BoneChat #80 - VisionOR and other AI applications in Healthcare, with Andy Reid with Mission 3A.

So this is Bone Chat discussion number 80 with Andy Reid. He's the managing partner at Mission 3A, and some of you may know him from his leadership positions at Wright Medical and, and Inovus. Uh, Mission 3 is a venture studio. It helps creates, you know, and scales small companies with first mobile-first apps and like SaaS plays in healthcare. So anyway, that's— and I'm handing it over to Andy.

Yeah, thank you, Tiger. And, um, just going to put this up real quick. And so what I thought I'd do is kind of, uh, walk you all through just a few things that we're doing at Mission 3A, um, and You know, this is supposed to be— obviously I'd like you guys to interrupt, ask questions. So I want to tell you a little bit about what a venture studio is within venture capital. And then I want to tell you what I'm doing within the VC space as far as our health tech AI portfolio. And then I'll talk a little bit if we have time on VisionOR. Which is one of our focus companies that we've invested in. And I think you guys will like that where there's a lot of AI focus inside the operating room. So I'll just get right to it. And this is basically what I'm going to present to you is like an investor presentation. And this is how I present to investors. So a little bit about Mission 3A. We're launching a $10 million seed fund to back health tech AI companies. And that's led by our GP's track record of a 25x return on our past 7 related investments. So a 25x multiple on your money is pretty absurd. So when people see that, it gets them really intrigued. And I'll explain how we got to that 25x multiple. So a little bit about the team. I'll start with myself. You know, I don't know how many I've met of you, but, you know, give you a little bit of background. I started in pharmaceuticals right out of school, um, worked my way up, increasing responsibilities every year. And, um, and about 7 years ago, got into the orthopedic space and worked at Wright Medical. I was their vice president of sales, and we got bought out by Stryker, which I'm sure many of you are familiar with. Um, so I stayed there for a little bit and then followed actually Kevin Cordell, who was our chief operating officer over to Innovus and built out their capital equipment division for 2 years. And, and then I got this tremendous opportunity from a friend of mine that I've known for about 10 years now. His name is Matt Hostetler. So Matt's background is he worked at Citadel. He was a quarterback at Brown. So if you know the Hostetler last name, he is related. That's his uncle. He went on to Harvard Business School and then worked at Citadel, worked at JAT, which is one of the Tiger Cub portfolios and was extremely, extremely successful, made a ton of money. And when he was at church, he met Trey Moore. And this was down in Texas about 5 years ago. And Trey is a serial entrepreneur. He's most famous for probably founding Airstrip, which I'll talk a little bit more. I was a Sequoia-backed company and he founded Mission 3A and, and he's my partner for the health tech fund specifically. So, you know, what's the value of the two of us leading this portfolio? So Trey's obviously got the entrepreneurial background, the tech development, which I'll talk more about. And then I've got the industry ties and the commercial experience, and that's what we're trying to marry together and really see us as a differentiator. So here's where we, we kind of really attract people's attention is our, our track record. So Trey, back in 2009, um, he was asked by Steve Jobs to be the guest speaker at the Worldwide Developer Conference for Apple. Um, actually, the most recent one just happened on Monday. So if you're a tech guru or anything like that, you know, they just came out with theirs on Monday, and it's a really, really big event. And it was mainly for developers. It became a little bit more of a hardware program in the last several years, but it's really a software and development program for the developers. So it was a tremendous honor for Trey to present there. And he basically had developed on your iPhone what measures all of your vitals, right? And that was called AirStrip. And then he went on in 2015, Tim Cook asked him to be the guest speaker and he had taken Airstrip and ported it to the Apple Watch and it became the very first FDA-approved mobile app. So, so that's just one. And by the way, that same software is in every hospital across the United States, really globally. And, you know, that was— he sold it off to Sequoia and they just got a tremendous return on that. That's just one. I think Trey's had 35 exits, so What I found from leaving corporate America and coming into this world is it's the same developers and the same entrepreneurs that are doing a lot of these things. You know, I'm in a program right now. It's called VC Labs, and I work with a gentleman by the name of Adeo Ressi. And Adeo was Elon Musk's roommate. And it really has taught me a ton about VC, how to run a portfolio and what it takes to be, to be successful, right? And why I bring his name up is not only because it's a tremendous program, but also because you'll see it's a really, really small world when you get into that development world and into that tech world. So, so from there, we've got Trey's background where he developed Airstrip. I'll just give you a couple other companies that you may know. So another one is called Splice. So Splice is a video editing app and it does over $1 billion in revenue every year now. And he sold that on to GoPro. So just another example. So track record, right? Like if you're investing your money with us, what's the expectation and what, what do you want to see? So if you had a traditional startup, right, if one of you started and said, hey, I want to start my own company, on average, right, you get a multiple of 2x on your money. You