Video Transcription
Marc Zemel 00:02
Hi, I'm Marc Zemel. I'm CEO and co-founder of Retia Medical. Our vision is to provide actionable information to protect the vital organs for all high-risk patients. We currently are selling the Argos hemodynamic monitor, and we'll be launching the Argos Infinity later next year. This is a $4 billion market for high-risk surgical and critically ill patients, we're FDA cleared, we have the CE mark, and we're currently sold in 14 countries. Among our many customers and leading academic medical centers include eight Cleveland Clinic hospitals. They have over 50 monitors and will be buying another 20 by the end of this year. In 2022, we did a $15 million Series B, led by Fran Yes, another global strategic. Last year, we got on Premier Vizient and into the VA hospital system. Those contracts allow us to access many more hospitals. This year, we closed on a Series B2, with participation from all our current investors and some new ones, and in the coming 15 months, we'll be accelerating our commercial ramp. We'll be launching Argos Infinity and additional AI algorithms. Proactive, data-driven care is the key to preventing costly complications. In the US alone, there are 15 million high-risk surgeries and stays in the ICU, and all of those patients are at high risk of acute kidney injury, cardiac injury, and mortality. These are obviously very costly to the healthcare system and terrible outcomes for the patient. A key risk there is circulatory shock. The longer a patient is in shock, the more likely they are to get that complication, and up to 70% of them experience this circulatory shock. It's like a regular emergency, and today, that shock is detected by the bedside monitor, the GE or the Philips, with the hypotension alarm. But in fact, there's a period of silent shock where the advanced hemodynamic parameters are abnormal, which we can detect before the hypotension alarm, before the emergency. Some doctors use hemodynamic monitors, but many do not. Our goal is to make hemodynamic data ubiquitous for guiding care. So of the 400 million surgeries every year that we're looking at, the top 25% are the highest risk of complications. Of those, 20 million patients every year get an arterial line for beat-to-beat blood pressure monitoring because those doctors are worried about circulatory shock. But yet, only two and a half of those folks, two and a half million, get the hemodynamic monitor, typically from Edwards. They have 95% market share in the US. It's a product that doesn't work on all patients. So our thesis to grow this market was to provide consistent accuracy, streamline the setup, and make it intuitive to use, and then make it affordable for every patient. That was our thesis 10 years ago. It was validated last year in a survey of over 600 MDs. So this is the product: the Argos hemodynamic monitor provides 10 parameters to detect, diagnose, and guide treatment of shock, and we've earned clinical trust through our superior accuracy. The multi-beat analysis algorithm that was developed by an MIT PhD has been proven in multiple studies to be 50% more accurate than the leading competitor, and it's the only monitor that's accurate in cardiogenic shock and in arrhythmia. So this is what everybody was waiting for, right? They'd been burned before, right? And so now they're talking to us, and they're using us as a reference in their big data studies. For example, at Hopkins, they recently completed an almost 10,000 patient study, and they showed that exposure to silent shock detected by our monitor led to an increase in AKI, cardiac injury, and even mortality, and that was statistically significant. So we have a growing network of hospitals. We just hit 50—sorry, 60 hospitals in the past few weeks, many of the names you know here. Each one of them where you see an asterisk is a repeat customer. Over 50% of our business is from repeat customers. It's not just the wealthy hospitals like the Cleveland Clinics; it's also those who treat the underinsured or the uninsured, like Temple and University Hospital. They each saw the clinical and economic value of this technology. We've been steadily growing our adoption in hospitals and accelerating our growth of patient monitoring, approaching 30,000 patients monitored by the end of the year. Typically, in the OR, we will be installed on the anesthesia machine, and then in the ICU, they'll mount us next to their infusion pumps where they're titrating their vasoactive medications and other medications to treat circulatory problems. I mentioned our repeat business; typically, in the OR, we will be used 20 times a month. We track our net promoter score, which is 83; typical MedTech is like 15-20. We have pictures of people hugging our monitor. They're so happy because it's helping them do their job. Here's a case in point. This was a patient, a 60-year-old, and the trauma ICU nurse was like, "My patient's fine. Look at the blood pressure, look at the heart rate, clinical exam, I don't need your monitor." Well, we said, "Look, give us one minute, one cable. We'll hook it up, and let's see what we see." And in fact, all the abnormal parameters you see there, right? We caught a bleed. That patient had a liter of blood that came out once we unclogged the drain in his abdomen. Right? You only have five circulating in your body. It's a significant issue. It's a mortality risk of 10-20%, and it's very expensive to treat. So this is the thing that I'm going to say over and over again: silent shock is what we detect, and we help prevent that emergency. Over 90 studies show that using hemodynamic data to guide care can lower that rate of complications by up to 50%, shorten the stay in the ICU by one to two days, and then save thousands per patient. But we're not satisfied with the Argos monitor. We're taking it to the next generation, which we call Argos Infinity, which is an AI cardio-respiratory care platform. We're taking that algorithm out of the box, and we are deploying it in a tele-critical care environment. Think of this as your air traffic control tower, where we're running that algorithm in a massively parallel way so we can detect, diagnose, and treat shock on any bed at any time. We've already started a pilot in the next four to six weeks with a major IDN across 200 beds, 17 hospitals. The beauty of this is this is now a platform to deploy our additional AI algorithms, which I'll talk about in the next slide. It's a software subscription business, so we'll be getting FDA approval probably Q1 or Q2. We've already gone through the pre-sub process, and this will make our algorithm available for multiple connected care platforms. So here's an example of AI-assisted shock diagnostics. Think of this as lane deviation assist in your car, where we can see a problem coming, and we can tell that rookie nurse at the bedside, "Hey, you've got a patient here before the hypotension emergency," right? And not just that there's a problem, but what type of problem? That's the missing link between all those other risk scores out there that say your risk is going up. They don't tell you what to do. We can tell you what to do because this is physiology. So everything in green here, this is a septic patient. Everything in green is their normal blood pressure. They're fine. You see all these different colors as their case evolved. They needed different interventions because of the different types of shock that they were experiencing. With the capital that we're raising, we'll be approaching cash flow positive in 2026. We'll be announcing by the end of this year a significantly expanded distribution partnership with one of our global strategics. Yet by 2028, we'll still be only penetrating about 5-10% of the market. Currently, we're selling in the US at $25,000 with a gross profit of over 85%. There's plenty of margin for us, but still, we're saving the hospital millions of dollars. I'm very proud of my team. Just an example: Jerry Korten, my executive vice president, took his ventilator company to $20 million before selling to GE, so we have all the right people in place on the execution side. Our advisors include world experts in critical care and anesthesiology. Our vision is really to implement AI-assisted cardiopulmonary care at the bedside to protect vital organs using a systems-based approach. Right, whether it's a ventilator, an ECMO, or managing brain health, whichever organ it is, right, they all are receiving blood to keep those organs alive through oxygen delivery. This is a key piece of the puzzle that all strategics need to complete that offering at the bedside. The activity in this space: just recently, we added the BD acquisition of Edwards' critical care division for 5x; it's pretty consistently 5x sales. We're opening our Series C; I'd love to talk with everybody. Thank you for your attention. My contact information is there. Thank you.
