Butterfly Network - Earnings Call - Q4 2024

Executive Summary

• Butterfly Network delivered record quarterly revenue of $22.4M in Q4 2024 (+35% YoY), with gross margin expanding to 61.4% and adjusted EBITDA loss improving to $9.1M; management attributed strength to iQ3 pricing/volume and enterprise software momentum.
• FY25 guidance set at $96–$100M (+~20% growth) and adjusted EBITDA loss of $37–$42M; Q1 2025 revenue guided to $20–$23M with adjusted EBITDA loss of $9–$11M as seasonal hospital deal timing and event costs weigh near-term.
• Operational progress highlighted: iQ3 adoption, EU expansion, Octiv partnerships (including Sonic Incytes), and HomeCare pilot with early positive outcomes (no readmissions to date in a small sample); capital raise added $81.7M net proceeds on Jan 31, reinforcing liquidity.
• Narrative tailwinds include validation of ROI (URMC study) and AI ecosystem growth (Butterfly Garden, HeartFocus training app); watch EU RoHS exemption revocation process (recommendation expected by end of 2025), which could structurally favor chip-based ultrasound.

What Went Well and What Went Wrong

What Went Well

• Record quarterly revenue ($22.4M) with product revenue up 45% YoY and units fulfilled up 22% YoY; software/other services grew 20% YoY, signaling balanced demand across channels.
• Gross margin expanded to 61.4% (from adjusted 56.6% in 4Q23); operating expenses declined 9% YoY and adjusted EBITDA loss improved to $9.1M (vs. $15.7M) on cost reductions and execution discipline.
• CEO: “We’re well-positioned to scale in 2025 and beyond,” and confirmed progress on strategic pillars—core POCUS growth, Octiv partnerships, and HomeCare services—supporting medium-term growth optionality.

What Went Wrong

• Software mix declined to 34% of revenue (−4pp YoY) as hardware outpaced software; management noted higher production and warranty costs on iQ3 offset some margin benefits.
• GAAP net loss remained elevated at $(18.1)M and cash/CE+restricted cash fell to $92.8M at year-end (from $97.8M at Q3), reflecting ongoing burn despite improvements.
• ARR growth described as only “slight” with enterprise software ARR +8% in Q4; inventory stayed high at $70.8M, implying working capital tied up as scale builds.

Transcript

Operator (participant)

Good morning and welcome to the Butterfly Network Fourth Quarter and Full Year 2024 Earnings Call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing star then 0 on your telephone keypad. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then 1 on your telephone keypad. To withdraw your question, please press star then 2. Please note this event is being recorded. I would now like to turn the conference over to Heather Getz, Chief Financial and Operations Officer of Butterfly. Please go ahead.

Heather Getz (CFO and COO)

Good morning, and thank you for joining us. Earlier today, Butterfly released financial results for the fourth quarter ended December 31, 2024, and provided a business update. The release and earnings presentation, which include a reconciliation of management's use of non-GAAP financial measures compared to the most applicable GAAP measures, are currently available on the investor section of the company's website at ir.butterflynetwork.com. I, Heather Getz, Chief Financial and Operations Officer of Butterfly, alongside Joseph DeVivo, Butterfly's Chairman and Chief Executive Officer, will host this morning's call. During today's call, we will be making certain forward-looking statements. These statements may include, among other things, expectations with respect to financial results, future performance, development and commercialization of products and services, potential regulatory approvals, and the size and potential growth of current or future markets of our products and services.

These forward-looking statements are based on current information, assumptions, and expectations that are subject to change and involve a number of known and unknown risks, uncertainties, and other factors that may cause actual results to differ materially from those contained in the forward-looking statements. These and other risks are described in our filings made with the Securities and Exchange Commission. You are cautioned not to place undue reliance on these forward-looking statements, and the company disclaims any obligation to update such statements. As a reminder, this call is being webcast live and recorded, and we will be referencing a slide presentation in conjunction with our remarks. There may be a short delay between the live audio and the presentation being shown. On the same page, you'll also be able to access the webcast live and as a replay once the call has been completed.

I would now like to turn the call over to Joe. Joe.

Joseph DeVivo (Chairman and CEO)

Thank you, Heather, and thank you all for joining us this morning. I'm very pleased to report that Butterfly is performing well in all areas of our business. In March of 2024, at our Investor Day, we laid out a strategic five-year plan outlining growth initiatives for our core and new businesses. I'm pleased to say that we've completed the first year of that five-year plan, and we're right on track. In 2024, we delivered $82.1 million in revenue, which represented 25% top-line growth, while improving adjusted EBITDA by 42% to a loss of $38.9 million. What's just as important is we've built the foundations for key initiatives that we believe are essential to reach our overall goals. Butterfly is the leader in point-of-care ultrasound devices powered by our proprietary semiconductor technology.