target anywhere from 3 to 5. If you were in a Venture Studio model, which I'll talk more about, you're most likely to get a 6x on your money. But based on our, you know, prior 7, you know, we expect a 25x on that. But I want to focus on, on one other piece here. So if the beauty of the Venture Studio is it's a fund of pre-seed and seed investments. So normally, let's say you had $100,000 and you thought that there was a great company that you wanted to invest in and it was AI. Let's just say it was an AI company. You said, I really think it's gonna be great. So I start that company and you give me $100,000 and you said, you know, let's make this happen. Well, what happens if 6 months from now I realize that I'm either too late to the game or it's just not going to work, right? I'm not going to most likely say, hey, I want to give you $100,000 back, right? I'm going to— I'm going to say, oh, I've got to figure this out. I've got to figure out a way to make it work. Well, the beauty of the studio is if we go down a pathway where we start to see something's not working, we can just allocate those funds to a different company or move it in a different direction. So you have— you're de-risking yourself by putting multiple companies in that portfolio where you can add drop at any point in time. I hope that, that helps a little bit. But, but that's the beauty of a studio. Um, so, and I, and I look at it like a, um, like a mutual fund, right? A little bit in, in the investment world. Um, so again, we'll, we'll just skip over this because the track record, but again, right now for this fund, you would expect a target return of 10x just based on that historical track record. Um, we're backed by the venture studio Mission 3A. So when we started this 3 years ago, we set out to raise $15 million fund, and we wound up raising $40 million. And, um, was very humbling. But that, that is a very, very difficult thing to do, is raise money. And happy to answer any questions about that. But, um, I basically have found out that once you get into VC, you You're raising money every single day. It's— you're selling yourself, you're selling the companies you're working for, and you're gonna need capital basically to be successful because every step along the way you're gonna need more money to kind of grow those companies. You'll see some pretty famous people here that have invested with us and that work with us, you know, especially in the finance world. But we also have another arm, that sports arm. That work with Matt. And because of his relationships with Jeff, we have a lot of athletes, Shaquille O'Neal, Kenny Smith, and those types of people that are involved in Fund 1. So the beauty of— for, for myself, when I started this fund with Trey, is since we're backed by Mission 3A, which is the $40 million fund, I was able to tease out the best companies within that portfolio in healthcare and give my investors a preferred, um, a preferred stake within that, those companies, right? So if I took, let's just take these companies here, right, and we pulled those out and I said these are the ones that I want to bring into my fund. So Vision OR is one and Good OB is one. Well, if I knew that the value today is $10 million but Mission 3A did their first round at $5 million. Normally we would be saying, okay, the only way you can get into this company is at a $10 million valuation. But since we had did the investment, we're able to get allocate shares at that $5 million price. So why do I say that? Well, if you give me $100,000 and you put it into our fund and you're hoping that we're growing these companies, we're already bringing you in from what you thought was a $5 million company to a $10 million company right out of the gates. If that— did everyone kind of follow that a little bit? So that's how we warehouse deals. That's how we kind of make it attractive to the investors to say, look, we've got 5 or 6 companies already, which I'll go to the next slide, that we have preferred terms on, um, because we already know that either they're further along, um, in their value or we believe that they are, um, they've got a beautiful cap table, nice and clean, that we can take, um, and execute really, really big on. And I say that word, execute, and it's, it's another big learning that I've had is everyone has a great idea, but it's all about the execution, right? So, um, ideas come across my desk all day long, and I'm really looking at who can execute when I'm trying to decide if I want to invest in a company or a founder. So that's the key, is can you execute the idea? Because a lot of people talk about it, but it's very difficult to actually do. This will be more familiar with all of you. So in the first fund, right, we went, we cut, we raised that $500,000 checks. We went to high net worth individuals., you know, in town. I live in a town that's pretty wealthy. It's a big hedge fund in Greenwich, Connecticut. So that was helpful in raising for the first fund. But with the healthcare, my thought process was I wanted to get individuals that had skin in the game and that cared about healthcare and AI. So what do I mean by that? So with Venture Capital Studios, you get 99 investors. So I started this fund, let's just say March 15th, right? So from March 15th, 2025, I have one year to raise as much capital as I want for that fund. And come March 15th, 2026, the fund automatically has to close. That's an SEC rule. Or if I find— if I have 99— so I get 99 seats or 99 investors for that fund. So if by, you know, May, June, I have 99 investors, I have to shut the fund down and I can only use whatever I've raised with those 99 investors. Does that make sense as well? Any questions as I'm going through this?

Please interrupt. No, it's good.

Yeah.

The fund— most people don't have visibility to the fundraising side of—

right.

So I'm just trying to give a little background on that.

Right. You know, and I didn't—

right.

