Inside Orthopedics: Anatomy of a Startup - Q&A w/ Mark Foster, CEO Trice Medical (Podcast 31)

Brought to you by Tiger Buford.

Welcome back to Inside Orthopedics. This is Tiger, your orthopedic industry insider and retained recruiter for early-stage orthopedic companies. This is episode number 31. Titled Anatomy of a Startup: A Peek into How Trice Medical Created and Built the Dynamic Diagnostics Market. This is a real treat. It's a discussion with Mark Foster, the CEO at Trice Medical. In this episode, you will get a unique look into how this little disruptive Little startup has created a brand new category in orthopedics and how they are executing today. Note, please excuse the cell phone skips during the conversation. You will be glad that you listened. Enjoy.

Okay, I am live with Mark Foster at Trice Medical. How you doing, Mark?

Doing great, Tiger. How about yourself?

Great, great day. So you're in— just to set the stage, you're in the car somewhere.

Oh yes, in the car, headed home from worldwide headquarters in Malvern, Pennsylvania. All right, all right.

So I'm really thrilled to get a chance to talk with you and for the listeners to hear more about the Trice Medical story. My favorite orthopedic startups are those companies that create new categories or new procedures, and you guys are right in the middle of that.

And it's, uh, love—

I'll learn something, I'm sure. So let's just jump right in. First, about you, you know, there's a common theme in orthopedics. There's lots of athletes that are company leaders, surgeons, and I know you were an athlete. So tell start kind of tell me how you ventured into orthopedics?

Sure, yeah, well, first of all, I really appreciate you having us on, Tiger, and Tracey's got a great story, and it's great to have a partner in the industry that's focused on getting those stories out there and interested in helping as well. So thanks again for having us on today. I grew up in the Baltimore-Annapolis area, which unfortunately makes me a Redskins and Orioles And so it's been a rough couple decades, but I went to University of Richmond and played baseball there and then played in the Phillies organization for about 4 and a half years after that until I had some, had some arm injuries and had to get a big boy job, as they say. But yeah, I had a, had a great experience in there.

Wow. And did that draw you into orthopedics kind of naturally, or Sports medicine?

No, I think so. When I left athletics, I was looking for a career that really got a chance to partner. You know, I knew I'd go into sales in some capacity, and— but the opportunity to really partner with your customers, uh, it was, was important to me. So I actually started within GlaxoSmithKline, which is a pharmaceutical company. I worked for Kendall Healthcare for a little while. And I really enjoyed a long career at Boston Scientific where I spent 9 years in their gastroenterology as well as neurovascular divisions. And that'll come full circle here a little bit on our trace story. And then I worked for Todd Euston who got recruited to go to Smith Nephew. And I went over to Smith Nephew and spent about 8.5 years in their sports medicine division, and my last role was managing the US for the Smith Nephew sports medicine role. So it was great to get into the sports medicine piece. Obviously, all of our physicians are the team doctors, so understanding what makes them tick and understanding their drive to really treat and get patients back on the field quicker, faster is pretty fun to be involved in.

Oh, great. Yeah, I remember you left a big job at Smith Nephew to come to Trice, and it, and it surprised a lot of people. So what did you see? What did you see in Trice Medical?

Well, for me, I saw a couple things. One, uh, what probably got me going the most was I had a chance to do diligence for the ArthurCare acquisition that Smith Nephew did. So the opportunity to lead that transaction and the integration here in the US really got you excited about moving fast, putting pieces together. I've always enjoyed kind of a— figure things out. So that really got me excited about the opportunity to potentially go to the other side, and I thought about building a culture and building a team and how much I love some of the cultures I was with, with other companies. And, you know, the thought of getting to a place early and really getting people on the same page, building this healthy tree that can last for a long time and grow roots, really, really energized me. So Jeff O'Donnell at that time was the CEO of Trice, uh, great guy with lots of industry experience. So the chance to learn from someone that had had multiple exits in the industry, you realize that it's a different opportunity in your career. And specific to Trice, the thing that got me really energized was the amount of shots on goal that this technology has. That what Trice really does, and we'll get into it a little bit, outside of just putting a disposable camera on a tablet, is really impressive. So the amount of resources we have, kind of the, the opportunity we have both within orthopedics and outside of orthopedics really got me excited about, um, about coming over and making a move.