Our digital journey that we're on is an exciting exponential growth opportunity to bring digital capabilities to the lowest cost and most accessible medical image modality: ultrasound. Our vision is that every doctor and nurse in the world will have a personal Butterfly imaging device while we bring wearable ultrasound to qualifying chronic care patients who need more frequent real-time care. They will use the most advanced AI tools to locate and identify abnormalities with a secure location for their data throughout their care journey. Butterfly's powerful digital ecosystem will increase access to care, help lower costs, and empower all people to understand the care they need earlier. The building blocks of this opportunity are being set now, and several initiatives are in development that I'm excited to share with you later in 2025. In 2024, it was a great year for Butterfly. We got our mojo back.

The launch of iQ3 was nothing less than a resounding commercial success. iQ3 beat out 29 other products from healthcare companies who were considered for the Prix Galien Award, the highest award in healthcare for new medtech technology. We were a Fierce 50 Award winner as well. Since its launch a year ago, our next-generation imaging technology proved to go toe-to-toe and win against the largest imaging companies in the world. iQ3 represented 50% of our overall 2024 sales and units and 58% of our pro revenue, delivered higher ASPs than our second-generation device, and was helped by an all-in hardware and software program that proved very successful. Doctors who once hesitated to choose Butterfly in the past, wanting more from image quality, flocked to iQ3. Existing users upgraded to the new device. New users traded in their competitive devices.

New entrants to the focus market chose iQ3 to start their journey, and even medical students wanted to start their education with the best. As we saw when rolling out the new student purchase options last year, some of them actually purchased iQ3. To that end, I was very pleased with the impact ScanLab had on our education efforts. ScanLab helped new students of all ages hone their ultrasound skills. It helped new users practice without access to dedicated personnel. Where education and confidence acquiring and interpreting images are a barrier to adoption, ScanLab is now proven to be an education catalyst. Another catalyst in 2024 was the publication of the University of Rochester Medical Center data on scaled health system deployment of Butterfly, demonstrating the clinical and economic ROI.

As we look ahead, we are now leveraging these and other ROI findings to meet with hospital administrators to discuss broader implementations. Earlier this month, Butterfly convened its inaugural POCUS Innovators Forum. Sixty thought leaders gathered to discuss topics like adding imaging into everyday diagnosis, the power of lung ultrasound, empowering AI, POCUS in low-resourced countries, and a special session on the ROI hospitals are seeing in POCUS. We were excited with all the sessions and especially pleased with the ROI session as URMC was accompanied by several other large institutions who were able to demonstrate similar very positive economic data, further validating our strategy. Moving to international, in 2024, we received EUMDR in Europe for iQ+, which allowed us to feature the probe with our latest software capabilities and fast followed with iQ3 certification in September, allowing for the European launch of iQ3.

We want access to many new markets in Asia for iQ+, and I believe global penetration for iQ3 will power international growth in 2025 in both unit volume and ASP, as we will have both products available for sale throughout the entire year. I'd like to give you a brief update on ROHS, the revocation process in Europe. As you know, we formally submitted our application to revoke the lead exemption for piezoelectric handheld ultrasound devices. We believe the industry, of course, is aware and in the process of putting together a response. We also understand the EU Commission is identifying a third party who will begin the process of researching our petition and the counterarguments following the open comment period.

That should take the review to the end of 2025, and we hope that by this time next year, we'll learn of the independent reviewer's recommendation to the EU. If a decision is made in our favor, we believe it may take up to 12-18 months to implement from then. Wrapping up discussion of our core focus business, we're pushing ahead into 2025 with a focus on scaling. We have many software improvements planned to make data management workflows faster and easier, our integrations to be more expansive for all EMRs, and our data management to be more valuable, even for smaller customers. We will be focusing on combined software and hardware sales to health systems as we grow customers from departmental installations to multi-departmental and ultimately full enterprise customers.

Beyond the core business, our strategic initiatives matured during the year and brought greater clarity to how Butterfly will change in the future. Entering the fourth quarter, Butterfly Garden had 17 partners signed, each developing their applications to work in the Butterfly ecosystem. The team signed four new partners, including our first veterinary AI app in the fourth quarter, bringing a total of 21. In 2025, six of the 21 partners are anticipated to go commercial, five of which expect to win FDA clearance to become the first garden apps for clinical use. These apps will join the two educational AI applications already deployed in the garden, and we are very excited to welcome these companies and products and will work to amplify their capabilities to our user base.

