Q2 2021 Outset Medical Inc Earnings Call
[music].
Good day, and thank you for standing by and welcome to the outset Medical Q2.2021 earnings Conference call. At this time all participants are in a listen only mode. After the speaker's presentation and there will be a question and answer session to ask a question. During the session you will need to pass star 1 on your thoughts.
The phone if you require any further assistance. Please press star zero I would now like to hand, the conference over to your Speaker today, Brian Johnston from day Gilmartin Group. Please go ahead.
Thanks, operator, good afternoon, everyone and welcome to our second quarter 2021 earnings call participating from the company today are Leslie Trig, President and Chief Executive Officer, and Appeal Ahmed Chief Financial Officer. During the call. We will offer commentary on our commercial activities and review our second quarter financial results released after the close of the market today average will host.
A question and answer session. The press release can be found on the Investor Relations section of our website at outset medical Dot Com. This call is being recorded and will be archived on the investors section of our website.
And MBA was directly responsible for building and managing all of the financial operations as a business.
He had been a critical component of our success, both personally and professionally and we could not be more thrilled to announce his appointment.
Is a true pleasure to describe our team's exceptional performance this quarter together with the deal as a partner.
And speaking of our results I am pleased to report that through the second quarter. Our team continued to build on our momentum delivering another quarter of significant revenue outperformance.
Continued gross margin improvement and and outlook for the remainder of 2021 that leads us to raise our fiscal year 2021 revenue guidance.
For the second quarter, we reported $25 and $2 million and total revenue, representing 115% growth year over year, and 10% growth sequentially similar to previous quarters, we continue to add new customers, while also benefiting from existing customers expanding their tableau fleets.
To new sites across their networks, new order placements on the acute side continued to be driven by health systems, recognizing tablets economic value and ease of use in addition to their interest in in sourcing their inpatient dialysis program to take back control over patient quality compliance and costs, which is and.
And never been more important than in today's environment.
Earlier this year, we communicated a goal to secure sales agreements with 7 of the 8 largest national health systems by the end of this year.
I'm pleased to report we met this objective earlier than promised and the second quarter. We also made meaningful progress toward our other stated goal for year, and which is the sign agreements with a third of the top 100 regional health systems.
Last year of getting everything right first to ensure and exceptional patient and caregiver experience and the home before and more rapidly scaling I'm very pleased to report that our efforts against this goal remain on track and measure our progress we closely monitor leading indicators of patient experience that down the road may yield measures.
And clinical economic and measurable clinical and economic benefit for example, we look at treatment adherence how often are patients completing their prescribed number of treatments per week, and thus far the adherence rate for patients prescribed 3 times a week treatment on tableau at home is 99%, which is important because the published literature demonstrates.
And when patients net prescribed treatment their hospitalization risk is higher.
Additionally, we continue to monitor patient training times and retention rates, both of which continue to trend and an overwhelmingly positive direction relative to historical industry standards.
In addition to driving 100 per 115% year over year growth. This past quarter. We also strengthened our team and some important areas, most notably data analytics and machine learning and the only hemodialysis system on the market with FDA clearance for 2 way wireless data transmission tableau is a powerful data engine.
Both before during and after treatment and the hospital and the home and everywhere in between the systems and patient treatment data seamlessly to electronic medical record systems as well as to tableau hub, our proprietary cloud based provider portal that aggregates both treatment information.
And uniquely all tableau sleep maintenance information, which enables real time compliance friendly automated recordkeeping for customers at.
At the same time tableau captures more than 500000 machine performance data points. During every treatment, which is then used to fuel data analytics and machine learning algorithms that drive our R&D pipeline and they tableau smarter over time through wireless software updates.
Well. These features are already and industry, leading and we are just getting started and to power. Our vision, we welcomed J O Racine, who prior to outset headed engineering and science for Amazon Web services Health AI J O brings an incredible knowledge of the development of high scale and high availability services for the storage of health.
Data, which will be critical to the innovation, we intend to pursue to further empower patients and health care providers his background and designing scalable and performing cloud architectures for at home health and consumer products, such as Amazon Halo and fire TV and and using machine learning for retrieving health insights from data.
<unk> will be invaluable to our ambitious plans for the future.
