Cloud DX Inc.

It is now 2 p.m.

Eastern time. So I'm going to go ahead and begin our presentation today.

Good afternoon and welcome to CloudDX's 2022 Earnings Call and Investor Update. I'm Robert Call, the founder and CEO of CloudDX. And with me on the call today are Simon Selkrig, our CFO, Investor Relations Manager Jay Bedard, and also his colleague, Andrew Reid, who will be helping me with the slides and the questions. We would like to remind everyone that certain comments made or answers to questions that may occur on this call are subject to regular caveats concerning forward-looking information that is on the screen and is also available in our investor relations section of our website, also in our most recent MD&A and on CDAR. All right, moving on. The agenda for our call today will be first of all comments regarding the short delay in filing these 2022 financial statements review of events that are of interest to investors from last year a review of our financial results discussion of subsequent events that may be of interest to investors and then time permitting answers to questions please if you have a question use the Q a button at the bottom of the screen and please uh hold your questions or just Remember that we'll be answering your questions at the end of my presentation, and that way we'll get to the questions as soon as we can. Questions? Oh, that's all I have to say about that. Okay. Oh, one more thing. Yeah, sorry about that. If we don't get to your question today, I apologize, and we will answer you by email, and we'll make sure we get back to you in the next day or two. The recording of this webinar will be posted on our investor relations site in an hour or so. All right, without further ado, please, let's dig into 2022. And first of all, let me address the delay in filing our 2022 financial statements and our request to the Ontario Securities Commission for a brief management cease trade order to cure the delay. The delay in completing our year-end financial audit was caused by two overlapping challenges that have now been overcome. First of all, as noted in the announcement on May 3rd, 2023, this year, our auditors were not able to receive certain required information from third parties in a timely manner, and these unforeseen delays impacted the completion date of our year-end audit. Also, we should say that our auditor team has been extremely thorough this year and has examined a larger pool of documents in order to ensure investors of the integrity of our financial statements. This attention to detail took slightly longer than expected and contributed to the delay, but in the end, a more thorough audit protects investors. We'd also like to note that in addition to our annual financial audit, CloudDX is subject to strict regulatory audits every year under our ISO quality management certification, as well as our SOC 2 privacy and security protocols. This regulatory scrutiny also protects investors, as well as our clients and patients. And just as an example, in May of 2022, the company underwent a thorough medical device inspection regime audit by Health Canada as a good example. And we only had very minor findings in that. That was actually discussed earlier in previous investor calls. So let's talk about some accomplishments for 2022 that might be of interest to investors. And I think we can all agree that 2022 was the year of strong growth for CloudDX. We executed 28 new or extended commercial contracts with healthcare providers both in Canada and the United States. 11 of these new contracts were signed with U.S. clinical providers. That includes four large physician clinics based in Massachusetts, Pennsylvania, Michigan, and Alaska. U.S. clinic contracts are expected to make up a larger portion of new contracts in the next few quarters. In Canada, we signed a unique partnership with Equitable Life, the top rated mutual life insurance company in the country. We executed our first contract through Medtronic Canada and our partnership with them at St. Mary's Hospital in our hometown of Kitchener, Ontario. And that contract was one of three new contracts for pulmonary rehabilitation, which is a new use case for CloudDx Connected Health. This is a growing niche that we intend to continue making inroads into. In August of last year, we announced a partnership agreement with Teladoc Health Canada, and we integrated the Teladoc solo video platform and scheduling application into our connected health platform. We should note Teladoc is the largest telemedicine provider in the world, and we are now going to market both in Canada and around the world with Teladoc integrated into CloudDX. Furthermore, we signed six new contracts with five county-based paramedical services in Ontario, where the province recently, as of this year, this quarter, announced an additional $174 million in new funding for remote patient monitoring at home for patients waiting for long-term care beds. This is a huge and growing problem across Canada, and the Ontario program now offers funding to 33 community-based programs for RPM at home. We intend to expand our reach in this important use case as well. CloudDx was awarded $330,000 in new non-diluted funding in 2022 for research and development of our CloudDx extended reality product was shared in college and for our PulseWave 2 project at the University of New Brunswick in Dalhousie Medicine in New Brunswick. That project is to validate our PulseWave 2 device for Health Canada license and FDA clearance. Please move to the next slide we were granted our seventh and eighth us patents in 2022 and just to remind everyone, we now have 10 granted patents covering our innovations. Including vital sign measuring device patents medication adherence and augmented reality patents, as well as licensed patents covering our cough analysis software. We continue to apply for new patents and extend our granted patents to other jurisdictions. For example, we've received a granted patent so far in Canada with patents pending in Australia and the European Union. In 2022, CloudDx announced several separate patient satisfaction surveys. And in each case, over 95% of patients reported being satisfied or very satisfied with their CloudDx connected health experience. These results are key to competing in the US market especially because satisfaction is related to patient compliance and compliance to care instructions is required for US providers to be reimbursed for remote patient monitoring. Having published surveys of over 95% patient and provider satisfaction very much helps close sales, especially with our US clients.