As you know, each AI application will bring new capabilities for users, each making and capturing and interpreting ultrasound easier. Butterfly users will buy these new AI apps, and these companies will grow their business by being in the Butterfly ecosystem. It's just a win-win. Now shifting to Octiv, our wholly owned subsidiary that's tasked with commercializing our chip technology through partners in non-competitive markets. They've also been quite busy. In our second quarter earnings report, we shared that we signed a term sheet for a third partner. Today, we're excited to announce that partner is Sonic Insights, a commercial stage business pioneering a novel approach for liver disease assessment. Sonic Insights and Octiv are collaborating to develop technology that leverages ultrasound-on-chip for fatty liver disease assessment, a market poised for significant multi-billion-dollar growth.

We are also pleased to share that we've signed two additional partners. Our fourth partner is in the neuroscience space, a burgeoning market where our technology is uniquely suited given its broad, powerful imaging capabilities and overall flexibility, including miniaturization. Lastly, our fifth partner is one of the leading companies in the generative AI space who will be developing new hardware technology. We look forward to sharing more details on these partnerships in the coming months and anticipate all of these new signed partnerships to contribute revenue in 2025. Now let's turn to Butterfly Home Care. As we highlighted during our last earnings call, we recently signed a pilot agreement with the largest health services organization to deliver lung ultrasound services to the members residing in long-term care and assisted living facilities across two counties in Wisconsin.

We've trained their nurse practitioners to capture lung ultrasound images using our probe, AI-guided tools, and our Compass software. The pilot officially launched, and we're already seeing positive results. We're currently onboarding members with congestive heart failure. The initial participants are patients being discharged from the hospital after a congestive heart failure episode, and the goal is to ensure that they receive appropriate follow-up care and to identify any early signs of worsening heart failure. Through the pilot, they've already detected conditions like pneumonia, pleural effusions, and other complications, allowing the team to intervene promptly and deliver care according to the established protocols. Although it's still early, both we and our partner are encouraged by the outcomes since the pilot launch. Notably, no patients have needed to be transferred out of the facility for scanning, and none have been readmitted to the hospital.

We are confident that this pilot will showcase improved care and cost savings for our partner, and we look forward to keeping you updated on our progress. You know, I can't stress enough how important these findings are. We're teaching nurse practitioners who've not been classically trained in ultrasound to do lung ultrasound using AI to assess patients right where they are. This pilot is not just about the immediate business opportunity ahead of us, which is great. It represents the power of Butterfly. Butterfly has made ultrasound accessible, high-quality, mobile, and at a low cost. Now we're proving that all healthcare professionals can use it to help patients where they are efficiently and at scale.

As this program evolves from pilot to a new care delivery model, we expect to see new AI apps from the Garden to further empower caregivers with low-cost tools delivered on the go, wherever the patient is. This is only possible because of the evolving digital landscape that's driven by Butterfly. In addition to the pilot, at the end of December, Butterfly Home Care also executed a proof of concept at My Place Health. My Place is a PACE organization, and the acronym stands for Program of All-Inclusive Care for the Elderly. It is to demonstrate that Butterfly services can identify conditions in previously undiagnosed patients. Our pilot was successful in identifying previously undocumented conditions such as peripheral vascular disease, pleural effusions, diastolic heart failure, and potential cardiac failure, resulting in an immediate hospitalization.

Our work with My Place allows them to risk score their members, so they receive appropriate reimbursement and care. My Place is one of the 180 PACE organizations nationwide, and we expect to collaborate with them this year to expand with them as well as to expand to other PACE organizations. Now I'll turn it over to Heather to go deeper in the quarter. Heather.

Heather Getz (CFO and COO)

Thank you. As Joe noted, in 2024, we accomplished everything we set out to do at the Investor Day in March of 2024. The initiatives we laid out have been driving Butterfly's growth and will continue to do so in the future. Let's dig into the results. We saw continued strength in the fourth quarter of 2024 with revenue of $22.4 million, the highest quarterly result in the company's history. This represents a 35% increase versus the prior year period.

The increase was driven by both price and volume across all channels and was positively impacted by continued penetration of the iQ3 and global distribution. Breaking things down between the U.S. and international channels, during the fourth quarter, U.S. revenue was $14.5 million, which was 32% higher than the prior year, driven by higher average selling price and strong demand. Total international revenue increased 19% over the prior year period to $5.5 million, driven by higher probe volume. Breaking our revenue down between product and software and other services, product revenue was $14.7 million, an increase of 45% versus the fourth quarter of 2023. This increase was driven by higher average selling price and volume across all channels. Software and other services revenue was $7.6 million in the fourth quarter, up 20% versus the prior year period.

