Access Managed Services, LLC (VHL) Earnings Call Transcript & Summary

All right. I think we might kick off now in the interest of time. Good morning, everybody. Good morning, ladies and gentlemen. Thank you very much for your time investment this morning. And for, I guess, taking an interest in what it is we're doing, and to get a little more information around what it is we're actually doing with the business in the United States at the moment. It's hard to believe that we only [ kick off ] Australia, the U.S. business just over 1.5 years ago, and a lot has been achieved over that period of time. We've gone from no business in the United States -- but a reminder, that it's the largest health care marketplace in the world. So we've gone from nothing to a business that has -- sorry, I'm getting a whole bunch of ding dings, as I'm going through this. So sorry about this, everyone. Then we go from no presence in the United States whatsoever to an active business in a very, very short period of time. So we have a situation where we have patients that are on wheezo and on remote patient monitoring programs delivered by our partner, Access Telehealth. And our vision has always been platformed on the ability to improve the lives of patients with respiratory disorders, utilizing remote patient monitoring as an extension of the clinic. So providing care beyond the clinic -- and I guess, being able to provide doctors with an insight into what's happening to their patients, where problems occur, and that's in the real world. And with remote patient monitoring and wheezo, we have a uniquely differentiated offering, that for the first time, allows doctors and other providers to get a better understanding of what's happening with their patients when they leave the care of their physicians, and enter the real world where the problems occur. And with a successful remote patient monitoring program, we are confident that we can reduce events such as exacerbations and reduce hospitalization, which is everybody's goal, all [ stakers ] are committed to that. So this is culminated with the recent acquisition of Access Telehealth, who are our remote patient monitoring partner in the United States. I will go through today what it is, and the rationale was behind that purchase and the huge opportunities that this does provide Respiri in United States, and it really is a redefining moment or a company making moment or another company making moment for our organization in the United States. I've asked Will Sigsbee and Theo Antonopoulos to join us today. They are 2 of our senior executive members on the commercial side of the business. And hopefully, can provide a little more color around what it is that we are doing in the United States and how that can be accelerated to achieve the goals that we've set ourselves. So before I commence my discussion and presentation, I thought I might throw over to -- well I'll start with Theo, to give us a bit of a background on Theo's experience, both previously and currently within Respiri and how he sees things are progressing in the United States.

Thanks, Marjan, and welcome, everyone, for joining. Yes, I'm the Chief Commercial Officer at Respiri. And in fact, yesterday was my 2 year anniversary of joining the organization, and it's gone so very, very quickly. Previously, to Respiri, I worked for another ASX-listed company, medtech business, started in the U.S. -- sorry, in Australia, scaled in Australia, but also more importantly, did a very similar partner model in the U.S. and then acquired our partner in the U.S. to actually accelerate, land grab and scale in the U.S. So very, very experienced in delivering medtech kind of solutions, medical devices and using accompanying technology to support that. Prior to that, I'm a paramedical background, but also worked in pharma for over 16 to 18 years in Tier 1 pharma companies. So I've got quite a lot of extensive experience in understanding the provision of health, both from a patient perspective, but also from a funding perspective as well. Really excited about the recent announcement with the acquisition. It's a natural progression for the organization. We have a unique value proposition with wheezo, it has been articulated, and you'll hear more about it through Marjan, and it makes sense that a wheezo-led offering with differentiation, with respect to a broader remote patient monitoring services and solutions, makes a lot of sense for our organization as we scale. A very simple narrative around this, as Marjan and I have been traveling to the U.S. for the last part of almost 2 years now. And we have spoken to dozens upon dozens of clinicians, Tier 1 institutions, different type of organizations, accountable care organizations, primary care physicians, the guys in the street, and not but every single person has seen the value of a differentiated product like wheezo. But more broader, the acquisition allows us to take full control of that entire value chain, which I think is a natural progression for us. And I am been really excited to see the evolution of the organization, and I know Will and I, with Marjan's leadership are really excited to actually see that come to fruition and deliver value for our shareholders.

Yes. Thanks very much, Theo. I might hand it over to Will. Will's a newbie on the block. So Will, why don't you give us a bit of a background of yourself? You are on mute, mate?

