Learned about it a few days ago & had a chance to dig in.
A thread 👇.
The product: "Butterfly IQ+"
-Puts ultrasound on a semiconductor
-Ushers in era of hand-held ultrasound
-Linear, curvilinear & phased array ultrasound probe all in 1
-Connects hardware w/integrated software, AI & tele-guidance to drive faster, smarter, less costly medical imaging
1. Notes from Dr. Jonathon Rothberg -- Founder & Chairman
The resume
-Pioneered a process to sequence genomes on a semiconductor
-Launched field of next-gen sequencing
-Won a Presidential Medal of Tech & innovation… casual
Dr. Rothberg continued:
“I knew life had transformed when computing was put on a chip… I saw the power of Moore’s law & envisioned how it could be brought to DNA sequencing.”
Dr. Rothberg continued:
“I discovered majority of 🌏 had no access to medical imaging.”
What'd he do?
Put ultrasound on a chip.
“Today Butterfly IQ+ has the broadest FDA clearance for a single ultrasound probe ever... it's the world’s 1st & only full-body ultrasound system."
2. Dr. John Martin -- CMO
“Ultrasound is the fastest growing medical imaging modality.”
“For 50 years, ultrasound used the same piezoelectric crystal tech driving complexity & cost higher."
👆Means patients "wait for imaging in dedicated centers or for carts to come bedside.”
3. Notes from Gioel Molinari -- President
IQ+'s 3-staged approach to value:
a) ultrasound on a chip -- replaces piezoelectric tech w/9000 micro-transducers (tiny drums emitting & receiving ultrasound)
--Frees ultrasound to be
---Scalable
---Portable
---Affordable
b&c) 👇
b) Invested in software & AI tools to automate measurements & aid professionals in decision-making
c) Butterfly Enterprise: The IQ+ operating system (OS) for point of care ultrasound ensuring:
-quality control
-electronic medical record (EMR) integration
Molinari continued:
IQ+
a) offers 20 clinical sets ranging from shallow to deep imaging
--change depth setting w/phone app
--uses 1 probe; competition needs 2-3
b) performs a volumetric bladder scan
--gages if catheterization needed
--had been determined w/time intervals alone
Molinari continued:
c) "Don’t need to listen to the heart with a stethoscope… can image the heart in real time"
d) Demonstrated uploading results into patient records
e) Hit on their "imaging virtuous cycle" -- IQ+ improves as more data boosts AI & tele-guide capabilities
Final notes from Molinari:
“We hope to introduce a product to be used by patients to self-scan ultrasound in the home to send to doctors in real time.”
“We hope to continue miniaturizing our chip to enable wearable medical imaging… using our partnership with $TSM.”
4. Highlights from Laurent Faracci -- CEO
The market
-TAM of $8B & growing
-40M global HC workers to ultimately target; 8M initially
“By bringing imaging to the patient, we allow access beyond traditional imaging centers & broaden the settings for ultrasound”
Faracci continued:
“Plan to update our hardware every 2 years and to push out monthly software update to enhance utility”
Recent examples:
-Launch of "Needle Viz" for confident, ultrasound-guided needle insertion
-“Fast 3D bladder rendering”
-“Many more soon to go”
Faracci continued -- wearables
“In 2023 & subject to regulatory authorization… we plan to enter the wearables market representing 100M chronic patients in the USA alone”
"Our wearable patch will capitalize on momentum from higher-tier software & at-home monitoring trends”
Final tidbit from Faracci:
“This year we launched a salesforce to scale adoption… many of whom are practitioners already using butterfly today.”
5. Highlights from Stephanie Fielding -- CFO
a) $44M in 2020 revs from “individual professionals & small groups"
b) Will scale adoption w/large enterprises starting in '21
c) Expect a 66% CAGR through 2024
--$334M in 2024 revs
--Includes little future wearables contribution
Fielding continued:
Profitability:
a) Gross profit margin (GPM) to inflect from negative to 40% in 2021 via moving from developmental fab manufacturer to $TSM
b) GPM target of 70%
c) Expect free cash by 2024
Wearables to conservatively contribute 10% to revs by 2024.
Fielding final notes:
“Capital from the transaction covers planned investments, supports planned transition to free cash & allows for additional capital allocation.”
“Software revenue is expected to reach 40-50% of total revenues by the back end of the decade”
6. Deal structure BASED ON $17/share
a) EV roughly $2.85B
b) $175M PIPE @ $10/share
-- $THC & Fidelity part of PIPE
c) 23.3M outstanding options
NOTE: valuation slide below is off... based on $10/share not current price -- now it's more like 18x 2022 EV/Revs not 10.6x
-Complex procedures take a few hours & a handful of exams to master
-Per The Journal of Family Medicine: A Lung exam w/IQ+ takes hours to learn
-For trained users, Butterfly built a learning management system to provide scalable education
8. @Glassdoor reviews are limited & fine but not amazing:
-Strong IQ+ value-prop
-IQ+ is cleared
-Integrated, high-margin software business built in
-Leadership impressive
-Wearables = larger pursuit not factored into guidance
-High risk, high reward name
@Lemonade_Inc A digitally-native insurance platform featuring
a) AI & machine learning to more accurately price risk & more affordably price plans
b) Philanthropy to make a shady industry friendlier
c) A quick, transparent buying process
The machine is learning:
In 2017: $LMND AI bots (Jim & Maya) handled 6% of inquiries.
Today 32%
There is every reason to believe the % will continue rising for this less than 4 y/o company.
Fosters lower customer acquisition cost that company passes on to users. (see below)
AI edge:
$LMND loss ratios improve w/scale; opposite of competition.
(Loss ratio=$ paid in claims/$ collected in premiums)
$LMND: .67
Industry ave: .82 (low is 👍)
Machines > human mind @ scaling
A young company used AI to be 15% better at pricing risk than 100 y/o firms.