Software and other services mix was 34% of revenue, decreasing by approximately 4 percentage points versus Q4 2023. This decrease can be attributed to product revenue growth outpacing software revenue with the launch of our iQ3 in early 2024, as well as our geographic expansion. Our total annual recurring revenue, which is reported as part of software and other services, grew slightly versus the prior year period. This was led by an increase in our enterprise software subscription ARR that grew 8%. When looking at the full year 2024 versus 2023, total revenue increased 25% to $82.1 million, led by sales of devices where we saw both increased volume and higher average selling price, driven by the launch of our new generation iQ3, where we increased our MSRP by $1,200.

Furthermore, at the end of 2023 and throughout 2024, we made additional investments in our direct sales teams and signed new distributors in new markets internationally. Turning now to gross profit. Gross profit was $13.7 million in Q4 2024, a 45% increase as compared to the prior year adjusted gross profit of $9.4 million. Gross profit margin percentage increased to 61% from an adjusted 57% in the prior year period. While gross margin percentage was positively impacted by higher average selling prices and higher software and services margin, these benefits were offset by higher production costs of iQ3 and warranty costs. Moving to EBITDA and capital resources. For the fourth quarter of 2024, adjusted EBITDA loss was $9.1 million compared with a loss of $15.7 million for the same period in 2023. For the full year 2024, adjusted EBITDA loss was $38.9 million compared to $67.5 million for 2023.

The 42% improvement in adjusted EBITDA loss for both the fourth quarter and full year was driven by higher revenue, cost reductions, and efficiencies, which led to lower payroll, consulting, and other outside services. We saw a 16% reduction in operating expenses for the full year. These reductions are a result of us right-sizing the infrastructure over the past three years, leading to a cash and cash equivalent balance, including restricted cash at year-end of $92.8 million and a use of cash in 2024 of $46 million. These results demonstrate that we are delivering against our priorities set out in our March Investor Day. We launched iQ3 in the U.S. and internationally, launched ScanLab and iQ+ Bladder, reached 21 Butterfly Garden partners, and signed two more Octiv partners for a total of five. We also signed our first two pilots to enter home services.

Internationally, we received EUMDR for our advanced features of iQ+ and iQ3 while adding additional geographic footprint. We invested in our commercial teams and continue to expand our sales footprint both domestically and internationally, all the while reducing our cash consumption. As we look to 2025, our organization is humming. The plan is working, and we will continue to execute against it by driving adoption of iQ3 and expanding uses across all our channels. We have signed two pilots for home services and continue to develop the market for our ultrasound-on-chip technology through our wholly owned subsidiary, Octiv. Subsequent to year-end, we raised $81.7 million from our follow-on offering in late January 2025, which provides us with a bridge to cash flow independence.

This capital will enable us to maintain our current level of investment to sustain our revenue growth, as well as the option to opportunistically invest in strategic initiatives that can expand our market. To be clear, we do not view this capital raise as an opportunity to regress in the fiscal discipline we have instilled over the past few years. Notwithstanding these exciting and potentially meaningful tailwinds and establishing 2025 guidance, we have not included any new revenue streams or markets in our forecast. As we have in the past, we will take this prudent approach and guide to a full year 2025 revenue of $96-$100 million, or approximately 20% growth, with an adjusted EBITDA loss of $37-$42 million.

To reiterate, this does not include incremental revenue from our investment in Octave or the home services business, and as the year progresses, we will provide updates and further clarification. Now, specifically looking at Q1, we expect approximately $20-$23 million in revenue as we ended the fourth quarter slightly higher than expected, and Q1 is typically a slower quarter for closing hospital deals. For Q1 adjusted EBITDA, with expenses related to payroll tax and 401(b) reset, as well as our national sales meeting and POCUS forum, we expect slightly higher expenses and higher adjusted EBITDA loss in the first quarter relative to the remainder of the year in the range of $9-$11 million. To summarize, we had strong results in 2024, and we look forward to continued growth in 2025 and beyond.

We have been delivering against our plan and will continue to do so by going deeper and wider in the traditional ultrasound market, expanding the market by going where traditional ultrasound can't go with new users and applications, differentiating ourselves with continued development of ultrasound-on-chip technology, and by doing this, we will generate market-leading growth while maintaining our fiscal discipline by balancing investment with return. These objectives will allow us to capitalize on this attractive market opportunity over the long term. With that, I will turn the call back to Joe. Joe.

