Cloud DX Inc.

all right it's uh just a couple minutes after we're going to go ahead and get started thank you for joining us my name is robert call i'm the founder and ceo of clouddx and this is our first quarter 2023 earnings call and investor update with me today are simon selkrig our cfo and investor relations manager andrew reed who is handling the slides and the questions First of all, we'd just like to remind everybody 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 presentation on our website and in our most recent MD&A, available both on our website and on CDAR. Here is today's agenda. The first thing we're going to do is review the Q1 financial results for the company. We're going to discuss some events that are of interest to investors in the first quarter, and we're going to discuss some subsequent events that have occurred since March 31, 2023. Then, with time permitting, we will answer as many questions as we can. Questions may be submitted through the Q&A function at the bottom of your screen. If you can please identify who you are and where you're from when asking the question, it would be most appreciated. And importantly, if we don't get to your question today, as long as we know who you are, we will reply to your question after the webinar. So let's talk about Q1. Pleased to say that reported revenue for Q1 increased by $568,006, a 68.4% increase over the same period of 2022. More importantly, or as importantly, subscription revenue, which is the annual recurring revenue CloudDX receives from connected healthcare subscriptions, increased by 151%. Product revenue increased by 39.5%. And this is due, of course, to increase sales and deliveries of both products and services throughout Q1. Professional services revenue increased by just over $10,000. That's a 43.4% increase. To remind everybody, professional services includes customizations to our software, additions, new features, things that we contract to do with our clients that are outside of subscriptions and product revenue. government funding was flat at 80 887 for the quarter and um just to let everybody know fluctuations to both government funding and professional services revenue are very common quarter to quarter uh just depends on when we get a chance to in invoice and get paid for those professional services and on the funding side it just depends on the timing of certain grant payments So we're obviously on track for a similar grant payment structure as we were last year. I'll also let everybody know that under IFRS accounting rules, some recurring revenue in the period is earned but then deferred due to the way that our contracts work in the U.S. So you can see more details on that in our financial statements published on CDAR. Operating expenses in the period were basically flat, $2.599 million compared to $2.365 million. There is one significant point, office expenses. We saw a change in office expenses in the way they were calculated. So there's a one-time increase in that category, 49.4%. What that represents is data hosting charges have been moved from our cost of goods sold category to our office expenses category at the request of our financial auditors. So that's an increase in office expenses, but a subsequent decrease in cost of goods sold. Increase in sales, general and administrative expenses and salaries saw an increase. However, that was offset by decreases in professional fees and R&D costs. Cost of sales, cost of goods sold in Q1 decreased by 10.5%. And that's mostly due to the timing of when we purchase inventory. However, the increase in sales, increase in revenue did flow through to gross profits. Gross profits increased by $251,847. That's 183% increase in gross profits. However, part of that was accounted for by the change in accounting from COGS to office expenses. But that was only $46,000. So really, the true increase in gross profits was 206,000, which is still 150% increase in gross profit. So that's really critical. We're seeing revenue increase quarter after quarter after quarter. That reflects the increase in contracts we've signed, the number of patients onboarding our system. It really shows that our growth is not only significant, but is continuing and accelerating. We are keeping costs flat. and in fact, working on reductions in costs, and that will eventually speed up our pathway to cashflow positive. So how did we accomplish all this in Q1? We're happy to say that we signed eight brand new contracts in Q1 and we saw seven existing contracts grow and expand. We're seeing this now, these two dimensions in our growth at CloudDX. We're constantly signing new contracts. We're winning and applying for new RFPs. We're growing our US business with new contracts all the time. Simultaneously, our existing clients, our provincial and territorial clients, our hospital clients and our clinical clients are finding new use cases for CloudDx Connected Health. They're adding patients to the system. They're adding whole new departments to the system or new locations to the system. And that is organically growing our business very rapidly, while at the same time, very low business development costs because these are just happy customers buying more. And that's a huge that's a huge positive development, obviously, as we can as we can imagine. We're also glad to say we received two new patents in the first quarter. That's our 11th and 12th patents. We continue to grow our IP portfolio. The value of our IP portfolio continues to expand, and there