As I reflect on the first half of the year 1 of the other areas of notable strength for outset, whether policy and advocacy efforts with dedicated government Affairs leadership in Washington, We continue to make important investments to advance progressive patient centric policies.
1 example, this past quarter. It was the launch of the innovate kidney care campaign, alongside several partners, including the American Society of Nephrology, the National Kidney Foundation C. D. S anthem and others. This campaign is specifically focused on expanding access to home dialysis and <unk>.
And to collaborate with CMS on guidance updates and clarifications to the conditions for coverage that will enable a greater flexibility and convenience and care setting choice for patients.
We believe initiatives like this will help bring much needed change to the dialysis industry 1 of the largest most expensive and lease changed sectors of health care and ways that improve outcomes and lower costs.
As we have discussed on past calls there are a number of new tailwind serving to encourage more home dialysis use for the first time and well over a decade.
For example, ESR D patients now can enroll in Medicare advantage, which is changing the payment dynamics for commercial payers and ways, we believe benefit home dialysis grubbs.
The E T C model S or D treatment choices is underway with aggressive home dialysis targets in place for providers to meet in order to benefit from higher per treatment payment rates or to avoid penalties. Additionally, the recently released proposed rule added a new incremental payment mechanism to benefit providers.
And that increase their home dialysis rates among disadvantaged patients.
And other potential tailwind we've discussed in the past is such a pony program, which stands for the transitional add on payment adjustment for new and innovative equipment and supplies.
CMS designed it to incent providers to adopt innovative renal technologies, we submitted it to ponies application to CMS for the Tableau Council and the first quarter and the proposed rule CMS asked us to provide additional information on a few follow up questions and invited key stakeholders, such as patients and physicians to <unk>.
Comment on whether they viewed giving patients more flexibility and care settings, such as home as a substantial clinical improvement and whether tableau itself constituted a substantial clinical improvement following the public comment period, we would expect CMS to publish its decision on our application as part of the final rule some.
Time, and the fourth quarter of this year.
As a reminder, we have not incorporated chipotle into our home and forecasting nor is our expected growth trajectory at all rely up on it.
And it's the final outcome is not favorable for us. This year, we will have the ability to consider reapplying next year with the benefit of greater insight into this new CNS program.
We also established ambitious workplace school by promoting and all inclusive organization, where respect collaboration and merit based recognition are deeply embedded we have achieved and industry, leading employee retention rates and 92% higher than comparable employers and the area.
Additionally, we've invested heavily and employee well being and our new site. For example through collaboration with local government, we were able to achieve a COVID-19 vaccination rates of over 90% of the onsite workforce at the end of June.
In summary, we are really proud of our performance and the second quarter also continues to deliver strong revenue growth and substantial progress and achieving our top strategic initiatives for 2020, 1 relative to expansion within the acute setting foundation building for expansion and the home setting and manufacturing.
Cassidy and cost reduction initiatives designed to enable sustainable and profitable.
Growth with.
With an exceptional team transformative technology and the necessary capital to deliver on our commercial and innovation focused objective, we are more confident than ever and our near term and long term outlook.
With that I'll now turn the call over to you to be able to review our financials and provide more granularity on our expectations and key drivers for the remainder of 'twenty 'twenty 1.
Thanks, Leslie Blue and everyone I've been at ups and for a little over a year now and I am more excited than ever on our mission.
And our market opportunity and our team.
And I'm thrilled to be here and partner with Leslie and her entire team and my new role at this pivotal time and our company's evolution on them.
Moving forward toward digital and E.
No, especially mentioned second quarter revenues grew 116% year over year to $25.2 million driven primarily by increased Huntsville shipments from the 2 customers are you can see.
And with shipments our future interest lease agreements and increased services I believe and solstice.
<unk> revenues were 115% year over year to $26 million.
Console revenues on 106% year over year to $16.9 million.
Driven by higher console placements and increase DSP and can be availability of capital.
Consumable revenue was $3.8 million and increase of 150% versus prior year as higher volume and skewed it to them fully installed base was partially offset by the impact from a large customer would be down with the book income.
Totally levels holding a large to on board.
Service and other revenue was 124% year over year, and $6 million compared to $2 million and argued.
