ImpediMed Ltd

ASX:IPD

Earnings Call Transcript 2020-Q1

[Operator]

Thank you for standing by, and welcome to the ImpediMed quarterly results investor call. [Operator Instructions]I would now like to hand the conference over to Mr. Rick Carreon, Managing Director and CEO. Please go ahead.

[Richard Carreon, MD, CEO, President & Executive Director]

Thank you, Chantel, and welcome, everyone. Thank you for joining us today. We're hosting this conference call to discuss our 4C for the financial year quarter ending 30 September 2019. Our Vice President of Finance, Mr. Tim Cruickshank, will be filling in for Morten Vigeland, our CFO, who is unavailable for today's call.During our call today, I'll be referencing the 4C we launched earlier this morning in Australian time. As we normally do, I'll take questions following my comments.This quarter marks a key inflection point for ImpediMed. First of all, Software-as-a-Service became the key revenue and growth generator for the company, and recall, this is a business that is less than 2 years old. Two, we launched the lymphedema prevention program in both the U.S. and Australia. It's been extraordinarily well received in the market, and we believe this comprehensive program will accelerate both the adoption and expansion of our lymphedema franchise. Three, we significantly increased scope and resources we're putting towards reimbursement. Four, our heart failure program enters a new and exciting phase. And five, our growing patient database of over 69,000 tests equating to more than 200 million human data points is allowing us to fast-track several major initiatives, such as heart failure. And I'll be covering each of these points throughout the presentation.The financial results for the quarter ending 30 September were as follows. Total revenue for the quarter was $1.4 million, matching the previous quarter's rise and up 56% from the previous corresponding period.Let me refer you to our 4C we released earlier. Please note the graph on the first page. The light blue bar represents the revenue we received from the sale of our SOZO devices, and the dark blue bar represents our software subscription business. Overall, our SOZO revenue was down 1% from the previous quarter and was up 176% from the same period last year. Please note the seasonality in the past years Q4 to Q1 and has historically fallen between 14% and 31%.During the quarter, we sold 40 SOZO devices, bringing the total number sold to date to over 440. We believe this is a good result following on from the 51 units sold in the seasonally stronger quarter Q4 FY '19. I think it's important to point out the continuing growth of our SOZO SaaS revenue, which was up 250% from the previous corresponding period to $0.7 million. We've broken this revenue component out separately to highlight the compounding power of our SaaS model. As in previous quarters, our churn rate remains extremely low at less than 0.5%. Our contracted revenue pipeline, this is the revenue to be recognized over the main life of our contracts, increased to $9.2 million, up 6% from the previous quarter and an increase in the same period last year of 96%. The gross margin for this future contracted revenue remains at still plus 90%. Our annual recurring revenue, this is the revenue we contractually expect to receive over the next 12 months, increased to $3.9 million, up 15% from the previous quarter and an increase from the same period last year to 117%. Cash flow and operating costs were tracking the budget for FY '20. Cash receipts from customers for the quarter were $1.3 million and cash on hand as of 30 September 2019 was $18.7 million.Net operating cash outflow for the quarter was $5.3 million, which included payments to annual staff bonuses and other onetime expenses typical for the first quarter of the financial year. Net operating cash outflows for Q2 FY '20 are expected to be between $3.8 million and $4.2 million as a result of increasing cash receipts from customers and continued financial discipline. These results put us on track to achieve our FY '20 guidance of $7 million to $10 million in revenue. Adoption of our technology remains strong. Please refer to the graph on Page 2 of our 4C release. More than 18,000 patient tests were conducted in the quarter, again, increasing quarter-over-quarter by more than 20% and bringing the total patient tests on file to more than 69,000. Reimbursement remains a critical initiative for the company. So let me provide you 2 key updates. First, the payers we have met with have not announced any decisions regarding our request for payments. We remain engaged and have provided follow-up information as well as additional clinical data. We remain optimistic as we continue working through the process with them.The second update is with our growing body of clinical evidence and the cost of lymphedema analysis recently concluded. We elected to engage one of the U.S.'s leading reimbursement firms, MCRA. It specializes in helping companies obtain payment from insurers. They have already