will be more news coming. Of course, we are constantly both applying for and receiving new IP protection, both in the U.S. and Canada and in other parts of the world. In general, the overall contract value of the contracts we signed in Q1 is approximately a million dollars in the first year. So as you can see, that's a terrific run rate. We're now moving forward into a serious multiple of last year's revenue, obviously already in 2023. Let's see here. One more note, there's the patent slide. Yeah, one more note just from the point of view of patients enrolled in the system. As part of this growth, that's a key metric, and we're tracking that metric and working on ways to present that metric more clearly to investors. But the important point is our patients enrolled numbers increased by about 30% in Q1. Okay, next slide, please. the point of view of our client base our client base continues to grow both in canada and the us and I want to also reflect on the patient satisfaction numbers that we continue to see from our clients. Patient satisfaction and provider satisfaction is a key, key differentiator and competitive advantage for CloudDx. We see our clients running entirely independent third party surveys of both patients and providers. Some of those surveys are actually published in peer reviewed medical journals. we continue to see over 95% satisfaction from both patients and providers for CloudDX Connected Health. That's both driving new customers in Canada, but it's also very important for US clients. And just to emphasize this point, In the United States, providers are billing Medicare, Medicaid, and private insurance for remote patient monitoring products and services. Those billings are reliant on patient compliance with care plan instructions. If patients do not comply with their instructions, and physicians can't prove that the patient took the readings, then that reimbursement is not available. Patient satisfaction and provider satisfaction, but especially patient satisfaction directly goes to compliance and reimbursement in the US. And that is why it is such a key and important differentiator and competitive advantage for CloudDx. Next slide. We're happy to say that we are presenting at several different investor conferences the next few weeks. So this week coming up on Thursday, June 1st, we will be presenting through the Maxim Group, which is a U.S. investment bank based in New York City. And this is their Healthcare IT Virtual Conference 2. Information on this, which is of interest to both Canadian and especially U.S. investors, will be out on our website and will be available by press release and email in the next 24 hours. And then two investor conferences later on in the spring or early summer. We'll be in Montreal with the Capital Management Group for the weekend of June 16th, 17th, 18th. We'll be in Kelowna, BC on the 21st, 22nd, and 23rd. So let's recap after an amazing, really exciting Q1. How are things looking for the rest of the year? How is CloudDX being received? What is our platform growing into? To remind everyone, our Connected Health platform consists of three essential parts. The Connected Health kit that patients use in their homes. This is a kit of medical devices that are FDA cleared and Health Canada registered or licensed. And these devices are in some cases off the shelf, but in other cases are actually manufactured by CloudDX. Most of our connected health kits also come with a customized Samsung tablet computer. Now I say most, we're seeing larger and larger percentage of our deployments include only the medical devices and the app itself because patients are now getting better and better and better at using their own tablets and smartphones to use connected health. That's exciting for two reasons. It means the patient is even more engaged with the technology when they're able to use their own tablets or smartphones. It also reduces the cost of goods sold for our kit itself. And the margin on our kit is pretty good. We get about a 20% margin on our kits, but the margin on the services and subscriptions we receive is of course considerably higher than that. Anytime we can change the balance between the kits and the cost of the kits versus the revenue generated from subscription the more we weight that towards subscription revenue the higher our overall margin is for that contract so this move towards what we call byod bring your own device for patients eventually generates higher margins for CloudDx over time clinicians monitor those patients on a portal called connected health and that portal continues to develop we continue to add new features and we continue to make that portal stronger and more stable lots of good news in that area too lots of new things coming from the point of view of our clinician portal some of these innovations and some of these changes are driven by requests from customers and others are driven by our own internal team innovating our platform better then the final piece of business that we do every month and every quarter is services and integrations This is the work we build under professional services and the financial statements. And what this means is again, time and materials we build to create new features and to add custom features to the platform. We've recently integrated Teladoc solo platform into cloud DX, and we're working together with Teladoc health to market that technology, uh, all over Canada and in other parts of the world as well.

And so go ahead, go ahead, Andrew.

