Vitasora Health Limited (VHL) Earnings Call Transcript & Summary

Welcome to the Respiri Investor Webinar and Q&A today. [Operator Instructions] There will be a presentation from management before we have some Q&A based on questions that have been submitted via e-mail as well as using the Q&A panel on the Zoom app. On behalf of Respiri today, we have the CEO, Marjan Mikel; and the Chairman, Nicholas Smedley. The initial presentation will last for approximately 20 minutes and we'll allow for as many questions as possible thereafter. I'll hand it over to Marjan. Please, go ahead.

Good morning, ladies and gentlemen, and thank you very much for investing some of your time with us today. I'm going to share some very exciting news and progress that we've been making in the United States. You'll have to excuse me. I just landed this morning from LAX and I don't know Arthur from Martha as far as I can tell it, but I'll give it my best shot. So today, I basically wanted to take time to introduce the company again. Most of you have heard the story in the past, but there may be people here who are new to Respiri, and I'd like to give them some overviews. And as I said, then provide you with the opportunity that the U.S. provides to us, a major pivot strategically for the organization and an update on how eagerly and -- wheezo has been adopted by respiratory physicians in that country. As you all know, asthma is the third largest disease state to afflict the human race. Third only to cardiovascular disease and diabetes. There's about 350 million patients with asthma across the globe. In the U.S. alone, there's about 27 million patients with asthma and about 13 million with COPD, that's Coronary Obstructive Pulmonary Disease. So the opportunity for wheezo and Respiri in those markets are huge. And as I said, we are already delivering a remote patient monitoring solution to our U.S. -- through our U.S. partners to customers in the United States as I speak. I'll just give a quick note of our company overview. I mean our product is wheezo and it's important to note that we have FDA, CE and TGA approvals. Our indication is for wheeze detection. Now wheeze detection in any respiratory disorder where wheeze is an issue. The 2 that we focus on are asthma and Chronic Obstructive Pulmonary Disease. Our market in the U.S., the remote patient monitoring market is worth about USD 40 billion today and growing at about 30% per annum. Our business model is a bespoke model that we partner with remote patient monitoring partners who provide these services to doctors, institutions, hospitals and payer groups. And as you know, and I'll go into this in a little more detail, the major drivers for our opportunity in the U.S. is reimbursement. It is a unique marketplace and a marketplace that really provides an opportunity for patients to basically receive wheezo as a remote patient monitoring solution with very little out of pocket. Our revenues today about AUD 0.25 million and our market cap as of yesterday was about AUD 40 million. So what I thought I might do now is remind us what our product is. And one of the doctors or many of the doctors have said to me that they love the sophisticated simplicity of wheezo. To remind us, it is a sophisticated electronic stethoscope with the recording in the front and a noise cancellation microphone in the back. You simply place it on your trachea, like so and breathe normally. And to be honest, it blows the doctors out of the -- out of a water when they see how easy this solution is for their patients, because current solutions around electronic spirometry and peak flow are very, very difficult to use even when they're in front of the doctors, let alone in the land room by themselves. So the opportunity to be able to provide a patient with a device that allows the doctor to monitor what's happening with their patients that have respiratory disorders, sorry, from the real world in real time and be reimbursed and remunerated for that are huge. As I said, the U.S. market is a very, very attractive dynamic. 8% of Americans have asthma and I just mentioned, that's about 27 million. A remote patient monitoring is reimbursed in the United States and there are a number of different codes, which I'll go through later. The market itself is growing at a great rate of knots and we are part of that growth. It's interesting, as I've said in the past, that it's unique that the doctors are the actual people who get reimbursed to providing remote patient monitoring devices and services to patients. We don't get paid directly, they do, and our partners charge them a fee-for-service for providing the device and also the data required to be able to make the necessary decisions around what is happening with those patients. Important to note as well that doctors and institutions hospitals included, can outsource these services to third parties and those third parties are our partners, which is very, very attractive indeed. Important to note also that U.S. payers, CMS, that's the Centers of Medicare and Medicaid Services and private funders, understand the importance of funding preventative medicine because unlike in Australia, private health insurers over in the U.S. pay for all medical bills. So it's in their interest to make sure they keep patients out of high-cost health centers, such as hospitals. We know our technology is proven. Wheeze is indicative of reduced lung function. We know that