Christine Horton, Visura Technologies - Spotlight Interview | LSI USA ‘23

Visura manufacturers the world's first, FDA-cleared, disposable camera, the TEECAD System, that seamlessly connects to a transesophageal echocardiogram (TEE) echo probe, providing physicians real-time visualization for more efficient and effective probe placement for safer intubation.
Christine Horton
Christine Horton
CEO, Visura Technologies


Nick Talamantes  0:14  

Christine, thank you so much for joining me in the studio.


Christine Horton  0:16  

Thanks for having me.


Nick Talamantes  0:17  

Tell me a little bit about what you're doing at Visura Technologies.


Christine Horton  0:20  

Sure. So Visura is a manufacturer of the world's first FDA cleared camera that seamlessly connects to an transesophageal echo probe or TEE as we, as we call it. And really, the benefit of that is to allow cardiologists and physicians to visualize real time, the placement during intubation of the TEE probe.


Nick Talamantes  0:44  

So it's almost like a camera for the probe. 


Christine Horton  0:48  

Right, exactly. That's exactly what it is.


Nick Talamantes  0:49  

So how many procedures are you looking at? Just in the US, let's say that could benefit from this technology of yours where I imagined today? They're, as you said, they're just going in blind, right?


Christine Horton  1:01  

So exactly. Today, they're going in blind. And when we look at just the US alone, it's about 650 to 700,000 procedures.


Nick Talamantes  1:09  

So is this almost like to make a poor analogy, a guide wire for the probe? You're kind of going in first, and then the probe follows after? How does what is the workflow? 


Christine Horton  1:21  

Sure, sure. Yeah. So what we actually do is where we call it a carrier, so the probe, we placed a probe inside, essentially a carrier. And it just slips in very, very nicely into the end of our device. And at the very tip of our devices, a camera and a couple of lenses. And then they go in together. So into the mouth, down through the esophagus. And during this entire time, this an intubation, the physician sees what he's doing. So where today, they're, you know, blindly going in and feeling the everything right now is done tactile. So feeling the tissue, we just on a monitor, whether it's on the wall or a screen that that is placed somewhere else in the room, they are seeing exactly where they are the entire time, once that probe is placed, and they're exactly where they want to be, so they can get those beautiful high resolution images, we retract our camera back and they go on with the full imaging of


Nick Talamantes  2:29  

the heart. Is the device reusable, or is it single use? 


Christine Horton  2:32  

Yeah, good question. It's single use disposable. So once you are done, it is thrown away. And you know, no need to worry about sterilizing or cleaning it at no contamination issues.


Nick Talamantes  2:47  

When I think about it, it makes sense that there are complications inserting this, but there isn't a lot of information out there. So what was sort of the genesis for the idea? Was it an experience of a physician? How did this idea come to be? And this unmet need? How is it recognized? Yeah,


Christine Horton  3:03  

it's a it's a question we get a lot. And it's really funny as we talk to doctors now that we commercialized. And we fully commercialized last year, June of 2022. Yeah, thank you is, it's always a big deal when you get to do that. But Dr. David Marmore, was working in Chicago at Northshore. And he, you know, as a practicing physician, recognize the need, and every physician along the way has experiences that they think we could do this better. And he had one of those experiences where he's like, I need to see what I'm doing. And as we talk to physicians, now, they're like, I thought about this, we need this, this is, you know, we haven't talked to any doctor where they're like, Yeah, nobody needs to see what they're doing. It's very intuitive, right? If we're inside the human body, there is an absolute benefit to seeing what you're doing. And even though this is a short part of a longer procedure, being able to see what you're doing has extraordinary benefit for one, just being able to avoid disease. So there are diseases in the esophagus, there's diseases in the mouth, being able to quickly place that probe versus guessing where you're going. Those right there automatic benefits. The fact that some of your patients may have been smokers, there may be frail tissue. That also is definitely a benefit. You know, the other thing too is there's adverse events that happen and we can help avoid that. So hematomas lacerations, perforations, they do happen. And to your your original question, it is hard to find what those numbers are. A lot of times these TE is ahead of a structural procedure, right structural intervention. So ahead of what we all know Mostly is like Watchmen, for example. And so we're paying attention to the adverse events that happen with with those types of procedures. But anytime we're working with the human body, there can be complications or can be adverse events. So when you can see what you're doing, you certainly have the ability then to avoid a complication or an adverse event versus guessing where you are guessing where you're, you're placing that probe even with the most experienced physician thinks can happen. And then with the lesser, you know, experience, certainly, you know, your the chances of of having an adverse event are definitely greater, right. So, adding that visual aspect, the real time of seeing where you are, is truly to me and to those that we're talking to, it's like, yeah, this is absolutely, you know, going to become an essential component to doing TEE's in the future.


