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Thank you for standing by and -- ladies and gentlemen, thank you for standing by, and welcome to the ResApp Health quarterly results investor conference call. [Operator Instructions] I would now like to hand the conference over to Mr. Tony Keating, Managing Director and CEO. Please go ahead.
Thank you, operator. Good morning, everybody, and thank you for joining our quarterly results conference call. I'd first like to welcome our shareholders, our employees and members of our Board of Directors. After 5 years of hard work, we are now in a position where we have 2 products on the market that are generating revenue. Because of this, we'll make these quarterly results conference calls a regular occurrence, giving us the opportunity to provide more commentary on the quarter. It will also give you, our shareholders and investors, an opportunity to ask questions, which I hope will give you a better understanding of our business.As reported this morning, we had expenses of $1.1 million during the fourth quarter with the majority on staff costs and research and development. We ended the quarter with a bank balance of $5.8 million. And after the close of the quarter, we received an additional $1.3 million from the exercise of my options. This cash balance positions us well for the next stage of commercialization. Just to be clear that we did not receive cash from product sales during the fourth quarter. Our telehealth product did not launch until after the end of the quarter, and we did not have -- while we did have SleepCheck sales during the quarter, we did not receive cash from Apple during those -- during the quarter from those sales. The first sales of these products will affect our cash flow in the first quarter of financial year 2021 with reporting due in October.I'll start by first providing an update on ResAppDx, our acute respiratory diagnostic test for all clinicians. We were pleased to have signed binding commercial agreements with 2 Australian telehealth companies during the quarter. Coviu and Phenix are 2 of the leading telehealth companies in Australia, which are at the vanguard of the transition from in-person to virtual GP visits. Coviu offers a platform solution for GP clinics, allowing clinics to offer virtual visits alongside their existing GP practice. Coviu is a secure web-based solution that's delivered on over 1 million telehealth consultations in Australia. ResApp is offered via an add-on module in Coviu's platform. Installing the add-on is free for the GP practice and, when installed, activates respiratory symptom screening for all patients at that practice. If the patient answers yes to respiratory symptoms, they are then asked to perform the ResAppDx test. The results of that test are then provided to the clinician, once the clinician and the patient have joined the video consultation. Phenix Health operates a little bit differently. Phenix operates as a virtual super clinic, providing GP services directly to patients. Phenix has been operating since 2013 and has reach to doctors with extensive training in using telehealth. Similar to our Coviu implementation, all patients who present to Phenix' service with respiratory symptoms are asked to perform the ResAppDx test. Our Phenix solutions on iOS is app-based, we're able to integrate ResAppDx directly into Phenix' app, providing a seamless experience for patients. The results of the test are then available for the doctor who may be using the Phenix app or may be accessing the telehealth consultation via the web. In both of these cases, the test fee is paid for by the patient, the amount of which is within the range we have previously targeted of between $5 and $10 per test. This $5 or $10 per test is the revenue that we, at ResApp, receive. The actual fee may be more, with the telehealth provider, clinics or doctor receiving part of that fee. We're very pleased with the integrations in these 2 very different platforms and are excited to now have ResAppDx available to patients and their doctors in Australia. At this point in time, we're not able to provide any guidance about the number of tests or expected revenue. We're still in the early stages of commercialization in a market which is nascent and growing. There is certainly a large market opportunity for ResAppDx in telehealth, with COVID-19 accelerating the major shift towards virtual GP visits, both here in Australia and in the rest of the world. We will provide an update on the number of tests and our cash flow for the current quarter in our next quarterly report to be released in October.In addition to our telehealth channel, we've always had a strategy to provide ResAppDx through 3 additional channels: in-person clinical use, use in low- and middle-income countries and direct-to-consumer. During the quarter, we have made significant progress to commercialize in all 3 of those channels.For in-person clinical use, we've been working with a federal government-funded COVID-19 clinic to evaluate ResAppDx to triage patients who present with respiratory symptoms. This helps clinicians identify diseases such as lower respiratory tract infections, pneumonia, asthma exacerbations and COPD exacerbations. Feedback from adopters at the clinic has been really positive, and we are very happy to assist during COVID-19 by providing the clinic a no-cost license of ResAppDx through to the 1st of September this year.For emergency departments to adopt ResAppDx as part of their standard of care requires not just strong clinical data, which we have, but also quantified health economic data. Earlier this year, we received approvals from both adult and pediatric multisite health economic evaluations at leading academic hospitals in the U.K. In June, we were also happy to announce that Sana Klinikum Lichtenberg, a hospital in Berlin, Germany, had also