Andrew Malcolmson, Fifth Eye - Early Warning Solution for Patient Management | LSI USA '24

Andrew Malcolmson  0:04  
I'm honored, truly honored to be the CEO of Fifth Eye, you know, for a wide variety of reasons. But most importantly, because the team that fits I believe has developed, really what is the next generation the next breakthrough in patient monitoring clinical decision support. And I'm happy to introduce you to today. Before we get started, I'll just talk a little bit about some of the challenges and they are challenges everyone in this room is very familiar with everyone who's in this space is very familiar with. And they're very large and very significant. First one is really about how do I manage bed utilization and patient throughput? How do I know what patients need to be admitted versus sent home? How do I know who needs to be stepped up who can be safely stepped down? Doing that with accurate information that both gives you an indication of where they are now and where they're gonna go in the future is tremendously impactful for patient throughput from both revenue and an expense avoidance standpoint. The second one, and probably the biggest one is unreimbursed expense, I could talk about nothing but sepsis, and the numbers would be huge, and the problem would be significant. But later on to sepsis, other issues like respiratory compromise, blood clots, a DVT or PE s, a cold blood loss, all those other things, and then the opportunity becomes truly massive, hundreds of billions of dollars of avoidable expense spent every year all unreimbursed third is really the next generation of cancer care. I mean, everybody's talking about T cell therapies, immuno oncology is the the readmission rates that these drugs are achieving is staggering. However, the complication rates associated with their delivery is almost equally as staggering. And it's really what limits them from being deployed ultimately, in large scale on an outpatient basis, identifying early cytokine release syndrome so that you can be treated, mitigated and managed is a huge opportunity, both from a, you know, care standpoint, but also from, you know, enabling these companies to achieve the opportunities that their drugs have in front of them. So what is the issue? The issue is time, every clinician will tell you, if they had more time, they could address these issues. It's not that they don't know what to do. It's not like the treatments aren't defined, they know what to do. They just don't have the time. The end, if they don't have the time, ultimately, the result of that is patient decompensation and shock and far too many instances. And that's because, again, the early indications that you get from existing patient monitoring solutions aren't aren't that early. They're late. They're trailing, it's when you only a patient has ceased to have the ability to to overcome the challenges that they're facing. Do you start to get a degradation or roll if it's a step function, right? Patients fly into the ground. That's why there's rapid response teams. That's why there's literally books written on how to run down the hallway with a crash cart and save somebody's life. What we've developed in fifth is the analytic for hemodynamic instability. He like the fish is something that gives clinicians time, right time to identify patients at risk time to treat those patients and time to avoid these expensive, you know, adverse issues that affect every hospital on the planet. So how do we do it? We don't do it by looking at the typical sort of library of inputs, the clinical decisions are made today. So we're not looking at vitals. We're not looking at the EMR. We're not looking at labs. We're not even incorporating, you know, physician input or physician observation. We're actually looking at and measuring quantifying your autonomic nervous system engagement. How hard is your body your homeostatic mechanisms fighting to defend your hemodynamic status? It's again, the it's well known, it's well studied. Everybody understands it. So that's what we're seeing. And that happens, by definition by physiologic definition, prior to any deviation of any of those other things that I described. Couple things really quickly, just about that. So how we develop this, it's it's actually developed at the University of Michigan using a supervised machine learning model developed over about four and a half years 1000s of patients, hundreds of hours of clinicians time, mostly in exchange for pizza and coffee, and rotating data building this model. So it is not a black box. It is not an AI derived algorithm. It's a hard coded algorithm that's tied to physician input, long established. Secondly, it's not we're not pushing the boundaries of clinical science here at all the understanding of the autonomic nervous system and how it's studied, and how it's understood to impact, you know, care in response to adverse events is well understood public hundreds, if not 1000 publications on this topic. So we are not pushing those boundaries, that all third it relies solely on a single lead ECG. That's our only input even not even particularly high resolution 125 hertz or higher. So anything from a bedside ECG lead set, a tele pack right ambulatory ECG monitor, or even the ever increasing sort of library of wearable patches all are valid inputs for us. And it's two products