There we go. I was trying to keep the noise to a minimum. First of all, thank you very much for the opportunity to visit with everyone here tonight. Marjan, thank you for the introduction. My experience, I've been a health care executive for about 30 years here in the United States, leading medical device software and business development for a company as large as Medtronic, Hitachi and C.R. Bard, and most recently, running 2 companies in health technology, patient engagement for -- from start to exit. I love what's going on here at Respiri, and I wanted to kind of lay that foundation by kind of why I came here a little bit with -- as I look at what's happening here in the United States, the healthcare system is really reaching an inflection point. Most of our health systems are under massive pressure to contain costs, find staff and continue to deliver quality care to a growing population of patients, as people age into Medicare and so forth. All of our health systems are losing money or barely breaking even. There's only literally 1 or 2 health systems that make more than 2% or 3% EBITDA margin at the end of the year in the United States. And COVID was a catalyst that really helped reshape the way healthcare today is now being delivered or will be delivered as we go forward. So what's coming out of that, is some really interesting new delivery models that we fall right into and widely endorsed by CMS, state Medicaid programs and other payers as well. Programs like hospital at home, where care delivery occurs at the home, for about 50% of the cost of what is working right now for the right patient cohort in the healthcare system. Telehealth services and companies like Teladoc have become a standard component of care in almost every health plan and delivery network in the United States. And I'm going to start looking at remote patient monitoring, remote therapy monitoring, chronic care management services. They're all being touted as kind of the next way to manage patients with chronic conditions, multiple conditions, managed medication delivery, keeping people healthier and out of hospital. And historically, cardiac care, diabetes, weight management have been up until really now, the 3 areas where RPM technologies have really proliferated. When I saw what Respiri was doing with asthma COPD as a chronic condition, this is a massive market and it's an unmet need in asthma and COPD management for millions of patients across the U.S. And with the combination of what we have in proprietary IP centered around wheezo, and a telehealth service now with the combination of Access Telehealth, we have the opportunity to deliver and manage patients in an RPM-related strategy across the United States, and we're very uniquely positioned to do that. As a leading edge technology company, I think there are challenges primarily in attracting early adopters. That's something that we are facing right now and implementing at scale. But that will change. Health care in the United States moves like lemmings. You've got to find the early adopters, and then they all follow. And for the next many months, my focus in the organization is really in this order, is to dramatically improve our client adoption and expectations for performance with RPM. It's to work with our physicians and staff to train on RPM, identify the right patients, onboard it properly, address billing-related issues, which we've got a great payment strategy. They just are not familiar with it, and then ultimately build new client identification and a pipeline management strategy. And we will retrain our clients set expectations with KPIs and quotas for our clients, and we'll embed these criteria into the way that we go forward in the way we do business. Unless we've demonstrated a repeatable process and crystallized our ROI with our current client base, we have an opportunity to build a national sales team on our platform and become, I think, what will be a leading provider of telehealth services focused around respiratory therapy, but extending into all areas RPM. That's my 2 cents.