Got it, makes, makes sense. So take, take us back to the beginning of TRICE because I don't know the story and most people don't. I think it was founded in 2011 and that's about all I know.

Yeah, TRICE was founded a little bit of seed money from BioStar, which is a small VC company in Michigan, physician-backed. And the idea was, can you put optics at the end of a needle? And there have been some attempts to do in-office arthroscopy with reusable equipment, but fundamentally you've got small cameras, you still have a relatively heavy capital investment, and you also have some of the issues of sustainability of having some parts reusable and some parts disposable. So the idea originally was if you could build a needle with optics on it and have it plug into some sort of tablet, it would be amazing to be able to look inside of a joint instantly and deliver information for patients. There's over 8 million MRIs in the US just in shoulder and knee. And those patients, the experience of having an injury is really a long one. So what typically happens is the patients will go to the physician, they'll have some sort of knee pathology. Physician, many sports medicine physicians already know based on the physical exam what's going on for some of these pathologies. 45-year-old comes in, played basketball over the weekend, heard a pop, chances are that physician after doing their physical exam feels confident that there's a meniscal tear. However, in today's world, what they need to do is they need to confirm that with some other tool. So the normal pathway for a patient is to take off another day of work, go get the MRI. MRI's in the US, The price varies wildly from $300 to $3,000. And additionally, the MRIs are really a, what we call a static image, in that it's information at one period of time. They're not a dynamic image, which allows you to move the joint while you're getting information. So at the end of the day, the MRI is an amazing tool, but not flawless. There are many patients that can't have an MRI. And MRIs are certainly better for some things than other, for example, cartilage, cartilage damage. So, get back to the story. So typically a patient will see that physician, they'll have to take an off, off another day of work, go get the MRI, spend the money there, and then at that point you still can't get an answer to your question about your pathology. You need to take off another day of work, go back to the physician's office, and get into their schedule again. When they're seeing patients. So that time is on average over 2 weeks from the time you would see your physician to the time you get information about your pathology. So the MyEye was really developed with the idea of condensing that time, which of course condenses the cost and increases the value in the healthcare system.

Yeah, it's not only the expense, but it's the loss of the continuity with the conversation with your physician. That's the thing.

I think it's—

I think that's one of the biggest benefits is the videos I've seen is the surgeons literally diagnosing the joint while they're talking to the patient and giving them a tour of their own joint, and then you're discussing treatment options all within a few minutes.

It's incredibly powerful. It's— I mean, I have seen patients in— an office looking at a joint and they literally turn to their significant other and say, "See, honey, I wasn't crazy. There is something wrong with my knee." And, you know, a lot of times these MRIs are inconclusive. The most common MRI is inconclusive because oftentimes the radiologist might not want to make a definitive call. Additionally, most MRIs will show— I can guarantee based on my 20 years of throwing fastballs that I probably have some sort of rotator cuff tear and possibly some sort of instability in my shoulder, and yet it's not something that I would need to be treated. But if I got an MRI, chances are it would show potential cuff tears. So, and those patients experience the same things. So our physicians that are using MyEye love the fact that Patient comprehension is better. If you've ever seen an MRI, hopefully you know better than I do what it's actually saying, but I've seen many cases where the MRI goes up on the wall, physician's walking the patient through what's in there, and the patients are kind of nodding their head, and I know that they have no idea what they're looking at. So the camera image seems to bring it home a little bit. Physician will say, "Hey, you see this knee?" You see those two shiny white areas? They're supposed to look like two balls and very smooth, and this bony area is a cartilage defect. And if I just give you an injection, it's not going to totally take care of that cartilage defect. Let's talk about your options. And I've seen that really sink in for the patients, and it's very powerful.

Yeah, so MyEye was the first product. Was there a breakthrough with the camera, the optics, the disposability? What was the— because lots of companies have tried this in the past. What was the breakthrough?