begun an aggressive outreach program of targeting insurers to meet with over the coming months. We are very encouraged by the breadth and depth this organization is bringing to bear on our reimbursement initiatives.Now for the NCCN guidelines. As you recall, Vanderbilt, The American Society of Breast Surgeons Foundation and the world's leading patient advocacy group, LE&RN, submitted an application, which was accepted and presented at the annual NCCN face-to-face panel meeting. We believe that this application was compelling. The submitting clinicians are requesting inclusion of bioimpedance spectroscopy in early detection of lymphedema be included in the guidelines. We are currently awaiting the outcomes of this panel meeting.The PREVENT trial. We have the opportunity to meet with the principal investigator and discuss a broad range of topics. Joining our meeting, the principal investigator informed us of the following. One, they were integrating the comments from the site investigators on the 2-year data analysis that was circulated earlier. She informed us that final manuscript was to be submitted shortly. Two, in addition to the 2-year data manuscript, 2 other papers are in the process of being readied for submission. And three, she's announced to all of the enrolling sites that final patient follow-up was to be completed no later than December of 2020, with the primary endpoint manuscript to follow and the secondary endpoint manuscript to come out shortly afterward. Now this is a very important time line that has been released by the principal investigator. It puts all the 10 sites on notice. There is now a definitive end date to the patient follow-up; secondly, assessment schedule for the primary and secondary endpoint manuscripts. So we're very, very excited about this latest announcement.Now as we've noted in the past, this is the single largest randomized controlled trial ever undertaken for lymphedema. To date, 2 papers have already been published. I outlined 3 more coming out over the next several months, with at least 2 at the conclusion of this study. This makes it 7 papers, and there are many more being discussed by the principal investigators. As the data matures, there are a number of clinically relevant and important discoveries that are being uncovered.We are also expecting the publication of a meta-analysis of a large number of independent lymphedema studies using our technology to come out in the coming months. We expect this to be a very positive publication. Heavily discussed in the past, the meta-analysis is viewed by the American Medical Association as just as valid as a randomized multi-center trial. As you can see, the clinical data to be published is significant. We believe that these upcoming publications provide us an opportunity to engage payers as well as the NCCN on a regular basis.We recently announced our campaign to end cancer-related lymphedema. This was developed to provide cancer centers a turnkey solution for implementing an effective lymphedema prevention program. The initial response from the market has been extremely positive. This program focuses on a protocol of test, trigger, treat.In the past, we sold a device to address a problem and help the sites to develop an overall solution. This new program provides current and new customers a comprehensive turnkey solution which was developed in conjunction with our most successful institutions. To see more about this, I would encourage you to go to www.preventlymphedema.com.And now I'll turn to our heart failure initiative. Last month, we held an advisory board meeting where clinicians reviewed all of the data from our studies, both the in-clinic and at-home patient records. At the conclusion of this meeting, a subset of clinicians volunteered to further refine the data and develop reference ranges for patients living with heart failure. We use this data to establish fluid overload parameters for heart failure patients. We then use the data from the more than 69,000 patient records in our SOZO cloud to establish reference ranges of fluid imbalance -- or excuse me, fluid balance in a healthy population. We're currently using both of these reference ranges to develop applications for both identifying heart failure patients with fluid overload as well as effectively tracking heart failure patients' daily fluid burden. We believe these are significant steps forward. We will be presenting additional information on our progress in heart failure as it becomes available. We expect the first release of this exciting data will be at our upcoming AGM meeting next month.With that, I would now like to open the lines for questions. Chantel, would you please give our listeners the instructions for getting into queue?

[Operator]

[Operator Instructions] Your first question comes from Moore Family Nominee, a private investor.

[Unknown Attendee]

Rick, Ian here. You said you met Sheila, and you talked about commission of the 500-patient year 2 data. Was there any mention of the 1-year data on the whole 1,100 patients?