Services for a larger installed base.
This HHS to be service revenues contributed to the year over year zone.
As we have previously shared service and other revenue was down slightly on this and she'll basis strong renewals and service contracts from new consultations.
<unk> expenses X, 3 of which and or future gestures.
Moving to gross margin and operating expenses I will highlight our non-GAAP results I encourage you to review the reconciliation of GAAP to non-GAAP measures, which can be found in today's release.
Our non-GAAP gross margin was.
And improvements of approximately 45%.
This is.
This improvement was primarily the result from our cost reduction activities, which are meaningfully lower and comfortable.
Consumable costs, while enabling decreased consoles.
As Wes mentioned, we are now manufacturing all of our financials moving forward our facility and that's.
Non-GAAP operating expenses and the second quarter was $7.1 million up $7.6 million versus the prior year period.
Driven primarily by head count growth and all sorts of investments and our commercial organization and G&A expenses tied to operating income.
Compared to the prior quarter non-GAAP operating expenses increased $2.9 million.
And on investments and added head count.
And for being a public company our energy project.
We reported second quarter GAAP net loss of 30 from $2 million, resulting in a net loss of <unk> 66 cents per share compared to a net loss of $26.5 million or $4.68 per share from the prior year.
Non-GAAP net loss was $26.3 million 67 per share compared to a non-GAAP net loss of $25.8 million or $4 and 46.
<unk> per share the same period from 2020.
We ended the quarter with approximately $430 million of cash cash equivalents restricted cash and investments.
I'd like to move now for 2020, 1 outlook, we project revenue for the full year 2021 to range from $97 million to $100 million, which represents approximately 94% to 100% growth over fiscal year, 2020 right.
This compares to prior revenue guidance of 92 million from $97 million.
Our full year guidance contemplates our expectations for back half growth to be concentrated and of course.
Moving to gross margin you know projected sequential improvements in the second half of the year exiting 2021, and what really gross margin from the low double digits gross margin expansion is being driven primarily by our cost down activities and lower cost of manufacturing <unk>.
Additionally, we continue to forecast sequential increases and operating expense and planned investments to drive long term revenue flow.
In closing we are very pleased with our financial results.
We remain confident and our ability to execute against our goals of growing our installed base driving top line revenue growth and expanding margin.
Look forward to providing an update on our Q3 progress during our next earnings call.
We will now move to the Q&A session. Operator, please open the lines.
And as a reminder to ask a question and you will need to press star 1 on your telephone Covid draw. Your question press the pound key please standby, while we compile the Q&A roster.
Your first question comes from the line of Rick Wise from Stifel. Your line is open.
Hi, good afternoon and congratulations.
And on a.
Modest quarter, and congratulations to you and maybe on.
Maybe let's start on.
Day throughout 2021, and beyond and we expect cancel bookings on on the home side to continue to grow sequentially quarter over quarter. So I think all that is good news.
Uhm I still I guess, reflecting on.
All of my experience across my medical device career, and launching new technologies I still believe what matters, most et cetera and.
Early stage of rollout and especially with the technology that is so fundamentally disruptive really is doing it right at the beginning so let me talk more about what does that mean.
That means operationally are we delivering a great experience on distribution and logistics our patients receiving the supplies they need on time every time.
At the console, arriving and their home and being installed every time on time at the time, it's been requested those details seem mundane, but I think we can all relate as consumers and there's there's a big value to promises made promises kept and we want to be a promises made promises kept company to all of our customers providers patients and families and.
Like so Rick that's 1 way that we're measuring herself operationally.
And some of the other leading indicators that I talked about let's talk about training time, and how that would set us up for success for for growth next year, which is really the question you're asking.
If we know that patients across the spectrum, regardless of age regardless of education, regardless of other differences on.
Are consistently learning tableau, let's and 10 days or less compared to existing systems, where they previously had to spend 4 to 6 weeks well if we keep those training rates consistently low that gives me a lot of confidence that we can look out and projects pretty exciting patient adoption and growth rates and the out.
Years, and so that's why we got our eye on training time and are trends and Q2 on training time, we're no different and integrate way, we're still seeing training time that our 10 full days or fewer.