effectively, which is why we call it the IT system. The first one which you can see on on your left, has green and red and every two minutes the system posts, are you compensating or are you not? Obviously, red is compensating. Green is you are not the high resolution Look, there is typically used to assess what the patient's history is, are they getting worse? Are they intermittent? Are they pervasive? And also to manage the treatment as you are titrating? Meds we had an presentation on infusion, you know, how effectively are you delivering these drugs? If you're pushing pressors? are they solving the problem? Do you need more right getting real time feedback on that is really critically important. That was a de novo clearance. It's on the market. It was agony, but it's there. And it's, it's ready to go. The second one is called rtpi. The analytic for human and African stability predictive indicator, it is the look into the future. So again, a cleared product, in this case a 510. K, it tells you what the increased risk of that patient is for a hemodynamic instability, a first instance of hemodynamic instability in the next hour. And if it's red as it is, in this case, the patient is 51 times more likely to have an episode of hemodynamic instability, which I think as everybody knows, is the precursor to decompensation and shock. And so two other things that we really needed to do when we're developing these products, actually, three, first one is make sure that it was obvious and intuitive of how it can be used. And I think you can see, it's pretty intuitive. We actually spent a lot of time making it simpler and simpler, because physicians told us I don't want I want to be able to look at it and understand is there something that I need to do or not so red, green, and in one case, yellow from the predictive standpoint, the other two things that needed to be accessible, and it needed to be incorporated will, if that's a word incorporate people into clinical workflows, right, you know, what do they do when they have these some of these indications. And so the fact that it was built as a pure software solution, a cloud based solution, SaaS based solution, SAM D cleared product enabled us to do that. So we use the sensors that are already on the patient's ECG, or can easily be applied to the patients, we put the number, the indication, in the screens, you're already looking at, at the nursing station at any ICU, you know, wherever that might be. And thirdly, we have a REST API. So we can push the ultimate indication into epic into Cerner into your flow sheets into the decision and the protocols ation that you're already using. It's just one more input only a much earlier input. The other thing that's really important about the sort of this hardware, less pure software solution is that it enables us to really drive our go to market strategy, because while we can deploy this as a standalone solution, and we have and we will continue to the real value is when you couple it with one of these other vendors, one of the sensor vendors, one of the patient monitoring vendors, one of the remote patient monitoring vendors, because adding it to your mix, adding it to your portfolio makes it better. So our whole strategy is the channel market reseller partnership, and we have four already in place. Two with patch vendors, and two with patient monitoring companies. I'm running at a time but the only thing I'll say on this slide is we believe almost all if not all of the risk has been eliminated from this business, strong IP position, strong signal processing capabilities, we have an algorithm that would take others years to compete with, we're cleared. We have nine publications out there, all of which actually have better outcomes than our FDA clearances. And we have early commercial traction, we have two big pilots at major academic medical centers, and we have more that are on the way. So again, I mentioned the beginning that I'm honored to be part of this business. And I think it's true because I don't think there's anything else out there that has the ability to reduce adverse events and reduce costs the way that all he does. So I invite everybody, whether you are an investor, whether you are a clinician, whether you are a potential partner of us to work with us reach out and and let's move this. Let's move the ball forward. Finally, last thing. Again, we have a pipeline that's in place already a number of pilots, a number of existing partners that we're already working with lots of future growth opportunities as well at the home for peds. Right now we're clear for 18 and older inside the hospital endo us. Again, this application would work equally there. Well there we are laser focused on the hospital us above 18 market right now though. And then from a fundraising standpoint, we have a convert convertible notes. It's actually open right now. I'd happily talk to you about it. That's closing at the end of April. And finally we have a Series B that we're anticipating doing at the end of this year as some of these major pilots, including a 630 bed, virtual ICU pilot is fully complete. So thanks for your time. Here's the team, you know me. Happy to go through this later. But thanks for your time again, if you have any questions on the investment on the technology and the clinical side, grab me. I'll be here all evening. Thanks for time.