Feedback (LSE:FDBK) — Company Update

0:08 Good morning, ladies and gentlemen, and welcome to the FEEDBACK Investor Presentation. Throughout this presentation, investors will be in listen only mode. This meeting is scheduled to last around thirty minutes. Are encouraged and could be submitted at any time via the Q and A tab situated on the right hand corner of your screen. Simply type in your question in the box and press send. The company may not be in a position to answer every question it receives during the meeting itself. However, the company review all questions submitted today and publish responses where it is

0:39 appropriate to do so. These will be available via your investor meet company dashboard, and we will send you an email to notify you when they are ready for your review. I'd also like to remind you that this presentation is being recorded. Before we begin, we would like to submit the following poll, and we'd be grateful if you could give that your attention. I'd now like to hand over to Tom Oakley, CEO of FEEDBACK. Good afternoon to you, Tom. Good afternoon, and welcome to all of the audience. It's very nice of you to join us today and for giving us your time. Hopefully, we'll have a a lot of interesting things to talk through. I'll start the deck, and we can then take questions afterwards.

1:27 So for those of you who don't know FEEDBACK, just ever so quickly give you a bit of background about us. So FEEDBACK are a medical technology company. We've been established for actually quite some time now and have a background in medical imaging being a PACS system provider to the NHS since about 2001. PACS actually stands for picture archiving and communication system. And the best way of thinking about it is it's a digital library for storing medical images, and it's how hospitals store their medical imaging studies and how radiologists, such as myself, would draw pull out studies and then report them. In the last two years since I've been chief executive of the company, we've actually moved away slightly from our core PACS business to actually look at how we can take our expertise in medical imaging into new areas within health care.

2:19 We've been particularly looking at how medical imaging applies to frontline clinicians, how they use this in their day to day work, and we've also been addressing some of the challenges that that face those frontline clinicians, most notably around how they communicate with each other, especially as clinical practice is increasingly becoming more remote and spread over wider geographies. So what we've actually done is built secure messaging and video calling capabilities around our medical image viewer, our PAC system. And we then also learned how to integrate that system into other hospital systems so that we can do things like call reports and laboratory investigations relating to the patient. And we've wrapped this up all in one amazing CE marked medical device called Blipper.

3:05 And Blipper is a bit of a play on words because it replaces the bleepers or the pages that, clinicians typically communicate with. So what is Blipper, and and how does it work?

3:21 On your day to day work as a clinician, you typically work with individual patients one at a time, and it's a really important safety feature within our application that we deal with patients on an individual basis. This is for twofold. If you are in a chat conversation and you have multiple patients within that chat, there's a possibility that you might end up talking about the wrong patient or you might associate the wrong results with the wrong patient, and that can lead to treatment errors and potentially patient harm. The other important consideration is that if Sorry. You Sorry. Just to cut across. Could I just ask you to turn your volume down on your PC just so that it's giving you a slight echo coming through back on you? Oh, okay. Sure. Is that better?

4:08 Unfortunately, not so. There is a you you can I just confirm you've only got one browser? I can't actually hear you now. That's the problem. I'll carry on. If if it continues, then just just interrupt. So so the important thing about having conversations happening around individual patients is also that those conversations can then form part of the patient record. And that's actually one of the great time savings of applications like BLEEPR is that actually it it removes the need for clinicians to have to duplicate. The conversations that we're having around patients where we're making all those decisions typically aren't captured, but applications like Blipper allow us to capture those conversations rather than having to separately document them. So what we've done with BLEEPR is created a series of individual patient streams around which we build a clinical team of clinicians that can then discuss the case dynamically, and then we bring information from various hospital systems around that individual patient.

5:07 And that most notably includes medical imaging. And this is the really hard bit that is difficult for people to do. In order to bring medical imaging into the application in a way that's clinically useful and certified to be safe for use, we have to be able to handle a format of imaging called DICOM and be able to integrate with PAC systems at the individual trust that we're working with. We then also have to be able to certify that as a medical device and also manufacture it according to independent standards such as ISO thirteen four eight five. So our ability to integrate medical imaging into patient chat and discussion is a really difficult thing to do, and it is a unique thing to BLEEPR. We are, at this current time, the only c marked communication platform for medical imaging review, and that gives us a real USP in the market.