Think that the retention rate is another big 1 as it informs our vision of the future. If we know that we are succeeding and allowing patients to stay at home for longer and we.
We know that we can incrementally achieved those high growth rates and the out years, because your fallout rate's will be lower right and the last thing you want is so the proverbial leaky bucket, where you got patient and flow, but then you've got a lot of patient outflow that is not our model.
Our model is high patient and flow and very high retention and the home and again the trend and in second quarter was no different than what we've seen and reported on and quarters tasks patients are differentiated Lee if that's the word.
<unk> on on tableau at home for longer compared to what's been reported in the past with other devices. So that's a little bit more color about how I'm thinking about it wreck at least.
Thanks from and.
And.
And your Bill, let's pick on you a little bit.
[noise] 2 aspect from your.
Gardner.
<unk>.
Give us a little more car your comment.
Grilled.
Cause we think we're from checking that Burger me back have concentrated are you and me from my understanding.
<unk> and I mean, obviously, we have and my step up here 2.2 verses 1 too.
Are we thinking or are you sort of implying and maybe I'm. Just told me and this was reading and the the third quarter is more.
For some reason sequentially for average with the second quarter and.
Whatever wearable point and.
<unk> <unk> <unk> <unk>.
Could potentially from a very large fourthquarter, how should I understand your comment.
Yeah, absolutely and so the comments was an hour back have grilled will be concentrated more and 2.4 and so you know let me just read it back up a little bit you know when we do our guidance. It's informed by backlog, we have come and you to the corner and and the pipeline that we have as we sit here today and moving forward.
From the back half of the year and our pipelining, our backlog Ah really informed by when our customers need us to deploy on consoles right and to the advantage to having this backlog and this pipelines and we have great visibility and the back half and it also tells us that we will see sort of moderate and sequence.
She will grow 2 and 2.3 but really that the bulk of the back half growth will come into force.
And so you're basically saying just read the orders and hands and the shipping day, that's just the way it's going to break up with you on.
And what is that and.
<unk> Yeah go ahead and look like.
Yeah, it's exactly that with orders that we haven't had and remember our backlog is committed orders that we have non cancel orders and then it's also on a pipeline which is you know.
Deals that we are working but we expect to close.
Gotcha and what else.
1 last if I could selfishly gross margin.
Come in and to be able to throw you expect to be on the low double digit rate is your exit of the year and clearly.
Or telling us and and multiple ways on the set up for that meaningful gross margin improvement, but back to sort of this cadence and question. So so you're not going to be at that double digit level and and the third quarter grilled <unk> hold.
Fourth quarter them get through a bold double that you're ready for how should we think about that cadence and and magnitude and direction. Thank you. So much.
Yeah, right and of course.
So we are looking for sequential improvement and gross margin here and Q3 and then you are right. It is cute for that we expect to be and the low double digits from and gross margin perspective, and again driven by our Mexico facility that is now producing 100 per cent of our consoled by our ongoing.
And costs down program, and then as Leslie mentioned by our expectations and a cartridge production and Mexico and and get some food here and the fourth.
Got it thanks again.
Thank you.
Your next question comes from the line up and it hasn't from Goldman Sachs. Your line is open.
Hey, this is so on for me and thanks, so much for taking the question I, just maybe starting with guidance going back to Rich's question I'm interested in any anecdotes would you can give over what you've seen and the last few weeks particular and and cute side.
With what's <unk>, what's going on in adults and how that's kind of and informed or physical witty cause a backlog and and your expectations for 3.2 and 4 too.
Hi, Yes. This is Leslie obviously I'm happy to answer that.
It's an interesting question and obviously a timely 1 based short answer is based on what we know we see today, we don't expect and a direct impact on our on our business and look I think the advantage. We have today is some history right. When when we look back at 2020, our business was very resilient and that's <unk>.
Probably for at least 2 reasons I think 1 as a reminder, we operate and serve a therapeutic space that requires patients to receive this treatment at least 3 times a week reign.
For me I, I really assign a tremendous amount of value to existing customers. We do talk about our commercial strategy is land and expand right and and I think for any medical device company eventually run out of land.
And so my philosophy has always been commercially that you you should really focus on doing an exceptional job at the expand part as early as you can and so what I liked about Q2 I like for the whole first half of 'twenty 1.