[Richard Carreon, MD, CEO, President & Executive Director]

Ian, welcome, and thank you for the question. Listen, she did not talk about that. When we first approached the payers, it's the long-term data that's critically important. So the decision was made by the principal investigators to get the 2-year data out on the first 500 patients. And then, as I said in my comments, they're expecting a large number of papers to be coming out over the next year, 1.5 years across the board. I would imagine at some point there would be additional follow-up on the largest subset of patients.

[Operator]

Your next question comes from Elyse Shapiro, Wilsons.

[Elyse Miriam Shapiro, Equity Analyst]

So first one is just about how many of the old machines you are converting on to SOZO at this point.

[Richard Carreon, MD, CEO, President & Executive Director]

I'm sorry, Elyse, can you repeat that again please?

[Elyse Miriam Shapiro, Equity Analyst]

Yes. So just much further you have in your transition from the older device sites into SOZO.

[Richard Carreon, MD, CEO, President & Executive Director]

I'm sorry, Elyse. Thank you. Listen, right now, there's a handful of large institutions who are keeping our device for clinical reasons. They are undergoing clinical studies, and they need to be able to measure the patients. And so I would say there's a handful of large institutions. There's a number of smaller independent offices that are individual surgeons for whatever reason are keeping them. But I would say that we have very little to do, and the rest are going to be really focused on new customers.

[Elyse Miriam Shapiro, Equity Analyst]

Good. And then just around the private payer piece. I mean can you give a bit more color around where you are in those discussions, when we might start to see some more payers signing on? And just wondering if they've seen that 2-year PREVENT data under NDA.

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. Very good. Well, first of all, the 2-year data has not been made available under an NDA at this point. We've not had a single payer that we've met with request 2-year data. So we're certainly not going to bring it to their attention. We certainly don't want them to use that as an excuse not to weigh in based on all of the current data we have. When we go to a payer today, we present the PREVENT trial on the first 500 patients. We took that subset alone with more patients in a single randomized study than has ever been conducted before. We also bring along with us 6 other studies that we present to them as well, and those range up to 27 months so more than 2 years of data. So at this point, we presented that information. As we get additional information, such as the cost of lymphedema, we get some more analysis. We're forwarding that on to the accounts -- excuse me, the payers that we have seen, and we keep engaged with them, and we'll continue to do that. I think you can see with the pace of data coming out over the next number of months, we'll have a number of touch points that we'll be able to go back to the private payers with.

[Elyse Miriam Shapiro, Equity Analyst]

Yes. So I guess, any idea around timing of when we might start to see a little bit more buy-in? And will you be announcing individual payer sign-ons?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes, I would tell you this. When we start to see payers change their policies, publish a policy, then it will be making those -- I can tell you from the standpoint of typically, we would have seen some notification by the payers at this point. However, they are requesting additional information and so -- or they have referred it on to their technical review group. So we see this as all positive. Several years ago, 3 or 4 years ago, when we had our very first big push into the private payer arena, we were given answers very, very quickly. So this for us, we see this as a positive that they are carefully studying and reviewing the data. And believe me, the moment that we get any information either way, we'll certainly be providing that to the market.

[Elyse Miriam Shapiro, Equity Analyst]

Got it. And just one last thing on the last comment. What sort of information are they requesting? Is it on the clinical side? Or is it cost effectiveness side?

[Richard Carreon, MD, CEO, President & Executive Director]

Actually both. They're asking if there's any new data on cost effectiveness or which study that we think are the most pertinent ones. And what we've been referring to them about on the cost analysis is the vascular study that came out that showed the 2-year cost of complex lymphedema to be $120,000 difference over a breast cancer patient who goes through treatment and does not have lymphedema. That has been a very powerful study. That study, I will tell you, was drawn from more than 56,000 insurance claims over 8 different states here in the U.S. So it's statistically significant, and it is a pretty powerful paper. And then from a clinical side, we've been providing them the different data sets from those 6 clinical trials. And if they ask if anything from Australia, we've been providing the ones out of Macquarie and so forth. So it's really just been more of a data gathering at this point than it has been anything else.

