Inovus Medical | Elliot Street, CEO

(Transcription)

Elliot Street  0:03  

Well, good morning, everyone. First of all like to say thanks very much to Scott and the team for inviting me long to present to you today. As you've heard, my name is Elliott Street. I'm the co founder and CEO of Inovus medical. And I'm gonna be talking to you about connected surgical training. So in us as a business is driven by a very clear purpose. And our purpose is to improve surgical care through connected training. And we're on a mission to become the world's partner for surgical training technology. And we know that we can deliver on both our purpose and our mission by rigorously sticking to our core values as a business which are to develop accessible, affordable, and highly functional technologies. Now, innovation is a strong operational business, we're already providing products to over 70 countries worldwide. They're manufactured in our facility in the UK, which we own, we have a significant headroom for growth there, based on our current supply chain systems and processes raised over $4 million of outside capital. And importantly, we're a revenue generating profitable business. We've enjoyed over 200% revenue growth in the last two years. As you can see it an EBIT da north of 30%. And all this is driven and underpinned by our patented paradigm shifting augmented reality and computer vision technologies that are already in use and over 70% of NHS Trusts and hospitals. And as you can see in use by many of the strategics, primarily in the UK at the moment. So it just wants to take a step back and look at the problem we're solving as a business. And this problem is this antiquated approach to surgical training. And this is this old see one do one teach one adage, where Importantly, the majority of the early learning curve is still at the patient bedside. And as a clinician, myself and one of the founders of the business. So I looked at this and said, Well, why have we not shifted the paradigm of the early learning curve away from the patient's and into a simulated environment simulators already exist, this technology here, there must be something going on. That means that the surgical fraternity has not driven this drive. When we started looking at this, we realized there are a few main barriers to that shift. So the first of these is cost. Traditional simulators use VR as their underlying technology, it's really expensive to develop, it's very expensive to deploy. And that means that you've got capital equipment over $100,000. This leads into the next problem, which is accessibility. So you've got large bulky bits of kit very few and far between. That means that the modern day surgeon is not able to go and access this regularly. And when then move on to the probably the most important piece which is poor functionality. Now, I'm well aware that this VR company is coming after me. So I may be setting myself up for a bit of a whacking later but I'm gonna go for it anyway. So VR uses software and motors to provide what we call haptics. So that's how does this operation feel? Using VR for macroscopic haptics? Like turbulence in a plane is fine. But we're talking about microscopic haptics, how does this five mil vessel feel how does that tension on that tissue feel, it's really not fit for purpose. And then we come on to the final piece, which is connectivity or integration. And we need to make sure that our technologies are integrated and reduce the friction for adoption by the modern day surgical trainee. And we'd like to think that we've done that here at universe. So here is an example of our laparoscopic augmented reality simulator, lab AR. And very importantly, this is being operated on in a plastic box. And those are real instruments, those are not avatar instruments. So you can put any brand of instrument you'd like inside this box, there's no headsets, this is a direct view onto a laptop screen. And as you can see, the instruments are currently picking up and playing with a soft tissue Phantom. So that gives us what we call natural haptics. We understand what the tension of an appendix feels like, you're going to go ahead with a pair of scissors now start dissecting the MISA appendix, and you get that feel of the plane of dissection. And what this allows our trainees to do is get a really realistic environment for the practical skills. But we also have the cognitive skills training, because we mustn't forget that. So here we've created a complication we've cut through blood vessel, we now ask the trainee to gain hemostasis by selecting the right next step, which would in this case, is electro cautery. So we're going to go ahead, stop that bleeding. And then we're going to carry on with our operation. So we're going to dissect down to the base of the appendix here. And then of course, what we're able to do, because of the way we've developed this platform, it's industry agnostic system, I could put in clips, I could put in loops, I won't name any particular brand names. And then I can go and set my appendix and I can complete the rest of the procedure. Now while all this is going on, we've got really powerful computer vision algorithms tracking the instruments. So we're getting loads of rich objective data off the instruments. And of course, we've got a video transcoder which is recording all of that for later review in our web based management system. So it's all well and good hear from the founder what we've solved this massive problem, but I think it's probably best that we hear from some customers as well.