And with I think that we were showing that expand is working as well not only happens if you're creating a consistently good experience for customers and and patients again, along the lines of promises made promises kept so that was that was 1 interesting aspect of the quarter was very balanced blend of new customers and expansion within existing customers who decided.
And to deploy tableau to new hospitals within their networks and I.
Thank.
The other interesting part for me of course was the significant increase and home console bookings and that continues to give us confidence that home demand will continue to grow core tableau and lastly of course, we were very very pleased to see about 7 of the H Nash.
National Health systems, now, having signed agreements with with tableau again, a quarter or 2 earlier than we had communicated. So this is the thing that really stuck out to me in terms of customer mix and and contracts signed and if that's helpful.
And so much fun from Portuguese.
Next question comes from the line of Duke and Yang from Morgan Stanley. Your line is open.
Hi, Leslie and Doug Congrats from your.
Thanks for taking the questions just to go back on gross margins for a second.
Just hearing more and more of a tech companies talk about inflationary costs and free being a burden I. Appreciate that you gave guidance talking about sequential increases and.
Low double digits by the fourth quarter, which is can you give us a better sense for your confidence and gross margin expansion for the back half.
And if you've kind of look at the upper end of your revenue range should we be thinking that would be the higher end of low double digits for for gross margin just trying to get a better sense there.
And also if you are if you are seeing any supply constraints or semiconductor shortages as your.
And building up your installed base here.
Yeah happy to.
So with respect to our gross margin and sort of guidance here and the sequential increase and I alluded to we have a high degree of confidence in and that trajectory and it's really for the reasons I mentioned with Rick It's really the fact that now our plant in Mexico is up and running and obviously as we build more.
On shoulders, and get better absorptions and amount of that facility, we will see improvements and margin, it's our cost down strategy and our supply chain team is pursuing and then finally, it's the treatment. So we have a high level of confidence.
Now with respect to your supply chain question.
We.
We are definitely on top of and not immune just sort of what you're seeing and the market in terms of supply chain challenges and now we have a great supply chain team, who is laser focused on this issue and we have not seen disruptions and our supply chain at all and sort of our strategy and here to mitigate have been placing per.
It just orders from suppliers for long lead time items, making sure we have committed supply.
Making sure that we have inventory of raw materials components, particularly long lead time items and then it's also making sure that on our balance sheet and we're carrying finished tableau you know, having a buffer stock and finished by blows with which we can sort of service and near term demand. If there is you know if something happens but to be clear.
High confidence and our ability to deliver these double digit gross margins in Q4, low double digit gross margins in Q4 and sort of just a rocking supply chain team, that's keeping us in good shape.
And I just wanted to follow up there.
And with the cartridge approval expected in the fourth quarter.
That actually contemplated and you're sick.
Sequential increase commentary for gross margins.
It is but remember that the real benefit from their cartridge cost down and we'll be in 2022, so there's a little bit of benefit here in <unk>, but honestly the real benefit is going to be and 22 for us.
Okay and.
Leslie and maybe this one's for you, but with E. T C for a moment can you just maybe talk about the.
If you are seeing kind of that being a direct impact as youre approaching customers and building out the market.
Is it still very early days are you seeing an impact is more yet to come just any help there would be appreciated. Thank you.
Yeah sure.
I would say with respect to the E. T C that it is and in our experience right, which is all we can comment on I think it is very much top of mind for our for all of the providers that we work with and talk to them I would characterize it very broadly and still in the preparatory.
And planning phases, I still think and I think I've probably communicate in the past that we're really excited about the T. C. We project that having a bigger impact on home dialysis market expansion per.
Probably more like 2023, 4 or 5 then we would expect it and certainly not in 'twenty, 1 or even in 'twenty, 2 because I think and and in all fairness providers need time to understand how they want to increase their home dialysis numbers, what programs, what new technologies and.
I want to start using them to try to reach these targets and benefit from them from the advantages and ETP.
And I continue to be very very optimistic that the a T. C will have an impact and I would just guess that its impact will be probably as I said and more and that and the 'twenty 3 and beyond period, rather than nearer term.
Great. Thanks for taking the questions.
Yes.