[Operator]

Your next question comes from Sally Watson, Oblique Logic.

[Sally Watson]

Just a quick couple of questions. I've looked at the 4C, the net operating cash flow of $5.3 million. I'm just not fully clear on what period that is relating to in that paragraph set there.

[Tim Cruickshank]

So for Q1 that just ended 30 September 2019 was net operating cash outflow of $5.3 million. And then towards the back of our 4C announcement on the actual cash flow release, we show a forecast for the following quarter ending 31 December 2019. And that's where that range of $3.8 million to $4.2 million net operating cash outflow comes from.

[Sally Watson]

Okay. And one other quick question. Just with that seasonality, is that mainly due to payer cycles that we're seeing that?

[Richard Carreon, MD, CEO, President & Executive Director]

What we typically see for seasonality, the end of a financial period for hospitals is either going to be 30 June or December 31 for us, and that’s really from the standpoint of capital equipment. If they've got an excess budget, let’s say that they canceled or they've decided not to use all of the budget that they had, and at those points of time, they have that excess budget that they can apply. So typically, our seasonality has been our strongest quarter, tends to be at the end of the calendar year. And the second strongest quarter tends to be at the end of June 30. So -- and again, that's really just based on when the hospital fiscal years come to an end.

[Sally Watson]

And is the SaaS component of that still considered part of that budgeting? Or is that a separate cash component for the hospitals?

[Richard Carreon, MD, CEO, President & Executive Director]

Great question. So here's what happens. When a hospital signs an agreement with us, they need a capital expenditure to buy the equipment, so the SOZO device itself, and that's what's under the scrutiny of their annual budgeting process. The SaaS model, because it's a monthly fee, falls into their operating budget and is not constrained by that same seasonality. That's why you've seen that graph on the first page. So once they agree to our contract for 3 years, they typically set that money aside for 3 years so they budget for that for the duration of the contract. And that, for us, comes on a monthly basis. And so it's really just the capital equipment part of our business still that you're seeing the seasonality.

[Sally Watson]

That's great. So with the software income, as that gets bigger, so the number of devices out there, you'll see more of a modulation of that seasonality on the device.

[Richard Carreon, MD, CEO, President & Executive Director]

That's correct. In fact -- yes, I think what you'll see long term once we get a larger footprint in the market, we will consider actually eliminating the capital equipment altogether because then it gets us out of this in the capital equipment cycle, and I think it will start to accelerate the adoption of our program. And I think we would make that decision once we started to see a break in the private payer reimbursement.

[Sally Watson]

Okay. And with respect to Europe and the U.K., can you just give us a very quick update on any movement in that space?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. We really have not. For example, we announced last year that our focus was going to be on the U.S. launch and supporting Australia because we're seeing traction in both those markets, and we will use the U.K. and Europe mainly as opportunistic for us, and that remains. So I think until we see that traction in the U.S. and continued growth and possibly the launch of heart failure that I think we're just going to continue to see that as opportunistic. We occasionally sell a device over there. But the big issue for us is going to be the security. So right now, as you know, our -- all of our readings go into a cloud, and the security issues for the EU continue to change. And so I think for the short term, at least for the next 6 months, it's best if we just sit on the sidelines and see where they're at. I can tell you we're compliant, fully compliant with the entire EU security for handling patient information, but I think it's best for us to sit on the sidelines for the next 6 months until they finalize their recommendations and we see exactly where we're at. And if we see traction in the U.S., then we would make that decision to move into the EU at that point.

[Operator]

Your next question comes from [ Ian Hyde ], shareholder.

[Unknown Shareholder]

Quickly on the revenue for this quarter, the tests have gone up by 20%, but revenue hasn't matched. Is that just simply a timing issue of receiving payments?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes, great observation. So understand that a number of tests we use as a way as our technology being adopted. If you recall, on our revenue model itself, that an institution pays us a monthly fee and they can put as many patients through that device for that period. So I would say this, use the patient's adoption as a way to say as our technology is continuing to spread. I can tell you this, as a number of patients that an individual institution tests, the more devices they need. It's difficult, it's not impossible for these large centers to funnel all of their patients through a single device. And so we routinely pick up a sale or 2 every quarter of new accounts for providing us opportunities to expand our program. And we believe the lymphedema prevention program will only accelerate the need for these accounts to pick up more devices. So use of the SaaS revenue as a way to gauge the future health of the upcoming business and the ARR and then the patient numbers that we provide on a quarterly basis to really gauge the adoption within those accounts.