Video playing  4:42  

Laparoscopic suturing in a virtual world just just doesn't, it just doesn't translate as well to in the actual clinical scenario, but when I've used the vaginal vault model, for example, And you're practicing your laparoscopic suturing. On that, it translates much better to then doing it on a patient that feel that you get through the tissue, you don't get that in other augmented reality worlds.

Elliot Street  5:18  

It's pretty powerful feedback from a senior gynecologist there in the UK. And I appreciate if you're not seeing this technology before, it may be a little bit difficult to get your head around what's going on here. Hopefully, this helps. So we use this traditional box trainer model. So that was a plastic box that you saw in that previous video. It's attached into a laptop, and it streams the direct image. So again, just to reiterate, no headsets are so just don't wear headsets to the theater, we shouldn't have them wearing them. When we're doing simulation, we then have an institutional system for training in the live environment in hospital. And if you're a user of this, you can use the ones at the bottom for take home or remote learning. And then you can go ahead and use your same login login to institutional system, all the data, you're creating a sense up into our web based learning management platform where you can do certification, you can review videos, and you can connect with your senior surgeons. Now I just wanted to talk about how we built our technology stack. So we effectively have this digital training platform sitting over top of some hardware. And we built this in what we call a scalable modular infrastructure approach. So all of these features are each each one is a different module. And when we're applying our technology stack to a different type of simulator, for example, you just see lab AR working, we will turn on these various features. However, we know that laparoscopic surgery is just one type of surgery, there's lots of different things we need to simulate. So if we want to go ahead and for example, simulate hysteroscopy with our history, our platform, there'll be some features in our stack that we don't need. But we don't need to rebuild our platform, we just turn off the features that we don't need, or we add in new features as we go along. So it's super scalable as we start to really ramp up the growth of the business. Important thing to know, does this technology actually improve surgery? The answer at the moment is yes. This is some anecdotal data from a multicenter study we're doing with Health Education England in the UK shows a 41% reduction in time to operate and a 60% reduction in distance traveled when a theater. So in terms of the business model, we already have strong verticals in laparoscopic and hysteroscopy. We're coming down the horizontal into new specialties as we go. The way the business makes money is through capital revenue. And then two recurring revenue streams from both consumables and software. The market we play in is the digital sorry, the Healthcare Simulation space, which is really exciting space. So over $2 billion market already growing over 17% a year. It's highly fragmented and unregulated. So that's really a big driver of innovation. Our customers include the undergraduate setting the postgraduate space, or residency programs, and of course, the strategics for their professional education activities. And of course, you can probably imagine, our technology has some reciprocity into the digital surgery space as and when we want to go there. We've got a really cool team, I like to think I'm the Clinical and commercial founder, I've got a co founder, Jordan, who's the CTO, he's both a hardware and software engineer on non exec Chairman's got over $100 million of exits under his belt, our CFO has got over $240 million worth of capital raises under his belt. And we've assembled a really, really strong team across both the development commercial and operation side, in terms of how we're going to grow the business. We're very strong commercial in the UK, our next steps are to put a direct sales force on the ground here in the US, we're going to be doing that this year. And of course, we're then going to be expanding our r&d capabilities. So we can come down that horizontal I showed you in the previous slide. Now we do have an ask for any strategics in the room, we are already working very closely with your colleagues in the UK. Our platform allows you to put your instruments and your devices into a system operate as if you're operating on a factory animal byproduct, but it's synthetic tissue, and have all the same things that you get from a digital platform. So you do not need to demarcate between live training, and a digital platform. We do it all in one we'd be really interested to speak about how we can do that with you here in the US. And for any investors in the room. We will be raising capital at the end of this year. We know that's a relationship game. We would love to start speaking to you here and start those conversations before we get going with that towards the end of this year. So all that remains is for me to say thank you very much for your time. And I'm going to leave you with some more powerful feedback from the people that matter who are surgeons