Your next question comes from the line of Daniel and Delphi from SBB Leerink. Your line is open.
Hey, good afternoon, everyone. Thanks for taking the question maybe I'll congrats on on the CFO position and Leslie I have a question for you. We've done a lot of work on the renal space and specifically the potential per home dialysis adoption within that home hemo adoption.
Over the last 6 weeks and the feedback we're getting is is incredibly positive I've been following this space for a long time and.
And it really does feel like the barriers have fallen from a technology perspective regulatory perspective, and I guess my question for you is.
Why arent, we today and and adoption inflection already because based on the data points I got it felt like we were and I guess, if we or is it really just you you outset sort of the you guys. What are the gating factor as far as what you are willing to or can supply the market are you pacing.
And the inflection or am I missing something thank so much.
Yeah, no. Thanks for sharing that feedback on from from your own research.
And look I have a couple of thoughts I guess I I think that where we're not at the inflection point, yet however, I would say that if you look at the income and device and and the incumbent services provider, who owns that day by a few they've reported I would say frankly amazing growth and the home dialysis market with.
And their own network of dialysis centers, I think they're doing a terrific job already and expanding the utilization of up on dialysis within their own facilities. So I think it's starting to happen on what we're seeing is on.
The rest of the providers and.
Really starting to.
Activate and and set goals and targets and objectives about where they want to be with them over the next couple of years and.
And that alone is major progress Danielle I got to tell you and you know just to even hear a provider and say hey, we want you know 30.35 per cent, 40% of our patients at home over the next 3.4 and 5 years, that's a big deal now that being said everybody wants to do it well everybody wants to do a good job and it's hardly going to help just to start to kind of.
Push and many patient patients home and you can as quickly as you can and not really have it stack and so I wouldn't we're obsessed with the stickiness of it and stick and it comes from the experience that you have both with the provider and the technology and and so and my view is I think providers are and are ready for it and.
And and probably taking some really smart steps more on the how we've moved away from the weather and the F. I think we're past that I think it's all about house, which is really exciting. So I think we're just coming up on on the inflection point.
Okay. That's helpful. And then just as a follow up to that then as we think about embarking upon this adoption inflection where are the key sticking point, though to that how sort of what what still needs to be done to get the market ready to absorb or be able to.
Absorbed this adoption inflection for home and the infrastructure is at a.
You know awareness like what what needs to happen still for the how to to be answered. Thanks. So much.
Sure absolutely 2 things come to mind, right and kind of off the top my head I would say 1 is training them and I think that we're going to see a lot of invention and training and both through technologies like tableau simply because they are.
Easier to learn right, there's just fewer steps with tableau theres nothing to memorize, there's no mental math on the instructions are always there on the screen for the patient every time.
And so on and so 1 of our big Big design objectives with tableau was to to get to get tableau down to sort of a P. D. Like training experience and wish everybody. I think you know sort of hold physical standard for short patient training time, and and we've achieved that I think that and there's more we can do that to probably make training even.
More convenient for the patient and maybe changing a little bit of the setting of the training model.
And that I think will further accelerate and the patient and frankly, the patient backlog of people, who do want to go home. So I think trainings and area that you'll see you'll continue to see providers and out that innovate on to loosen up that are that pipeline and the second thing that comes to mind is is physician education, and that's probably no different than any other area.
Medical devices right when you got something new whether it's a new device or a new way to treat patients that takes time, we haven't had and in this country, a tremendous history and deep physician education on home modalities, but again you have now I think our whole community of providers and health systems that have.
A lot of motivation to educate the physicians that they work with about home and and better outcomes and lower costs. So I think that the faster we can get out there and at the community and educate physicians and find you know continually newer faster better ways to train patients I think that's going to make a big difference.
Thanks for that.
Your next question comes from the line of had been seeing from Wells Fargo and your line is open.
Thank you so much for taking the questions I have a 3 part question and I'll just ask it upfront first as a clarification I just wanted to make sure you said a modest sequential growth in Q3 with respect to sales that would probably put you at the upper end of guidance.
The second 1 is just with respect to the home setting you know can you help us understand you know how far do you have visibility into these orders and how are you thinking about the competitive response and then just lastly, you know you talked about data science and AI on the call could you just elaborate on some of your specific on.