Well, it's more than 2 cents, mate, but thank you very much for that. I just wanted to take the opportunity to say that I'm a very lucky CEO to have these 2 guys on the commercial team. They make my life that much easier. And between the 3 of us, I think we have, what it takes to be able to provide the leadership, not just to our internal team, but also to the newly acquired team, who also has an excellent pedigree of people with it. And one of the reasons we decided to acquire them, was because of the pedigree of people that are involved in the business, and they have so much to contribute to our growth and aspirations as an organization in the United States. So what I'll do now, ladies and gentlemen, as I will head to the presentation. At the end of the presentation, what we will do is, as a group, address some of the questions that have been put to us, and we'll take it from there. Now as I said, we recently announced the acquisition of Access Telehealth. They've been a partner with Respiri since February of 2022, and have been one of the lynchpins in driving our business forward. It's important to note that today, we have a business in the United States, where patients have been put on a reimbursed remote patient monitoring program using wheezo. And those patients -- remote patient monitoring claims have been processed. Doctors have been paid. They're putting on more patients as we speak. Will mentioned the fact that we are now looking at how we can accelerate the onboarding of patients within our clients. Remembering that these clients are huge organizations. I mean some of them as large as Tenet, have a way of doing things, and we need to do things to make sure that we integrate into the way that they operate. But importantly, don't disrupt their workflows. And that's part and parcel of what it is we need to continue to learn to accelerate what it is we're doing successfully now. It isn't the case of getting it to work. We know that it's working. It's just not working as quickly as we would like it, and we are well on the way to remedying that situation. The acquisition of Access provides us with an opportunity to provide an integrated, scalable proven growth engine for remote patient monitoring from [ go to low ]. And it really will unlock huge opportunities within the U.S. marketplace that as an OME (sic) [OEM], an original equipment manufacturer, we really didn't get the opportunity to take advantage of. Although we've had good success with wheezo in remote patient monitoring being delivered through our partners, Access Telehealth being one of those, having the acquisition provides us with a vertical integration, that gives us a number of key advantages. At a snapshot, I mean, we're buying Access Telehealth for an upfront payment of about USD 1.5 million. We will become the first Australian company to deliver end-to-end RPM services to U.S. providers, and we're already doing that. So with the acquisition of Access, we have an end-to-end solution that's currently delivering RPM services. Access was already a sales and marketing partner for the wheezo device, and we know that organization very, very well and have got to know them very well over the last year and a bit that we have been working together. And it is important to note that Access' IP and people are device agnostic. They really do provide RPM services to a variety of different disease states, including wheezo and respiratory. Wheezo being a very differentiated product, because there is no real alternative for remote patient monitoring to wheezo in respiratory disorders. But they also work in other disease states such as cardiovascular, diabetes, obesity and of course, respiratory. The economics of the deal are very, very attractive from our perspective and also from the shareholders' perspective I suspect. We're going to improve our returns per patient per month up to tenfold. We go from basically USD 10 to USD 20 per patient a month to up to $100 per patient per month. Remembering that all of these services are reimbursed or backed by reimbursement. So all the things that we do are paid by reimbursement, and we have the track record in that space. The important piece with the improving dynamics and the upside in revenues, is breakeven is reduced from 30,000 patients on -- active on platform originally to only 9,000. And we see us breaking even in the second half of calendar year 2024, which is very exciting for us, and something that we've worked towards with our strategy in the United States. It's a huge growth opportunity for us as well. We go from a respiratory market of about 50 million respiratory patients. Once you add in the larger 2 diabetes and cardiovascular and obesity markets, it's 150 million-plus patients across the United States. So it's a huge increase in the way that we can deliver, remote patient monitoring services and really provide a service that our customers want. The customers that we speak to, don't want an RPM service just for respiratory disorders necessarily. They have needs across all of these disease states. And I'll get into a little more detail about how we interact with those customers, when we go through the selling process. Importantly, wheezo has and will remain a door opener for us. It is a unique value proposition and the only real value proposition that's available for doctors to use in the remote patient monitoring sense for respiratory disorders. Nothing else is easy to use, and nothing else is bundled up the way that it's bundled up with the Access value proposition, which I'll get into in a moment. We also have a very good existing customer pipeline, which -- most of which we've announced through our announcement to the ASX, but a wonderful pipeline, which I've just spent the last month working through, and we'll have some very important announcements to make over the coming weeks about the progress that we continue to make with existing clients, but also with new clients. Within Access, we have a team of proven leaders and a commitment -- and a clinical team that really can deliver on the requirements that will allow doctors to claim remote patient monitoring reimbursement CPT codes. Now remembering you need to get a level of compliance, at least 16 days of data to qualify for any of this, Access is best in class. They outperform the average market performance by more than double. And wheezo is at the forefront of that level of compliance and persistence. As I said when we first started this, we have a great team. You've met Will and Theo, the Board with Nick Smedley and recently Brian Leedman, have a great track record in healthcare and delivering on strategic initiatives, such as the one that we're embarking upon. And the people within the Access team are people who are going to add to that particular mix of expertise. We've always set our sights on becoming an integral part of the remote patient monitoring journey for patients. And our initial foray to that space was, of course, with our proprietary wheezo. So today or yesterday, I should say, we were basically an eHealth SaaS company that supported respiratory healthcare, by using wheezo in the remote patient monitoring space. And we did that through our partners, who leverage wheezo's advantages as a differentiated offering, to get their entire service into these clients that we're dealing with. Post-acquisition, we have a unique opportunity to integrate wheezo, Access Telehealth's business and our business to create a diversified remote patient monitoring provider, that combines our in-house IP, the wheezo, to continue to differentiate our remote patient monitoring offering to hospitals. You'll see that the clinical services provided by Access are second to none and best-in-class. And we know that we also have the ability now to use wheezo to differentiate -- continue to differentiate the remote patient monitoring that our new organization has, and also provide remote patient monitoring services to other disease states, which customers want, in cardiovascular medicine, diabetes and obesity, using other very freely available devices that are on the market right now. So it's important to note that underpinning this entire value proposition previously and moving forward is the unique selling proposition that our IP wheezo provides the organization, and that's really, really important, and that's opened up doors for us with major accounts, faster than they normally would have. So when we look at the details of the Access acquisition, it really is transformational for us in the sense that we now have an end-to-end solution that we have direct responsibility for. We've seen how well