Trellus Health plc (TRLS) Earnings Call Transcript & Summary

Good afternoon, and welcome to the Trellus Health plc Full Year Results Investor Presentation. [Operator Instructions] The company may not be in a position to answer every question received on the meeting itself. However, the company can review all questions submitted today and publish responses, where appropriate, to do so. Before we begin, I'd like to submit the following poll. I'd now like to hand you over to Dr. Marla Dubinsky, CEO. Good afternoon to you.

Good afternoon. Thank you. Good afternoon, everybody. Hi, I'm Marla Dubinsky, Co-Founder and CEO. And I'm joined today by Joy Bessenger, CFO and Strategy Lead. And we're excited to be presenting today on Trellus Health and our innovation for whole person health, our annual results. Here's our disclaimer. So I just wanted to refocus on our company overview and focus on some key elements of our value-based innovative solutions that we're offering for comprehensive management of chronic conditions. There are three main sort of key constructs around our product, which is it's patient-centered, it's outcomes-focused and value-based. We're going to get a little bit more into the terminology around value-based and where health care in general is going, particularly in the U.S. Just to remind you about the two key elements of the method that we license from Mount Sinai and focus first on our ability to apply a scientifically validated metric or measure of an individual's resilience, which has been able to identify, stratify and predict individuals who are at risk of high-cost, low-resilient behaviors in a population of inflammatory bowel disease patients, which includes patients with Crohn's disease and ulcerative colitis. We're also the first company to take an understanding of an individual's behavior and be able to actually target and focus personalized support that is based in condition management resiliency and being able to prove that it's able to modify health behavior, meaning individuals' behaviors that they're exhibiting, and also improve psychological resilience and health outcomes, which mentions comes in the value-based, which is reducing the cost of care. So not only are we elevating the outcomes of individuals who gain resilience but also reducing the health care costs that are associated with these low resilient behaviors. We're deploying Trellus Elevate, which is really the whole entirety of the program, which includes the platform or the engagement platform where individuals who are enrolled in the Trellus Elevate program interact with the learnings, the teachings, the education and the team, all delivered digitally, to be able to change behavior. And these interventions are supported, and recommendations are solely driven by an expert-trained support team. So this concept where we're technology-facing but really this hybrid model where we have a team of trained individuals that are focused on customizing and designing the program to meet the individual needs of that member who has joined the program based on their initial assessment of where they are in their spectrum of resiliency. And also note that, because we are focused on resiliency of an individual who is suffering from a chronic condition, that allows us to really deliver value by actually partnering with the member, making these members more active participants in controlling their condition and also actively engaging in their overall care, which allows us really to align, and we'll show you a little bit more as we discuss some of our opportunities and our partners really where we align in this value-based ecosystem because everyone really in health care is interested in saving money and improving individual outcomes. But at the end of the day, the cornerstone is really being able to actually help individuals become empowered and take more control over their health. And that's really the construct under which our programs have been focused and designed and developed. So just to highlight the 2023 highlights. As a reminder, some new leadership. Dan Mahony came in as Chairman of the Board. Julian Baines, who was our previous Chairman, is now with EKF. And similarly, Steve Young, who is serving as Interim CFO, has joined Julian in EKF, and we were able to be fortunate enough to have Joy Bessenger come on as our full-time CFO and, as noted earlier, leading the strategy. A couple of key highlights also, we developed the irritable bowel syndrome program. So we already have a program that is ready to go and that's built for our clients who want to expand their offering beyond inflammatory bowel disease, who also want to encompass other chronic GI conditions. So because they're similar in nature in terms of the type of resiliency training, it allowed us to easily sort of customize an IBS program. We launched our early B2B pilot programs in inflammatory bowel disease, we'll get to that in just a moment. We did complete our direct-to-consumer model and transition them to a community testing program. Our DTC model, which we've talked before in the last two, both interims in October and also our annuals last year, was really to talk about that we needed to ensure that the model worked outside of Mount Sinai, which was really in-person, analog programming to be able to make sure that the program is something that is needed across the country not just in a region, not just in one hospital health system, and be able to ensure that we're evolving with the needs of the individuals that would be using the platform. We had positive data and real-world evidence that supported the Trellus Elevate model based on our direct-to-consumer model, and we actually showed that, unlike at Sinai where we actually saw it took about 8 to 9 months to really notice behavior change, what we saw is we can get there faster when you actually go to where the patient is living and be able to have it digitally delivered. So they're not needing to come to a provider's office but it's actually being delivered where and when they need that support at that time. Also, in 2023, we have finalized the scope of work for a national health insurance plan. We've now launched. We'll get to that in just one moment. We also had talked about, last time, that we really were ready and built to scale and built an enterprise-level platform which accounts for many things, reporting metrics, it also accounts for privacy, our ability to have certification which is really the industry standard around privacy and security controls and compliance when you're dealing with personalized health information from our health plan partners, and attain the operational scalability while maintaining cash runway into mid-2025. So now let's get to the post-period highlights. We're here, April of 2024, so we're happy to note that we executed indeed on our contract with a large U.S. health plan, which is UnitedHealthcare. We not only executed but also launched Trellus Elevate. We completed our early pilots, and we'll talk a little bit about what we learned from that. Also, I mentioned the SOC 2 Type 2 certification which, as noted, was really meeting industry standards for system security and reliability. We signed 2 licensing agreements with pharmas, one for our proprietary resilience assessment to look at how individuals who enter into clinical trials, what is their overall resilience portfolio and can their resilience, in any way, impact outcomes and data seen in a clinical trial setting; and the other one was for content. We have a whole person sort of support content and wellness and lifestyle content that one of our pharma partners who they themselves have an app and want to deliver more holistic support for individuals with ulcerative colitis who are either on their drug that they're marketing or just having UC alone, being able to offer something beyond just a therapeutic but actually the whole person approach. So they've licensed some of our content for some of our modules, which