6:02 Outside of just case discussion, BLEEPR is also used now for e referrals between specialties and between clinical teams. We're also looking at how BLEEPR can be used to facilitate referrals between different care settings, such as primary care to to secondary care. We also are able to use BLEEPR to conduct what we call multidisciplinary team meetings. MDTs, as as they're called in the trade, are actually where we get specialists from across a broad range of different specialties, such as radiologists, surgeons, and medical specialists, all to discuss cases, particularly complex cases like cancer. Now, BLEEPR can enable these clinicians to work together dynamically in and around their existing workflows in what we are terming asynchronous MDTs.

6:52 And this is a new way of conducting MDTs. It's only possible through instant messaging and through our ability to pool patient data around that patient. And this is a really exciting opportunity for BELIIPA to support clinicians to practice in the way that they actually want to practice, which by and large is becoming increasingly remote. And it gives a number of very exciting opportunities for BLEEPR. For those who follow our news, you will have seen that very recently, we've been awarded our first paid contract with the NHS with the Royal Bancher Hospital in Reading. This is a fantastic trust for us to work with, and they see a huge amount of potential within Blipper for how we can actually change and deliver health care within the trust and and beyond.

7:40 The contract size is 84,000 plus VAT. And, actually, this is a fairly sizable contract within the NHS, particularly at an individual trust level. And I think it's an amazing achievement for our company to have been able to secure a paid contract from the NHS just under two years, actually, from the original concept of. And so I think, actually, the contract that we have with the Royal Barks, we hope, will really help to show the the market and you as investors that the the NHS has now recognized the value of BLEEPR, and the important message is that they are prepared to now pay for it. You will have also now seen within our RNS about this announcement that we are also looking to develop a number of features within BLEEPR to support some initiatives within the trust.

8:37 Most of these features are actually largely already developed, and we did this in anticipation of a robust contract. Wherever possible, we actually look to develop features so that they align to commercial opportunities and new market areas. And one of the features that we've developed for the Robarture Trust is photo capture. Now photo capture allows us to take a clinical photograph of the patient in a zero footprint way. And zero footprint is it basically means that no data is stored locally on the device that you use. So if you're a doctor like me who's regularly use losing them on my phone or losing other things like tablets, there isn't actually any patient data on those devices for you to lose. So all that would happen is we would switch off access to that device and then give you access to a new device so that you can continue delivering care to your patients.

9:31 So photo capture will have a number of important uses within the trust, both within trauma cases where often you need to see both the nature of a wound that a patient has had and also the x-ray and CT imaging relating to that patient, But also for things like dermatology, where actually we want to be able to see see rashes of lesions and moles and to be able to quickly share those between clinicians for specialist opinions. We've already mentioned briefly the multidisciplinary team meeting features around asynchronous MDT, and this is something we're really looking to develop with the trust. And I think we'll have a much broader application outside of just the whole Berkshire. I think the most important thing to say on this recent contract is that it is finally recognition that BLEEPR is a product that can deliver for the NHS.

10:21 And as we emerge from COVID, trusts are beginning to be willing to be paid to pay us for this product. We are making fantastic progress within the NHS and outside the NHS. We've actually seen a number of users for BLEEPR at our site up in Manchester grow quite dramatically since our initial pilot back in December last year. B for now is a core application within Pennine Acute Trust and is used for a number of patient referral pathways within the trust between core clinical specialties. And we are further expanding that use both within the trust and into some of the neighboring trusts outside of Pennine. This is a very exciting opportunity for us to actually see how BLEEPR can be used between hospital sites as well.

11:12 It won't have escaped anyone's notice that actually in this last year, we have all been afflicted by COVID. Now COVID has represented, on one hand, an opportunity for Bleepa because it clearly demonstrates the benefits of this product and the use cases for it. We've been able to support clinicians to work remotely. We had a gastroenterology registrar who actually was able to manage the entire gastroenterology pathway from home, providing senior advice and guidance to junior staff on the frontline and also managing referrals into their specialty. And this was vitally important because they actually had to shield at home because of their own comorbidities. And cases like this have really shown us the power and potential of PEEP to change the front line.