this has worked as a partner of Access. But now with the end-to-end solution, we're in a position to continue to use wheezo as a differentiator, but to be able to provide and get revenues from remote patient monitoring services across all high-risk disease types, not just respiratory. The Access RPM platform remotely is device agnostic. So we're very capable of putting in devices that we need to provide the services that our clients are asking for. As I said, our hospital, for instance, doesn't want a remote patient monitoring service for one cohort of patient. We've been in a position where we've sold them the concept of remote patient monitoring, and they want a solution across all their chronic disease states. They want a one-stop shop, and that's what Access provides. Wheezo provides the key to the door to getting in there. The integration with Access' telehealth remote patient platform is already complete as we've announced. And basically, this new relationship increases or expands the addressable market for us, from 50 million patients for respiratory only, to over 150 million patients in the United States. The revenues and margins also improved significantly with this deal. We go from currently $10 to $20 per patient per month for the wheezo RPM services delivered, to $70 to $100 per patient per month with the new model and the model that Access is currently delivering. Remembering all of this is backed by reimbursement. And as I said previously, what this does is, it reduces our journey to cash flow positivity on a monthly basis from 30,000 wheezo patients on platform to only 9,000 active RPM patients across all conditions. So the deal makes sense because we can get up to 10x of the value per patient per month [Technical difficulty] to breakeven to the second half of next year, which is very exciting for us. Importantly, none of this would make any sense unless we could scale it and scalable infrastructure is what it is that we have in the form of Access. We provide clinical staff and services that are best in class. And we're best at getting lean data and engagement with patients we need, to get reimbursement. It's important to note the scalability of new trained clinical staff, we call them patient advocates. The staff will cost us about $70,000 per annum, and that staff member will generate at least USD 240,000 through their actions and working with patients. So it's a highly profitable business model we have in place. And as I said, it's backed by reimbursement and the fact that physicians, institutions and hospitals can outsource the entire program to us and Access Telehealth. The market is not going anywhere. Will and both -- Theo, touched on the point that the remote patient monetary market in the U.S. is still growing at an exceptional rate. It's growing at over 30% per annum and is forecast to be worth more than $85 billion by 2026, and that's not that far away. We've currently got 10 customers that are delivering services to patients across 14 states and utilizing wheezo as well. And we know that we've been paid as a result of physicians being reimbursed for those services. We've also had quite a number of discussions with other major institutions around ACOs, which is the accountable care organizations, and are in advanced discussions with a number of private pays and insurers, who are also very interested in seeing what we can do to partner together, to accelerate the shift of healthcare delivery from high-cost tertiary institution delivery hospitals, to lower-cost delivery, which -- there's nothing more lower cost than doing it at home. The benefits of that are that, there's an existing revenue stream with Access Telehealth, which is growing at a great rate [indiscernible] and a very strong customer base with opportunities to accelerate growth. As I've said, we've got a board and a management team with a proven track record in this space. I mean I've done a bit of work in this area in creating healthy sleep solutions, which I sold to Air Liquide, which is a French publicly listed industrial conglomerate. And that business is still moving along in Australia. It went on to become Australia's largest provider of remote patient monitoring services in sleep apnea. Reminding everyone that ResMed was a cornerstone investor in that organization when we started it. So we've got a team that can deliver on everything and the opportunities that present themselves to us. I won't go through the details here, but we have a device that we know works, engages patients, is easy to use and qualifies for remote patient monitoring and allows doctors to extend care beyond their clinics by getting greater transparency into how well their patients are being managed, once they leave their care. Now we can talk about dollars and cents and margins and everything else, but at the end of the day, if we do not deliver a health outcome that's good for the patient, none of one of these that I've just mentioned today, will make any difference whatsoever. The fundamental underpinning of remote patient monitoring is that wheezo works, and the fundamental reason that Access Telehealth is getting the traction that they are, is because for any successful remote patient monitoring program, you need an easy-to-use device, a platform that allows data to be shared with healthcare professionals, and people to help patients with ongoing day-to-day compliance, persistence and counseling. As I said, the market that we're now dealing with is at least 3x as large as the market that was ours prior to the acquisition. So what that does is, it offers us a huge opportunity to provide more and get a greater share of wallet from the clients that we're dealing with, when we acquire Access. We are no longer just talking about respiratory patients, but we're talking about cardiovascular patients. We're talking about diabetes. We are talking about obesity and all of that on the platform of -- that wheezo provides us with, because it is unique. And as I said previously, and I'm boring you with this, but wheezo is the only really easy-to-use device that doctors are comfortable and confident will deliver the information they need, in a remote patient monitoring setting for them to make clinical decisions. The value proposition is well understood by the marketplace. As I said, Medicare and Medicaid, both reimburse remote patient monitoring across all the states of the United States. It's mandated in 28 states, [ for all ] intents and purposes, the insurers are a little disappointed at how quickly the RPM program has been adopted by institutions, because they can see the value in moving healthcare from high-cost environments to low-cost environments, and we know that from the discussions we've had. The United States understands preventative medicine. They really do. They understand that keeping patients out of a hospital is good for the patient, is good for the public purse, and it is good for resources. That plays in our hands. And importantly, physicians get the reimbursement for the RPM, we don't. We charge a fee for service. So the U.S. is one of the few markets in the world where that's the case. And importantly, they can outsource all of that to a third-party, Access Telehealth, and stay true to what it is they do. They want to be doctors. They don't want to be experts in remote patient monitoring. Remote patient monitoring, they outsource to us, because we're good at it, and we provide them with objective answers to questions that they're already asking, to help them better manage their patients and keep them out of hospital. The revenues that I -- sorry, mentioned, the economics just add up. The acquisition sees our monthly fees increase up to tenfold. And that is backed, as I said, by reimbursement, and I keep reinforcing this, because it's important to remember, a lot of services in the U.S. aren't, and we can provide proven benefits, because we've got the data that says that our remote patient monitoring programs are best-in-class and result in improved outcomes, which is what healthcare professionals and other stakeholders want to see. And when it comes to generating income, a physician can make up to $2,500 or generate $2,500 per patient per month -- that's per annum, sorry, if they claim all the RPM and the Chronic Care Management [ accounts ]. That's $2.5 million per 1,000 patients they put on any remote patient monitoring program, and they can outsource all that to us and we charge them a fee for service, for delivering what they need to be able to claim those services from reimbursement. So it is no small feat, and it's certainly not loose change when it comes to the