[Unknown Shareholder]

Okay. And just on that as well, with the new SOZO devices, you touched on it there. But can you start giving information at some point as to with the new devices, the new accounts that are established as opposed to people that -- or institutions that are putting further devices in with the ones they already have because that would give a lot more color around how it works from the outside looking in as well?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes, that's a good point. We certainly can start to put more color around the number of devices that have been sold into new accounts versus replacement accounts. And we should also consider maybe the expansion of current accounts. So maybe break it out into 3 ways. Yes, we'd be more than happy to consider reporting that. So I think as we go into the new year, we wanted to start to establish some of the metrics that people have been requesting. And obviously, as this business continues to accelerate and grow, we'll provide more color. So we've taken those notes down and we certainly will consider doing that. Thank you.

[Unknown Shareholder]

And just with the tech review as well, are they requiring any more data or information for their assessments? Or has the submission for that, which previously you've advised that that's a rather important piece to get over the line before the private payers will start actually looking at reimbursement? So do they have everything they need? Or will they be asking for more and/or do you have any idea when that tech review will be completed?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. Very good. So the 2 tech reviews you're referring to would be the AHRQ, that’s for the centers of Medicare and Medicaid and then the other one was Evidence Street Blue Cross Blue Shield. So I can tell you, we have applications into both. I can tell you that both of them have requested additional information. AHRQ, for instance, just asked for a request for international data specifically coming out of Australia. AHRQ is known to look at data both in the U.S. and in Europe and Australia. So we saw that as a very positive sign. And Evidence Street has asked us to provide some additional cost information. I can tell you that both AHRQ and Evidence Street are in figurative process. They continue to compile data. They continue to look at things. And as they have questions, they'll get back to you and ask those questions or ask for additional data or ask to speak with some of your larger using sites who may have data that is not published as of this point or data that they're currently collecting. So I would say that both of those tech assessments are in the early days, but both going very positive in our opinion and the opinion of our advisers.

[Unknown Shareholder]

Okay. And just with more data, the CHF trial with 200 patients, that's actually completed and they're now reviewing and discussing that data and a lot of that will be what you will be releasing, as you mentioned earlier in this call, sometime within the next month?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. I can tell you this. They have not concluded the 200-patient study. What they did at this group at the advisory board, Ian, is that they sat down with all of the data that has already been compiled over the several studies. If you recall, we've done 2 different studies. One, we've done an in-clinic study where the patients were coming in several times a week and being measured. And then we have a daily protocol that's being done with patients at home. The advisory board looked at all of the data that was currently available that was presented by the principal investigators for those studies that was reviewed by all of them. And they believe there is enough data to definitively prove that we can track small fluid changes in the heart failure patients that are medically meaningful. They're going to be writing up their conclusions, and that they wanted to do is start to establish reference ranges. So much like an L-Dex score where a patient starts to develop lymphedema, we can detect it early. They're trying to build reference ranges for heart failure where you could monitor a patient in a relatively normal state of fluid. And then as they move into fluid overload or fluid accumulation being a heart failure patient, that we would be able to notify clinicians that they're now moving into a state that needs to be addressed, i.e. either through diuretics or brought into the clinic for evaluation. So that's the exciting step we’re reporting. That's the data that we will be presenting in the next couple of weeks. They're moving -- the clinicians are moving very quickly to get this information in a way that could be usable. And again, we'll report on that as soon as we get it. I can tell you the next big meeting of the group is going to be in the coming weeks, which they'll present their data, and they are scheduling ongoing meetings to continue to review this data. So we think this is very positive.