The value prop here, folks, is threefold. Patients really, really love our technology. We know that because we ask them in surveys and they universally almost 95% say satisfied, very satisfied, would recommend or highly recommend CloudDX. It's empowering to be able to care for your own chronic condition or work through recovering from your surgery at home, safe in the comfort of your home with a very, very robust two-way feedback loop with your care team provided by Connected Health. So we're avoiding medication errors. We're reducing pain scores. We're reducing length of stay in hospital. And all this is being documented by our customers in studies and surveys and eventually published papers. Providers, doctors and nurses also love our system. They find it easy to use. It makes their jobs more efficient. It makes it easier to care for more people with the same resources. But more importantly, they know that their patients are happy. And guess what? When you're a physician or a nurse and your patients are happy, that also makes you happy. That's a big deal. And of course, payers in the context of Canada, that's provinces and provincial health departments. And in the U.S., that means insurance companies, employers. They see enormous returns on investment. When you shorten hospital length of stay, you reduce ER admissions, you reduce hospitalizations. These things are cost drivers in the system. And this is how we're delivering more care for the same dollars every day. So what makes CloudDX special? We've had these conversations several times on these earnings calls. And if you look back, you'll see that there's really three things that are very important about CloudDX. The first is, of course, that we are very innovative. We do bring new technology to the table, both on the software side with new features and integrations and on the hardware side with our continuous vital sign monitor called Vitality. AccuScreen cough analysis technology and platform, and even with CloudXR, which is our virtual reality or augmented reality platform under development right now at Sheridan College, all funded by third-party, non-dilutive funding from various sources, foundations, and grant funding agencies. So we're continually growing our technological base. We're making our technology better and differentiated from the competition. And that, of course, is backed up, as I mentioned, by 12 patents so far and more to come. We've spoken at length about compliance and satisfaction, driving compliance and driving reimbursement. And the last point, of course, is our partnerships. And our partnerships generate both credibility when it comes to replying to various different competitive tenders and RFPs, but also drives business. Teladoc Health is working directly with CloudDX to grow both businesses, both in Canada and other parts of the world. And of course, Medtronic Canada is a closely aligned partner with CloudDX With Medtronic, we're offering and delivering connected health to post-surgical programs in Ontario so far, and also marketing that across Canada. There's hundreds of hospitals that use Medtronic products and services that are currently thinking about or looking at connected health. Other partners include CBI Health, Medeo, Equitable Life of Canada. We actually have nine corporate partners, and these partnerships are growing our business as well as our own internal efforts. We do receive a lot of awards for innovation and excellence. We have not announced a new award in Q1 so far. That's a rare quarter for CloudDX where we don't announce some form of recognition. But I will emphasize that in addition to a full trophy case, which is always exciting and motivational, these awards often come with non-dilutive funding. The largest bucket of non-dilutive funding comes through the XPRIZE and the post-Prize Tricorder XPRIZE. a program that is still offering CloudDX. Five years after we became the Bold Epic Innovator and the Tricorder XPRIZE, we are still receiving financial support from the XPRIZE Foundation and University of California San Diego, in particular working on our AccuScreen products. We also received funding from NSERC through the Synergy Award. That funding is still available to us. And those are the two big buckets on this page. So, A lot of that work and a lot of that funding goes towards published peer reviewed research, we do have two exciting projects that are underway right now. With population health research institute both will be evaluating the vitality continuous vital sign monitor both will lead to publications in the future around the accuracy and efficacy of the vitality system. That's a project called Verdict 2. And then on using the vitality system to monitor patients after surgery all over Canada and in other parts of the world as well, a 20,000 patient study called Vision 2. Those projects are now teed up and underway. And that's an exciting area, both of validation and continued financial growth, because again, non-dilutive funding is what's backing these projects.

Okay. So,

after the end of a really great quarter um wide Vesta cloud DX obviously we are still growing and meeting real needs one in three people in in in the world but especially in North America has a chronic illness one in six has a neurological disorder that needs some kind of monitoring 29 of surgeries have complications we have the published peer review backup we have the user satisfaction we've seen the growth in both revenue and gross profits and our partnerships continue to prosper and expand so that is um that is the news i have some questions here i'm going to address now so let me do that and um let me jump in this is actually a really great question this is from a gentleman named ton benethe and the question is has there been any consideration to privatizing the company and so you know that's an interesting question privatizing a public company is a move that is made when management the board and key investors agree that for whatever reason in this case it would almost certainly just be Market volatility in the current state of the markets that shareholders are not receiving the you know enough value in in the market price of the company could i think definitely argue that cloud dx may fall into that that territory only because we've seen um you know deterioration or flatness in the share price for well over a year now despite quarter after quarter after quarter of increased growth increased gross profits reduced costs reduced burn rate reduced