11:59 However, on the flip side of that, of course, the NHS has been consumed in responding to COVID. They have been focusing both on their vaccination program and initially, in the early stages, actually combating the the disease as patients came through. And what this has meant is that on one hand, we have clearly demonstrated the use and benefits of BLEEPR, but on the other hand, it has been very difficult to engage with trusts in a meaningful way, due to their, other conflicting priorities. Now what we are seeing, which is very encouraging, is that as trusts begin to emerge from the COVID crisis, they are looking at what digital tools they should be engaging with and where the lessons have been learned during COVID. And therefore, we're very optimistic that BLEEPR is now extremely well positioned to gain the interest of a number of trusts across the NHS, and we will hopefully be providing further updates on this as things progress.

12:58 It's well worth us investing in features with Bleeper, especially where these are aligned to commercial opportunities. We've already spoken about the MDT solution and photo capture, but we are also looking at how we can how we can integrate with and withdraw information from even more hospital systems to provide better value and better information to the clinicians that are using the application. Our end goal and ambition is that as a clinician, rather than having to log into multiple hospital systems and search for patient information in each of those systems, But you can use Bleepa. You can log in to an individual patient and see all of the information that you need to about that patient in one space along with all of the colleagues that you might want to interact with about that patient.

13:47 We're also focusing more on how we optimize the DICOM image viewer within BLEEPR to really enhance its value proposition to more specialist image interpretation like those conducted by radiologists. And this is really so that we can enable BLEEPR to be used for case discussion between radiologists and frontline clinicians, which is a very common occurrence in in frontline clinical practice. For those of you that are following the company, we have also announced previously a partnership with an AI company, Axial three d. One of the great opportunities for Blipper is that we hold the relationship both with frontline clinicians but also process DICOM medical imaging files. And these are the files that AI companies need in order to function and to deploy that software.

14:39 As a number of these AI tools come to market, they will actually be looking for a route into the hands of frontline clinicians. And therefore, we're confident that actually a number of them will see as a good deployment partner.

14:55 One of the opportunities that we we have with Axial three d is around using three d segmentation of imaging to assist with surgical planning, and we are looking at how we can conduct this within the MDT environment. Essentially, the user will be within Blipper. They will click through to the Axial platform. And in the background, we will push the DICOM study to Axial three d for processing. The report then coming back into BLEEPER to be available to the clinicians. And this is just an example, one example of how AI relating to medical imaging can be deployed within BLEEPER. With a number of AI applications now looking to come to market, we believe that this is an opportunity that will grow and continue to expand. As I've indicated, we actually have a very strong pipeline now as NHS trusts begin to emerge from the COVID nineteen crisis.

15:54 We also have been working closely with private sector institutions and also looking at opportunities outside of The UK.

16:04 Again, those who follow the company will have seen that in December, we went out to India as part of the Department of International Trade Mission. And this was really a great opportunity for us to scope the Indian market and to see how the lessons we've gained from the NHS can be translated to the health care setting in India. We actually had a very good initial response to that trip and have actually been following up with a number of leads. So much so that we've actually taken the decision to appoint two in country personnel in order to help us develop those opportunities and explore them. We continue to work very closely with the regulatory bodies within The UK. One of the most important features within BLEEPR is our medical device credentials.

16:55 It's a little known fact within the NHS and something that we are working hard to educate trusts on. But anytime that you do anything with digital patient imaging for a diagnostic purpose, you actually must be using a CE marked medical device under regulations called the medical device

17:13 directive. That means that anytime a patient image is shared between clinicians, anytime that a image is discussed as part of an MDT, those clinicians must be using a CE marked platform. And as we've mentioned, BLEEPR is the only communication platform to be CE Marked for medical imaging. The effect of not using a CE Mark product is that actually the individual clinicians and their employing trust are open to civil claims liability risk for any decision that they make using that platform. So BLEEPR is a really important tool for frontline clinicians and trusts because it protects them from litigation risk when they're doing anything with medical imaging. We're continuing to work with the CQC and NHSX around how we can help to spread the message around compliance to trusts because it is a really important issue.