are called jump-start modules, which are in-the-moment sort of health behavior, how to manage pain, how to manage your mood, how to manage stress, worry, all in the moment. So these are short exercises and videos that our pharma partner will be offering on their application. And continued scalability and operational scalability while maintaining cash runway into mid-2025, you'll see the theme, and then Joy will update us on the financials, and we'll get back to that a little bit about where we are. So just taking us back to where our role is and how we offer value and what our business model is, it really is about understanding that the totality of Trellus Elevate and the program and the platform, by focusing on individuals and getting them to have an active role, really is a cornerstone to value-based care. Now there are many companies in this value-based space, right, because the value quotient is, if you improve outcomes of individuals and do it at lower cost, meaning our health plan partners or health systems save money doing that, that means you've met the definition of sort of enabling or providing value or being part of an enabler of value-based care, no matter who is trying to deliver that. Now there are key components to be able to do that, and I'll just highlight what we do. And why it is considered patient engagement and really focusing on individual self-management and activating is because patient engagement, it really is a cornerstone of value-based care. And a lot, as noted, of companies are focused on the provider, changing provider behavior, working ways to improve billing efficiency, our electronic medical record, or maybe referral pathways to get people in the door sooner, trying to reduce the ED utilization, trying to reduce hospitalizations, trying to really avoid unnecessary care and try and connect individuals to take more control of their health and relying less on the emergency room or the urgent care. So essentially, there are really two main components at a very simplistic way is, one, you have to identify and assess individuals at most risk of using the emergency room, having more surgeries, not adhering to their medication, because that's really where cost accrues. But it's one thing to identify that individual, but it is another to go in and engage them and personalize and drive behavior change. And that's why I started at the beginning talking about really the two components of the method, and that really is the visibility and the ability to predict that someone is going to use their health care system unnecessarily but also intervene and fix it and really deliver at a customized, tailored way to the individual and not just everybody does the same program. I think when we talk to our partners, the key things that they want to know is, one, you could actually tell the reason why someone may be engaging in low-value care. Yes, because we have visibility into their resilience. We go to their home. We understand what are the drivers of high-cost care, low-value behaviors. And we also personalize their management or their support based on where they are in their journey and specific to their behaviors and sort of this concept of assessing and engaging leads to improve outcomes. And that's really the green box really is, what value-based care is. You actually improve the clinical outcomes fiscally responsibly and be able to lower the cost, all while improving the health of individuals, both mind and body, this concept of whole person. And that's really, again, the cornerstone of value-based care. And we got that solution, that's how we partner with our clients. Also, just to go back and understand what does it mean to be a company or a solution that offers value or enables our partners to deliver value-based care or sustain this value-based model, so we're enabling our clients, right, addressing both the physical and emotional aspects of having a chronic health condition. We offer personalized support, activating lifestyle and behavior change. We use technology to be able to improve efficiency and customization to a user. We use understanding, education and empower. They want to actually better self-manage, not rely on, as noted, the emergency room or the constant in-basket message to providers who're at their own pressures to be able to deliver their financial responsibility to the system. So there's a lot of a lot of work to be done to really keep patients out of the ED in the hospital, and part of it is being able to actually empower the patients to start activating their self-management. All of that results in the end game of cost savings, right? So we do all of that, right? That's our presentation to our shareholders. That's the presentation to our clients. That is our story. And we have had this story from day 1. But we thought maybe to just remind all of you where the integration of what we do and why it matters and why this is an important moment for Trellus because we're able to take what we did at Sinai which, just as a reminder, what we did at the Mount Sinai Health System is we showed that when you measure someone's resilience and deploy a program that is personalized to build someone's resilience, when resilience goes up, health care utilization goes down and outcomes improve. That is at a very large health system with a very high prevalence of inflammatory bowel disease, patients who have complex disease. And the fact that we were able to do that in a very complex patient population -- because we're tertiary, we're like fifth opinion, seventh opinion on occasion, patients have had long-standing disability and sort of long-standing both mental and physical disability, and the fact that we were able to teach someone resiliency and lower the cost of care through the patient, right, going directly to the individual, not trying to change me as a provider behavior but really focusing on what we know changes cost, and that is the individual. So knowing that and knowing the importance of what we already did really allowed us to have very high-level discussions. We talked about it in '23 and now launching, so we thought we would tell you at a high level summary. As you can see, we just recently launched with UnitedHealthcare. This is the terms around the current agreement, sort of the first phase of our partnership. The region that we're focusing on delivering Elevate to, Trellus Elevate, is in the New York and Connecticut region specifically. The term of the contract, the initial term, is 21 months. That includes a 6-month enrollment period. And every single individual, from day 1 of the enrollment period until literally the final day of the enrollment of that, 6 months, everybody has access to at least 12 months on the program, free access to the members. There's no cost to the provider as well for their patients to be on the program. So those are the terms around the initial contract. As noted here, resilient scores are a key outcome metric. Why are we emphasizing that is because, on the Sinai slide, what I showed you, it is very well-known that when you raise someone's resilience, even at 4 months or 6 months, it predicts that you will have better health care outcomes. So the point of this is that resilience score is really an early indicator that we are moving forward in terms of providing what we said we're going to provide to our partner. And that is a predictor of lower health care costs. So it's important to note that the initial assessment of our value to our partner is really our ability to change resilience in these members early. And they saw that at Mount Sinai, we were able to do that. And then in our early direct-to-consumer data, that data was very important because it actually showed that we can do that within that 6-month time frame because that means that, long term, there will be health care savings. So the fact that we can do that early, and we don't need to wait until 12 months to show that someone's health behavior changed is an