I didn't know a lot about fundraising getting into this, and they kind of just threw me in the deep water. But it's one of those things that, you know, I think it's good just to understand a little bit about it. So what did I do? I decided to be a little strategic about it. And I said, I'm going to split the fund where the first 50 seats I'm going to dedicate to people like yourselves, right? That probably can't cut a half a million dollars. And you may all— I don't mean to be disrespectful, but it's hard to cut a $500,000 check, right? So I've reduced the minimum to $100,000. And why did I do that? Well, my thought process was I have a lot of companies that are going to be in pilot phase and that I'm also going to need feedback on, and I'm going to want people that care about what we're doing and can help me. So, so that's what I did is I started off and I'm now already at $5 million. And those are all individuals that work at different companies in the industry, that work at different institutions, ambulatory surgery centers, you name it, they're involved somehow in the healthcare landscape. So, they, all of those individuals, the minimum investment was $100,000. And that means it's a 4-year investment. So, $25,000 year 1, in March or the day they invest. Year 2, March 1st, $25,000. Year 3, $25,000. And then year 4, $25,000. And it's a 10-year commitment. So that means that $100,000, you're expecting to get your return over a 10-year period. We all hope and we expect in years 3 or 4, you're going to see that money though, and then some. Some of the other things that I've done is I've put an advisory board together. With some industry leaders. Patrick Fisher, who's the president at Orthofix. Kevin Cordell, who was a CEO at a couple different companies and is now really on just boards. And then Dr. Greg Berlett, who you may be familiar with, who put in the very first total ankle replacement and was out of the Ohio State University. So incredible board. They're good friends of mine. They're extremely intelligent and they're so, great to work with just in so many different ways. So why did I pick AI? And, you know, I'm sure everyone is saying, well, that's an easy one, but just look at how big this market is and how quickly, you know, it's going to grow, right? By 2030, $187 billion. Just incredible numbers. So to kind of close out the investor part of the presentation, right? $10 million, 10 years. So what does 20% carried interest mean? So what that means is let's just say I leave it at the $10 million. I sell my first company for, um, $12 million. The first $10 million goes back to all the LPs. So all of you that invested, it goes back to those individuals and they get their money back. But then we've got $2 million extra. So what do we do with that? Well, it's an 80/20 split. So what I mean by that is 80% of that $2 million goes to the investors 20% goes back to the fund and the fund is broken up by me and Trey and by Mission 3A. So that's the 20% there. So again, just wanted to kind of give you guys a little background on how that works. So let me give you a little— let me stop there. I want to get— just get some interaction here. So that is an investor presentation, high level, right, that we usually tell people. We tell them about the companies. I didn't get into the portfolio companies just for the sake of time because I could tell you about each and every one of them. You know, we've got a robotic hand. Let me just go back real quick. I'll give you a 2-second, but—

Yeah, give us the orthocentric companies.

Yeah, so here's my current portfolio, right? So this first one, it just says AI MIT drug development. I'm not allowed to share the name. Of the company just yet, but I will tell you that I was introduced to these guys by, uh, by an investor. And I walked into the room and, uh, it was Bob Langer, who was the founder of Moderna. And they're working on a drug development, and what they do is they take existing drugs that, you know, have either black box warning or have something that is, you know, difficult for the patients and for the physicians, and they try to reduce those errors and with, with improving the process using AI to reduce the amount of time to market, right? I guess that's the best way to say it. Extremely exciting company. We were able to get in there where the fund was already closed and we got preferred terms. So again, why that's exciting for my investors, because we got in when we couldn't, when it was really difficult for due to our relationships. VisionAware, I'll come back to. GoodOB. So GoodOB is a home fetal monitoring device. It's a wearable strap that goes around the expecting mother's stomach. And what it does is it manages to monitor all of the vitals for the mother as well as for the fetus. And it sends signals to the phone, you know, on an app on your phone to let you know if there's any issues, or it can go directly to your OB-GYN and let them know that there's an issue. And it can tell you to go to the hospital, or it can tell you that you need to, you know, get something adjusted or do something along those lines. So they have something like that on the market today, but it's only in hospitals and it costs thousands of dollars. So what we're trying to do is take that and make it available to every patient.

Turn it into an app. Yeah, you've turned it into an app and made it democratized it.

Yeah.