18:08 Primarily, for us, we consider this an issue of patient safety. Ultimately, the regulations and the CE mark are there to ensure that imaging is delivered at a suitable quality for clinical review, and applications that don't meet that threshold are actually putting patients in danger as well as just the clinicians and the trust. We continue to focus on our compliance and our security, and in recent months have gained the ISO 27 k certification for cybersecurity. We have also extended our cyber essentials creations credentials to include cyber essentials plus certification, which includes as part of it penetration testing of our system, and we're delighted to

18:55 be able to say that actually we passed that with flying colors, which means that we are now surpassing the expectations of security for the NHS. Hopefully, investors that follow the company would have seen an increased effort around marketing both through social media, but also through our new website. This was a necessary investment for us to help broaden our opportunity and to engage with our our target market. We have also been focusing on doing a number of press releases within core industry journals, very much targeted at our target customers within hospitals who typically speaking are the chief information officers who are responsible for data security and also for regulatory matters such as the CE marking.

19:44 So I hope that that has given everyone a bit of background and a bit more information about our exciting recent announcements, most importantly, the Royal Berkshire announcement. I will now open the floor to questions, and I look forward to being able to give you further information. Tom, thank you very, very much indeed. And your audio is spot on perfect. So thank you very much indeed for your presentation. Ladies and gentlemen, please do continue to submit your questions using the Q and A tab situated on the right hand corner of your screen. I

20:17 to remind you that the recording of this presentation, to along with a copy of the slides and the published Q and A can be accessed via your Investor Meet company dashboard, and we will send you an email to notify you when any questions perhaps reviewed after this meeting have been addressed, and they will be available, as I said, on your dashboard. I'd also like to remind you that your feedback is important to the company. And immediately after this presentation has ended, you'll be redirected for the opportunity to provide feedback in order that the company can better understand your views and expectations. And if you could allocate a little bit of time to that, I'm sure it will be very beneficial to the company. Tom, obviously, investors had with lot And the the And company.

21:11 Integration? In So just before I answer that, I've had to put my volume back back up to here. So let me know if you're getting feedback. Yeah. You all know I think everything's perfect. Thank you, Tom. It is. Okay. Okay.

21:26 So how long does it take to integrate BLEEPR into a hospital trust? Actually, not not very long at all. The the rate limiting step is actually often finding the relevant experts within the trust to facilitate the hookup into their systems. We can actually install Bleepa within the morning. The the the thing is we just have to have all of the relevant personnel on the side of the trust to be aligned so that we can we can go live. But we can install completely remotely, which we've had to do during COVID nineteen, which means we can do we can deploy deeper anywhere in the world. That's perfect. Thank you. The next presubmitted question was is what typical contract length are you looking for? So contract length will will very much depend on how a BLEEPR contract arises.

22:19 One of the things that I I didn't actually touch on in the presentation is that BLEEPR is on a national framework for communication tools run by NHSX. That framework is designed to provide central funding for BLEEPR and other communication platforms for up to two years. But one of the ways in which you can draw down from that that framework is usually on an annual basis, which is actually what happened with the Robarture

22:45 Trust. So, typically, I would expect initial contracts to be for perhaps one year. But we obviously if we can negotiate contracts separately, we'd be looking for a a longer term. One of your key features about Bleeper is it is a software service product, so it is designed to generate recurring revenue through user licensing. And therefore, although the NHS likes to procure annually, we are very optimistic that once we are within a trust that that contract will be renewed. And once we are outside of a framework, we'll be able to negotiate longer contract terms. Thank you very much indeed. I I was reading a couple of the questions from, Liam b, around India, and we had a a pre submitted question around India. So perhaps, you could expand further. It says, is the company expecting a similar style rollout of Blipper in India?

23:38 And can this be repeated elsewhere such as in The US?