Joseph DeVivo (Chairman and CEO)

Thanks, Heather. Today, Butterfly is in complete control of our destiny. We have revenue momentum, a pipeline to empower growth for many years to come, a successful fundraise allowing us to continue to invest in our growth initiatives, as well as a runway to get the cash flow positive with our current balance sheet.

Our core business growth will be powered by our efforts to increase health system opportunities, drive the one probe per student model in medical schools, and continue global distribution to both iQ+ and iQ3. In our new business areas, we expect to progress more Octiv opportunities and convert our home care business from a pilot to commercial revenue. This is consistent with the roadmap that we laid out at last year's Investor Day. Butterfly has ended our first era, which had us fixating on image equivalency to other POCUS-based handheld probes. We are not looking back. We are looking forward to not just being equivalent, but surpassing the market to deliver a new digital experience only Butterfly can offer. While Butterfly is in the POCUS category, we are differentiated as the only company with a true mobility solution.

Most POCUS devices are just one step extensions away from a cart workflow in a hospital. As we see it, Butterfly today is the only mobile solution because it is a single personal imaging device for every doctor, nurse, and qualified chronic care patient in the world, powered by a plethora of new AI tools, cloud connectivity and processing, seamless integration with hospital systems, while working completely independent of them in the most remote places in the world. We will go anywhere a doctor, nurse, or patient braves to go and will carry the best experience for them. To understand this future, you don't need to look too far away. History does repeat itself, and the power of digital over analog technology has been proven time and again.

Just as digital cameras replace traditional film, chip-based ultrasound is set to dramatically expand the medical imaging world, and Butterfly is the platform to lead this change. Everything we do going forward will be to increase imaging power even further, make in-hospital workflows easier, miniaturize the device to drive mobility further, make the device smarter and easier to use with AI tools, and connected to a very powerful and safe cloud ecosystem. I look forward to updating you throughout the year on new developments and our accomplishments, as there are many great things brewing. With that, operator, please open it up for questions.

Operator (participant)

We will now begin the question and answer session. To ask a question, you may press star, then 1 on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing the keys.

If at any time your question has been addressed and you would like to withdraw your question, please press star, then 2. Again, it is star, then one to ask a question. At this time, we will pause momentarily to assemble our roster. The first question comes from Josh Jennings with TD Cowen. Please go ahead.

Josh Jennings (Managing Director)

Hi, good morning, Joe and Heather. Thanks for taking the questions. It's been a remarkable path of progress since the Investor Day last year. At that event, you laid out kind of a long-range target of $500 million in revenue.

I mean, I think you already answered this question in your presentation here this morning, but would you love to just kind of get an update just on your confidence level and where you stand today, almost one year out from that big investor event in 2024, in terms of the progress and confidence in getting to that $500 million revenue base in the out years?

Joseph DeVivo (Chairman and CEO)

Thank you, Josh. We put a plan together, and the plan certainly was not guidance, but it was the shape of how we are organizing our investments and where we think our revenue can come. As I said in the beginning of my prepared comments, we had a great year, and we are right on plan. I am really bullish about our growth initiatives.

I'm bullish about the continuation of the growth rate of our core business, and that's kind of where we're guiding towards right now. I'm also really bullish on the two areas that we've identified that will deliver meaningful growth in the future. I'm very bullish on Octiv. I look forward to letting you know about the new partners that we just signed, and the pipeline is just increasing. It's not only increasing, but the names are getting bigger and bigger, and it's really cool. We have our best people in that business, a couple of our executives that we really admire, and they're doing a hell of a job building out that business.

I think, first of all, Octiv, as we get to the second half of the year, we're probably going to see some meaningful revenue, and we may be forced to start pulling it out. Second, the home care business, man, it is just such a delight because we're eating our own dog food. We're using, we're getting our devices used with our training, with our software, and then with our wrapped around services to help first-time ultrasound users scan, and they're scanning in one of the highest-cost use cases in healthcare, which is readmissions for congestive heart failure patients. These patients are a revolving door from skilled nursing facility into a hospital and back, and it is a substantial amount of cost.

I have mentioned this before, but if we are able to just do just a small part of this market, it will double the size of the business. The upside optionality is huge, and we are taking it one step at a time. Aside from informing investors what we are doing, we are not getting ahead of ourselves. We are not guiding towards it yet. We are communicating with you quite transparently our progress. The best part of that business, as I mentioned in my prepared remarks, is not just the fact that we are able to, that there might be a business opportunity where we convert this pilot into a commercial opportunity. It is proving the model.