Well, as you can expect, the chips in this space are getting better and better and less and less expensive. So just like in your phone or your iPad, we are at the very beginning of where this technology is going to go. I always say we're on the iPhone generation 2 right now, and our world is so far ahead of us. So the chip platforms are moving very quickly, and Trice is really well positioned to take this technology where it ultimately will go. So the breakthrough for us between our first and second generation cameras had to do with chip breakthroughs to allow more pixelization a bigger, wider field of view and a deeper depth of field. So, all those things continue to advance, and the camera technology is getting better and better.

Another—

so, the current MyEye2 is actually the third-generation camera, and as you can imagine, there will never be a final-generation camera, final-generation tablet, or software for Trice. We're always going to be innovating in this space. So, the breakthrough between the MyEye— we went from the Plus to the One to the Two— had to do with chip technologies. Additionally, the tablet, the first-generation MyEye camera, we made our own tablet. And then we decided that Microsoft is a little better than we are at making tablets, so we now have a partnership with Microsoft where we are leveraging the Microsoft horsepower and computing capabilities with regard to our tablets. So we've got a long way to go.

So you get the advances of Microsoft along the ride.

Yes, we just launched our latest tablet and this current tablet has twice the amount of pixels, twice the amount of storage and the processing power. Again, we're very early in where that technology is going to take us.

Wow. So, walk us through funding. So, I know you started at BioStar with seed funding, but you guys are venture capital backed, right? So, can you kind of walk us through kind of in general how you guys have been funded?

Yeah, we've had 3 rounds of funding. Really, the first two were kind of get the prototypes, get through the FDA, get the proof of concept going. The last round, which we closed probably close to 2 years ago, was for our commercialization efforts to round up some of our sales organization here in the US.

So you're done with fundraising? I assume you're profitable or close. Unless you want to go out and get growth capital, you're pretty much done.

Well, we, you know, we're going to be very opportunistic and we think that there's a big market with regard to this minimally invasive orthopedic space. So our last fundraising was partially to acquire a company, which I'm sure we'll get to, but we plan on continuing to be opportunistic with regard to— the fields that were penetrating. Got it, got it.

So on the reimbursement side, are there new codes that were needed for MyEye, or did you piggyback an existing code?

Luckily, we did not need new codes. Fundamentally, the MyEye is a camera that's FDA-indicated to be used in any man-made or normal orifice. So it's a camera. That can be used anywhere. So the codes are up to the physicians to use. One of our most frequent procedures that are done is an in-office arthroscopy. The existing codes for diagnostic arthroscopy have been around for a long time. So if a physician chooses to use the MyEye for diagnostic arthroscopy, those codes are stable and have been around for a long time. A physician could also choose to use the camera for a therapeutic arthroscopy in the operating room or the surgery center or even an endoscopic carpal tunnel. So there are many indications for the cameras. They could also use them to confirm a reduction of a trauma wrist fracture or ankle fracture. So there's lots of different indications for using the cameras and, you know, many appropriate codes that go along with it. Interesting, interesting.

So, and I think last year you added the ultrasound capability, so going from intra-articular to extra-articular. Kind of tell me the— kind of how— why you did that and how you did it.