Next.

We're very excited to remind everyone about this announcement. On November 8th of 2022, the company announced its participation and leadership in the Continuous Connected Patient Care Project. This is led by CloudDx and Medtronic's innovation team in partnership with St. Paul's Hospital, Providence Healthcare in British Columbia, Simon Fraser University, and two important Canadian small companies like ourselves, 3D Bridge Solutions, which provides a connected medication monitoring platform, and a company called XLR Technologies, which provides data connectivity between CloudDx and electronic medical record systems, as well as Medtronic systems and the systems of other partners. Together, we're integrating a new Medtronic continuous vital sign monitor into our connected health ecosystem for eventual sale around the world. This $12.8 million project received $5.2 million in non-diluted funding from the Digital Technology Supercluster. And that funding envelope includes $560,000 in direct funding to CloudDX to complete the integrations prior to regulatory clearance and adherence. So this really solidifies our relationship with Medtronic, as well as giving us a global platform for a whole new use case for our technology. CloudDx was named a top 10 new innovator by Canadian Business Magazine and was recognized as a member of the CB Insights Digital Health 150. This is big deal. This is a list of 150 of the most promising companies in the digital healthcare space, which is chosen by one of the top sources of investor information in the world, CB Insights, from over 13,000 applicants. So that's a clear signal that we've arrived on the stage. All right, we're now pleased to discuss our financial results for 2022. For the year ending December 31st, 2022, we recorded a revenue of $1.166 million. which is an increase of 49% compared to the same period of 2021. In that total revenue number, product revenue more than doubled. Product revenue is revenue on connected health hardware and technology. That increased 108.3% and subscription revenue increased by $142,791 or 38.6%. primarily obviously due to new patient enrollments and sale of connected health kits. We like to point out here that under the IFRS accounting rules that we work with, some recurring revenue, especially US recurring revenue, even though it may have been received in 2022, winds up being deferred until 2023 because of the way that services are delivered. That deferral of revenue is a line item in our financial statements. So if you have any questions about that, please refer to our financial statements that are on CDAR. So these are really great results. These results show that CloudDX's sales and revenues are accelerating on a year-to-year basis and a quarter-to-quarter basis. And based on the number of contracts signed over the course of 2022 and 2023, I think investors can conclude that that acceleration should continue. We saw two numbers that changed in the other direction. Professional services revenue decreased slightly due to simply fewer customization, integration, and optimization contracts being invoiced in the period. As well, government grant funding received was lower by 59% simply due to the payment timing of open grants. And these are the two numbers that are lumpiest in our financial statements, everybody. These numbers fluctuate depending on when projects that are customization projects are invoiced and paid and when grant funding actually flows. So you'll see those numbers fluctuate on a quarter-to-quarter basis. But in general, those numbers are always part of our financial statements. On the expense side, we saw $389,568 or 3.6% reduction in overall operating expenses. And some of that is due to a decrease in stock-based compensation, which was compensated by a slight increase in salaries and other wages and benefits reflecting the inflation that every company is currently coping with. When we released our Q1 numbers, we will be reporting to investors on optimization of our operating costs. And we'll have a lot more to talk about at that point. Just to remind everybody, our Q1 numbers will be released before the end of May. So very soon. Finally, gross profit more than doubled. Gross profit increased by $311,000 or 107%. This represents Obviously, increased sales and revenues offset by a decrease in operating expenses and cost of goods. Overall, that means that our EBITDA improved by a total of 14.5% or $1.48 million. That's the trend we all want to see. This is the trend that's leading the company in the direction of cash flow positive. And as I mentioned earlier, as we begin to report Q1 numbers, we'll be able to speak more about improvements in the bottom line, essentially. I'd like to also share that just a customer statistic, CloudDx took care of over 3,500 unique patients in 2022.