our device is as good as a specialist in detecting wheeze. We know that we are reimbursed for remote patient monitoring in the U.S. and because we measure a physiological parameter, breathing. And to date, we have been very well received by pulmonologists or respiratory physicians in the U.S. I have yet to talk to a doctor, hospital or payer that hasn't said this is a great idea. So really -- and there's also a very strong interest in conducting further studies, real-world studies with wheezo and that's not to prove that wheezo works or doesn't, but it's to show outcomes data -- health outcomes data that introducing wheezo to patients with respiratory disorders will reduce health care costs and keep patients out of hospital. As I said, we've got a very robust model. We have best practice remote patient monitoring partner providers. And they generate sales for us by purchasing the devices off us initially from somewhere between USD 50 and USD 60 per device and then pay us a monthly per patient SaaS fee, which is ongoing and is part of them providing doctors with the device data and in some instances, helping the customer/doctor manage their patients. We've already spoken about our first customer, Michigan Children's Hospital, and this is a large hospital. They see about 4,500 patients with asthma, children that is of asthma in a year. And they're very, very excited about using wheezo as part of their standard of care. And we'll be putting our first patients on the wheezos towards the end of July and early August and moving forward. So we should have reimbursement claims processed in August/September. It is important to note that Respiri will be the first Australian company that will have processed and claimed remote patient monitoring reimbursement claims. No other company has done it and we'll be the first, which is a big step in the right direction. We already have a little over 120 qualified leads, possible payers and doctors and we're working through those as I speak with our partners. And it's important to note that many of these leads have been generated not by myself or our team, but rather the RPM, remote patient monitoring partners that we have in the United States. And we have to be able to do that because there is no way we can scale without our partners not being expert in what it is we do. And really, as I said previously, there is really little competition when it comes to remote patient monitoring in the respiratory space. Respiratory disorders are a huge burden across the globe when it comes to health care expenses and the U.S. is no different. And as I said, 1 in 13 Americans have asthma. That's about -- equates to about 1.6 million ED visits. That's the Emergency Department visits with patients having exacerbations. Each one of those visits, excuse me, costs the payer about USD 8,000. COPD, not quite as prevalent, but the cost per patient per ED visit is a lot higher, as you can see. Now it's important to note that current remote patient monitoring solutions are basically subjective tests, questionnaires I should say. So we're relying -- doctors are relying on patient's recall about something that may or may not have happened and the patient is self-assessing, which we know from every epidemiological study that's ever been done, they're not very good at. This assessment is unreliable but it's the current gold standard. Now we know that Respiri's wheezo can provide more objective information about the patient symptoms, which is the way that doctors manage and diagnose asthma and do it in real time from the real world and in doing so, provide a solution and data set that is reimbursable. I've spoken about the use of spirometers. It's extremely difficult for patients to use spirometers in a supervised environment. That's why doctors will usually do 3 spirometric tests and take an average. Now there is no way in the world that a patient will be able to do that in the real world and have reproducible data. And that's why doctors don't trust the data that these sort of these spirometers provide them. So that's really an important thing to remember as we go through the opportunities that we are exploring in the U.S. We know, as I said, that wheezo is so easy to use. 30 seconds of breathing and the breathing is Bluetooth to a smart device. The smart device has the app and the algorithm, which analyzes the breathing for abnormal breath sounds, in this instance, wheeze and calculates a wheeze rate. Now we know from clinical data that's already been published that a wheeze rate of more than 5% is considered to be clinically significant. Important to note that one of the questions that the patient gets asked by the doctor either through the asthma control test or the asthma control questionnaire is how often have you been wheezing and how bad is your wheeze. And really, given that often wheeze is not audible, you can't hear it, a patient ability to be able to answer that accurately is somewhat flawed. The app also allows us to capture other information such as symptoms, air quality, pollen count, pollution, medication usage. All these factors help build a longitudinal picture up for the patient -- about the patient, sorry, that a doctor or a doctor's nominated staff member can start to get a better understanding for what the conditions, what exacerbating factors are causing problems for their patients and be allowed -- and allow them to better provide a asthma management plan