Yeah, so it's a really fun story, and again, part of the reason why I go to a startup is to be able to move quickly. So we went from— so if you think about this computer that we're leveraging for this tablet. This computer can do more than just process imaging for arthroscopy imaging. It's got much more horsepower than we were tapping into. And the idea of having one system that you could do diagnostic procedures and therapeutic procedures off of is really, really intriguing. So the idea is this becomes really the wedge of an orthopedic practice in the office, in the surgery center, and in the OR, and off of this tablet, you're able to diagnose disease with the cameras. You're able to inject under direct visualization with the cameras, which is something you've never had the ability to do before. And with the ultrasound, which is a very big existing market, you're able to either do a diagnosis— ultrasound's a fantastic tool, particularly in the shoulder, to— just like we talked about MRI being a bit of a static image. Ultrasound also gives you that dynamic imaging where you can move the patient around, reproduce their pain, and, and understand what's happening with the pathology. It's also most commonly used to aid for injections and to make sure that your injections are going to the right spot. So as these materials are getting more and more expensive with stem cells and HA and fat and different types of systems out there, you certainly want to at least make sure that it got to the right spot. So the ultrasound provides you that. So we started with the idea of putting ultrasound on the tablet, and our team is just amazing. And from, from idea to having a product on the market took us under 8 months from the time we had the idea. Wow. At the time we had the product on the market. As you know, being an engineer, That's awesome, and that's just something you don't get the chance to do at a big company. Yeah, crazy fast. Yeah, we end up with the number one, the highest amount of megahertz of any handheld transducer on the market. So I feel strongly that we have the absolute best handheld portable system on the market. It's 15 megahertz. It's designed specifically to mimic what physicians are used to with the larger systems. Dr. Don Buford, who's an amazing resource in ultrasound and biologics, really helped us get some of the settings right. So it's really designed so that you can turn on the tablet, hit shoulder, hit knee, hit ankle, have the settings automatically adapt to be exactly what you're looking for, process those images, give them to the patient on their phone, and really be easy to use at a very, very cost-effective price. Wow.

That's called MyUltra, and you're on Gen 1 with that?

Yeah, so we've got a straight transducer, we launched a curved transducer, we have a few others coming, and it's a reusable MyUltra transducer that again is at a cost-effective— many of these are— what we always say is we've taken a $60,000 arthroscopy tower and a $50,000 ultrasound machine and put them on a $2,500 tablet. And it's really amazing to be able to combine those two platforms. And that transducer itself is, you know, typically in the $10,000 to $12,000 range, which is a significant value proposition versus some of the larger towers that are on the market.

Wow, makes a lot of sense. So, uh, recently you, you acquired Segway. Uh, tell us about kind of why and, and what, what is Segway?

So this is, if you think about the evolution of Trice going from having cameras that see and provide diagnostic capabilities, then you have this tablet and we add additional ultrasound capabilities that can see and do injections. The natural progression is to get into therapies. So what types of procedures can you do with small cameras and ultrasound, and what type of devices do you need? So we went to our physicians and said, we've got a 2mm disposable camera, we've got a high-quality ultrasound on a portable tablet, and you could put this thing in a backpack and go do procedures. And it's amazing sit with physicians, show them the technology, and they kind of lean back in their chair and their mind starts racing with where I could put it and what I could do and how it would change. You know, it's very disruptive. And so we scan the market around what other procedures that use small cameras, um, and endoscopic carpal tunnel is an incredible opportunity. So in the U.S., there are over 700,000 carpal tunnel procedures every year. 1% of the world's population has carpal tunnel. It's a very common indication and unfortunately growing quickly due to people like you and me that are on our phones and doing podcasts. Typing, typing, yeah. Typing. So it's a growing market. Today, about 25% of those carpal tunnel procedures are done endoscopically. So that leaves you with over 150,000 procedures a year that are done using a camera. Segway, under Stuart Seymour's leadership— Stuart was the CEO of Segway— is a great American success story. You know, really started and built a business on his back, kind of the old-fashioned way, getting out there with 3 or 4 sales managers, building a distributor network, and really working with physicians to understand the technology, and they have the safest system on the market for endoscopic carpal tunnel. It's got a unique system because you have the ability to probe and rasp the ligament under direct visualization without having to open up that blade or without having to probe with the blade. You can go in and out with the camera, so you come underneath the ligament and you're sitting in the the transverse ligament, you can probe and rasp to make sure that the nerve is not in the way, then start to unzip your cut with their blade. And at any time, you can put the probe back in, make sure you're comfortable with what you're doing, and make sure you don't go anywhere near that nerve. So a very, very safe system. It's really perfectly designed for physicians that understand the benefits of endoscopic carpal tunnel but are a little nervous about making that transition into a system. Some of the other systems that are on the market have got a gun system where you hit a trigger and a blade pops up. So they're a little nervous about just automatically hitting the blade and pulling back. So people that use that system are having great results, but the 75% of the market that's doing it under open is a little bit nervous about making that change, and the Segway provides a really great tool for them to make that transition. So the idea was, okay, there's 150,000 cases done with reusable cameras out there. Why do they have to be reusable cameras? If we had a smaller camera and disposable instruments, could you move that procedure out of the operating room where you need 5 members of staff, anesthesia, arthroscopy towers, reusable trays, reusable cameras, servicing, put that into a disposable kit of instruments and a disposable camera, and now a physician and one staff member under local anesthesia can perhaps do this in a procedure room of a surgery center and allow you to maintain, keep your big towers for the large rooms of the ORs doing your rotator cuffs, your SCRs, your ACLs, leave that equipment in there, drive efficiencies, bounce back and forth between the procedure room, and just bring your tablet and your disposable carpal tunnel kit. Additionally, it opens up the opportunity where some physicians might actually want to transition all the way into the office and do these carpal tunnels in an environment that makes the patient more comfortable. So it really enables that. So the Tread story is one where Now we have a tablet to drive diagnostic and therapeutic opportunities for these small cameras and small procedures. And carpal tunnel is just the first of many others. Segway, for example, has got a product that is also used for— and endoscopic cubital tunnel. And we have some other products. In the works as well. Wow. Wow, that is—