23:43 Yes. It's a good good question. So the Indian health care system is, in some regards, similar to the NHS and, in some regards, very different. It's similar in that there are a range of different trusts and hospitals of of varying sizes in different sort of development levels of cities. What is different is that most of those hospitals are private, and therefore, the decision making processes are usually more straightforward. And therefore, we're optimistic that, actually, once conversations are initiated, we can reach a conclusion to those faster. So I I'm hopeful that the rollout in India will actually be much faster than in the NHS. Of course, it's slightly difficult for us to gauge this having just come out of COVID nineteen, which is also affecting the Indian Continent, and they are somewhat further behind their vaccination program than we are here in The UK.

24:37 That said, we think there's enough similarity between the functionality requirements of BLEEPR in the NHS and in India that actually the product can be rolled to India as is. So we're we're optimistic we won't have to do much development in order to meet the needs of the Indian market. We are looking at a number of different strategies approaching Indian market, which involves both selling directly to large hospital groups and private networks, but also looking at working with distribution partners and and OEMs to see how we might best approach the Indian market given its huge size, scale, and opportunity. The fact that we have achieved such success within the NHS, especially during such a difficult time as COVID nineteen, stands us in very good stead internationally.

25:26 I think it was clear from our Department of International trade visit to India that NHS accreditation goes a long way to convincing them the value of the product. I think the second part of the question was in relation to The United States. I think that BLEEPR is probably gonna be the leading tool for communications everywhere. That's what I'd like it to become. Health care institutions in The United States have very similar requirements to those in India and in The United Kingdom, and the relevance of BLEEP is just as true there as it is here. One of the other opportunities with both The United States and India is around being able to track interactions by clinicians within patient episodes and then being able to link that to billable events.

26:12 And, obviously, with BLEEPR, we keep a complete audit trail of who's interacting with the patient when. And so that does create opportunities within the private sector that aren't necessarily reflected within the NHS. There are different regulatory thresholds within The United States. One has to conduct an FDA application, and so there are some barriers for us to cross before we move to The United States. However, within India, we meet all of the required regulations. That's great. Well, thank you very much, Tom, for addressing those questions that were pre submitted. If I could just draw your attention to the q and a tab in in front of you on your screen there, Tom. And if I could ask you to perhaps start at the top and just if I could ask you to read out the questions and where appropriate to give response. And what I'll do is I'll pick you up at the end. I'm mindful of time also, but obviously, if I hand back to you, and then as I say, I'll pick up from you when you're done.

27:11 Okay. That's fine. So let's see. So it's on the right hand side. I think the first question came in at 11:30 sorry. If you just scroll on the right hand side. If you're happy, I can address some of these questions for you, but it's on the right hand side on the q and a tab. Okay. So oh, yeah. I've got them here. Okay. So first question. Actually, some of these have answered in our presentation. So So the first question there to to just to to direct your attention to the top, it's will Bleep continue to develop new features and what markets do they open up?

28:02 Yeah. I I hope we've addressed that within the presentation there. I mean, the the answer is is we will where we see a commercial opportunity and where it's tied to a commercial opportunity. What we won't do is continue product development and feature development where there's not a proven opportunity. We develop photo capture to get in in small part the raw parts contract, so that's evidence that we are linking it to commercial opportunities. I see here actually a question from Liam b. Are you surprised that trusts continue to use WhatsApp given that they are not CE marked and they run the risk of being sued as you continually point out? And I think it's it's it's a fair question, and it's something that obviously we are saying a lot about.

28:49 The the slight difficulty is that as an NHS trust, you have a lot of competing priorities, especially during a pandemic. A lot of the time, clinicians are using WhatsApp independently of the trust's instruction. What I hope we can see are the trust begin to recognize their responsibility as data controllers and that they cannot meet those if continued use of WhatsApp is is allowed by their clinical staff. So I am surprised it's taken this long for the NHS to really address it. I think they addressed it in part through the NHSX communication framework, but I think that increasingly, trusts are going to become more aware of this.

29:36 The NHS is a very complex organization. It takes them a long time to change course on on most things. And but I think there is widespread recognition that clinicians want to practice in this way, that there is a need for them to embrace this both from a workforce perspective, given the staff shortages that they have, a staff retention perspective, given that clinicians want to work this way, they will expect to be able to use this technology. And I think fundamentally because they are beginning to now become aware of these regulatory issues both from the CE marking perspective, but also in their response to GDPR and their their compliance requirements with those. I also have another question from Liam.

