you know, back up after, you know, what they've been through the last six months has been very challenging. We're gonna focus on getting the organization, you know, to where it needs to be. I'm telling you these things that we're working on, I'm very excited to share with you because I believe, you know, by the end of this year in 2024, it's gonna be a lot of fun around here. Thank you for your time.

Moderator

Thank you, ladies and gentlemen. This concludes today's call. Thank you for joining. You may now disconnect your lines.

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