[Unknown Shareholder]

Okay. And just on to the PREVENT trial. Previously, it was announced that the second year data should be released before the end of the calendar year. Is that still your understanding? Because today, you said in the next few months. So does that mean it could flow over to the next year or information on that?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes, that's a great point. I asked the principal investigator. She felt confident that they would submit it here shortly and that it would be published this calendar year. Obviously, we don't control the publications, neither do they. I think there's a number of publications that are eagerly awaiting further follow-up on this landmark study. So she felt confident that it would be published here shortly so -- actually submitted and then ready for publication, which would mean there would be very few, if any, edits and turnaround time on that. But again, the other thing we've done is they're requesting online access so that the moment it has been approved by the publication, that it’s released online and that would be prior to the hard copy publication coming out that physicians typically obtain.

[Operator]

Your next question comes from Shane Fitzgerald, Monash Investors.

[Shane Fitzgerald]

Just a couple of questions, I guess, on time lines. With regards to the NCCN guidelines, is there any sort of guidelines as they typically have or they like to meet, a submission is actually put in before they make a decision? Or is it just up to -- left to the gods, so to speak?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. Shane, that's a good point. I can tell you that the NCCN -- there's 2 things. They have their face-to-face meeting, and then they have monthly conference calls depending -- well, they can have monthly conference calls depending on the number of submissions. And then they release that data on a regular basis. Now if you think about all the different tumor types they have, there are -- I would say, in a given quarter, there are dozens of releases. They may not all be pertinent to the tumor type they're looking for or the type of treatment. So really, it's up to them. Again, what they try to do, they try to stay clinically focused on only the data because there they can move entire hospital systems to change what they do. So they take their job obviously very seriously. And then two, if they have further questions, they'll either get back with their clinicians or they'll contact the submitters, in this case would be Vanderbilt. So it's really -- we get alert on a regular basis, and you can go to the NCCN website and you can take a look and browse what they publish on a regular basis. And you can get alerts, and that's exactly what we do. That's the first time that you will be notified is when you see the new guidelines -- new additions to the guidelines. So it's not quite up to the gods. There's a very detailed process they go through, Shane.

[Shane Fitzgerald]

Right. Fair enough. And just coming back to the heart failure so I understand that clearly, what's happening now is you're going through the 18,000-odd patients test degree done and working out what the normal range for fluid levels are, and then that will establish some sort of baseline that you can then use heart failure bigeminal testing on. Is that correct?

[Richard Carreon, MD, CEO, President & Executive Director]

Yes. So thinking about it for a moment, right now, the biggest challenge in heart failure patients is the fact that what should a normal range of fluid look like in a patient or at least normal for a heart failure patient. So one of the things that came out is that our data looks extraordinarily positive from a standpoint of what does fluid overload looks like. Now the question coming out of the meeting is, how do you establish what an unhealthy population or a healthy population look like? They may not be in fluid overload. And so we were able to go back with our own data sets that we have in the cloud and quickly pull outpatients so we could establish those normative values, and these are very -- obviously very large databases. And we don't need tens of thousands of data points to establish that. It's really a much smaller number but we have that. And we have the clinical proof points of where we were able to get that information and in a large number of cases, which ones were healthy, age distribution, so on and so forth. So we use that to establish what a normal healthy range would be, i.e. much like the lymphedema prevention -- or excuse me, much like our L-Dex. We know what a normal healthy patient should be and then when they start to trend out. So that's what the team is currently working on is to further refine that information and make it available.

[Shane Fitzgerald]

And what's the likely time line for that work to be complete? And then I guess, what's the next step after that?

[Richard Carreon, MD, CEO, President & Executive Director]

Well, here is what they want to do. They want to continue to refine the data. They've given it for the final refinement. They want to make that this calendar year with a publication shortly to follow. And as I think we've said in the past, getting the publication for heart failure is much easier than getting it in, in the cancer space because things rapidly change in the heart failure space. So they're expecting something shortly on that. But they do want to release some initial results so they can see the progress that's currently being been made on this technology. So like I said, we're expecting to release some data in the coming weeks soon.