so you're marrying diagnostics with treatments now, which is— and you're moving it to the surgery center or office environment. That is fascinating.

Yeah, we really think that, you know, the camera diameter— the really, really unique thing about our camera is the IP around— it's one integrated system. So for those of you that haven't seen the camera, it's one percutaneous needle with a camera embedded inside of it. What that means for the physician is that they don't have to make a needle stick, they don't have to use a scalpel, they don't have an open lumen. So our product, they literally numb up the patient, insert the needle of the camera percutaneously, hit a button, retract the camera, so that you're not having to exchange multiple devices, which we feel strongly is aiding our safety profile. So we are published over 1,500 patients with zero infections in those patients, and our physicians— and that was at 13 different centers with 13 different physicians for those cases— our physicians and I feel strongly that the integration of the needle not only makes the procedure faster because you don't have to put in a cannula and make a trocar and take out a trocar, but also has the potential to safety benefits of not having an open lumen or open channel, particularly if some of these procedures push out of the operating room and into the procedure room or the office. Right, makes sense.

Wow. Are you guys in the US? Only, in the whole United States, or Europe? Tell us where you are now.

We are— we're in the US. We have CE mark. We have Health Canada approval. And we have a couple other countries that we're working with as well. Okay.

Wow.

Moving to—

and what does your sales and distribution look like?

Is it a hybrid? Is it direct? Yeah, we— today we've got a bit of a hybrid. We have a direct sales— small direct sales organization, and we have some incredible distributors as well. So some parts of the country, we're really— what you try to do at this stage of company is prove your model. You really— it's a great opportunity to test lots of different things. So in some markets, we have just a direct rep. And the opportunity there is, okay, if you didn't have anything to put food on your table besides our platform of products, how would that look? We have other areas where we have just distributors that carry other products, and our sales management team works directly with them to make sure they understand the benefits of our system. And in some areas, we've got a bit of the kitchen sink where we actually have a direct rep and a distributor. And we're looking to see if we threw a lot of resources into a market, would that, you know, what would that do? And then you have the opportunity to really test all those things and measure them and really decide what's best for the organization.

Wow. So Mark, what are your biggest obstacles right now? I mean, you've— and there's lots of obstacles in growing— companies growing as fast as you are.

Sure, so I'd say two things. One, the company was founded on very much of a market development activity. So it's not as if there's 3 million in-office diagnostic arthroscopies happening and we're trying to go get our share of them. We're building that market, and building markets takes time. It's education. Educating staff, reimbursement, making sure the physicians are comfortable. So, you know, your traditional market development issues of staying focused, being targeted with your approach, consistent with your message. So, you know, that's one. And probably the bigger one is really balancing all the opportunities we have in front of us and staying focused. So we also are very active outside of orthopedics, which I'm sure we'll get to on this call. But as a business for TRISE, we've got some really exciting technology that we're going to be launching in the first quarter of next year. So it's a matter of, you know, scaling up your organization, being patient but excited, and being targeted with our focus.