that takes those things into account. The data is collected and sent up into the cloud. And basically, as I said, it provides for a personalized asthma management plan. And in the instance of the United States, these sorts of plans or this data transfer is reimbursable. It's an integrated technology, as we've discussed. We have the wheezo, it interfaces with the app. That's all securely stored in the cloud. And that information is then shared with physicians, clinical staff or third parties and to be better able to manage a patient's respiratory condition. And as I said, with that sort of interfaces in place, we qualify for remote patient monitoring reimbursement. So -- and we have a stand-alone platform ourselves, but importantly, we're also integrating with our partners' remote patient monitoring platforms, which in turn are integrated with doctors and health care organizations, hospitals, et cetera, electronic medical record systems. So I'll go into a little bit more about that as we go through the presentation. I won't go through this in too much detail, but you've seen this probably 100 times. We know how and how well wheezo works. We know that when you look at a spectrogram of a breathing recording, it doesn't matter what I or a doctor thinks they may or may not have heard, you can clearly see the wheeze in the spectrogram and that's basically how the algorithm has been written. So we know that it works. We know that it's reproducible and we know that we can share that information with physicians. So it is really important to understand that we have a device that works and works very, very well. If there's any clinical work that we'll be doing moving forward, including the work that we'll be doing with the King's College in London is not to work out whether or not wheezo works, it's to determine the outcomes, the health outcomes that introducing wheezo into the life of a patient with respiratory disorders, asthma in this case, are improved by providing the patients with a device that helps them better understand what's happening with their condition and allows that information to be shared with their doctors and care teams so that they can take the appropriate measures if things are deteriorating. And I really want to make that very clear. We have a clinical plan, like anything, we are a medical device company. And as such, clinical development continues to be a cornerstone of what it is we do. We know that the algorithm has been extensively studied for over 20 years across the globe. We know that we use the data from Box Hill Hospital study in 2019-'20 to improve the algorithm, and we know that algorithm now is as good as a specialist for the stethoscope. We're finalizing some papers with Mark Levy. He's a GINA Director from the U.K. and provides us with advice on how we can move forward with this. And we're targeting a publication in Q4 of this year with the Journal of Asthma. So that will be throwing the cat amongst the pigeons because basically, it's going to be suggesting that the current gold standards of a stethoscope and a doctor may need to be rethought, particularly given that we have devices now that are much more accurate and reproducible in their data when it comes to listening for wheeze. As I've said previously, there are numerous independent studies that document wheeze rates of more than 5% are indicative of clinically significant wheeze. And we know that for wheeze to manifest lung function has to be reduced by at least 30%. So we know that to be a fact. And that's -- if you were to talk to a doctor about what they would do with a patient with a reduced lung function of 30%, they would be reaching for medications to make sure that patient was looked after and that the lung function is returned. As I said, we're working with the Birmingham University to get a better relationship between wheeze rates and lung function. We announced just recently that we're working with King's Hospital College, where we were successfully funded by the National Institute of Health Research, the NIHR. That was a competitive bid. King's chose wheezo as one of their devices of choice and they were successful in gaining about GBP 2 million in funding for this particular study. And the first patient in this study will be in quarter 3 this year. There's also other studies and I won't go into too many more details about. But basically, they plan to look at other areas that we might be able to use wheezo technology to better manage other areas such as exercise induced laryngeal obstruction or EILO. We're also working with 2 major university hospitals in the United States to study remote patient monitoring with wheezo in children with severe asthma and also in adults. So that's likely to kick off in quarter 3 this year as well. And that data will be invaluable to us along with King's in trying to provide an objective measure of how well health outcomes improve when wheezo is added to the treatment engagement with patients. So we had a very good participation with the American Academy of Allergy, Asthma and Immunology. And as I said previously, the generated interest from KOLs was quite pleasing, and we've generated quite a number of leads from that. I won't go through any of the other bits and pieces that are there. Suffice to say that we have a very strong presence with our partners at all the major respiratory functions that are run in the United States. And we're making very good