important metric for us to share with you. Another sort of highlight that we want to talk about, when we talk about the program in general, is really the commitment of our partnership here, is that we are in real-time, weekly, having steering committee calls, which allows us to review where we are, ensure that the messaging is aligned, ensure that, together, members have access and know about the program. And that's really been instrumental in us problem-solving. If there are things that we need to change, if they need to change, if their outreach needs to be different or the messaging needs to be different, we are sharing in that knowledge and lived experience in real time. Also, just a reminder of the business model, our pricing model, for this particular program, it's a monthly fee per engaged member, per individual member of the program. But we also had a onetime implementation fee in the initial term. But also highlighting, just to let you know how sort of it works, is that an individual member, an eligible member, is made aware of the program. They then go to the website, which starts their engagement. They fill out their resilience assessment and their disease complexity assessment. And then they have a call, a first human touch with a Trellus team member, which is a resilience navigator. At that time, the navigator is reviewing the scores and the results of their online assessment, determining whether they qualify for the program. So being eligible means it's offered to you at no cost from your health plan but then making sure that we are engaging with the right individuals, those who have very high disease complexity, those with low resilience. For members who happen to have very low disease complexity -- sorry, not high disease complexity but have low disease complexity -- and have high resilience, those members already reached the outcome for which Trellus was built. So at that moment, we do screen them. We let them know that at this moment, they have their high resilience score and give them a tip sheet of when to come back. So that way, we are actually reimbursed for that screening fee for those who actually don't go into the monthly. But at any time during the opening of the contract, during the term of the contract, they are able to come back and reengage because our partner knows that life changes, IBD constantly changes. So the ability to have a place like Trellus, if things change in their disease, if they've had surgery or there's other life events or challenges that have rendered them needing a little bit more of a toolkit, then they are going to be reassessed and reengaged in the program. Another sort of concept that we warrant is the importance of a co-branded customized launch site. So individuals will be given their material, which is the marketing material, the outreach material, by both us at Trellus and our digital marketing campaign, but specifically from the health plan where there are e-mails and they're actually mail campaign, with trifolds and brochures that come in the mail with a QR code, as well as every month that someone becomes a new member with a health plan, they actually get told about this opportunity. So there's this constant sort of funnel of new people every month who have now a new health plan, for example, during the 6-month enrollment. Additionally, those that are already members will also have reminders and outreaches directly from UHC. There's also a provider campaign because what is known is that patients often rely on their providers to sort of endorse that there are programs out there that would work along their treatment plan and don't want to intermediate or do something that their provider wouldn't approve. But the good news is, as some of you may have heard me say this before, Trellus Elevate was built for providers as well. Because us, as providers, IBD is very complex. It's hard to monitor our patients outside of the office, and Trellus really provides us connected continuous support. And my provider friends know that if it's driven by something that work at Mount Sinai, their patients now have access to something that is considered gold standard nationwide. So I think this really allows us for them to be reminded, providers, that this program is available. And also Trellus has engaged -- and we show a screenshot here of Ms. Sydney who is talking about her experience with Trellus and sort of that holistic approach and sort of that 360 integration of mind and body, physical, mental, emotional. And we've got a whole marketing campaign, Instagram, Facebook, LinkedIn, et cetera, for our ability to really get into the ecosystem of how people are searching for health care solutions these days and be present. When they're getting this material from their health plan, they know what Trellus is. They see a face of someone who has experienced Trellus. So that's been really important. And the final point is the fact that it's located in Connecticut and New York, which is where I am located physically. It allows me to have some direct honest conversations with my colleagues who have always wanted to have sort of the method somewhere and send out their patients to us at Mount Sinai just for the program. But because we have to only see patients who are followed by us, it's not something we offer to patients outside of Mount Sinai Health System. This was really an opportunity, for now there are patients to get access and get into what is considered gold standard whole person support. So it's set up really for success. And hopefully, you hear the tone around our partnership and our relationship with the team that's been working with us to launch this program. Just to update you, we noted in post-period highlights that we've closed down, we've concluded actually, the pilots that we initially started with Mount Sinai because those programs weren't based on cost savings, meaning our KPI or outcome was not to save money. It was really to ensure that individuals at Mount Sinai, those who seek care for IBD at the Mount Sinai Health System, have broader access than just those that may only see me and Laurie at the IBD center, as an example. So these were a couple of different ways that people can have more access. We saw again that through the program, that individuals met their outcomes of increased resilience. And a couple of things we also learned is that it is really important that the health plan is driving the messaging and reminding them at no cost that this is available. And that was sort of the learnings that we learned outside of Mount Sinai is that this needs to also go beyond Mount Sinai and that being able to get a broader reach of members who are at other health care systems really is the way that Trellus moves forward. But also another aspect is we have a set limit of team members. We have a set budget for technology. We have set resources that we needed to ensure are available for UHC, right? It was very important that now that we have sort of a contract that is focused on cost, real metrics around resiliency and its association with total cost of care, we wanted to just focus all of our resource allocation to this contract. And so that's why we've concluded these. And one of them, the managed care health plan, will be concluding at the end of May. So that's where we are with that. We really field tested our method, our technology. We improved actually our technology because of some of the feedback. And what we really also learned is all around engagement. It was really important. So we've really focused on ensuring we develop the right UI or user interface and UX, the experience. And now we're really also focused on engagement because we're able to get this early field testing to say this is what keeps people on the program. And because we're paid per engaged member per month, part of it is, one, getting people on but also ensuring that they engage over time. And that's really been the focus. And Joy will talk about the financials now.