And we're going to try to turn it into a product that'll be less than $100. BioZen, I'm gonna skip down there. That's a chip that is in phase 3 right now. And basically you put your finger and press it on the chip and it's able to tell you both your, you know, top and bottom line for your blood pressure where there's nothing else that can do that today except for the cuff. The expectation is if we get through this is that it will be in every phone, iPad, you name it moving forward. Um, we have an agreement with semi— was it Taiwan Semiconductor? Uh, so we're working with them really closely on that. Extremely exciting company as well. Um, AltBionics. So AltBionics is a really interesting company. Um, it was a prosthetic hand that was used for mostly, um, you know, veterans and, and the like that lost, you know, their hands. And they started adding all this data and AI to it. And it's a really differentiated product because most of these hands today, they look like, um, they don't have fingers, right? They, they look like a clip or, or something like that, where, um, this one has fingers and the fingers can be removed and replaced. In addition Not only that, but it's working extremely well with the humanoid robot sector. So that's who we're really targeting with this. And we've gotten multiple contracts on that and we're already generating revenue there. And just the last one I'll just say is Leah and Fetch. 1 1 3 in this world, in the VC world. And what I mean by that is we had a platform in Fetch that was an EMR that we were presenting to UnitedHealthcare. And Leah was doing Concierge Medicine in New York City. They were doing about $2.5 million in revenue. They had all this patient data. So when we met with them, we provided the EMR and we were able to get a significant amount of equity in that company. So now they've invested that money and they've bought those Mercedes Firestar, I forget what the type of, but it basically, they put a CT scan in the back of it. It looks like a little van and they can drive right up to your house with a CT scan. They do Botox, you name it. They've got everything in there. Similar to those big RV ones that we use in ortho, but this would be a small van and they can bring it right up to your driveway. So again, a little bit about those companies and then I'm just gonna jump to Vision OR because I think That one is probably most closest to this group. So any questions, thoughts here before I move forward? Sure, Elizabeth, you're muted.

Yes, I will say as someone who was designated an older mom many years ago, when I had to truck to the doctor's office multiple times a week so that they were making sure the baby was kicking and I would have to ingest, what was it, jolly, Jolly Ranchers, Jolly Ranchers to make sure the baby would kick. And then when she didn't, we'd have to beat a pot to make sure everything was okay. Sounds like the Stone Age. So I think pregnant mothers everywhere and probably dads too would welcome this innovation.

Yeah, that's great. And I'll tell you, you know, so, so Trey and Matt, both of them, this, this is legacy for them, right? They have enough money that they're doing this for the right reasons. And when we first sat down for this specific product, we did like a retreat where we all sat in and thought how we could make this product come together. And coming from the world that I came from, the first thing I said is, well, can't we charge the insurance companies a bazillion dollars? Because that was my mindset. That was how I thought about things. And they said, Andy, if you're going to have that mindset, you're not going to work well with us. So You know, they, they think, they believe let's do what's right for the patients and for the individuals and the countries and all that sort of stuff. And everything else will come into play, uh, or it will go the right way. And I, you know, I commend them and I've learned a lot from them and it's, it really is what I think will make you successful. So, um, and the last thing I'll say on that is it was near and dear to my heart because my daughter was born at 26 weeks, 3 pounds, 3 ounces. She's great now. She's flourishing, still a little peanut, but. But yeah, so if we had that, who knows if we could have gotten to the hospital before my wife was 8 centimeters dilated. Thanks. All right, moving on to VisionOR. So I went to the AWS conference this year, and I will tell you everyone is talking about AI in healthcare, right? Not only AI, but specifically in healthcare. What's funny is everyone's talking about it, but very few are actually doing anything about it. And it reminds me of my Striker days where, you know, to get anything approved, you had to go to, you know, 8 different people. And again, if anybody here works for Striker, I love Striker, but still, it takes so much to get approval and to get things through, uh, big corporate. So, um, so what does it look like today, right? So this is the company— AI company landscape. And what I mean by that is These are the companies that are doing something in AI today. So when you take that and you break that down a little bit further, if I can do that, all right. So this is the application programming interfaces, API ecosystem. So what does that mean? So these programmers like Trey and team, they build off of these as well. So in the past, if you were to try to, you'd have to build from scratch and you'd have to say, okay, I've got to figure out how to build my own AI model. Well, today, the beauty of what Apple has done and all these other companies has done, they've taken these AI models and they've allowed the programmers and developers to basically plug and play off of these.

So this is the toolbox for the developers.