received approval to run a health economic evaluation. These health economic evaluations are critical in obtaining real-world health and economic data, such as time to triage, time to discharge and diagnostic tests performed. With COVID-19 still affecting clinical growth globally, especially in the emergency departments where we conduct these evaluations, these sets of evaluations are currently on hold. However, in parallel, we've also begun discussions and received initial feedback from NICE, the U.K.'s National Institute for Health and Care Excellence, who provide guidance and standards for health care throughout the U.K. For in-person clinical use, we also have an Android ruggedized handheld under development. There are certain clinical situations where a smartphone may not be ideal, and having a low-cost ruggedized and secure handheld is a great and, in some cases, necessary option for our sales team when talking to potential customers. Alongside our handhelds, we're developing a wearable device. However, this is a different use case. This is 24/7, long-term monitoring of chronic diseases such as asthma and COPD. For both of these products, we expect to obtain CE Marking during this current quarter. With the original research that was performed by Dr. Abeyratne and his team at the University of Cleveland funded by the Gates Foundation, we've always had a strategy of providing health care workers in low- and middle-income countries, the same opportunities as those in more developed countries. With over 500 million people in Africa struggling to access high-quality health care, we were pleased to announce in June that we've partnered with Ilara Health to conduct a 3-month evaluation of ResAppDx in Kenya. Ilara offers low-cost, AI-powered diagnostic equipment to clinics in Africa, giving doctors faster and affordable access to test that they need. Phones with ResAppDx preinstalled on them are currently on their way to Kenya, and we expect the evaluation to begin this quarter. Since the founding of ResApp, we've always talked about bringing ResApp directly to consumers. And our MoU with RB is exactly that. RB is a health products manufacturer with global reach. The product that we're building with RB is still in the early design phase, with the premise being to empower consumers to make the best health care choices based on their respiratory conditions, whether this means staying at home, visiting a pharmacist for an OTC product, seeing a doctor via a video consultation or seeing their GP when convenient. We're excited to be working with -- closely with RB, bringing our joint version of a direct-to-consumer product to life. Now after 3 years of R&D, we were very pleased to launch SleepCheck on the App Store on June 29. SleepCheck is the world's first and only regulatory approved and clinically validated direct-to-consumer sleep apnea screening app. One in 5 Australian adults may be affected by sleep apnea and up to 80% of those do not know that they have it. SleepCheck is targeted as a mass market direct-to-consumer app. And so our marketing message and strategy is especially important. We've been working closely with the creative team with Isobar in Sydney to create an engaging campaign around snoring and sleep apnea. Isobar are a leading digital marketing agency, who have worked with some of Australia's most prestigious businesses and brands. We're all looking forward to next week's launch of that campaign. Based on our product road map and early customer feedback, we have product improvements in the pipeline and we'll release an update for SleepCheck next week. This includes the translation of SleepCheck into 5 European languages, and so we'll be broadening the availability of SleepCheck into additional countries in Europe and Asia. We're also working to have SleepCheck available in the U.S. and plan to file a pre-submission meeting request with the FDA in August.As well we've been working on making SleepCheck and ResAppDx available on Android devices. Android is a tricky platform to work with many different hardware devices being used. These different devices have different microphones, and we need to be 100% confident that these microphones behave in the correct ways. And importantly, our algorithms perform as expected. We now have a comprehensive bench testing protocol and are working through various makes and models of Android phones. We hope to have products available on an initial set of Android phones later this year. Overall, we are very pleased with the progress that we've made in the last quarter, with our first commercial deals completed with telehealth companies and SleepCheck being released on the App Store. The initial response from the market for this product has been very positive, and we look forward to continuing to see the use of these products grow. There are many complex parts to ResApp's business now with multiple products and multiple channels to market. In the long term, we're focused on getting our products into the hands of consumers to help them better manage their health, empowering telehealth to bring convenient but also high-quality health care to all and helping identify common but underdiagnosed diseases such as sleep apnea at scale in very large populations. But we are also focused on the short-term goals, with our goals for the current quarter being the first expanding use of ResAppDx in Australia in telehealth with Coviu clinics but also with additional partners; to expand the use of ResAppDx in 2 European countries, in particular the U.K.; and to deliver on a strong marketing campaign to drive engagement around snoring and sleep apnea and ultimately downloads of SleepCheck.I'd like to thank you for listening to the call. If you're a shareholder, then I'd like to thank you for your continued support of the company. Operator, I'd now like to open the call for any questions.