Thanks, Marla. So we ended the year with cash of $12.2 million versus $19 million in the same period last year. Our adjusted EBITDA loss was $5.8 million versus $8.1 million in the same period last year. So you can see that even though we've made a lot of investment this year, getting really ready to scale for United, we were still able to really bring down our costs and be very careful managers of the investment. We've spent about $9 million in capital investment to date since our founding on our tech and our software. We expect that to start going down, starting this year. And I'm going to talk about that a little bit more as we go forward. So we're looking to focus on bringing in more partners, large and midsize partners. We are able to continue to develop and scale with what we have on hand. Our cash resources are sufficient to get us into mid-2025. That's with assuming conservative revenues and actually understanding that we can start bringing down our incremental capital investment. I'll talk about this more as we talk about traction. So in addition to revenue growth, improving our cash flow, which are obviously very important, the health plan, the licensing agreements we signed earlier this year, are important. We're going to expand our active members. We're going to be able to bring in new clients. We can do this at a lower cost because now we have a playbook for how we approach this. Now we have the metrics in place for reporting for our content and what we can offer, how we can tailor. We're able to be very nimble. We've been able to improve our technology. We're going to be able to lower our cost, deliver at scale. We're already doing that with United, and we're going to focus on expanding with Trellus Elevate to meet market demand. Again, we're seeing this. When we announced United, we already saw some sense of FOMO perhaps in other insurers. So they are actually starting to pick up their pace of the conversations. And I think just to touch back on the other point about the capital investment, we're in a unique position as a company at our smaller size, at our stage of development, we have built an enterprise-level solution. We are ready to cater to the Uniteds of the world. And I think it's important to note that we're able to do this while we can now start moderating how much we spend on capital investment, how much we spend on our platform. And going forward, we are able to tell partners, if you want something especially bespoke, we will build that for you. It will be included in the implementation fee and won't start being built until the contract is fully signed. And they think that that's an advantage we have over other companies our size.