net loss obviously on a growth trajectory So having said that, privatizing a public company is really most easily done by some kind of merger or acquisition, something that we're not in a position to discuss at all right now. and or purposefully delisting the company from the stock exchange, which is a negotiation and something that would require shareholder approval, board approval, and would only be done if it was in the clear interests of all shareholders. So it's not something we're shy of. It's something we are, I wouldn't say actively considering because it's a little complicated, but it's something that's certainly a possibility. But at this point, I would say that at least for the next quarter or two quarters, we're focused on growth, revenue growth, contract growth, caring for our patients, and in the in the hope that the market will acknowledge that and eventually give us some credit for that which we believe has to happen sooner or later so that's a great question um here's a question about a competitive question and actually i'm really i appreciate this question from simran there's another company in the remote patient monitoring business that's public on the tsxv it's a company that many investors at cloud dx are aware of called relic health technologies Relic is a company that, although based in Canada, does virtually all of its business in the United States. And Relic has done very well in the last few quarters, growing quickly, adding new contracts, delivering a connected health platform that is superficially similar to CloudDX. What's different about CloudDX compared to Relic Technologies is the three things that I mentioned. Genuine innovation, new features and new products and new benefits that allow us to both charge more, to attack different use cases, to grow faster. Very, very, very high patient satisfaction. I can't speak to Rolex patient satisfaction because they don't publish those numbers that I'm aware of. However, I am aware that we have very high satisfaction and that does make us very competitive. And then the third thing, of course, is the relationships and partnerships we have, which is helping us both on the credibility side, but also on the business development side. What I think is fascinating about CloudDX versus Relic is that if you look at the two companies, there's about a year separating us with regards to revenue. You go back maybe a year to maybe a year to a year and a half. If you go back through Relic's financial statements, you'll start to see some parallels. Rates of growth are approximately the same. So Relic is a little bit further ahead of us when it comes to growth and business development, but not that far. On the other hand, Relic achieved a relatively high market cap during the pandemic, when a lot of companies in the connected health business did, and has managed to hold on to that market cap, which is very much to their credit. We believe that CloudDX represents a very similar value, and yet CloudDX's stock price and market cap are not yet where they need to be to match Relic's. Does that make CloudDX an opportunity? That's for the investor to decide. But you might want to take a close look at that because if you compare apples to apples, you'll see that, in fact, I don't know what to say. Some companies might be overvalued. Other companies might be undervalued. It might be worth a look. The key to take away for both companies is that the market itself is growing dramatically. It's growing very quickly. CloudDX is the dominant player in Canada where Relic doesn't compete at all. Relic doesn't sell in Canada. And in the United States, the business is so huge, the opportunity in the US is so large that we also really don't bump into Relic there and they don't bump into us. If you ask Relic's sales folks if they're ever competing with CloudDX for contracts, the answer is really no, just because there's so many potential clients out there, it's not necessary. So that's an exciting question and we're looking forward to comparing those notes time and again. And so a similar question from Simran again, and this comes right back to the numbers we released today. What we released today and what we're showing investors today is an exciting increase in revenue, especially recurring revenue, which is the subscription revenue, 151%, flat costs, costs are flat, and therefore gross profits are up. That trajectory is a trajectory we have been on since Q4 of last year. We reported that trajectory two weeks ago with our 2022 numbers. That trajectory remains the same today and moving forward. And so the exciting... part about that is that when you look at, which is profitability, what we're doing to improve that and speed that up, of course, is grow our sales business and invest in sales and marketing, grow our organic business where we nurture our customers and they order and purchase more from CloudDX because they're satisfied and because demand for RPM continues to grow, while at the same time working very hard to control our costs. And we'll have more news on that Going forward statements that recently in this Q2 with an electric. So terrific question from our friend at Maxim, Alan Klee. And he's asked us to review the timing between signing a contract, onboarding patients and getting adherence and when billing starts. So this is something that cloud is also excited about. We have a program that we've invented in-house. It's called Patient First. And Patient First is an interlocking series of protocols and workflows that we use to enroll and onboard a clinic and then begin enrolling and onboarding patients. It's called Patient First because, as you can probably guess, it very much is focused on the patient side of the equation. But what we do with Patient First, first of all, When we sign a contract with a clinic, especially a US clinic, the process begins with an onboarding meeting, an onboarding call. That's typically virtual. Then there's a series of training steps that are also typically done virtually. And then what we do is we physically visit the clinic. We have a team of folks that are able to do that because our sales and support teams are distributed. They're remote workers. They work in different parts of North America. So they're generally close to the market that they're serving. They're able to physically be there for the first week to 10 days. And in that process, we onboard anywhere from 30 to 50 patients. in a week, what the folks who are being trained to shadow and to