[Operator Instructions] Our first question comes from [ David Morris ] of Morris Superannuation Fund.
I'm wondering if ResApp has gone back to the FDA under the EUV campaign to fast-track certain devices like Dx to help diagnose when COVID gets more serious with pneumonia. Is that still something that's happening? And can you give me just some update on that?
Sure. So David, just talking about the emergency authorization program under the U.S. FDA. At this point, we are engaged with a number of consultants in the U.S. about reengaging with the FDA, following our FDA nonapproval letter that we received earlier this year. At this point in time, we have not submitted anything to the FDA as of today, but we are looking to do so over the next quarter.
[Operator Instructions] We have a question from [ Mark Rabi ].
Yes. Good work there during the quarter. I just had a question about the monetization of SleepCheck. Are we relying entirely on the $8 per download? Or can you see some kind of, I guess, finders' fees, [ it like ] going to the likes of ResMed? And have we talked to ResMed at all?
Thanks, [ Mark ]. Look, I'm not going to comment directly on individual companies. But in general, we see revenue from SleepCheck [indiscernible] at the first level as an app download cost of the $8 per test. But then we also see opportunities to provide additional value to consumers through educational materials and what's the next steps for that patient to go on. That next steps could involve referrals to sleep clinics, to therapy devices, et cetera. And so I think there are other opportunities to add additional revenue streams from providing those either referrals or advertising to those sleep therapy and sleep testing organizations.
Okay. So is there any, I guess, time line on that? Or have you progressed very far? Or are they concepts at this point?
We've had discussions with various groups. I'm not going to go into specifics around individual companies or what our time lines are on those.
And just one about Europe. I was just wondering about any delay there. Do you think it's more that providers -- telehealth providers in Europe want to see a live demonstration through Phenix and Coviu? Or is it sort of integration holdups from our end? Or can you make any comments around, I guess, why hasn't it happened 6 months ago as opposed to -- it sounds like the ball is rolling now.
Yes. Look, I think Europe is a different number of cases why it is taking as long as it's taking. I mean, I wouldn't call it delayed. I think this is a standard type of, I guess, sales pipeline that you would see for a medical device. I think you must realize that in these situations, we are influencing a clinician's decision about the health of the patient. It's not something that the clinician is just going to sign off on without doing a significant amount of due diligence into our clinical data but also our quality systems and our regulatory systems. So I think there is a natural sales time associated with going through due diligence.I think that COVID-19 has caused us some struggles in Europe with the lack of the ability to travel. We've been very fortunate to have our director of sales and marketing start in the U.K. right at the beginning of the pandemic, which meant we weren't as affected as badly as we could have been. So that's a positive, having Jamie start just in the beginning. But his travel has been restricted somewhat to do COVID.I think the final piece, and you rightly point out, having a live demonstratable product running in Australia adds to our value proposition and our sales pitch in Europe. So I think what we've seen to date has been sometimes spent by major telehealth companies in Europe looking at our clinical data and our quality systems and ensuring they're up to scratch. We now have the validation effectively of running these telehealth providers here in Australia, and we have Jamie on the ground as well based in the U.K. So I think with those steps in place, we're in a good position over the next quarter to push into Europe.
Great. That's everything from me. So good luck with the rest of it.
Thanks, [ Mark ].
Our next question is from [indiscernible].