Thank you. So then just to end, sort of thinking about the summary of what we've discussed today but also what's happening for us in the rest of the year, obviously, we began to deliver commercialization at scale. We're expanding the platform to engage more active members with our existing partner but also as we build out new partners. Obviously, the agreement with UHC does kick start a shift to more commercial scale and facilitate discussions specifically focused on the cost-saving model and that value-based enabling solution that we are. Obviously talked about the cash on hand to execute for our current partner and secure additional. I think that was really an important concept that we really want to make sure we've gotten across is that we built it for large scale, right? So we invested early, and you noted that towards the second half of this year, we'll be able to really get to a level where it's more of a maintenance for the capital investment. I think that's important because even though more people will come on, it doesn't mean more costs. And I think the fact that we've built it for such an important partner allows us to bring individuals on without incrementally increasing the costs. Ongoing discussions with other large and midsized B2B partners. And I think probably the most important messaging across is the systems playbooks and insights that we've really taken over this journey that we've had, getting to where we are today, highlighting what we understand to be our goals for traction, revalidating that we're in the business of value-based care, and we get paid when we save others money. And we know that our method saves money. And I think now, with confidence, being able to take all of our learnings and execute our current contract but also execute the additional contracts that we're going to be progressing in the goal we need to progress to, Of course, that's our growth opportunity that we now have a playbook to discuss. And I think that has been clear and has allowed us to be where we are today. So thank you so much for your time, and we'll open it up for questions.