Yeah, exactly. So it's really like that foundation, and I'll show a slide that, that helps break that down as well. But, um, anyhow, just an easier way to explain it for you guys. Um, so what's the opportunity in the operating room, right? Turnover, inefficiencies, lost revenue. We don't actually capture everything that happens in the OR. Uh, we're wasting time in documentation. We're wasting time in basically everything we do. Inefficiencies and burnouts from a manual perspective. So solution is, you know, Vision of R actually records and it sees and hears everything in the operating room. And all we do is use Apple products. So iPhones, iPads, Mac minis, and Apple Intelligence. Why Apple? I'm sure you guys can figure out what we're trying to do with Trey. We cannot, uh, say or, or not say what we're doing with Apple, but it's a fully designed Apple native platform. And we're working in a facility now where it's going to be on-premise, uh, well, working with 60 surgeons already, I should say. Pilot is already underway and it's been active for about 2 months. Um, and the data is owned by the, the facility, so at any point in time they could cut it off. But we also aggregate all of the data. We're able to capture all our workflows or make post-op docs, billing, implants, which I'll get into a little bit more up here. So what does it look like? This is the first kind of screenshot for you. And all we're trying to show you is we can have multiple camera views from anywhere in the operating room with just 3 little iPhones. So those iPhones are really supercomputers, whether you know it or not. They're really incredible devices. So what are we measuring here? We're looking at, okay, how long did it take for anesthesia to get in the room, right? Like if you're a surgical rep, you know it takes them 15 minutes, patient's waiting, right? How long did it take the patient to get in? How long did it take to clean the room? Did they do a good job cleaning the room? You know, when was the first incision made? All of those types of things from an efficiency standpoint we're measuring. And with that, we're making a dashboard and we're capturing all that data and we're putting those into data points that are valuable either for the surgeon, the staff, or, you know, the overall administrators and ambulatory surgery center owners, you name it, or the manufacturers as well, or the insurance companies. So there's a number of different ways that we can break this down. But for the pilot that we're working with, we've got 60 surgeons at an ambulatory surgery center. And they're asking for understanding basically procedure types, downtime, how much the room is being used and where they can basically make more money. So what does it look like? This is just a sneak peek. We've got, if you take an IV pole, you put an iPhone clip on the top and you have an iPad underneath it and you can roll it around anywhere. Doesn't matter as long as it's in the room. And it's a very small footprint. Which is beautiful, and it's unobtrusive, and you're able to capture everything. So again, we can maximize efficiency, minimize downtime, deliver better outcomes, and reduce burnout. So what does it look like? So we talked about earlier, like, the, the base that you can build off, right? And then you have the Apple Intelligence. So you've got this platform where you take everything we talked about with the AI and then the API, and then you put Apple Intelligence on top of that. And then what we've done is we've built on top of that this Vision Core platform. So the Vision Core platform has a number of different applications that we apply to it that we could use. So we have a billing application. So during the procedure, it's watching and it understands exactly all the CPT codes for that procedure, and all of your billing is done live, real-time while the operation happens, right? So you think of everything that's going on at UNH, not fun to think about, but this solves for that, right, at least in the operating room. The dashboards we talked about, right, there'll be a dashboard. We can make it and to however that facility wants it, we can make those data points. And we'll have a dashboard to provide to them. And there's multiple for every room, for different facilities, however they want. Post-op notes, all the post-op notes are completed during the procedure because all of the audio and video is actually capturing the information that's needed for the post-op notes. And let's say that they read them at the end of the procedure. Well, if they read them and they make some changes, the AI is learning it. So the next time that they have a procedure with that exact same physician, they'll know how that physician writes, and it will start adjusting to their tones and to their language. In addition, it will learn the procedures better every single time, which it's doing today. We have inventory tracking, which I'm going to show you, where every single piece of inventory that you want, we can track. We can tell you exactly where it is, how much is being used. How much isn't being used. We have an assist program that can ask you questions during the procedure on the iPad, or it can voc— you know, verbally put it out there for you to help with cut guides, to help with different parts of the procedure, to also help with your post-op notes. We have remote consults. So those Apple phones also, I don't know how familiar you guys are with this, the Apple Vision Pro, if you're looking at me there, but What we're able to do is make a digital twin of the operating room so you could put that on and you can stand anywhere in the world and you will be real live time in the operating room walking around as if you were there. And when I say walking around real live time, I'll show you a little video, but it is mind-blowing. It's not like anything else you've seen before where it's like strategy or like it looks fake. Like you're standing basically over the patient. And it's incredible. It literally makes you feel like you're there and you can see everyone and touch them. So that's the remote consults, which is great for education as well. And then the scheduling. So scheduling for a rep, scheduling for the anesthesiologist, scheduling for the surgeon, all that can be completed and done via this application. So again, we've got an active pilot. So this is just a couple of views of what it looks like. So you'll see here, like, it— once it identifies the individual, right? Like, this just says surgical team, but we'll say, okay, this is Andy Reid, right? And now everywhere I go for the rest of my life, it's going to know that I— it just by my eyes, it's going to know, um, that I'm Andy Reid, and it's going to be able to follow me for no matter what hospital, what institution that Vision OR is in, it's going to recognize me. So now you see here, this is when the patient comes in. So you can see how we blurred out the patient, right? So, you know, no detection there, but again, kind of HIPAA rules and things that we've already solved for. Here is, you know, during the procedure, you can just see again, just let you know how we're capturing some of the AI there. Um, let's see, kind of talk about some of this stuff. The op notes we talked about because you guys understand what op notes are. Um, Vision Assist we talked about. Here is your inventory management. So while it was capturing those individuals, it also is capturing— okay, that's the drill bit, right? That's your, um, whatever tool. So every single tool is being measured. And you know exactly what's being used. Here is another one, right? So you've got all your different tools. It's identified each one of them. And no matter where you put it in the room, it's going to know where it is and what it is, right? So, you know, again, if you wanted to take it even further, we could wear these Vision Pros and actually have the tech wearing them to identify everything and know what it is. And have steps in the procedure. We haven't gone that far, but there's another reason why. So just one more example of implant tracking. So if you took, just to show you how good the AI is, right? Like, you just dump it upside down, your tray, all of your hardware is identified immediately. Really incredible stuff.