Nick Talamantes  6:01  

Yeah, I would agree with you that there is a fine line between having too much information and not enough. And in this situation, being able to just see what you're doing probably results in reducing procedure times and, obviously, complications. Is there a cost benefit, then that sure technology is offering? 


Christine Horton  6:22  

Sure. So, you know, when we look at the range of what can happen, you can look at the fact that some patients are just really tough to intubate. So, I may have to pull out a peds pro back to your original question of like a guide, peds probe, sometimes we pull out because then they become like that guide wire, They guide us down the esophagus, it's easier to place a smaller probe, and then you put the adult probe down, right. So that's one way sometimes you have to call an anesthesia, sometimes you have to call on Gi, this delays a case now you're pushing patients back. Sometimes you have to cancel the case, if you cannot intubate that patient. That is one end of the spectrum, the other end of the spectrum is a worst, which is you perforate the patient goes to the ICU, there is can be, you know, death associated with that. That is rare. So you know, I want to be clear that that is not something that's common with T. But certainly it does happen. So you have this range of events, that can happen. But when you can see what you're doing, it certainly is an advantage. I don't think there's anybody that would say in medicine, doing things without being able to see is certainly an advantage to a physician. I don't think there's a patient that would say I would rather a physician didn't see what they're doing when they're working on me. So it is intuitive. It's just something that wasn't available. And so now we have this device that can augment the TEE procedure. And it's very cost effective. It's very easy to use, it's very easy to train the physician on. And it's you know, it's readily available. And so if we can do better, we should do better.


Nick Talamantes  8:04  

Sure, as a readily available device. Does that mean it's device agnostic? It works with all the major trend TEE devices that are out there on the market today? 


Christine Horton  8:12  

Yeah, really good question. So currently, we're able to be used with Philips. And right now we are working on being able to be used with the other major probe manufacturers. So that's definitely a goal of ours, because we want to be able to be address all those 650-700,000, you know, cases that we originally talked about. So yes, it's something that we are actively working on right now.


Nick Talamantes  8:38  

You started with Philips, was that the result of a partnership? Or how did that happen?


Christine Horton  8:43  

Yeah, no, we don't have a partnership with any of the manufacturers. That was a decision that was made, I believe, you know, early on, because Philips is a market leader. And I had I've been the CEO for about 14 months. And I think that that was a decision that was made early on to just go with the market leader at that time.


Nick Talamantes  9:06  

I'm curious. Where are you guys at in terms of funding? What are you guys looking to do next? Now that your commercial? What's what's next for the company? 


Christine Horton  9:16  

Yeah, yeah. Well, it's a great, it's a great time to be involved with Beiser and the TEECAD. So again, we commercialized June of last year. We closed our series B in December of last year, and now we're actively commercializing. We have revenue. We're working with a lot of the major centers of excellence in the United States. We have a sales team, we've moved our manufacturing back to Minnesota to reduce our cost of goods. We are really focused on working with hospitals and physicians that recognize the need to do something better, you know, offer a solution to Doing to moving away from Blind TEE intubations. And we're, we're really busy, and that's busy, it's good to be busy. We like it. We're a small team, we're really experienced team, essentially everybody that I've brought into the organization is about a 30 year veteran in medical device. And it's been a lot of fun. You know, I think that's how it should be. We were, we're all working very, very hard. But I think we're having a lot of fun at the same time.


Nick Talamantes  10:31  

That's an important balance to strike. Definitely. Yeah. You know, you and I were talking prior to this interview about the complications and really understanding how prevalent these are. Is there any possibility that you guys become champions of your own cause? And go do a, you know, a study, to understand it to raise awareness of how prevalent this problem is?