I just want to confirm the cash position of $5.8 million at the end of last quarter. That does not include your exercise of option of $1.4 million. Is that correct?
That's correct. That exercise was post the end of the quarter.
That's right. So currently, we'll be sitting around EUR 7 million-ish.
Yes. Yes.
And then secondly, can you shed some -- I'm just jumping the gun a bit. Can you shed some light on the revenue model with -- I mean, if it is eventuated in RB and the hospital in U.K. and in German?
So with RB, that is an MoU that we're working together exclusively to develop this product. Part of developing that product is building the business case. Obviously, RB has their own expectations of what that business case looks like. We also have our expectations. So we need to come together and work out what's the right end up revenue sharing or business model of that looks like in the end. So I can't really make any more comment beyond that. For the U.K. and German hospital groups, those are really studies at the moment, looking at the health economics. So quantifying the time savings, quantifying the cost savings that using ResAppDx in the hospital environment would bring. And so at this point, we haven't really changed either because of the in-person clinical use, we still see a business model of a per-test fee being used in those hospital settings.
Right. What about the Ilara? Is there like a yearly subscription, low-cost type of revenue base?
Yes. So we've previously disclosed that we would look at subscription-based models in emerging markets.
Our next question is from [ Terry Flynn ].
I just wanted to check in on the SleepCheck app. Were you planning on, I suppose, reapplying to have that accredited as a diagnostic tool and not just a screening tool?
So at this point, no. So at this point, we believe that as a screening tool, we have the best chance of making a larger impact in the general population. So I think you need to -- what's important to realize is that there are 2 different opportunities in many health care situations. So one is a screening opportunity, which is screening a large number of people and identifying those people who are at risk. And then obviously, the second part, which is the diagnostics part, which is the formal diagnosis to lead to treatment. So our target with SleepCheck is -- the first is to mass screen large numbers of people. That's the mass consumer market products to identify risk. And so the second part there, we may end up towards, in the longer term, moving through a diagnostic product. But we believe that the commercial opportunity today is actually the mass-market product. And that is map screening and identifying risk.So I would say rather than being a regulatory decision about whether it's classed as a screening tool or a diagnostic tool, it's actually a business decision. We believe that the best business opportunity here is screening -- mass screening direct-to-consumer product here.
Our next question is from [ Dan Hamley ].
My question is based upon your appearance in your last visual, you looked pretty tired or physically run down. Was that just on the day? Or is that a general feeling for you lately?
Look, I mean, that was probably another day where I had a number of calls to Europe the night before. Look, I'm feeling very healthy at the moment, actually. So I'm happy to say that. And I'm very pleased with the way that the company is running, have a really great team behind me. We've been doing some outstanding work. We've hired some great people over the last 6 months, as I mentioned, Jamie, in the U.K. We've got Maya here in Australia on business development who done some great work landing the telehealth deals that we've done over the last 6 months. We've recently brought on a product manager. We've expanded our quality and regulatory teams. So yes, ResApp is not just all about me. There's a really strong team behind me, and I'm really pleased with the things that we've achieved with that team.
Can you tell me -- we talked a little bit Europe and perhaps putting on your marketing guy in Europe, what about the Asian situation right now? Does that present any opportunities for ResApp? I know you mentioned Ping An a few times in your visual presentations and through different types of publications. Can you tell me if there's any update around the Asian kind of area?
Yes. So look, we've had quite open discussions with telehealth companies throughout Asia, whether they're in China or whether they're in Southeast Asia. I think China is a very special case where you do need to partner with a major player to be able to run through the regulatory channels, the government channels to get into that market effectively. So we're still, I guess, opportunistic, I would say, with somewhere like China, where we are -- we have, I guess I would say, open phone lines with a number of parties, looking for when the time is right for both parties to accelerate those sort of discussions. Similarly in Southeast Asia, it's opportunistic talking to telehealth companies that are approaching us or that we think might be a good fit. But then getting the economics right, getting the partnership right is really important. So at this point, I would say, with Jamie based in the U.K., Europe is a much higher priority than Asia today. But then, as I said, with people like Maya doing business development out of Brisbane here, Asia's not that difficult to do from here or at least at the initial stages of Asia.