30:23 Are the Indian appoint are the Indian appointees full time employees or part time, or are they consultants? So they're they are consultants. They are largely commission based, and they are on a a very fixed term contract that allows us to minimize spend and evaluate outcome. So we aren't putting huge resource into this at the minute. We are trying to do it in a as lean away as possible. Let's just see if there are any other questions coming through. A question from Mark d. Can you provide any indication regarding potential market size?

31:14 Yes. So, Barry, we want Blipper to get into the oh, it says I'm muted. Oh, no. I'm muted. Sorry. I'm I'll start that again. Blipper is designed to be used by every member of the clinical team. So frontline clinicians, nursing staff, physiotherapists, and allied health care professionals to really provide a comprehensive team around that individual patient episode. And that means that there is a huge potential market in every country and setting around the world. The World Health Organization indicates that there are about 15,000,000 doctors. There will be probably at least twice that number of nursing staff and then further to that even more allied health care professionals.

32:07 It is a it is a huge international market. And even within The UK, there are about 200,000 doctors and, again, even more nursing staff. So even in our domestic market, it is a very sizable opportunity. I'm conscious Yeah. I'm just mind I'm mindful of your time. There was just one question that that just came in that perhaps I can just put to it. It says, how can the company reduce its reliance on the NHS? And then perhaps I could hand that one to you, and then perhaps I'll take the floor back. Yeah. No. No. Sure. So the the the strategy has always been to cut our teeth in the NHS. It's one of the one of the best internationally recognized hallmarks is success within the NHS, and that is both through frontline use, but then also through the NHS actually contracting with your your company and your product.

33:09 But we have always been aware that the NHS is notoriously slow to do business with at scale, and that there are numerous steps required to really achieve scale within the NHS. So from the outset, although our approach has been to start in the NHS, we have always been mindful that we would very rapidly look to expand into different market segments, private sector in The UK, India, internationally, and also parallel market segments. So I think we have been mindful of reducing our dependence and reliance on the NHS from day one, but it was always necessary for us to prove a product in our domestic market before we could do anything else. We now have done that both from a regulatory perspective, but also now that we have a contract with a rural Berkshire hospital from a consumer approval basis.

34:04 And we will be looking now to leverage that as quickly as we can, both domestically and internationally. Tom, thank you very, very much indeed. Now I know, particularly investor feedback will be important to you. What I would like, if possible, if I could ask you for a few closing comments just to wrap up with, and then what I'll look to do is just redirect investors to provide you feedback. Yes. Thank you. I I think this by way of of closing this, BLEEPR is is clearly the best tool within the communication space. We're the only ones to be regulated to hold that c mark for medical imaging. And I think that the award of a contract from the from the NHS communication framework is clear evidence that the frontline now recognize the value of and are prepared to pay for it.

34:59 We are hopeful that now that the NHS and other health care settings are beginning to emerge from COVID nineteen, that we will actually begin to see increased engagement, and increased awareness of our of our product. And we look forward to really working with health care providers both in The UK and internationally to further deploy and grow the opportunity for people. We have a great technology. It's been two years in the making, but we are now ready to really engage in the market. And I think the market is now ready to engage with us. So we are optimistic going forward. Tom, thank you very much indeed for updating investors, and thank you also to all the investors that have submitted questions both during the event and pre event. And just to remind you once again that any unanswered questions, we will be reviewed and published responses.

35:49 And we will notify you when they're ready. Could I please ask investors not to close this session as you'll now be automatically redirected for the opportunity to provide feedback. If you access this meeting from our website, the feedback page will appear. If you access this meeting via the link sent you via email, you'll simply be asked to, log back in to submit your feedback. And if you could spare a couple of moments to do so, I'm sure that'd be greatly valued by the company. On behalf of the management team of FEEDBACK, we'd like to thank you very much indeed for attending today's presentation. That now concludes today's session. Good afternoon to you all.