headway with those leads that are generated from those particular -- from those particular encounters. So [ all goes well for ] a very, very successful quarter 3, 2022 for us. The U.S. commercialized strategy is really straightforward. We've already delivered FDA approval in March last year. We have selected Access Telehealth and mTelehealth as our remote patient monitoring partners of choice and have basically knocked back quite a number of others that we don't believe have the standards that we would like them to have when it comes to dealing with customers. We have a U.S. approved product and packaging. Remote patient monitoring pathway and app and portal have been developed, which allows us to provide doctors and our partners with the device and tools that allow them to claim the remote patient monitoring reimbursement codes. We have built inventory to meet the demand that we expect to generate in the United States. And as I said, the revenue model is quite straightforward. It's USD 50 to USD 60 per device, depending on volume. And our SaaS monthly patient fees will range between USD 5 and USD 20 depending on the type of services that institutions or doctors outsource to our partners. As you know, there are quite a number of reimbursement codes. And the beauty of the United States is that the physician can outsource the entire remote patient monitoring model to a third party, hence, why there's a difference in the scale of monthly fees that we get from patients -- sorry, from the doctors. In progress, we have a significant physician and payer user engagement with our remote patient partners. The last 3 weeks in the U.S. have been no different. We had at least 10 patient engagements over that period of time. And we're making very, very good progress with making sure that our systems fit into the hospital's administrative and electronic systems. So again, this is not to say whether wheezo will be used or won't be used. It's to make sure that the wheezo and data fits into the way these hospitals operate. And the beauty of doing this once is once we've done it once, a great chunk of the integration plan does not need to be repeated. So it becomes a lot easier for us moving forward. So -- and as I said, many of the hospitals that we've been talking to and the physicians, the respiratory physicians have never really had remote patient monitoring as a service they provided, so -- and they're allowed to. And that's the exciting thing for these people because they can now use remote patient monitoring reimbursement codes to fund these patient engagement plans to ensure that they reduce readmissions into the hospital and hence, keep up their 5-star ratings with the payers. So we're moving very, very nicely in that area. And as I said, there's over 120 leads that we're currently working with. And these leads will basically provide us with initially hundreds of patients, but that will grow to thousands as we start to ramp up the patient engagement with the doctors in those institutions. And once we've done that, the next step is to make it embedded as part of the standard of care. Now that's part and parcel of the journey that we'll take with each of our customers, and our customers are being typically hospitals. And importantly, we are making some great headway with some of the payers, so the private insurers as well. Because as I said, a lot of these guys really do understand the importance of preventative health care because every patient they keep at a hospital saves them an enormous amount of money and they're very interested in making sure that they do and fund whatever it is they need to do to make sure that happens. Very commonplace in cardiovascular and diabetes. And our current partners already claim RPM in the area of -- sorry, in the area of cardiovascular and diabetes care. So we are by no means an experiment for our partners, the remote patient monitoring partners, Access Telehealth and mTelehealth. We're just another area of opportunity for them to use the systems that they've already got in place. There's also opportunities with the Federal Communications Commission and the United States Department of Agriculture. They make health grants available for lower socioeconomic rural areas. The FCC grants are up to USD 1 million per contract and the USDA has a grant pool of about USD 0.5 billion that they will invest in the health care of less fortunate and lower socioeconomic areas, which are typically rural in the United States. So we're making some good progress in that area as well, and I hope to be able to provide you with further information as that comes to hand. As I said, we're just going back to why there are different levels of monthly fees that are paid to Respiri for the remote patient monitoring. You can see on the left-hand side there, there are quite a number of remote patient monitoring codes that a physician can claim and they can outsource any one or all of these to a third party. Now some of our partners, Access Telehealth in particular have built a patient delivery model, not that dissimilar from the remote asthma monitoring program that we developed here at Respiri. So that's the fundamentals of their business model. So if they basically have a doctor outsource the entire remote patient monitoring service, they'll make that doctor about USD 160 to USD 180 a month, charge for the top -- per patient to deliver on all those services and the bottom end around and