Our next question is from [ Robin Miles ] of Miles Superfunds.
Tony, just a couple of questions. Firstly, you talked a little bit about the respiratory clinic. What's happening with regards to more respiratory clinics, for example, having them in Melbourne? And what sort of revenue do you think these things could give us?
Yes. So we are talking to a number of other respiratory clinics as you probably are well aware. The government have effectively sprung up respiratory clinics around the country over the last 3 to 6 months. There's some in Melbourne, there's some in Sydney, some in Brisbane. And we're in discussions with a number of those clinics about doing something similar to what we're doing at Morayfield in Brisbane. So we're excited about that opportunity. We think that really -- the feedback we've received from Morayfield has been extremely positive. It's really solved some issues that they have with evaluating these patients in the current, highly, I guess, conservative infectious disease situation that we have. So we're in -- I guess, we're in discussions with a number of these clinics, and we hope to getting used more broadly in that setting.On the revenue model, I guess, yes, again, we're still looking at a per-test fee. That has not changed. Similar to telehealth, that $5 to $10 per test has been always mentioned and really hasn't changed in 5 years since we started the business. On revenue forecast, we're not in a position to give those, as similarly to telehealth, it's an emerging technology, it's an emerging field. Once we get some runs on the board, once we get some revenue coming in and we can start to make forecast, then we'll be able to provide that sort of guidance.
Just one more, how are you going getting into Australian hospitals other than the respiratory clinic? Is anything happening in that regard?
So as I said in the call, the key piece of information that we need for in-hospital use is the health economic data. So while we've got great clinical data, we also need to quantify those health economic benefits. So we need to show that using ResAppDx cut the time that a patient requires to get treatment or to get fully diagnosed. We need to show that we can save cost in those emergency departments. So that's why it's really important that those health economic studies that we're running in the U.K. and in Germany are run. That will give us that data, which will be effectively the valuable marketing information to enter hospitals, both in Europe but also back here in Australia.
Our next question is from [ Lisa Sakaris ] of [ LJT Investments ]. We'll come back to [ Lisa Sakaris ]. Our next question comes from [ Tom Schultz ].
A couple of questions. You mentioned on one of your last talks that Jamie had 3 or 4 companies looking under our hood, I think, is what you were referring to in U.K. I was just wondering how that was going.
Yes. So there are a number of companies in the U.K., in Europe that are looking at different levels of due diligence in ResApp. And as I said, the key for them is we are affecting the way their doctors are treating their patients, so they must be very comfortable with our clinical data. So they need to evaluate that clinical data in detail. Similarly, on the regulatory and quality standpoint, they need to make sure we're delivering good software, good high-quality software, that's in accordance with the regulations. So they want to look at those certificates. They want to look at our processes and ensure that we're doing that. So yes, we are in due diligence or they are in due diligence to look at what we can bring to them.
What sort of time frame? Assuming that they were happy and they ticked off, what sort of time frame before you would expect any of them be able to progress to coming onboard, 3 months, 6 months? Do we have an idea of that?
Yes. Look, we're very hopeful. I mean, this is -- I guess, shouldn't be seen as guidance, but we're hopeful and pushing very quickly to try to get some of those partnerships together and signed off. If you look at the deals that we did with Phenix and Coviu, after signing the deal, it was probably another 3 to 6 months before they are actively using the product. I think that will be shorter in the future because we've learned a lot of lessons from those implementations, and we can translate a lot of that knowledge across. But over the next 3 to 6 months, I would be hoping that we would be in a position to talk more about these partnerships in the U.K. and Europe.
All right. One more question. The indigenous trial in WA, I haven't heard any more on that. Is that still progressing?
So nothing's changed there. So that is still a COVID-type situation. We're back engaged with the clinic. Everyone is still very excited there about running the trial. But right now, we are waiting effectively until the COVID situation sorts itself out.
Right. And you mentioned that on the 1st of August, we're launching in 5 other countries or something, is that what you're implying?
So we're launching in additional countries in Europe as well as in Asia. So we'll be launching SleepCheck.
On the 1st of August?
Next week.