amount of money that can be made, for providing a very important service to their patients. You'll see from this slide, and most of you have seen the CPT codes that we qualify for in-remote patient monitoring and chronic care, essentially prior to the acquisition of Access telehealth, we had the code of 99454 as our source of revenue. generated by our devices. Post-acquisition and with the clinical staff platform and everything else that Access Telehealth provide, you can see that we now have Access to claim on behalf of doctors, all of these codes, which add up to the $2,500 per patient per annum, to be able to take advantage of the improved margins that we are generating for our clients. Best in class, I mentioned, no one is better than Access in delivering a solution remote patient monitoring, that keeps patient persistent and compliant. The average for CMS claims over a 12-month period is about 4 months. Access delivers almost 10 months, per 12 months, where claims are made, which is best-in-class. So we have bought an organization that knows what it's doing and it is very good at what it does. I just wanted to touch on an example of how this all comes together, now that we're one happy family. And one is, I've spoken to Arkansas Heart Hospital, a deal that we struck late last year, one of the fastest deals that we've ever struck or I've ever struck in this space. And it's a large institution, it focuses on cardiovascular medicines, it's one of the largest private health hospitals in the United States. And it, like many other hospitals, was not achieving its 30-day remission metrics, I should say, and basically was getting fined significant amounts of money by CMS for not hitting those targets. We led with our wheezo device, which is interesting because there are cardiovascular organizations, on the back that quite a number of patients with cardiovascular disease have chronic obstructive pulmonary disease. Now 39% of their patients would have a comorbidity of both of these, meaning that 60% of their patients that are cardiovascular alone, we wouldn't be generating any income from under the old business model, but we secured that business on the back of wheezo. With the new model, we not only pick up the Luiza patients that are those patients with comorbidities of COPD, but also have increased the number of patients available to us, to almost all patients at Arkansas Heart, who have got chronic -- sorry, a cardiovascular disease. So you can see that wheezo gets us in the door, we pick up some of the business, but the great majority of the business will be on the back of what we've done with wheezo in other disease states. So that really does give a good example of how we interact with clients. The opportunity that now being -- having Access as part of our organization, presents us in growing the number of patients available to remote patient monitoring through Access, and importantly, working with the organizations who are becoming our partners in the way that they want to be working with us. And that is a one-stop shop. So as I said, we need easy-to-use devices, wheezo is obviously one of those and the only one in respiratory, a platform to be able to share data, so that people can make decisions and very importantly, clinical staff and support patients, when it comes to their condition and complying with whatever has been put in place by their doctors. Importantly, the United States is one of the only countries in the world, that all 3 of these things are reimbursed. The more time we spend with patients, the more reimbursement we can claim or the doctors can claim. Now no matter how much data and how much technology we introduce to the RPM situation, the need for people is still very important, and that's one of the best practices that Access provides us with. We've got a proven team. I've had a bit of experience in this space. I don't know much about many things, but after launching healthy sleep solutions in Australia, we captured 40% of the Australian marketplace of sleep apnea. And as I said, we got the interest of ResMed, who became a cornerstone investment, and got interested in by the French multinational Air Liquide, who ended up buying the organization. So we have a team that I'm lucky to be part of, that has done this before and ridden this pony before. The Access team have extensive commercial experience in this space and will add to our abilities to be able to execute with a level of excellence that we need to accelerate what it is we're trying to do. You've all met Will. So we've got a Chief of U.S. business now, who is on the ground there and will be leading the Access team moving forward, as we start to grow our business and accelerate everything that they're doing well and also introduce many of the things that we've learned in our various experiences in other disease states and other areas. So I'm really confident about what it is that this will be able to provide us, and more importantly, provide our customers. So I think I've done this to-date, but we've done quite a bit in the 18 months since we've been in the United States. We've gone from nothing to an organization that has now acquired one of its partners. And this is in the largest marketplace in the United States. So I couldn't be happy with progress that we're making. I'm never satisfied, of course, but I'm very happy with the progress we've made, and it's culminated with this acquisition of Access Telehealth. The journey has started with our first client, which was Michigan Kids, and you'll see from that, that there's a nice little journey of all the new clients that we've picked up. And importantly, ending with the employment of our own Head of U.S. operations and now with the acquisition of remote patient monitoring. So we have got a very rich customer list and pipeline. Our challenge and the challenge for the entire organization is streamlining and improving scaling and improving, as Will said, patient onboarding, which is happening now, but not happening as quickly as we'd like it to, for a variety of reasons, and most of those are structural within the organizations that we're working with, who are all very large conglomerates. So we're working towards making sure that we do what it is we need to do, to set expectations and accelerate patient acquisition. Our footprint is slowly coloring in the entire USA, and our objective is to be in all the major states in the next 12 months, and we're very comfortable of doing that as we move forward, particularly with some of the larger institutions and payers that we're working with. So one of the near-term growth drivers. I mean, this is a huge opportunity for us. This is in the sweet spot for our team. We've got a situation where we now have enhanced economics, all underpinned by reimbursement up to 10x revenue per patient per month and a clear path to breakeven by the second half of next calendar year. Growth opportunities; we're no longer just playing in respiratory, but we're looking at multiple disease states where remote patient monitoring can be delivered, as a one stop shop and on the back of the differentiating factors of wheezo. We've got the infrastructure in place with Access Telehealth to be able to scale and onboard patients, thousands of patients right now. And we've got an existing customer base and a very, very exciting contract pipeline, which also includes payers and ACOs. We've got a team that knows what it's doing. And I'm excited about what it is that we'll be able to do to further accelerate what we're doing. And reminding everyone again, that it's been only 18 months in the United States, out of Australia, that we have built a business. And now with the acquisition, we've got all the levers that we can pull and have the benefits of the Access team adding to our experience to be able to drive shareholder value by getting patients on the remote patient monitoring solutions and delivering superior health outcomes. This is a really great opportunity for us. And with that, I will stop the presentation there and to say -- there is a great opportunity for us to leverage the acquisition of Access Telehealth for all the reasons I've outlined. It is a natural progression for us as an organization, in a marketplace that is very fragmented. There are many, many RPM providers across the United States, and there is no single national organization that delivers the service across the entire country. So we're well placed with better economics, but bigger market and a team that I know that can deliver. So thanks for that. What I'll do now is I will look at some of the questions that have been sent through us.