we make a percentage on those particular numbers on a monthly basis as well. So it is important to note that the doctor doesn't have to outsource the entire service. But at a minimum, the device with the data, which is item #99454, will be reimbursed USD 55.72 per patient per month. And we're already making some very good progress on providing a completely integrated service through our partners to their customers. It won't be a little complicated on this slide, but I just wanted to remind everyone that the United States is a unique marketplace because it's not just that remote patient monitoring is reimbursed, but it's the doctor that gets the fees for providing the service, not me, not the providers, but the physician. Now the physician gives the patient a wheezo and they can then outsource those particular RPM patient services to our partners. Our partners then basically pay us a fee-for-service on a monthly basis per patient of somewhere between USD 5 and USD 20, and we also get a fee for the sale of the wheezo of between USD 50 and USD 60. So that's fundamentally how the money works in the United States. But important to note that it's the only country in the world where doctors are remunerated and rewarded for providing remote patient monitoring services to their patients. So in closing, I just wanted to remind everyone of the U.S. clinical success factors. As I said again, and I'll keep laboring this point, that reimbursement is a key part of our strategy in the United States. CMS or the Centers of Medicare and Medicaid Services reimburse remote patient monitoring across every state in the United States. 28 of the U.S. states have mandated that RPM be reimbursed and that requires all the private payers to cover RPM as well. And to be honest, most of the RPM, most of these providers in the states where it's not mandated, pay for RPM anyway. Payers understand RPM has been preventative method because they pay for hospitalizations. Unlike Australia, where if you have an asthma attack, you go to our best hospitals, which are public hospitals, and they're either paid for by the states or if you go to your GP, that's paid by Medicare. So our private health insurers really don't have the same burning plank as the insurers in the United States who pay for everything. Important to note again, physicians can outsource remote patient monitoring to third parties and most third parties are our partners. It is a physician-led strategy, which is really important because it's the doctors that are driving wheezo's usage with patients. We know that wheezo qualifies now and that there are really no solutions for respiratory disorders in the remote patient monitoring space and our partners are world-class when it comes to delivery. Important to note that we have built up our inventory in the United States -- sorry, our inventory of wheezo to meet the demand in the United States. And we've currently got about 20,000 units of wheezo on hand. And we have also managed to secure another 12,500 chips, which we also have in inventory, and that will mitigate any of the problems that have plagued industries across the globe when it came to chip security and manufacturing. Wheezo 4.0 will meet our COGS objectives of about AUD 50 or USD 35 as well. So the actual manufacturing and inventory build on hand has gone to plan and we wanted to make sure that we had enough inventory to be able to handle the demand that we will see moving forward. Important to note that we own all inventories. Every wheezo we sell, that's money in the bank for us as well. So in closing, everything is going to plan in the United States. And really, the pivot to the U.S. marketplace isn't really company defined. It is huge, physician-led and reimbursed. We have the best RPM partners in our sites. And as I've said, wheezo been very, very well received by payers and physicians. We've got our first patient reimbursement wheezo deal with Michigan Children's Hospital, and we have over 120 other leads that we're actively working on and working through. We know that wheezo is FDA-approved. And we know that when it comes to the United States, asthma creates about USD 82 billion worth of financial burden to the health system in the U.S. So there's a real reason to introduce remote patient monitoring solutions to reduce that. Breath sounds in wheeze are considered important physiological parameters in the treatment guidelines by physicians. And the presence of wheeze as I've said in many independent studies is associated with a significant reduction in FEV1 or lung function. And FEV1 reduction is an established parameter that predicts exacerbations and mortality. So all in all, we have a marketplace that is screaming out for a solution like wheezo in a market where patients and doctors, sorry, get paid and remunerated for providing remote patient monitoring solutions to their patients. And in a disease state, respiratory, where there are currently no real solutions for doctors to use until wheezo came up. So thank you very much for taking the time to listen. I hope I have been able to provide you with a little more information about where we're at and how we're traveling. I do apologize for my tardiness a bit, but my heads is not where it's supposed to be. But I hope that I've been able to provide you with the information in a way that's understandable. And with that, I'll hand over to Matt and have any questions that we've had given to us.