Christine Horton  10:53  

Yeah, yeah. So, you know, from the from the study side, what we will have some data, we've submitted data for ASC, Mayo Clinic has, we're hoping to find out pretty soon here, if that's been accepted, what we look at is, you know, when when you're deciding where to spend money, it's, we provide real time visualization. And the benefit of that is essentially, can you see what you're doing or not, when you're placing that TEE probe, we welcome the opportunity to certainly have institutions perform studies and look at some of the some of the benefits of being able to see what you're doing when you're placing that probe. We know there's there's a paper that's also available on our website, and we'll be publishing an update to that soon, where the Mayo Clinic has concluded that not only is this an essential part of cardiology, TEE intubations, but they share that they've had no adverse events, using the TEECAD system, they've had first pass intubation success. And that, you know, it really is a savings when you look at the time and keeping patients on schedule. And so you know, all of those benefits, we think, are pretty self explanatory. And that when patient or when, you know, hospitals and physicians get into actually using it, the benefits are going to be very obvious to them. But we certainly would love it if they start sharing their experiences, their real use experiences with others and through publications, for sure. That would be you know, we would absolutely welcome that. But this technology, too, is it's like saying to somebody, do you need a backup camera or not? Right, we are all we who doesn't love their backup camera? I think when I've but it's also one of those situations where I think when somebody first said to me, Oh, this car's got a backup camera. I was like, Who needs a backup camera? Am I really experienced driver, you just look behind you right? Now that I know the benefits and the safety of bearings, right? I was driving probably 30 years before backup cameras became a thing. But now, I had to drive a car rental car, and they're like the backup cameras broken. And I panicked. I was like, Well, I don't want this car. It's not it's not safe, right? Well, having that extra safety feature is a big deal. And it's kind of like the same. It's same thing with TEECAD. Now. We have doctors that are very experienced, that have been doing these procedures for many, many years. And they are very good at it and they're in there fast. But why not offer that extra safety? Why not have that? And why not? As you're teaching new fellows and younger doctors coming up? Why not have this again, now that we have it. And it's cost effective, and it doesn't modify your existing TEE probes? You know why? Why not start using and especially, you know, as we look at those patients that we think are going to be more challenging. There's a history of disease in you know, the esophagus, things like that. So we think the benefit is is pretty huge. To these to this procedure.


Nick Talamantes  14:29  

Certainly I do know that some physicians are very resistant to changing the way they've been doing things. And education is the first step in helping them realize I actually need that backup camera. It's really nice to have, how come I haven't been doing this forever. So I am full support of what you guys are doing to build that educational toolkit that you guys have. It's my understanding that as you build that adoption process just go so smoothly. So speaking of that adoption process? Are you facing a lot of resistance? And when you're introducing this? Or is it one of those, like we get it,


Christine Horton  15:06  

We are not facing resistance. We are people, our physicians are really seeing the benefit of it. And where we're really seeing a lot of uptake in interest is in the teaching institutions. Right? 


Nick Talamantes  15:25  

Right place to start


Christine Horton  15:26  

Tt is and and it makes a lot of sense. You have these great, younger doctors up and coming. And it just becomes extra intuitive, right? To allow them to see what they're doing and provide that visualization as as a necessary tool, and to ensure that the adverse events don't happen. And so yeah, we're seeing great uptake, when we're working with some very well known large institutions, and like I said, we are generating revenue. So we're very appreciative of, of the support that we've gotten the recognition that this is needed. I think, Dr. Marr Moore's great idea, and the fact that we've been able to patent, you know, the technology, and that we've got US patents that have issued international patents that have issued and we have more that are pending, as well. So


Nick Talamantes  16:21  

you have this device definitely seems like it's ultimately about improving the experience for both the physician who's performing the procedure, but also reducing those complications and for the patient. So that's terrific. Tell me what brings you to LSI this year?


Christine Horton  16:36  

Yeah. So you know, quite frankly, I didn't know if I would be done with the series B. So when we presented in the fall at the LSI meeting in Europe, it was a great experience. And we were, you know, in the middle of our series B round. And certainly that went that went well. And so, you know, closing on that round now, being commercial in that going, being a success so far, early on, obviously. But now it's more about sharing, you know, having the conversations with potential strategics our goal is to have an exit at the right time. And we'll know when that is. But right now, we're obviously continuing to build the value in the organization get that experience, we, we have our goals of what we want to achieve. And we're very focused on that. Right, we know what the unmet clinical need is, it's pretty obvious. We quote unquote, see it. And so we want to build on that our investors are aligned, our board is aligned on what we want to achieve prior to the exit. And so now it's just working with the the physicians and the hospital systems that that you know, want to work with us and to offer this as a solution to blind TEE.


Nick Talamantes  17:58  

Christine, thank you so much for telling about your solutioning developing at Visura technologies. It's incredible and I wish you the best of luck.


Christine Horton  18:05  

Thank you. We appreciate it.


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