That number is changing on a quarter by quarter basis as well. All right.

So let's talk about subsequent events and some announcements that we've already made in 2023. So just to remind everybody, we announced 28 contracts in 2022. As of Q1 of 2023, we had already announced 15 additional contracts. Eight of those are new contracts, and seven of those are extensions of existing contracts. Contract signed is a leading indicator for CloudDX. You know, our... Audited and posted financials are a trailing indicator. But as you see acceleration in the number of contracts signed, that gives you a really good idea of what the next quarter's growth is going to look like. And so when the Q1 numbers come out and the Q2 numbers come out, we'll be able to speak to that pathway towards cash flow positive and begin to give the market some guidance on how quickly we expect that to happen.

All right.

I'm happy to say that CloudDx will be attending two different events in Canada through capital event management. If you're familiar with CEM, they're a terrific venue for investors to meet. public companies and private companies that are potentially interesting investments we've worked with cm in the past and we were actually able to arrange for these conferences um at a low cost so in fact we'll be speaking with investors at the Montreal conference next month and then again in Kelowna at the Kelowna conference in July So now I'd just like to remind everyone about CloudDx's business model. Some investors here on the call may be relatively new to CloudDx and what we do. So just to remind everybody, CloudDx Connected Health consists of three components. We have our proven Connected Health technology that the patients use in their homes to monitor their vital signs and communicate with their care team. And that Connected Health kit is designed and created by CloudDx, and some of the devices in that kit are manufactured by CloudDx, who is an ISO-certified medical device manufacturer. Clinicians monitor hundreds and hundreds of patients at a time through a clinical portal. And one of the things that we're excited to talk about and we'll have some media announcements about this at some point in the near future is that some of our hospital partners are literally putting together command centers. You can imagine it from a sci-fi movie, a special command center, giant flat screens everywhere, monitoring all the patients to the hospital system using the CloudDx platform in one location using a dedicated team of nurses. This is where the maximum efficiency and the maximum ROI is delivered for our clinical customers. The third component of our work is services and integrations. And I spoke about this a minute ago, but this is projects that we do for our clients that might involve customization. It might involve critical clinical care pathways, customized surveys, integrations into various EMR and health information systems and integrations of new devices that clients want to use for their patients. So that forms a fluctuating but growing amount of work that we do for all of our customers. And it's in this world that we work with partners like Medtronic and Teladoc as well.

The value proposition of Connected Health by CloudDX for our customers and patients is

overlaps all those groups patients get to go home sooner after surgery one of the the metrics that we're tracking with our our partners right now is the reduction in length of stay for patients patients especially from the surgical wards get to go home a larger and larger number of days early that's much better for patients but it also saves the system and saves the hospital those extra days of cost we also allow patients to avoid medication errors and reduce pain scores and this has been validated in peer-reviewed published research providers doctors and nurses have a very high satisfaction score for CloudDx because we make their work more efficient and just easier to do we're able to monitor patients remotely and automate that monitoring in order to reduce the amount of work that it takes to make sure a patient's symptoms or a patient's a patient's overall care plan is optimized. And that efficiency is what drives the ROI for payers. Payers mean, in the Canadian context, the provincial health authorities and the Canadian healthcare budget. In the US context, of course, it means Medicare, Medicaid, and private insurance companies. All of those payers are benefiting from the optimization and efficiency provided by remote patient monitoring.