It's proving the vision that Butterfly has always had, where by reducing the size, by reducing the complexity, by increasing the power, and then pulling AI into the tool, it's allowing first-time ultrasound users to very quickly get up to speed and have immediate low-cost point-of-care clinical impact. These patients in a skilled nursing facility, if they all of us historically in the workflow, if they started to regress after they came back out of the hospital, they would be put into an ambulance. They would be sent to the hospital, and then they would have an ultrasound scan in radiology. Just that one, and then they'd have to come back to the skilled nursing facility after that scan to determine what to do with them. You know what cost that is? It's insane. That's what the healthcare system is paying for today.

Now a nurse pulls out of her bag this small device and does a few scans around the lung and then is able to get a remote expert opinion to make a determination at very low cost and immediate. We are on the tip of something very big, and I think those two businesses, if you just run out our core business as it was in that sediment chart, and then you start layering on these opportunities, again, it is hard to predict timing, but the level of excitement that we have is off the charts.

Josh Jennings (Managing Director)

I appreciate that, Joe. I wanted to ask about the home care channel as well.

I mean, I think you've provided a lot of intel here in that last answer and during your prepared remarks, but is there just maybe help us think through the steps required to go from pilot to a revenue-generating franchise and any timelines you can share? I know you haven't baked any home care revenues into 2025 guidance, but maybe just helping us understand just the next steps and what it will take to turn that home care channel into a revenue-generating franchise.

Joseph DeVivo (Chairman and CEO)

The beautiful part about it is when we were initially looking at services, we thought we'd be hiring our own technicians, our own nurse practitioners, and then we'd be sending them into the home or sending them into facilities because we wanted to force the model. We wanted to show this could be done.

If you were going to hire people, that would take cost, that would take time, that would take learning curve, and especially, of course, the time to onboard those people. Our partner did not want people just walking in and out of their facility. Our partner was like, "Train our people." We have been able, by eating your own dog food, you realize how good your tools are. Also your people. We have some of the best trainers in ultrasound and people who understand our technology. Every time they encounter our customers and they encounter someone who wishes to learn, it is just such a delightful experience because they are so incredible. Basically, to train someone up was very quick, and then they have to go through a protocol with ScanLab, so they have to practice and complete this and complete that.

Once they get there, it's really the training of the on-site personnel, which is the time to execution, and say that's a 90-day process. Everything else for Butterfly is virtual. The beautiful part about the scalability is that you have training of the on-site teams, but then you have this amazing scalability because we're using telemedicine, we're using our Compass software, we're using remote, then follow-up, etc. It is a highly, highly scalable model, and we think we can take on thousands of patients, tens of thousands of patients over multi-state and be able to provide this service. This is new territory for us.

We haven't done this before, and so it's hard to just turn around and say, "We can do this by this date." From the pilot experience so far, we think the degree of difficulty is well within our means, and the timing is nothing that's really crazy. I'm hoping that what's occurred for us so far continues. If it does, then I'd be stunned that at the end of this pilot, it wouldn't turn into some type of commercial opportunity because the benefits to these patients—we had a, there was one patient the other day who was discharged from the hospital, came back to the skilled nursing facility, and they were on a protocol with a very high dose of diuretic. It was kind of the highest dose that you'd give someone. It's at the higher spectrum.

When they came back in, they did a baseline scan, and they found that the patient had very little wetness to no wetness in the lungs. The B lines were not present. The clinical team went back to the nurse and said, "Hey, this patient's doing really well, and we'd recommend that you don't maintain the level of diuretics. Your diuretics are really high." They were stunned that the prescription was so high for that patient. What it would have done, you give that many diuretics to a healthy patient, you dry them out, you dehydrate them so fast. That is what would have happened to that patient. By them being able to have a confirmatory scan, them getting expert advice from a remote cardiologist, and then being able to course-correct immediately just for that one patient changed their course.

I think that's having constant awareness, having a constant ability to scan is the same type of benefits we saw in the Rutgers study where if you have an intensivist who's in the hospital rounding and scanning every day, you're able to immediately monitor their progress. You're not looking in the rearview mirrors from a week ago when they were scanned, and you're still treating them based upon that baseline. Every time you scan them, you're getting them. This is the beginning of a new paradigm of healthcare. It's not just about selling devices. This is a new paradigm, and we're on the forefront of it, and we're going to benefit from it.

Josh Jennings (Managing Director)

Excellent. Just one last follow-up on that home channel.

We saw the prototype for Wearable, I think, at the Investor Day last year, and I think we talked earlier this year about that pipeline development effort, but maybe just give us an update on where that program stands and when you may see approval and then utilization in the field. Thanks for taking all the questions.