Thank you, Marjan. That was a very good presentation. We'll move on to the Q&A. As you've mentioned, these are based on questions submitted via e-mail and on the Q&A panel within Zoom. First question is, can you explain the range in monthly SaaS revenue outcomes per patient and the process of working through what that is for each customer?

Yes. As I said during the presentation, there are numerous reimbursement codes that a doctor can claim for remote patient monitoring. Now our monthly SaaS fees are a percentage of the total bills that our partners, Access Telehealth and mTelehealth charge to the doctor. So at the lower end with just the data supply, it will be around about the USD 5 mark. At the upper room is where the doctor provides, sorry, the doctor outsources the entire reimbursement schedule to a partner. And that would include patient engagement, data transfer, chronic care management and providing a wheezo and that's at upper end. So we get a percentage of either USD 45 or up to USD 85 as well. So that's why we get a varying number in our monthly patient fees.

The next question is, what is the process of prioritizing and working through customer leads?

Yes. That's a very good question. We have basically targeted those areas where there is a high level of respiratory medicine being practiced. So all the leads that we've got at the moment have been obviously in the area of respiratory medicine. And it's important to note that our partners have established a relationship with these institutions anyway. So they use their own patient management -- sorry, customer management tools to understand which of the patients -- I'm sorry, which of the customers are more likely to jump on the wheezo bandwagon than others. So they are pretty sophisticated in the way that they manage their customer groups. And really, to date, they've been making some great inroads. And I hope you'd be able to share a little more of that with you in the coming months.

Next one is, do we have a time line for any potential grants via mTelehealth?

We do have a time line for the first grant to be awarded in the coming months. So we're not talking years, so we're talking about the next few months. And it may or may not be mTelehealth, but it might be with other partners as well. But you'll understand I can't go into any more details around that.

Next question is, to what extent is the U.K. trial relevant for U.S. progress?

Yes. The U.S. trial is very relevant across the globe. I mean, as I said, we know that we would qualify for a patient monitoring, but we know that if we can present a compelling outcomes data from a real-world study like the one from King's College, we will be in a better position to negotiate even higher reimbursement rates for what it is we do. Now that's very, very important for the United States. Importantly, also in the U.K., the NIHR is a government body, and they're not in the business of funding studies on technologies such as wheezo, unless they see that it could be something that they may want to reimburse through the NHS. So this is a stepping stone in the U.K. as well. But I will reinforce that the data will be particularly pertinent to whatever is we're doing anywhere in the world. But our focus is in the U.S. and that data will be used in the U.S. And it's important to note, as a next pharmaceutical guy, we're not paying for this study and -- which puts a smile on my face, given my background. But -- and we're not utilizing shareholders' contribution for funding something like this. We're relying on those funds being provided by the NIHR in the U.K. So it's a win-win for all of us.

Next question Marjan is with Propeller's involvement in the U.K. trial, what are the company's current views on the potential complementary value of wheezo and smart inhaler?

We have -- the intention has always been to provide physicians with the most objective sets of data possible to help them better manage their patients and rely less on the subjective nature of what patients tell them they're doing or not doing. An integrated platform is certainly something that we are still very interested in exploring. And a smart inhaler is certainly something that we would consider -- continue to consider as a possible complementary technology to wheezo. We're in no discussions with anybody at this particular moment in time, but having a one-stop respiratory shot is certainly something that is still very attractive as a solution and it's further differentiating as a product.

Next question is, is there an update on the development plans and time line for the wearable?