Next.

So why CloudDX versus the other players that are out there? We come to market with three main differentiators that are allowing us to grow at the breakneck pace we're growing at right now. First of all, we do innovate more than anyone else in our space. And by innovation, I mean not only new medical devices or new types of software, but also new ways of delivering care, new ways of onboarding and optimizing and training patients and clinicians. We're constantly making changes and improvements to the way we deliver our solution, as well as making improvements to the accuracy of the technology. And the satisfaction numbers speak for themselves we've already mentioned that during our call today cloud gx routinely and repeatedly demonstrates 95 or more patient and provider satisfaction which i think essentially is as high as you can get in the real world And then the last point are the partnerships we've announced and the partnerships we've discussed on this call. Being partners with Medtronic and Medtronic Canada has allowed us access to some incredible sales teams and sales staff. It gives us entree into every hospital system in the country. The same thing is true of our partnership with Teladoc. Integrating our Teladoc solo solution into the CloudDx platform gives us an absolute best-in-class solution with a built-in potential market of over 55 million patients around the world. these partnerships which were signed in very late in 21 and early in 2022 are really going to hit the ground in 2023 and really going to start showing results throughout this year last slide And I think we've also, we've touched on this as well, and this is the key, key differentiator for CloudDx. We do original research. By publishing randomized controlled studies in the highest quality medical journals and scientific journals in the world, CloudDx validates our technology at a level that the hospital systems and the providers and the payers in the healthcare system need to see. This is not an easy thing to do. We've generated millions of dollars over the course of our existence in non-dilutive funding that goes to academic projects that generate published peer-reviewed research. All of that takes years of work. It's not something that a competitor can do really quickly or sometimes ever. This is the basis of our market-dominating technology for both Canada and our growing penetration in the US market. So why invest in CloudDX? We're meeting real needs. One in three adults in the world, and especially in North America, has a chronic illness. One in six adults has a neurological disorder. 29% of surgeries have complications. These are the available markets we're reaching out to. We have the published peer-reviewed proof that our technology is superior. We have the highest user satisfaction possible. We are verified vendors for the provincial health authorities and hospital systems across Canada, and we are the market leader now. Our growth continues to accelerate, as we mentioned earlier, a 233% acceleration in 2022, and already in 2023, 15 new contracts. We are the trusted partner of the largest companies in the entire digital healthcare space, and we're just getting started. so now what I'm happy to do if there's any questions is if you can please put your questions in the Q a section at the bottom and has everybody got access to the Q a

Andrew, can you double check that that's working? All right. The Q&A is open. All right. Thank you.

Excellent question.

So in the Canadian market, Plaid VX for most of 2022 really had only two competitors. One competitor was a company called Atonix, which is a division of a larger company that's in the oxygen space. The other competitor in Canada is a division of Telus, which is Canada's largest or second largest cell phone operator. Telus Healthcare is our largest competitor in Canada. We have routinely actually bested both of those competitors in RFPs and competitive tenders across the country. And unfortunately for them, recently, Atonix was the subject of a rather significant data breach, which has slowed their momentum, really putting us even ahead of that competition by a long shot. So at this point in Canada, the only competition we have now is TELUS Healthcare. And in the U.S. market, It's a different story. In the US market, remote patient monitoring companies are sort of thick on the ground. There's a number of different remote RPM companies that superficially have an offering that allows US clinicians to do RPM. There is no giant competitor. There's no large established company that currently is dominating the market. And so we believe that the market is wide open and addressable, and we are addressing that market ourselves, really with the maximum effort from our sales and marketing team. I can tell you that we work with a group of companies that deliver market intelligence around physician practices and hospital systems in the United States. And the key metric we track for our US clinicians is the size of the practice. And by that, I mean, it's not too small and not too big. It's a little bit of a Goldilocks moment. And the number of patients that practice addresses. So we're looking for a practice that has between two and 10 physicians and has between 1,500 and 3,000 addressable patients. And it turns out there's over 20,000 clinics in the US that meet that criteria.