Joseph DeVivo (Chairman and CEO)

No problem, Josh. This is all progress. If we came out with a Wearable today, there wouldn't be a market for it because what we have to do is build the use case first, and then as the use case develops, you build the technology to meet the use case. As we had laid out in our strategy last year, this is a multimodal approach.

The first step is to create the use case and to demand in the home with nurses, teaching them how to do this type of ultrasound. Once we get this and once this now has some velocity, the second phase is how do you automate it? How do you do it where now, instead of having to go and just do the scan, you can now place the Wearable? We are actively in development of a Wearable. It is something that is not far away, but we're also not rushing it because we're developing the market. As we succeed in this home care business and as we now convert it into commercial and we're active, the next phase after that would then be to start easing in the Wearable into that use case. That's how we're building a business.

Building the business is not about just launching a device. It's about preparing the market, preparing the users, preparing the need for the opportunity, and then moving forward with that Wearable. Everything is literally right on plan, and actually the results that are coming back are much better than we expected.

Josh Jennings (Managing Director)

Great. Appreciate it, Joe. Thank you.

Operator (participant)

The next question comes from Benjamin Haynor with Lake Street Capital. Please go ahead.

Benjamin Haynor (Managing Director)

Good morning, guys. Thanks for taking the questions. I appreciate all the commentary that you've had so far on the home care opportunity. I was wondering if you could share maybe a little bit more on maybe how many residents were involved in these long-term care facilities, how many days they've been kind of followed, if you will, how many readmissions you have anticipated, things of that nature, anything else that you can provide there?

Joseph DeVivo (Chairman and CEO)

Yeah. We trained 18 nurses at two skilled nursing facilities in Wisconsin. That's so far. We have done the initial training. We have done a ScanLab follow-up training. What's also a wonderful part of this virtual service is as our cardiologists are reading the scans, they're not just diagnosing the patient, but they're also letting the scanner know, "Hey, what they could have done better. Hey, you got a little bit too much of this." This is a constant process of evolution. First of all, that's the scale so far of the people that we've trained, and we're very pleased with that progress. As far as I don't have data to share with you as far as the absolute number of patients, etc., we've now started. The pilot is designed for 200 patients, and they are now scanning all kinds of patients.

We have, of course, early anecdotal information like the one case I shared. So far, of all the patients that have scanned, no one has been readmitted, but it's a very small sample size so far. Sure. Got it. Congrats on the capital raise, by the way. I was wondering, you've mentioned some of the software things that you're working on. Any hardware kind of developments that you might intend to accelerate? It didn't necessarily sound like it. If we could get an update on kind of where you're at on the cart-based iQ Station. Sure. Consistent with the presentation that we made at JPMorgan a few weeks ago, we have, first of all, are active with the P5 chip. We showed the image on that, and that P5 chip is really the essence of the next generation.

We have some hardware, we have some hardware probes and some things that we are working on for the next generation, and it might not just be as simple as the next probe. We are working on some things that are a little different and would continue to build the market for us. We are also working on, absolutely, as you said, the iQ station, which would really start moving us more into the lower-end cart business. Those are all things that there's nothing that's changed since our JPMorgan presentation. I think the thing that has changed is by bringing in the money, we can just keep doing what we're doing.

If we didn't bring in the additional capital, we'd be in a mode of continued, let's say, cost reduction, and it would have extended into opportunity reduction because we wouldn't be able to fund the programs that we're currently funding. We are not in a mode of saying, "Okay, now that we have the money, we're going to fund all these additional things," because we're very intent on solid cash management. We're very intent on making, maintaining, and getting leverage in our operation because we want to see our revenue grow, and we want to contain our costs. We march along that path towards cash flow independence. If we didn't bring the capital in, we'd be cutting programs like the ones, or we'd be pushing off or choosing one over the other. Now we don't have to do that.

All those exciting things around the next generation of semiconductor, as well as the cart-based focus, as well as the Wearable, we're going to go upstream into the hospital, and we're going to go downstream into the home. We're going to expand the market opportunity of ultrasound, and we're going to now, as I mentioned, this is a new era for us. We've been playing catch-up in the beginning. We've been trying to create our camera that would show that it's as good as film. Now it's as our Wearable is as good as anybody's. People might like this one feature of one company, one feature of another, but our image quality is there with anybody's. Now we're just focused on how do we improve the experience for the physician, for the nurse, and for the patient?

How do we now become even better and change the entire world? iPhone-esque, how do we make this a universal device that captures data easily, that lives with doctors, nurses, and patients, and allows us to capture a massive market opportunity? That is where we are going.