[Operator Instructions] As you can see, we have received questions throughout today's presentation. If I could perhaps hand back to you at this point just to run through the Q&A, I'll pick up from you both at the end.

Sure. So I'll start with how does Trellus help measure and evaluate member engagement with the platform? A great question, actually, because you saw it's per engaged member per month. So we actually have a number of ways that individuals can engage. And we've set up the platform, whether it's just a direct message, whether it's log-in, whether it's tracking your medications, whether it's tracking your vaccination, whether it's having a telehealth visit with your coach, whether it's filling out your resilience assessment, so we've got sort of a composite. We've got so many ways. And push notifications, so someone gets a push notification if there's a new assignment. We also have the e-mail. So someone will get an e-mail that their team sent them a new assignment. They can click right on that e-mail and get back into the platform. So as long as they engage in the program, through multiple modalities, that defines engagement. So we built it to be able to win on the engagement strategy. So thank you for asking that question. In terms of KPIs for effectiveness, so as noted, the real KPI is the resilience score in the short term. And we actually measure that at day 90. So we will already know sort of 90 days in, it's a standard, we measure it at baseline 90, 180 and then again 350 for those that are still extending beyond 180 days because not everybody is able to rally and get their resilience back to high resilience in just 6 months. The lower you are in your resilience assessment when you join the program, the longer it takes. That's a lot of work that patients are willing to put in, obviously, our members. But if you had the disease for 20 years and you have depression and anxiety and you had 3 surgeries, it's going to take a while to get through sort of the complexity. But we did it. We did that at Mount Sinai, so we know that this is actually possible. And so it's really about the metric of resiliency. And of course, as everyone approaches their 12 months, looking at the total cost of care. That is still our business model, right, is that we still need to show value from a cost. Remember, the quotient for value is both increased outcomes, which means higher resilience, as well as lower cost. It's not just the cost base, so there's this balance between outcomes and costs. But thank you for asking. So beyond the current agreement, obviously, our goal is to continue to expand discussions with health systems, other either regional or national health plans, as well as continue to build out some of our pharma discussions actually because as I said at the beginning, what's interesting is the common denominator for everybody in health care is the patient. So everybody has their own ways of helping themselves improve their value because they're going to be held accountable, but nobody actually has the patient in mind. And so I think what you'll see, our diversification over the goal for the rest of the year is really to show that we do live in different lanes because we are helping patient center, right? So at the center is the member itself. That's who our user is, right? Our end user is the member, the patient. So I think that's what you're going to see, and that's our goal, is that we're continuing right after sort of the signature happen, Joy and I were obviously already saying this is where we're going next and evolving those discussions faster because we had been able to progress with executing and signing contracts.

So we look forward to updating you on the pipeline when we are here again.

Yes. One question on regulatory because I think that's a great question. And for those who have been with Trellus since minute 1, you know that we actually initiated in 2021, as building provider offices across the country and getting psychologists and nurses to deliver it and try and copy and paste exactly what happens at Mount Sinai, and in spring of 2022, when there was thoughts around the fact of is this going to cost more money to set up professional corps across the U.S. and get people credentialed and higher providers, the answer was, yes, yes, yes. And there was a strategic decision, at that moment in spring of '22, to actually switch to a coaching model where we're not delivering care, we're not diagnosing, we're not treating with a drug, we're not using any regulatory hurdles to deliver it. And I think once we became condition management through health behavior change, in the FDA guidance from 2019, there is all around this wellness concept. And within the wellness products falls behavior change strategies, lifestyle companies that are focused on behavior change. Category one is general population. Category 2 is lifestyle behavior change specific to chronic conditions. So that allowed us to live in that environment. And as noted, there are clear criteria what [ dings you ] a device. And we do not need criteria of the device, and we are not delivering care in the traditional sense of prescribing. And those were really important components. So thank you for the discussion or the question around it. So maybe, Joy, you want to take the cash?

I feel like we talked about this a little bit, but I'm happy to highlight it again. So the question is, despite the decrease in net cash position, the extension of the expected cash runway until midyear '25 is mentioned, could you provide more details on how the company plans to manage its cash resources, particularly considering the ongoing commercial traction. So I do think that probably in the near term, the most important thing that we can discuss is to just reinforce that we expect we are in an unusual position as a company at our stage of development and at our size that we build an enterprise-level solution, which United is now on, which has room for more people to come on. As it is, right now, we were ready for this. It's already at commercial scale. So we are able to continue to not just keep a good eye on our spend, but also more importantly, we're not going to have to make further really big capital investment as we have been up to date. We're going to start seeing that drop off. It's already starting to come down a bit, it will drop off in the second half when we go into maintenance mode where we're maintaining the tech, updating it, making sure we keep up with the times. But we're in a really good position. And I think that was done deliberately. Thank you for the question.

Yes, and thanks, everybody. There's no further questions. So one, we just want to thank everybody. Hopefully, this update sort of gave you the information you need to understand where we've come and how we're going to be gaining some traction. I think when we come back in October, there's going to be some interesting data that we're going to share as well as update you on our further discussions with other clients. So thank you so much.

Thank you, everyone.

Perfect. Marla, Joy, thank you for updating investors today. Could I please ask the investors not to close the session as you should now be automatically redirected to provide your feedback in order that the management team can better understand your views and expectations. This might take a few minutes to complete, but I'm sure it will be greatly valued by the company. On behalf of the management team of Trellus Health plc, we'd like to thank you for attending today's presentation, and good afternoon to you all.