experience exactly what it takes to select and onboard those patients. Secondly, it proves to the clinic that that pace is possible. One of the questions we face whenever we enroll a clinic is, I mean, how fast can we really grow this thing? We're very busy. It's not like we have anybody sitting around here doing nothing. So what is it really going to take to get this done? The easiest way to do that is to show people. So it's a really nice, exciting week for those folks because they get to see how fast this actually moves and how quickly patients are interested in and able to adopt connected health. The third thing it does is it sets up that initial cohort of patients, which immediately is billable in the following 30 days. that means the clinic sees a significant boost in revenue out of the gate it's not two patients it's not five patients it's not 10 patients it's 30 to 50 patients and actually that process is becoming even more efficient as time goes by so those three things really mean that our clients are seeing tremendous success right off the bat that means that they go on to enroll our target of anywhere from 150 to 400 patients per clinic and as those clinics come on board the recurring revenue continues to grow. So it's an exciting part of our delivery to our clients. And I appreciate the question because it's a way for us, again, to differentiate CloudDX from virtually all of our competitors. Another excellent question with regards to CMS reimbursement in the US. And so I can report that we have not at the, at those who are not aware of Canadian investors, uh, CMS and center for Medicare and Medicaid services. They're the, the agent of billing in the United States for Medicare and Medicaid in the states that are using Medicaid and RPM CMS publishes what we call CPT codes, which are the billing codes that doctors and nurses use to bill, not only for their services to patients that are being reimbursed virtually, but also the equipment and services code that pays cloud DX. typically $58 a month, $75 a month. These are adjusted every year in January. And what's a recent pattern has been that while the codes themselves fluctuate a little bit on dollar volume, they continue to add new codes. They add new opportunities. This past January, remote therapy codes were added. What this did was it expanded the pool of clinicians, providers who were able to bill for RPM services, and it added new use cases, including respiratory therapy and musculoskeletal therapy to the types of patients you can actually bill RPM for. So it's a constantly evolving equation. But there's another area of growth that we're targeting. We mentioned this in our MD&A, and it's an exciting aspect of what we're doing at CloudDx. We have identified a niche in the concierge medicine world in the United States. And again, this is a foreign concept for most Canadians, but in the United States, where healthcare is paid for by a whole hodgepodge of programs and private insurance and out-of-pocket experiences, expenses and so on.

A lot of folks who are in a position to go forward to join the air practice, which as you can imagine,

means that you pay a little extra out of pocket. It gives you, I guess you would say, more convenient access to your provider. Saturday appointments, it pays for physical every year. What it does for the provider is it gives them a steady additional revenue stream, which allows them to see less patients overall for the same amount of income, which gives them the ability to give each patient better service. We've recently been able to show is that by adding CloudDx Connected Health, that level of service and patient satisfaction goes up tremendously. There are over 12,000 identified concierge medicine practices in the US that we can address with this new customized concierge program. And we, in fact, enrolled our first one in Chicago in the last week. This is something we'll be hearing more at CloudDx, but it's an area of growth that is less reliant on billing codes, which is good for the company, but also great for patients. Here's a question just regarding Insider Holdings. And there may be a typo in the deck that you're looking at. So the question is Insider Holdings have grown, actually. So under the most recent reported Holdings Insiders, which is board members and officers of the company, own about 41%. Previously, that was 34% at our RTO. It's gone up ever since. None of our insiders has ever sold a share of CloudDX. But I apologize, Simran, if you see that old number there, that 34% is a typo. The true number is 41%. And I think, you know, this is a great point. Insider participation in CloudDX, insider participation in all of our financings is a very strong factor. indicator of the trajectory that we're on and of course anytime you see insider buying in a small cap public company especially significant six-figure insider buying you know that the folks who know what's going on and are running the company are very bullish on the company's success going forward they're literally investing with their their dollars so that is actually something that we're excited about and uh There is a question. This is from Mike, a question with regards to active patients. And that's a number that we don't report normally. I don't have that number off the top of my head. I did mention, however, that active patients on the system are increasing. And the quantum of increase in Q1 was approximately 30%, which adds up to over 120% on a run rate basis per year. But that's driven by a couple of different things. Again, it's driven by that organic growth, new existing clients finding new ways to deploy the connected health kits. And at the same time, addition of new clients, especially US clients, which typically have between 175 and 300 patients to onboard per clinic. So those are numbers that we'll be reporting on in the future. And that seems to bring us to the end of our questions today. So again, just to wrap up, Claudia had an extraordinary Q1 of 2023. Our numbers are moving in the right direction. The market remains challenged on the commercial side. CloudDX has never done better. We've had our strongest quarter yet, and we're optimistic that the remainder of 2023 will maintain that trajectory. So please keep an eye out for additional press releases and news from CloudDX in the next few weeks and months with regards to how things are going. And we thank you very much for your time and support. And we will see you on the Q2 earnings call in a few months.