Does it tie that to HQ, to the catalog number, or is it just no size?

It just knows size. And so, like, you take one— I mean, it's as much information as you put into the system. But, like, if I want to give it its name, size, dimension, it's gonna know it after that. So it's like you scan one through and then it's done. So this is, when I was talking to you guys about the Vision OR, right? So if you— now, as a sales rep, picture that you live in Kentucky and you've got a case, you know, 3 hours away. Well, you could put on this VisionOR today, right? And you would be able to have multiple views inside your operating room. You would be able to talk to the physician as if you were standing there. You would be able to look at multiple operating rooms at one time. So there's a number of different, you know, you could be just staring at the back table talking just to this individual and telling them what to do and circling and doing all sorts of things, which, you know, save you time, right? You don't have to drive 3 hours. You can do it this way if it's a procedure that's maybe not something that you have to be at, right? Like, we all know those types of procedures. So, and you can blow these up. You can do so many different things with the different screenshots. This is— this one's using the LiDAR depth data, which it's kind of a sneak peek. We haven't really rolled this out yet, but you can see where we're going with this. So this is in my living room, right? So I have the Vision OR on, and okay, I'm looking at different views within the operating room. I'm measuring the vitals as well and talking to a colleague at the same point in time. So all of this can be done, you know, in my living room. So let me just— oh, yeah, and again, different types of views. You can bring them out. You can make them 3-dimensional. You can switch out which views you want. So which, you know, you say, oh, I only want camera 3. I want camera 4. It's kind of like you're, you know, producing a TV show or a ballgame where you have multiple cameras and you're picking what you want to look at. Just let this finish out and I'll show you the next one. So this is another one that kind of shows you the spatial view. So what that means is When I talked about that digital twin, you'll see here, this is the digital twin of that operating room in real lifetime. And there would be people in here as well, right? This is just the OR with nobody in it. And you could get that close to the patient and look in. You can zoom in, zoom out. You can also make the background white so you don't see the tables and the chairs and all that. We didn't do that for this demonstration, which probably would have been a little bit neater to see, but you can see where the back table is. Um, and again, you can kind of move, move the OR around if you want to, you know, go to a different part of the, of the room, all with your fingers. And again, this is all built on the Apple, um, system, so it's so intuitive and so easy to use. Really incredible.

Right.

I think that kind of gives you the majority of that view. Oh, yeah.

That's really cool.

Anybody else speechless?

Everybody. Why don't we— can you go back to slide 35 that sort of shows the apps? Because I think that's— I think that is where everybody all the, all the apps in the operating room. There we go. Yeah, billing, dashboards, op notes. I think that's kind of—

it's, it's all that's captured on that mini Mac. So that's a mini Mac on the right. I put that there. It looks like, um, I have an Apple TV, I don't know, Hub, whatever it is, but it looks like that. So it's— that's how small it is, and it captures all of this data. So The beauty is, you know, if you were to sell this, which, hey, maybe we keep in touch and you help me there too. But if you were to put it into a facility, you know, you don't have to go through their IT team, right? You don't need to worry about someone. This is Apple. If they can hack Apple, then they can hack into the patient data. Otherwise, there's no way to break into it. It's not like you're going through the system or anything like that, which also helps us from a lot of legal perspective. So I'll answer the elephant in the room question, which is usually my first question. Okay, what if I'm a surgeon and I operate on the left foot instead of the right foot and this is all being recorded, video and audio, right? So what we've done is it's like a black box. We've been able to identify the individuals, identify all of the inventory, everything that's going on. But we delete the actual video and we keep all of the data. So it can never be pulled back in the court of law because it's all deleted afterwards. We just have data points. Um, so it's like a dumped video as soon as the— like running. So it happens within a 26-day period or something like that where it automatically is recycled out.

Cool. Let's stop here and open it up because I know people are— their wheels are turning. Thoughts, questions? Can you— what are, what are the uses? Go ahead, Mark. What are the uses people see?

Well, you saw my, you saw my comment to everybody. Basically, I'm sitting here, go— one word's coming out of my mouth, begins with F, and it just goes and goes and goes. It's it's amazing. And what's kind of also ironic, uh, Andy, is that just this week I'm doing a— I'm signing up a pilot program. I'm signing up docs for a new AI that does in the clinic using the Apple technology, Telscribe, and the Apple Watch or the iPod to basically see everything, hear everything, write their notes, and then based on their previous input, edit their notes and then do one more thing, which maybe even your op notes don't do, put it automatically into the EMR/EHR without a HL7 or FHIR connection. So it's totally agnostic because the EMR companies love to hold you hostage and make you connect with them. And that's just a giant roadblock. And I, I'm sure that as brainy as Apple is, they've figured a way around that too. But if they don't, I have a solution.