Marjan, before you do that -- if you don't mind if I make a comment about that, because I'm the last bullet point on your list here. One, I think you're right on. I think this is a phenomenal opportunity, as a guy that has done this in the United States now with multiple product launches in many different companies for 30 years. I think this product, this strategy, this niche is underserved, and we're ready to attack it. And I think the tools and the acquisition of Access makes us a very formidable force in the space to be able to attack it. I'm excited about it. I think persistence is the key, getting more adoption from clients, and we are right there to be able to do that. We've got some great clients that are lined up to do it. So I'm excited about it. And happy to answer any questions regarding our strategy as we go forward.

[ Oh mate ], I am going to be throwing a couple of questions both your ways in a moment. So let me just have a read of what we've got, but thank you for that. One of the questions -- Theo, I might throw this your way. What hospitals in the U.S. have signed up for the wheezo device? How big are they? Are they part of larger hospital networks, how many hospitals do they have? Are they respected? I guess we sort of touched on this with some of the presentation, but you might want to give a little more color to who we're currently working with and without reaching any confidentialities, what the pipeline looks like?

Thanks, Marjan. Yes, from -- I mean, it's not that we've announced to the market prior, but I mean a couple of the really key ones we talked about is Michigan. We talked a little bit about Michigan's Childrens. We started recruitment there. Really exciting in fact -- and something we probably should share in our socials. The head physician there was also interviewed on FOX News or FOX 2 in Michigan, Detroit. And wheezo got a great mention, talked about that as an incredible product and a solution for families and children, especially coming into their sort of spring. May is very, very -- a big month for them and June, et cetera. So we're getting a lot of noise out there in building the awareness. But Michigan is a well credentialed, well respected, one of the best children's hospitals and specialty centers across the nation. Respiratory health is a big issue there with environmental factors. They're part of a bigger group, we've announced in terms of Tenet Healthcare, dozens upon dozens of hospitals are part of that network, community centers and other allied facilities. We've spoken to their CEO with respect to Childrens. He's really excited about what this program, led with wheezo can deliver outcomes and savings, and he's right there with us to see the value and then to accelerate that across the Tenet Healthcare Group. So really excited about that opportunity for the organization. The other one we're talking historically about is the organization and the group in North Carolina, part of a bigger Wake and Atrium Healthcare Group. That's another great opportunity for us. It talks also to what you spoke about earlier, Marjan, around Arkansas Heart. Again, a wheezo-led conversion, but also they -- they also look after hundreds and hundreds of patients, if not into the thousands with cardiovascular disease, and very similar to the Arkansas Heart opportunity there, in terms of 60% of the patient cohort is non-respiratory, and it's very much mirrored with respect to North Carolina. We're also having a lot of interest. I mean we have a couple of organizations with respect to specialty units. So a group of doctors coming together are looking at patients in tertiary care or in specialty care. And we've got those organizations on board. In terms of the future, we talked a little bit about earlier around private payers and insurers. There's a lot of excitement there. Statewide health systems are looking into our remote patient monitoring services and solutions. Again, wheezo led, and we're in extensive discussions. Some of them at different stages, in terms of that sales pipeline and that sales conversion. But my recent trip to the U.S. will obviously be based there and Marjan, there at the moment, we've had extensive discussions with statewide groups and leadership looking at solutions to help their patients, and we're really excited to share with the market at the right time, some of those opportunities. And to give you guys a bit of an insight, we snagged one of those large opportunities in one of those states, and you saw the slide earlier, which will be shared on the ASX. Just one group in Georgia. The funding is actually not through CMS, which is CPT Code, but funded through a statewide funding model. We actually delivered that program and delivered at scale. We basically kicked it out of the park in terms of the 9,000 patients. So it just gives you where we're at in the opportunity in front of us, and what Will and Marjan have spoken about. So we're going to get the fundamentals right. We've got to execute with excellence, and the acquisition allows us to actually do that and take ownership of that full suite of services. And once we scale that organization and our organization with all the people on this call, but also more broader, we can take advantage of those opportunities and have our hockey stick moment, which is around the corner.

Will, did you -- I mean, I was lucky enough to spend a couple of days with Will, he might not think the same, but we had the opportunity to talk to some blue-chip healthcare organizations that reached out to us about wheezo. Will, without breaching confidentialities, of course, do you want to give a bit of background, into what the future holds moving forward, to add to what Theo has already said?