So that's the market we're going into as quickly as we can.

Here's an excellent question with regards to cost drivers. And this is something that we'll address in more detail in our next earnings call for Q1, but I can share with you that the two largest components of our costs as a provider of our remote monitoring are staff costs, so salaries, wages, and benefits, contractors as well, and inventory and cost of goods sold. Inventory and cost of goods is a cost that rotates through our financial system or financial statements. We obviously purchase inventory, deliver it, get paid, purchase it again. We're moving towards addressing the growth of that requirement with non-dilutive sources of bank financing, for example, in the coming quarters. with regards to salaries and benefits this is an area that we've been optimizing like many companies we've been doing that aggressively and we'll be able to speak to that optimization in more detail going forward but I can share with you that we are aggressively moving to reduce our overall expenses while we make our operation more efficient in order to get to EBITDA positive as quickly as possible I've just been reminded I need to read out the question. I thought that when I clicked the button here, the question also was available to everybody, but I'll keep doing that. Okay, so here's a good question. So congratulations on our 2022 revenue increase. Thank you very much. What does the increase in contracts announce for 2023? What does that mean? Let's see here. So what's the question, educator? 15 contracts announced. Well, I think we've already spoken to this. Again, when we think about what it takes to deliver virtual care, first we sign the contract, then we train and onboard the staff in the clinic, and then we actually work with the staff to onboard the first group of patients, which could be anywhere from 25 to 100 patients. So there's a time lag of signing the contract, onboarding the clinic and then beginning to onboard the patients and then starting to receive that revenue. That's what makes contract signed a leading indicator because it's giving us a good window into what the revenue numbers are going to look like in the following two, three quarters.

So that's a great question. Thank you.

Here's a question with regards to taking the company private. Some public companies are going private. Is this something that we're considering? You know, there's many pros and cons to both being a public company and being a private company. I think we can all agree that the stock market today, especially for companies of the size of CloudDX, is not responding to fundamentals or responding to performance. And we can say that because the share price of CloudDX, as everyone knows, has fluctuated in a relatively narrow band around 15 to 20 cents Canadian for over a year now. And even during that period, we've signed over... nearly 40 contracts and are increasing revenues, as you've seen, at a dramatic pace. So to answer the question, have we considered taking the company private? That's a question that's been raised. We're not in any position to announce anything along those lines at this point. I can tell you that the board of directors and the management of CloudDX is very carefully considering both the costs and the pros and cons of either remaining a public company or taking the company private. So thank you very much for that question. What is the development status of the Vitality device with regards to sales and collaborations with our partners? I'm happy to say that the Vitality project, which for everyone who's not aware represents the continuous vital sign monitor technology that CloudDx has been working on now for several years with several million dollars in non-dilutive funding behind it, is now moving into the clinical validation phase. In the next few months, in McMaster University and Hamilton General Hospital, we'll be testing the vitality system on live patients for the first time under an investigational testing authority from Health Canada. That's an authority that allows us to use technology on live patients for research purposes. That testing involves two factors. The first is what we call human factors. So how do people like using the device? Is it comfortable? Is it easy to use? How's the battery life? What are those human factors that make the device a convenient and satisfying device to use? That study begins almost immediately. And the second study, which is a very important study, is called VERDICT2. The VERDICT2 study obviously follows on verdict one. Verdict one was a study that we published in 2021 that demonstrated the accuracy of the vitality system for measuring non-invasive blood pressure. And that study was published in a peer-reviewed paper in the Journal of Medical Internet Research. Verdict two will follow on now and will actually measure the accuracy of all of the metrics measured by vitality, including not only blood pressure, but also ECG signals, respiration rate, pulse oxygen, core body temperature, And I think that's it. Against hospital grade devices in the hospital. So it's an accuracy of data study. Once those two studies are complete, we'll then move into the third phase, which is validation data for Health Canada license and FDA clearance. All of that is underway with grant funding support from various sources, including the Canadian Institute of Health Research. And we're very excited to note that part of that funding includes direct cash to CloudDx for delivering some technology and services into the projects. And we'll be able to discuss that number in more detail shortly. Here's a great question. How many individual patients are using the CloudDx services and what will this growth need to be in order to become revenue positive? I mentioned just a minute ago that in fiscal year 2022, CloudDx took care of over 3,500 individual patients. When we release our Q1 numbers in the coming couple of weeks before the end of May, we'll be able to speak to the increase in patients during that quarter. That's a number that will be part of that release. That acceleration will give us a good direction to note how quickly we're going to be reaching the critical patient number. Now, the patient numbers we're looking for in order to reach cashflow positive depends on how you measure things, because we have three components to our revenue, subscription revenue, product revenue, and services revenue. But on a strictly subscription revenue basis, back of the envelope, We're looking at somewhere between 10,000 and 12,000 patients in order to reach operational breakeven. So 3,500 already in place from 2022. We'll be able to speak to the acceleration in patient numbers in the Q1 numbers, and that will help all of us make some calculations as far as what cashflow positive looks like. Also keeping in mind, as we optimize expenses, that actually reduces the number of patients required to reach operational breakeven.