Great. Well, I'd love to hear it. And we're working with Epic right now. Um, I'll tell you, garbage in, garbage out is the best way to say it. And if anyone on the phone works for Epic, I'm sorry, but, um, Yeah.

So it, it's, yeah, we can, we can put our, we can put our notes into Epic, Cerner, Athena, any of them.

Exactly.

It's add-on. So we, we actually prefer being a standalone system just 'cause it's cleaner and I think everyone likes it that way. Sure. But yes, we can marry up to any of the EMRs also, just so you know.

Cool. Well, Colleen.

Andy, congratulations. That's a really interesting and promising vision, OR. But can I ask a couple of questions about the Venture Studio?

Please.

Yeah. Maybe you can share your, I mean, how do you take a controlling interest in the companies that become part of the Venture Studio and, you know, have like management input as well as ownership control? And then how do you find those companies? What's your investment thesis there?

2 great questions. Um, so the first to answer, as far as the controlling interest and those types of things, it varies, right? So there's different stages. So you have incubate, which is where you come up with the company, you, um, you know, decide, hey, this is something we want to build out, and we incubate that, right? Then we have accelerate, which are companies that maybe we invest in that need to commercialize or take that next level. And then there's just the pure VC play, which companies that we invest in with the money that we raise. And again, we're taking all the money that we raise and deploying it at different stages to those companies. But as far as the vested interest, so the way it works is just think of a pizza pie, right? You got 80/20, as we talked about a little bit earlier, and that 20% that I said goes back to the fund. That's where I get 25% of that 20%, right? My partner gets another 25%. Of that 20%, and then 25% is going back to Mission 3A, the overarching fund, or the fund that's backing us, right? They're the ones that gave us the financial freedom to go out and even do this and gave us, uh, a significant amount of, you know, money, as well as the companies, as I told you, at a preferred rate. So they get 25%, and then that last 25% within the 20, um, we're using for incentives for people like yourself, for surgeons to help in areas that we may need and provide additional equity across the fund. So, so to answer your question, that's my vested interest from a fund perspective. Within the individual companies, for this specific company, I'm the CEO because it was my idea with another gentleman's to do all this. But all the others, you know, It's a different role for each one of them. Some of them were like a board member, some of them were actively involved, but we, we can do all of it, right? So if there's a company that comes to us early stage, we help them there. If they come to us later stage, we can help them there as well. The second question you had, I believe, was, you know, how do we get these deals? So every which way. So investors, as I talked to earlier, provide us a lot of deals that they've either seen or that someone has presented to them., you know, all of my network. So a lot of them are presidents and CEOs of these orthopedic companies and it may not be their, you know, digital may not be their thing. They're dealing with hardware, they'll send them over to me. And then really networking and word of mouth. So you go to a lot of these shows and, they're different shows than your orthopedic shows that, that we've gone to. But there's, you know, different ones that you go and it's like a Shark Tank kind of thought process where you sit down. I went to one on Monday night down in Dallas, and there were 6 different companies. And, you know, we were given a nice meal and each one of them presented to us, and we get to, you know, ask questions and basically decide if it's something that we want to invest in. So there's a lot of those, and that's basically, uh, most of the ways I get it. Some people just email me their deck, reach out, you know, and I would say on average I look about 5 to 7 decks a week I try to minimum look at.

Thank you.

Absolutely.

Are, are most of the apps diagnostic related that you guys are doing in healthcare? Is it— I mean, the, the operating room, the vision of our thing is fascinating, but, but the fetal monitoring and things, it looks like most of them are diagnostic.

Yeah, I guess there's no— it varies, right? Like, but yeah, I'm sorry, go ahead.

We didn't talk about business models, but is it a— is it SaaS play?

Is it, um, yes, for Vision OR it is, yes, and for, um, the fetal monitoring as well. So that is our goal, right? Um, just because we can lock it in and we can have continuing revenue and really high margins.

Yeah, yeah. And is it like, is it a— is like the meter's running like a taxi, or is it once a month?

Once a month. We don't want to do the meter idea. I'd rather just have a flat fee. What we may decide to do here is, you know, start off with like dashboards, and then, hey, if you want dashboard plus billing plus op notes, you know, we add on each one or something along those lines.

Got it. And do you guys provide the devices or can they just use their own device?