No. I think that's -- what Theo is saying is exactly right. I mean when you look at the market opportunity here in the U.S., I mean, we're a population of 300-plus million people now that are with a lot of different comorbidity issues and chronic care conditions. And when you think about asthma and COPD all in and of itself, just centered around the IP that we have with wheezo alone. I mean you're talking about a patient population of 20 million to 30 million plus, maybe up to 60 million people in the United States. Any one label, one logo, I'll call it, I'm all about logo acquisition, can turn the tables on where we're going as an organization. I think the challenge we have, and I said this earlier is, getting behind an organization and getting behind the thought leaders that want to lead into this realm. We have a couple of institutions that we were lucky enough to meet with, one of them based in Minneapolis that is world-renowned, I'll leave it at that -- based in Minnesota, world renowned. You can figure it out from there, that is very interested in looking at what we're doing and how that might play into a patient management strategy. Secondly, we met with one of the institutions, a large Midwestern footprint for a national institution here that could change the vector on everything. So we're getting the right bites at the apple, let's call it, with institutions that are very, very interested in the way we're approaching the equation and how we can help patients manage chronic disease remotely. And as I mentioned earlier, I mean, the whole push in the U.S. right now is how we reduce cost, reduce emergency room visits, reduce readmission rates, and it all starts with managing patients in their home with devices that are easy to use, can be administrated remotely and monitored remotely, and we fit that equation perfectly with Respiri and wheezo. But beyond that with our whole suite of telehealth services. So we're really, I think, at the precipice of a big change in what's happening and we're one of the unique organizations in the space that's not just providing a remote platform, remote monitoring platform, you go do it yourself or a device, you go do it yourself, or a telehealth organization. We'll build rather all those up and do it yourself. We're bringing it all together under one kind of equation here, that works really well. And so far, that is resonating, right? I think the adoption with RPM in the U.S. has been really, really low. And the reason it's been really low, is that no one's really come to the provider and said, we have it all. We have all the services. We have all the procedures, all the techniques and all the expertise and personnel, to help you deliver a strategy across all of the cardiovascular, the diabetes, the weight loss management, the congestive heart failure and COPD and asthma patients that we need to be able to see remotely. We are the one company that ultimately has a lot of that right now. And I know that sounds a little bit braggadocious, but I've looked at this space for a long time. I've been -- prior to coming in to Respiri, I was a consultant in healthcare space for the last 18 months, and I've worked with all sorts of constituents in the space, and it was the same problem. And I've worked with the biggest companies in the space, and it was the same problem. I came here because I think there's a unique way to do this and I think we've got a great way of formulating a strategy and we're right on the precipice of doing that. And the numbers, 6,000, 7,000, 8,000 patients, this is a rounding error ultimately to what we would ultimately be able to become with this. Now we've got to get it going, and we're at the tip of -- we're at the bottom of the hockey stick curve right now, but we're not far away from 1 or 2 institutions right now that get it, wanted capacity to deliver it. We lock in with that, and like everything else I've ever seen in the U.S. healthcare system, 1 or 2 providers starts to adopt, everybody wants onboard.

Fantastic. Thanks for that, gentlemen. We've got another 6 minutes, so let's do a few more questions. A question about Access, how many Access clients are part of their customer pool and are servicing other comorbidities? And how much on average do they earn from those sorts of patients? Access currently has about 10 active clients that they're dealing with. The great majority of those clients are major players. They are big organizations that have numerous outlets across the entire country, I should say. And they're delivering services for most of them across all the disease states that we have spoken about today. Some of them, like, for instance, Minnesota Lung centers, they have 6 clinics in Minneapolis and surrounds. They are just delivering remote patient monitoring for pulmonary patients for obvious reasons there. But for all other customers, they are onboarding as we speak, patients on to remote patient monitoring solutions using wheezo and other devices across all the disease states. The numbers that I mentioned in the presentation of $70 to $100 is what they're making for each one of those patients, regardless of what disease state. And the size of the pie, if you will, is determined by the scope of outsourced activities that are given to access by their customers. Some want more done, which means they get charged more, some want a little less done, which means they get charged less. But the beauty of this is, as I said, the model is device-agnostic. We can deliver on anything. Importantly, although it's device agnostic, wheezo remains the door opener for us, because no one else has got it and no one's got a real alternative for delivering remote patient monitoring in respiratory. That's a key. That doesn't change. Theo and I have been working on that positioning for our RPM partners for the last 12 months, and we now see the benefits and the fruits of that, because they're getting in, to see people a lot faster [Technical difficulty] because by definition leading with a commoditized product, where does that conversation go? Well, how much is yours? And when you've got 100-odd blood pressure cuffs, and 100-odd ECG machines and countless diabetes or glucose monitors and thousands of scales, it's probably not the way to differentiate a quality premium service. Wheezo, on the other hand, provides that for them. Theo? When will wheezo -- when will Respiri become confident they have a commercial business model? And what developments would you like to see that give you that confidence?