Yes. We know that it works. We're now playing around with it to find out where it's best placed on the chest to capture all the information that we need. We should have that sorted out in the next few months with the view of kicking off clinical studies with the device in November, maybe December this year. And there's no shortage of people who were in institutions in the United States and the U.K. for that matter, that would like to play with the wearable and help us, again, determine the clinical significance of the information that we're capturing. And remembering the wearable isn't going to replace wheezo. It's there to capture a lot of data that doctors already asking patients about. It will capture wheeze, cough, respiratory rate, body position, sleep quality, all the things that a respiratory physician asks their patients about that had asthma. So we're hoping that, that will all be in place, as I said, by November for clinical studies. And once the data capture is sorted out in the next few months, we will commence a 510(k) submission for FDA approval, which we hope to get in the back end of next year.

The next question, Marjan is the experience to date, what is the most challenging and/or time-consuming part of the U.S. customer sign up process?

Institutional selling is always a challenge. The hospitals that we deal with and the payers that we deal with are large groups. So working through their guide approval is very, very time-consuming and often takes longer than we like. But there is a process that we need to go through. And it's not the clinical need for wheezo, but as I said, it's how wheezo and remote patient monitoring and data fit into the current way that hospitals operate. So getting that situation understood, working through the process to make sure that we don't cause any headaches because you don't want to be introducing another system to hospitals, you've got to fit in with the systems they have. And as I said, that's probably the most time consuming but necessary part of the process.

The next question is, given physicians or GPs tell patients subjectively to monitor for ways, how has the reception been from U.S. doctors in regards to the value proposition of a device to objectively monitor or measure ways?

Look, the response that we've received in the U.S. from physicians has been fantastic. Seriously, I have not spoken to a doctor or institution that hasn't said that wheezo is great and we want to use it. So it really augurs well for the acceptance of wheezo and usage in patients. So they're very, very keen. It's interesting to note, too, that respiratory physicians have really never had anything that they could use to claim the remote patient monitoring CPT reimbursement codes. So there's a bit of an education process there as well, but it does put a smile on their faces when they find out that we have a simple device that's easy to use. And in using it, they can also be remunerated for providing a remote patient monitoring solution that will help them better manage their patients through the reimbursement codes. So it's been really, really positive. Puts a smile on my face every time I get there.

The next question is how much difference is there in the IT platform integration between different hospitals and customers?

Not that much. The major integration is with the electronic medical record systems. There are 2 major systems in the U.S., one's called EPIC and the other is called -- it will come to me. Anyway, they may make about 85% of all hospitals and institutions. We'd actually interact or interface through an API to our partner's remote patient monitoring platform. They, in turn, build the bridges into the EMR systems of hospitals. So once we do it once, maybe twice, the rest would be pretty easy. So as I said, we currently speak to our partners' platforms and their platform speaks to hospitals platform, EMR platform as well. So once we get it done for EPIC and the other one that I forgot now, but EPIC is basically more than a half marketplace, most of the work is done there.

The next question is, is it still the case that the semiconductor shortage is not likely to have a negative impact on the company? I know you've touched on this briefly, but...

Yes. We've got all that in hand. The team has done a wonderful job in building inventory, which we do have and also having in inventory, the chips that we need to make wheezos. So all in all, there's about 33,000 units that we can get our hands on, 22,000 immediately -- sorry, 20,000 immediately and another 12,500 can be manufactured very quickly. The turnaround manufacturing time for wheezo is only a couple of weeks. So we've won the brunt of all that and have come out the other end, well positioned.

The next question is, how has the availability of RTM codes with no need for physiological measures influenced your thinking?

It hasn't really. We qualify for both. The important difference between RTM and RPM is a physician or institution cannot outsource the management of RTM for a patient to a third party, they have got to do it all themselves. With remote patient monitoring, as you know, that whole service can be outsourced. And what's attractive particularly to institutions is they don't have to put on the infrastructure, the human infrastructure and systems to provide remote patient monitoring solutions to their patients because they can outsource that to a company like Access Telehealth, who has already got those services and resources in place. You can't do the same with remote therapeutic monitoring. The doctor or their staff need to be able to deliver that themselves. So from our perspective, we still capture the information that we have on patients. Doctors can outsource the entire remote patient monitoring solution to a third party, our partners. And that is a far more attractive model for us than focusing on remote therapeutic monitoring.