Okay. Are you allowed to tell us what those countries are?
Look, I think, yes, we've translated the application into Portuguese, Spanish, French, Italian and German.
And what about the Asian?
So there's been no translation there. But obviously, there are a number of Asian countries that use English-based apps. So we'll be looking at those.
Our next question comes from [ Lisa Sakaris ] of [ LJT Investments ].
I was just disconnected before for a minute or so. So I hope no one's asked the same question. Just in relation to the COVID-19 clinic in Brisbane, I was wondering is there any view to bringing that down to Melbourne where we've got like an aged care crisis at the moment and wondering if we can offer some benefit there because we do have so many more cases than in Brisbane or anywhere else in the country at the moment and what your views are with ResAppDx sort of helping the diagnosing? There's been word of that out there in relation to COVID-19.
Well, thanks, Lisa. Look, we are -- and I don't know that may have had calls in the last week or so with clinics in Melbourne. We know that there is also some telehealth clinics, some GP clinics using ResAppDx in Melbourne as well. So obviously, we would love to help as much as we can. The aged care setting is an interesting setting, and we've talked to a couple of groups who are active in the aged care setting, telehealth groups that are active in the aged care setting. So we're obviously investigating that angle as well.On COVID itself, I think we're still in a position where we don't know if we would be able to generate an algorithm for identifying COVID. There's a lot of challenges associated with that. One is collecting enough data. And then the second is that if you have an algorithm for COVID, it needs to be fairly accurate before people are going to use it to screen. Where we really provide benefit and where we've seen interest from COVID clinics, from governments around the world have been in triaging and assessing severity of patients. So being able to understand whether that patient has developed pneumonia or whether they've got essentially asymptomatic or mild symptoms of COVID. And so look, we're still in test on that. We're being a little bit cautious. We don't want to come in and say that we've got the world. But I think there are some similar opportunities. And we're still talking -- and we're in discussions, I guess, in Melbourne.
Okay. So because of the crisis that we're in at the moment, I thought everyone will be sort of throwing everything at it. So like ResApp going to them and then coming to us. So I guess that was mainly my question. Yes.
Yes. Look, I think people are just trying to deal with the situation that's in front of them. When you talk to a lot of hospitals and GP clinics and wherever, I mean it's -- especially, we've lived through it in some ways with our connections to Europe earlier this year and connections to China even earlier this year. And honestly, health care professionals are focused on doing what they know at the time when things are happening. They don't have a lot of time to go looking for new ideas here. They just want to care for their patients that are right in front of them now.
Our next question is from Iain Wilkie of Morgans Financial.
Just one quick question on this telehealth in general and the reimbursement for these services, but initially been funded to the end of September. I think there might be some overhanging concern that the Coviu and Phenix group operations in the volumes faster state. So just wanted to hear your comments on whether you see this Medicare support being extended, either just pushed out further or possibly full adoption in line with the standard GP clinics just in the longer term?
Yes. So look, Australian telehealth is being web sourced but the right at the moment. It's a very fluid situation. I think long term, we are looking at some sort of reimbursed telehealth in the long term. If you look at figures coming out of the U.K., as an example, so the U.K., the Royal College of GPs have said that currently, 70% of GP visits are virtual. They expect long-term that though to drop back to 50%. That's still a long way ahead of where we are in Australia. We're at about 30% of GP visits that are virtual. But again, this is a heavy political as well as health as well as economic decision on the government's part for this MBS rebate. So I'm confident that telehealth does have a part to play in the long-term future of visiting a GP in Australia. Whether it's 30%, whether it's 50%, whether it's 15%, it's hard to say right now. But I'm confident that telehealth in Australia does have a long-term future of being reimbursed.
Mr. Keating, that concludes the Q&A session. I'd like to hand back to you.
Great. Well, thank you, everybody. I really appreciate your attendance at the call. And I guess this is the start of many of these calls. We plan to do this every quarter. So please join us in October for our next quarter, which I'm sure everyone's going to be excited about with -- as it will be our first reporting of real revenue for the company. So thank you again, and I wish everybody a pleasant day.
Thank you for joining us. You may now disconnect your lines.