Here's a great question.

From what I understand, the provincial government in Ontario is in the process of selecting one main RPM provider. Do you have any insights on this potential timelines, announcements, and so on by the government? Let me clarify exactly what's happening in Ontario. At the end of 2022, the company that was delivering remote patient monitoring for the Ontario Telehealth Network, which is a subdivision of Ontario Health, a company, an American company called Vivify Health, sorry, blanked it there for a second, abruptly pulled out and left Canada. Ontario at that time published an RFP to replace Vivify for the patients that are using that technology. They have not announced the winner of that RFP yet. And obviously, I can't speak to that. That's a government announcement that needs to come. I will note, however, that that is a very narrow RFP. the hospital systems and the new Ontario Health Team structure that replaced the previous LHIN structure in Ontario is still free to choose whatever vendor they wish for remote patient monitoring under whatever program they're using to fund the system. I'll also note That the entire budget for the community paramedic program is actually not delivered by Ontario Health. It's delivered by the Ministry of Long-Term Care in a completely separate budget line item. That $174 million funding is an area that CloudDx sells in. The funding envelope in Ontario is complicated. Unlike Alberta, for example, which is a singular healthcare system that chooses one vendor for their entire remote patient monitoring needs. And in fact, which back in 2020 chose CloudDx for that role and extended the contract three times so far. that uh that situation is much more clear-cut in ontario we're still very competitive from the point of view of hospital systems ontario health teams and at the moment we seem to be dominating in the paramedical community paramedic space that was a great question by the way thank you and i think we're running up against time here but this is uh the last question that has popped up on the screen so we'll go ahead and answer this one and this speaks to our our fundraising so far in 2023 investors will note in our press releases that we announced the intention to raise 5 million Canadian dollars right around the beginning of February and then in March we announced the close of the first tranche of that raise we raised 2.6 million dollars in that tranche then between that time and today we obviously ran into the challenges we've already spoken to with regards to completing our financials for this past year and that essentially put a pause on fundraising until the financials were announced today. So now we're in a position to pick back up, and we intend to close the remaining financing in another tranche, the second tranche, in the coming weeks. And so there will be further announcements on that as that conditional approval is sought and received, and we move forward with that final tranche. And with that, I'm going to thank everyone for your time and attention. And thank you so much for your support of CloudDX. It's been a little bit challenging just in the last few weeks to get the financials all done, but we did that team perform beautifully. And I just want to congratulate the finance team at CloudDX for that. It was a heavy lift. And also I want to congratulate all the folks who work at CloudDX for an epic 2022. And we're very much looking forward to seeing you all again in just a few days with regards to delivering our 2023 first quarter earnings call. We will be announcing the date and time of that earnings call very, very shortly, possibly in the next 48 hours. So thanks again for everybody's time. We appreciate it. And we'll talk to you again soon.