Benjamin Haynor (Managing Director)

Makes sense. Thanks for the color on that. Lastly, for me, just maybe a point of clarification on what the revenue guidance includes. That does not include any new revenue streams. It does not include Octiv, Butterfly Garden, Home Care, anything like that. It is just traditional iQ+, iQ3, and software and services that are existing, correct?

Heather Getz (CFO and COO)

Right. It includes current Octiv contracts. It does not include any new Octiv contracts or Home Care or additional add-in businesses. Just that clarification on Octiv. For example, we have Forest Neurotech. That is already in our numbers.

That's in our guidance, but a new partner that we might sign would not be in there. The ones that were detailed in the press release and earlier in the prepared remarks, those are or are not included? The ones from 2024 are included. Any new ones signed in 2025 are not.

Benjamin Haynor (Managing Director)

Got it. Excellent. Congrats on all the progress status, and thanks for taking the questions.

Heather Getz (CFO and COO)

Great. Thanks, Ben.

Joseph DeVivo (Chairman and CEO)

Thank you.

Operator (participant)

The next question comes from Suraj Kalia with Oppenheimer and Company. Please go ahead.

Suraj Kalia (Managing Director)

Joe, a couple of questions from my side, and I'll pose them upfront. In your FY25 guide, how should we think about the same-store, new-store dynamic as iQ3 contribution picks up? The second part, or the second question, Joe, you just made comments about your image quality as good as anyone's.

Help us understand what is the most objective evidence that we should take as interpreting the image quality is as good as anyone? Thank you for taking my question.

Joseph DeVivo (Chairman and CEO)

Great. The same-store, new-store, as we can, Heather can talk more about the guide specifically, but we are now, we are anniversarying the first year of selling iQ3, where there is a lot of upgrades, there is a lot of new business, etc. The market is so big and the market is growing. We see a constant new business channel. Our e-com channel is a marvelous way to engage customers, and we are seeing continued new business. Also, we have unlocked the hospital channel. The hospital channel is a channel where we were not as present just because of what we had just mentioned. We were seen as more of a wellness or a personal device.

Now getting in and establishing ourselves in the intensive care units, establishing ourselves in the emergency rooms, establishing ourselves in anesthesiology and cardiology, these are now places that are open and opportunities for us. That helps us now with our enterprise software, where we are now going into hospitals and selling a full bundle. We feel that we're much more capable today with that full product offering than we were in the past. Regarding image quality, when I talk about image quality, I'm talking about image quality of handheld devices. Other devices out there, whether it's GE or Philips or Clarius or other devices, these are devices that benefit from 40 years of development of piezoelectric crystals and, of course, are the ones that imaging are people that are the most comfortable with.

Historically, our version two was a great product, a great universal product, and the only all-in probe in the market. It was not seen, especially in cardiac imaging and others, that we had a level of equivalence. Imaging is, when you talk about empirical evidence, it's like in the eyes of the beholder. We have seen, which is evidence in our growth this year, that people feel like we've closed the gap. People might think, "Okay, this one preset, this is better. The other preset, that is better," but we were not in the conversation before. Now we are in the conversation. You can talk to one person, they'll say, "Oh, I prefer a Philips." Another person will say, "I prefer a rescan." Now other people are saying, "I prefer iQ3." That just did not exist before.

Prior to launching, we did do an internal survey where we had 470 doctors who were given several images, and then they were asked in a completely blinded way to rate what image they like better. The majority of those doctors chose iQ3. That gave us the confidence before we launched to say, "Hey, we've gotten there." We wanted our own gut check. We'll see. There have been stuff in publications comparing our second generation to the other probes where we didn't fare well. I think today, you can even look at influencers who are doing unboxing, and there was a really good one that just came out from someone that compared ourselves to a Lumify, which has always been seen as the best cardiac image in the market. To be in the conversation now is fantastic.

That's where we are so far. Was there a follow-up, Suraj?

Suraj Kalia (Managing Director)

No, thank you. Got it.

Operator (participant)

This concludes our question and answer session. I would like to turn the conference back over to Joseph DeVivo for any closing remarks.

Joseph DeVivo (Chairman and CEO)

Everyone, thank you so much for being with us. We like this Friday morning format to give our analysts time to be able to digest our information and not have to conflict with all the stuff like last night and whatnot. I hope this works for you. We're very pleased about our progress. We're excited about 2025. We're excited about our core business, and we're also excited about all the new initiatives that we have. We appreciate the support with this most recent fundraise, and we are now just excited to continue all of the different things that we're working on.

Thank you, everyone, for the support, and look forward to giving you more updates in the future. Thanks.

Operator (participant)

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.