R&D initiatives and any timelines there. Thank you for taking the questions.
Sure, let's seem to be able do you want to handle the first 1 on sequential growth, yes, yes, and yes, I did say, it's modest sequential growth here and the third quarter and more sequential growth here and the fourth quarter, and that's precipitated where group and rather by the backlog and we haven't and.
And good quarter, and and the pipeline that we've gone and sort of as we look forward here.
Okay, Great and then okay.
So maybe I'll take the last 2 well it was kind of 2 and 2 a what your your 2 was about how much visibility do we have into the forward home pipeline.
And I would say quite a bit.
And we talk and that's not differentiated by the way from the acute setting I think we've always talked about and.
On our backlog are generally giving US you know, let's say.
1 to 3 quarters and visibility and I don't think that that's going to be any different so far as we can tell today I don't think that that's going to be any different from home I think we're gonna be similarly advantage and having a lot of visibility.
And on what what home is going to look like over the net debt over the coming couple of quarters.
So and so I think that's all very positive and you know underscored by a significant increase and you know the 90 per cent increase and facts compound bookings for this for this past quarter compared to the prior quarter.
On data science, and and AI, Yeah, and I'm happy to give you a couple of examples there is theres a lot and and this could be like a whole hour long conversation, but.
For example, big buckets, I mean, 1 big bucket for us is operational.
We now have the tableau has the unique capability, we are the only system and the market should be able to do remote patient monitoring.
That feature is enabled in the acute setting which became incredibly important during some of the height of COVID-19, so that our nurses and physicians could monitor and multiple patients with COVID-19 on tableau and multiple rooms at the same time without having to go in and out and consume T. B E.
We have the ability to enable remote monitoring for patients and the home, which I think has both the clinician and at a very unique and differentiated consumer benefit I think we probably all can relate to that and why that would be important.
On the AI and the data analytics and also now allow us to do remote diagnostics and provide remote support sort of teleporting into tableau, if you will and being able to to have much more rapid response, and giving people almost real time health, but in a way that is operationally efficient and productive for outset.
That's kind of 1 big bucket operational and I think to the big bucket here would be consumer and clinical as we look to kind of keep who do we want to be and and what sort of value do we want to deliver on the home I think our you know our data and the future probably will not be limited just to the treatment flow sheet that it is today, it's very value.
But to get blood pressure and arterial pressures and Venus pressures and all the wealth of information that we provide today on each and every treatment, but when you think about whole person care and the home I I think we can all imagine a very robust and much more comprehensive dataset.
Dataset that would allow payers and health systems providers to monitor the wellness of their patients and a much more.
Robots way. So we're looking at a bunch of a bunch of ideas and that way and and generally you know how do you make dialysis prescription and management on more personalized and more customized to the individual today dialysis prescription is more of a 1 size fits all and and we'd like to move to a 1 size fits 1 model and the future.
And that's really helpful color and just with respect to the home setting how are you thinking about the competitive response. Thank you.
Yes, I'm, sorry, I forgot about that 1 well I think first and foremost lip and $11 billion Tam you, you've got and expect some new entrants and I'd be surprised if if we didn't see anybody else show up I, you know and second thing I'd say is with such a large tam.
And we certainly talked about this before I mean, it could vary very easily support many many different technologies.
And particularly excuse me given the early innings on on home I mean at this point it still to me like the more voices and the better.
The the more Ito companies industries organizations physician and patient and all kind of unified around better choice more choice and.
And flexibility that the better all that being said of course from a technology perspective, we remain really confident and we are the only and we believe into the future. We will be the only enterprise solution and there can be used anywhere from the hospital to the home and.
I have great confidence and our current feature sets, which is and its differentiated today and and I think too you know our mindset is just not 1 and standing still.
Ambitious and we're impatient and we are not done.
I got it thank you so much.
This concludes today's Q&A price and if they call I will now turn the call back over the last day trip for the closing remarks.
Thank you so much thanks for the operator and and thanks to all of you for joining US today I really hope everybody has a great evening. Thanks again.
This concludes today's conference call. Thank you all for your participation you may now disconnect.
[music].
Yes.
[music].
[music].
[music].
[music].