The next question is how many claims by, excuse me, how many claims by how many physicians through RPM or RTM CPT codes have been made for patients using wheezo in the U.S. and what payment levels were achieved?

Yes. So we haven't claimed -- as I said in my presentation, our first claims will be processed in late August-September, and they will be generated by a couple of institutions, one we've spoken about is Michigan, and you'll have to watch this space for other developments in that area. Sorry, Matt, but remembering, when we do process the RPM CPT reimbursement claims, we will be the first Australian company to do so.

And the next question I've got is, it says, thanks to Marjan for refocusing Respiri's direction. Should investors be concerned about ResApp's device considering that Pfizer has shown a huge vote of confidence?

Well, they don't have a device. That's the first thing. But I think it's -- I think anything that reflects well on the respiratory space for medical devices or apps is a good thing. I think that the difference in what we do and what ResApp does, ResApp professes to be able to diagnose various conditions. That's not our value proposition. If they can diagnose that's great, wheezo is only available to patients who are already diagnosed with a respiratory disorder. And in the United States, you need to be diagnosed to qualify for the reimbursement codes in remote patient monitoring and you have to have a device. So from our perspective, that is a huge opportunity and will remain our focus moving forward. And as I said, anything that goes well in the respiratory medical device space is a good thing for all players in this area.

The next question is, when can long-term investors see a genuine uplift in income?

Income. As I said, I'm -- we're banking on banking, cash from reimbursement in the second half of this year. So we're on track to deliver patients -- sorry, customers through our third-party partners. And it's not going to be USD 1 million from day 1, but it will be, as we found with Michigan Hospital, a small number of patients first to make sure that they fit in with the systems, the hospitals have got in plan and then growing that particular presence in the hospital as patients present with asthma or COPD. So the trajectories for us look good for the second half of this year.

Another one, which to touch on is, could you introduce the new Director and tell us what he brings to the table?

Yes, sure. I don't know if Brad is online yet. But Brad Snow is our new Non-Executive Director, has extensive experience in medical devices in the United States, and he is currently a CEO of Angel-Medical, which manufactures an implantable cardiovascular device. He has extensive experience in the areas of reimbursement and he has already helped us understand a few bits and pieces around some of the nuances of the reimbursement in its situation in the United States, a wealth of information extremely well connected as one would expect after 25-odd years of experience in this space. So he's already helped introduce us to potential customers and certainly introduced us to people that we will be able to use to help better prepare us for the sort of reimbursement case, for instance, we might be able to claim for the wearable device once it's approved by the FDA. So a very, very experienced and well-connected individual who's also a good bloke. So I don't mind working with him. So -- and hopefully, we'll get him to introduce himself personally one day.

We just got time for one more, which was with regards to reimbursement. And the question is have ResMed or Cochlear done this yet?

No. ResMed basic business is CPAP machines, and they don't qualify for remote patient monitoring and neither do Cochlear. So they're implantable hearing devices. The Propeller device qualifies for the RTM codes. And as far as I know, they haven't made any claims in that space to date.

And just as an FYI, someone has quietly pointed out Cerner as the other?

Thank you. I'll give you break, I only landed a few hours ago.

Sorry, I'll throw it back to you just to provide a concluding comment, Marjan.

Thank you. Ladies and gentlemen, I hope that I've been able to provide you with some information on our progress. It is really an exciting time for the organization. And every time I go to the U.S., more and more doors open for us. As I said, institutional selling does take time, but I am very confident that we are on the cusp of something very special in the United States. And when I mean special, revenue-generating special. I do appreciate your patience and rest assured that the team and our partners in the United States are making great headway with potential customers, which I hope to be able to announce over the coming months. So thank you once again, everyone. If you've got any other questions, you've got my contact details, please give me a buzz or send me an e-mail, and I'll see what I can do. So thank you very, very much.

Thanks, Marjan and Nicholas for joining, and that concludes the presentation for today. Thanks to everyone for listening, and we'll see you next time.

Thanks, Matt.