So we provide the devices. There is a setup fee. It's less than $10,000 per operating room. Not a lot of money. And that's where we're looking with Apple to make some, you know, significant inroads there when we go and kind of really blow it out. So, but yeah, so again, it's— and the beauty of it also is, you know, I mean, every time Apple does an upgrade, right, that upgrade is affecting— and we— it's all software. We're not in it for the hardware, right? Like, we don't want to make money on the phones. We don't want to make money on the Mac Minis. We want to keep the software. And that's the beauty of this is we can also use the cameras that the facility has. And we found that that works well in some cases. But most of the cameras are outdated. So we find that the, the iPhone's better.

Yeah, the iPhone cameras are just amazing. They really are, and they keep iterating and keep getting better. Uh, can you control— can you zoom or unzoom the camera, or do you set it at a certain, like, range when you are in there?

So we set it in a certain, uh, location so that we can capture everything. You can zoom using your Vision OR. So if you're wearing that, you can zoom in and out. Um, otherwise you would just get a still shot. So like, if you put— if you were traveling and you didn't have your, your glasses with you, you could pop up your iPad and you would have a still shot of the back table, right? You'd have a still shot. Uh, but it would be a really clear shot. Like, it is really—

how many, how many employees are at Vision OR right now? And inside the three Great.

That's incredible.

Yeah.

See, this is the future, guys.

Yeah, it's scary, right?

I mean, with devices, you got 10 or 20 people and, you know, you got a regulatory and a quality and, you know, and, you know, when you're in software, man, you can scale.

It's the truth. And I mean, what we're doing now is why, you know, I say we're always raising is the— we are hiring developers and not full-time, right? But to take all of the inventory and run it through the system and get every single surgeon's face recognizable, all those types of things that you just need developers to do. And what we found, the beauty of the studio model, is we have 6, um, developers that are like world-renowned is the way I would look at it, right? Like Trey is the king and then 5 others are just as good, and We have found that those individuals are needed for the first 4 months, and then after that, we don't need them. So, we can use, you know, we can outsource it. We can use other people to do it because most of that, what we're finding is, you know, "Hey, Andy, can you switch the dashboard to this? Hey, Andy, can you add in this little tweak?" So, we can always go back to them if we need it, but most of those things can be handled by somebody else. So we save a lot of money in that as well. It also frees up their time to do other projects.

How's it going?

I'm going to your house.

Sorry, I'm muting Tom. I'm out of questions. Anybody? My wheels are turning. Kyle, you usually have questions.

I don't.

I don't. This is, this is fascinating. And it was interesting to hear you bring up that the data gets deleted, especially in the context of, call it liability or, uh, some sort of testimony later on.

Correct. That's brilliant because, um, the legal system goes way slower than 26 days. So that's, that is brilliant.

But technically the opposite could be true, right? That it doesn't have to be only negative. If the video still existed, it could be proof that somebody did something exactly right and you can't blame anything wrong on them.

So that's exactly the other— and that's what they all— every surgeon says that. But you know what we're able to do though is measure surgeon versus surgeon, and they love the competition so far. They want to know who's the best, they want to know who's making the most money, um, they want to know how long and And where I think I'll be able to sell this for a significant amount of money is, so let's say I get into 100 ORs by the end of the year. Okay. Which I think is very feasible. I've already got 100 signatures to do so. For me, it's more about the execution, as I talked about earlier, and getting it out there and doing it. But let's just say I get it in 100. So in 2 years' time, these large language models, LLMs they call them, right? They will run out of data. So what I mean, so, you know, there's all this patient data that's out there today that they're capturing and they have, but when they want new data in 2 years, where are they going to get it from? Well, I'm going to have the data across 100 different facilities, and I'll be able to aggregate that and tell you on average where, you know, how long it takes an anesthesiologist to walk in the room, how many times somebody walks in, whatever it is, I'll have all of this data that we can compare and do benchmarking for everyone in the industry. In addition, I'll be able to tell you if you're gonna rebuild a new operating facility, where the door should be, where the table should be, where the bed should be, where you should stand. And we all know every minute counts, right?

So, Is there— are the pilot customers big hospitals or ASCs or both?

ASCs. And I'm targeting ASCs for the obvious reason is they're just so much easier to get through and to see the value. And I don't see the ASCs buying it overall. I see either, you know, as far as who I would sell the company to, I would guess most likely that an insurance company or a manufacturer will buy us. Or another VC like a Sequoia or somebody like that, or even an Apple. But I don't see Apple— I see them partnering, not wanting to purchase.

Yeah.

Well, this is great. Thanks.

Yeah, I appreciate the time. And, you know, if anyone's interested in any more or wants to, you know, have me talk to a friend or a colleague about it, you know, happy to do so. And my, you know, again, it's Andy Reid. Just look me up on LinkedIn. And we'll talk then. But thanks for the opportunity, Tiger, and appreciate it.

Yeah, yeah, this is— you're blowing everybody's mind, so we gotta think about applications.

All right, all right, have a good one.

Take care, everybody.

Thank you.