I mean I think we've got a commercial business model, I think, at hand. There's no question. I think we know exactly where the reimbursements are and we know where the opportunities lie. We're nurturing those opportunities. I think in terms of where I see it wanting to go very, very quickly in the next 90 days, if not sooner, is grabbing the bull by the horns and the acquisition allows us to go there and actually get into these organizations that we have, and take ownership of the end-to-end. So making sure that all the physicians are in service properly, those little things that matter, making sure the onboarding of patients is seamless. To give you guys a very quick insight, and this is really, really low level guys. But to give you an insight, as a patient comes into the outpatient's clinic or into an organization, how is a program communicated to them, how do we make that process flow seamlessly? How do we execute flawlessly in that process? How do we onboard patients? What's best in class in terms of continuing to monitor those patients? Marjan, we know and we've got a lot of confidence that what the Access team have been delivering through that 9.6 months in that rolling 12-month period, but how do we even get that better. So how do we upskill that even more? So for me, that's what I'm looking for to make sure that we bed down and support Will, to make sure that he has got the tools necessary to drive that improvement and acceleration, because once we get that right, scaling off the back of that is actually going to be a lot easier. And as Will said, which I'm really heartened to hear, 2 years from now, we want to make that 9,000, 8,000 a rounding error, but you need to make sure you get your fundamentals right, and then you can scale off the back of that very, very quickly.

That's it. We've got a minute. A couple other questions. One is, do you believe that Respiri could become an attractive takeover target, once revenues take over? Look, I've been asked this question many times. And the answer to that question is -- we need to be a successful business first and the rest of it will look after itself. At the end of the day, we need -- we have a business model that's delivering now. We know it works. Our challenge is to scale it now, and that's no different to discussions I've had with many of you on this call today. And it's certainly something that Theo and Will hear me bang on about, and they're committed to making all this happen. That's the priority for us moving forward. But given that we have a unique selling proposition in remote patient monitoring, and given that respiratory disorders really can't be addressed from an RPM perspective, with anything but wheezo at the moment, makes us an attractive -- well makes what we do very attractive. And not just from a medical device perspective, but there are providers and insurers and healthcare organizations in the United States now, who are deeply disappointed at how slowly RPM has been adopted by providers and institutions. They get preventative healthcare. They want this to work, because every patient they keep out of an ER for say, COPD saves them $30,000 every single time they turn up. They understand it. They just haven't been able to crack the nut themselves. So if an organization like ours, continues to make the inroads that we are. Again, it's a narrative that's very attractive from at least a partnership perspective moving forward. So as I said, although I'm not here to say anyone's going to buy anything with respect to wheezo and Respiri, what I can say is what we're doing is a unique service in the United States and a unique service that can really help achieve the objectives of reducing costs, when it comes to healthcare delivery and improving the lives of the only reason we're in business. The only reason we're in business, is to provide a service to patients that will give them a better, healthier life. And the moment we forget that that's our business, is the moment we will fail. And we do it in a unique way. Devices, now with the acquisition of Access Telehealth, world-class delivery, and I have every confidence with the team that we have, the experience on this call at the moment. The people that are onboarding with the acquisition of Access Telehealth, the teams that Will and Theo lead, I mean we're a lean organization, and again, I just remind everyone, the U.S. is a behemoth of a marketplace, very complicated. It's not an easy place to start a business. Yet in just over a year and a bit, we've got a business that's generating income, and we started with nothing. -- which gives me great hope and confidence about what we're going to do moving forward, particularly with the 2 gentlemen that I've introduced to you guys today. We're in very good hands. And I have every confidence that the objectives that we're setting ourselves as an organization, with the acquisition of Access Telehealth, will be achieved and hopefully exceeded over the next 12 to 24 months. So we're just a little over time, ladies and gentlemen. Again, I'd like to thank all of you for your time investments today. So apologies for some of the hiccups when we first started. And I'll also -- maybe very quickly Will and Theo, a wrap-up from you in 15 seconds [indiscernible], please. Theo? That'd be you, Theo. The other Theo, sorry.

Sorry. I mean, in many ways, the story is clear. The strategy is clear. We need to execute and execute flawlessly, I am all about execution. And we've got the right guy in the U.S., I have no doubt about that. Great guy, great capability, and we're there to support and lead and drive. And I look forward to seeing the results and sharing them with the shareholders' quarter-on-quarter growth. That's what I'm looking for as well over the next period.

Will?

Yes. I want to just echo a little bit what Marjan was saying, answering the last question. That's a very hard question to answer, are we a takeover target? Where are we going? Well, the bottom line is that, we're here to build an organization first and foremost. And I think that the foundation that we're putting together is right on spot. We have a great opportunity in this market. It's a multibillion-dollar opportunity. Where it goes over the next 12 to 18 months, will start to give us indication in terms of what's next. But right now, our first charge is building the foundation, blocking and tackling, doing all the right things, to ensure that we have a replicable process and a foundation to build on, as an organization. And I'm excited to be a part of it. I think we've got a lot of the building blocks in place. We have great IP. There's no doubt about it in my mind. And now with the acquisition of Access, we have the opportunity to expand our reach, grow our foundation and reach more providers and go deeper and wider. But there's a lot of opportunity here. There's no doubt in my mind that this is going to be a successful endeavor. How high we reach, we'll see.

Thanks mate. Again, ladies and gentlemen, thank you again. With that, we'll close the meeting. If you have any questions, as you know, please reach out. You've got our contact details. I'll be back in Australia next week. So I'll be around for chats, if people want to do that. But again, many thanks. And with that, goodbye and good night -- or good morning, I should say. See you.