[Operator]

Your next question comes from Gareth Jakeman, Territory Funds Management.

[Gareth Jakeman]

You previously guided in terms of the number of sales staff that you have within the team at around 12 on a rolling basis. So that on my numbers equates to around 3 to 4 sales per team member in previous quarters on average. What are the -- what type of information can you provide to shareholders in the future that gives us a better understanding of how effective that sales team is given the increasing data or I guess the validation of the company's product set?

[Richard Carreon, MD, CEO, President & Executive Director]

Well, I think there's a couple of things that you can look at and certainly can draw conclusions from. I can tell you, we said that once we started to see some traction, we will start to increase the size of our organization. So getting the lymphedema prevention program, we will start building out our organization on a small scale, and we'll stay within the current projections. We've been in the market on a cash burn. We will be taking that money out of other parts of our business. But I think there's a couple of things. First of all, with the lymphedema prevention program, we should start to see an acceleration across the board. With these new hires that we're bringing on, that's more of a solution sell than a placement of a product. I think you'll start to see the productivity climb from a standpoint on a number of things. But I think the biggest indicator of the success of this business will first be apparent in the number of patients we test then followed after that by the number of devices being placed. And I would say that the test increases will be that leading indicator. Just from a standpoint the -- by the time you sell a device into a hospital, you sell -- you get the contracts signed, you get them installed and so forth. It may take a while, but I would say that, that would be one way to start to gauge the health and the productivity of the sales organization. Like I said, we currently have a number of physicians, a small number of physicians open, so we'll start to hire into that again because the initial reaction to the lymphedema prevention program has been highly, highly regarded as we started to talk to those major accounts.

[Gareth Jakeman]

Rick, just a follow-on question. Would it be unreasonable for the company to report the average number on a quarterly basis of sales staff, including new hires so that we can get a feel for, hopefully, an increase in the average number of sales? And just a follow-up point on that. At the AGM, shareholders are being asked to vote on a number of resolutions, one of which relates to sales targets. So I guess my point is that we may be able to see better data that relates to the sales and the resources from the recent capital raise going into that sales process.

[Richard Carreon, MD, CEO, President & Executive Director]

Yes, I think -- I don't think it's unreasonable for us to report on the number of sales rep and all, Gareth. Like I said, we're starting to hire into that. Our expectations are sometime in the current quarter we're in that we'll be in the 15- to 17-person range. From a standpoint of the full field organizations, we start to hire into global. I think it's -- pardon me?

[Gareth Jakeman]

Sorry, there's background noise.

[Richard Carreon, MD, CEO, President & Executive Director]

I'm sorry. Yes. So again, we're starting to hire into this. As we start to see this program and the reception that we get for us, we certainly can report in on that. In regards to the REM report and the remuneration and the targets, the LTI targets, we're very, very focused on the guidance we gave to the marketplace, not only for myself but all the way through the organization. Everybody in the organization now clearly understands what their job is to ensure that we hit the financial targets for the future, now and in the future. And we're very keenly aware of that, and we’ll report out on a regular basis to the organization. I mean in the past, we've had a combination both of subjective and objective targets. And I can tell you this fiscal year that we went to the Board and made it very clear that we want to be laser-focused on clearly defining those that you can hold everybody accountable for throughout the organization. But when it comes to revenue, I don't care if you are in the installation team, I don't care if you're in customer service, I don't care if you are in HR, everything is tied. HR has the responsibility to ensure that we've hired the right organization and we continue to keep them motivated, customer service ensure that we have no issues that would negatively impact our customers, so on and so forth. And we hold everybody accountable to those objectives. And again, we have a scorecard that we report on, on a weekly basis all the way up to myself on how people are doing versus those objectives.

[Operator]

Thank you. That does bring us to the end of the question time for today. I will now hand back to Mr. Carreon for closing remarks.

[Richard Carreon, MD, CEO, President & Executive Director]

Listen, I want to thank everybody. I know there was a lot of information that we shared, that was shared, and we'll be sharing more at the upcoming AGM. So thank you for everybody's participation today. Have a good day.