Intron Health - Investment Memo

Intron is Africa's first speech-powered electronic medical record (EMR).

Using clinical speech-to-text developed for 240+ African accents, we eliminate a massive barrier to EMR adoption, helping overworked clinicians overcome the fear and productivity drop when moving from pen to keyboard. Doctors can now complete documentation 6x faster using speech creating more time for patient care. Our customers are large and small hospitals across Africa where digitization efforts have failed previously or current efforts are challenging.

Transitioning Hospitals from paper to electronic systems

Intron was built to make paper records history, eliminating the frustration with lost or soiled records, manual result retrieval, and painful research. Intron helps large public hospitals transition from paper to electronic systems unlocking decades of invaluable data.

Intron aims to have 200 private and public hospital active across Nigeria, Ghana, Kenya, South Africa by end 2024, with the aim to be active in 350 hospitals by 2025. Hospitals are charged on a per-patient or per user basis.

ClinicMaster: Uganda's largest EMR provider with 200+ sites

Health-in-a-Box: Nigeria's largest EMR by provider by patient and provider volume. 48 of Nigeria's largest federal public hospitals

Netcare: South Africa's largest private hospital network, 50+ sites with 10k beds.

Intron’s platform accelerates clinician adoption across the developing world by replacing the keyboard with voice input (Speech-to-text), and provide reliable and affordable tech infrastructure (EMR). Engagement with hospitals is provide the following services:

1. EMR system: to replace current bulky systems with a paperless medical record system that caters for a range of daily activities that clinicians need
2. EMR + Hardware: for rural/remote hospitals with sub-standard power supply, Intron provides affordable tech and power infrastructure to ensure constant up-time
3. Speech-to-text: save clinicians up to 45-50% of work-day by switch from keyboard to voice
4. Payments: enable patients to pay hospital bills online

Overworked and inefficient clinicians

Largely paper-based healthcare in Africa

• It is one of the top obstacles to healthcare digitization at scale in Africa.
• Typing long notes contributes to burnout and longer wait-times
• 43% to 58%* of work-day is spent on documentation (*link)
• The average clinician in a very busy African public hospital experiences a 3-5x productivity drop when switching from pen to keyboard
• Clinicians seeing 30+ patients per day CANNOT afford the extra time to type long notes even when software and infrastructure are available.

• Over 95% of hospitals in Africa still use paper, Clinical transcription does not exist for Africa
• EMR penetration is <1%. Leads to inefficiency and higher hospital costs
• The most frequently reported major factors that limit EMR adoption are High initial/ongoing maintenance costs, poor electricity supply and lack of internet connectivity.

Speech module

Electronic Medical Records platform

1. Clinician Average Typing Speed was 20.1 words per minute (wpm), about half the average US adult typing speed (40 wpm) BUT the Average Speech Speed was 88.8 wpm.
2. 493 users from 13 countries (Repeat usage mostly comes from Nigeria, Kenya, Ghana & South Africa - where we have hospital engagements)
3. 0.81 hours of speech recording per day
4. 20.5 hours of transcripts have been recorded
5. 90% average accuracy per speech user

1. most used functionality -  Add patient, Add vitals, Add clerking, Add drugs
2. Average hospital client does average of 32 orders per user per month
3. 10% overhead reduction from printing paper files, forms, and folders
4. Save 2 hrs per day per clinician using 1-click rapid orders for lab tests, prescriptions, procedures, and radiology requests. No more form filling
5. Recover 10%+ revenue with Patient debt tracking & other accounting / reporting features
6. Block revenue leaks through real-time tracking labs, pharmacy, radiology, and procedures (20% revenue boost)

1. Reach break-even (38 hospitals) in 2023
2. Reach $1m Annual Recurring Revenue milestone in time for Series A: 50 large hospitals, 150 small-mid sized hospitals
3. First 10 international sites (Ghana, Kenya, South Africa)
4. Multi-GPU cloud instances for speech recognition model training & inference
5. Payroll for Engineers, Research, PMs, Support, Sales

Intron Health offers hospitals access to its products/platform on a SaaS model. There are 3 main products (see products ) and a charges based on usage (either patient or clinicians).

Revenue model

1. EMR: $0.50/patient/mo prepaid credits, hospital pays us and recoups from patients each month
2. EMR+Hardware: $500/$1000 one-time hardware consultation fee
3. Speech to text: $10/clinician/mo prepaid subscription

Average ARR per hospital type

1. M1 (small): 250 patients/mo = $750/yr
2. M2 (medium) 750 patients/mo = $4,500/yr
3. M3 (large) - 12,500 patients/mo = $750,000/yr

Intron is focussing on the public and private health care centres (approximately 100k) in Africa and has been engaging with the hospitals’ pain-points since 2017.

After 100+ hours of interviews with hospital representatives, the main barriers to technology adoptions are:

1. Prohibitive cost worsened by contract Inflation by middlemen
2. Ill-informed procurement choices undercut quality
3. Poor maintenance culture
4. Incompatible components
5. Complicated Retrofitted software
6. Sharp drop in productivity when clinicians need to type long notes. Longer queues.
7. Frequent power outages

🎯 Go-to-market plan

Commercialisation plan: 2025 goal > 500+ hospitals active

The next 18 months will be dedicated to ramping up the sales team and activities in order to have 200 active hospitals by the end of 2024 and 350 at the end of 2025

Sales channels:

1. Direct sales (B2B)
2. Clinician Referral Program: 1700 clinicians active
3. Target Hospital Network: sister/group hospitals referred
4. Channel partners: existing EMR platforms integrating the speech module

🖥 Doctoora

🖥 Helium health

🖥 AWS

🖥 Accuro

🖥 SpeechLive

🖥 nVoq SayIt

🖥 Nuance

🖥 iMedDoc