Yes, similar, reminds me a lot of Ellipse Technologies. We had magnetically controlled implants by remote control, and every time we showed it to a surgeon, their wheels started turning and they gave us 5 new ideas. And it's really hard to stay focused when the customer sees the potential.

Yeah, you're right. It's a balance between, you know, what is the mission? Is it to create lots of products, or is it to, you know, build a profitable business? And one of the things we're really proud of is we were just named a Great Place to Work in 2019. So we're, we're super excited about that. We've been working on our culture, getting our core values driven throughout the organization, and to be recognized at this early stage as a Great Place to Work is really a strong sign that we're not just committed to you know, building a company and getting to an exit, but creating an environment where people want to come here and work. They want their friends and their family to work here. And, you know, we're really happy about that.

That's terrific. Yeah, that's a long-term play. You know, the key people you bring in today are going to do all the hiring in the future, and they dictate the culture. And the culture is something that's really hard to build and really easy to— to do it wrong. So you—

that's terrific. Yeah. So let's—

I know other medical areas are— you have medical partners that are asking TRISE to develop new products. We do.

So we have signed licensing deals with other very large public companies. I'm not allowed to disclose them here because the projects we're working on they haven't disclosed, and they're going to launch very soon. So fundamentally, what Trice does really well is we combine optics, ultrasound, and tablets. There are some companies that have the ability to do the optic side, and they almost hand— we have the ability to go from tip to tail with optics all the way down to the tablet, to the user interface of software. the We have really more engineers than sales reps right now, which probably is music to your ears as an engineer. But what that means is we have again these capabilities we can leverage. So our first deal outside of orthopedics came in the neuro space where we have a science— so what we do is essentially we get products to third base, if you will, And we have partners, we then evaluate whether it makes sense for us to commercialize the product and to build a channel at scale, which can be costly, or to find other companies that are already in that space that have channels that can maximize the value of the opportunity. So our first deal was in the neuro space where we are essentially making a neuroendoscope, fully disposable neuroendoscope that also plugs into a a tablet. And we have a partner in that space that has some tools that will allow clots to be removed in a simple, elegant way. So that is an active partnership. We're also really excited about another partnership we recently signed for airway management. And in that space, you know, bronchoscopy, pulmonary, airway management is a a big market and the ability to not only look but see into the lungs and provide optical and ultrasound capabilities on portable tablets is a large field. And we have a partner there that we're going to be able to maximize that opportunity with. And we are also— have discussions ongoing with regard to urology, gynecology, and ear, nose, throat.—

wow, you can see the opportunity without even describing what the product is.

That's fascinating. Interesting. Yeah, the only field that we've got a commercial— commercially marketing sales want to take advantage of that minimally invasive orthopedic, but our engineering team as well as myself and our BD team are knee-deep in some of these other fields.

So when you say you develop it to third base and then sort of make an inside/outside decision, do you take it through prototype and all the way through regulatory clearance, or do you stop at sort of product concept and prototype?

So we— both of the opportunities we have signed were the company wanted to put their final stamps on the product. So we'll get it to prototype, we'll get it to working, and then the regulatory will be the last step. So we essentially get it to the point where it works, the design is frozen, barring any changes from our partner. And then sometimes the partner wants to have their own surgeons involved to kind of give it that last touch, make it potentially work with their devices in a more elegant way. And then we take it from there, all the way through the regulatory, all the way through the manufacturing and supply the product. So we have the capabilities to kind of stop anywhere in that chain. We could also bring it all the way through and get to the design and get it through the FDA. On our own, but each different field of use presents a different— they're really a bit of a matrix as far as when companies want us to come in or out of that equation.

Got it. Got it.

Makes sense.

Yeah, there's less investment to just go into prototype and you can go fast. It probably takes longer for the partner to get it through their system than your development side.

Well, that's exactly right. What we found is the quickest way for our partners is for us to finish the job. And, you know, it's a debate around we could go further. The asset is probably more valuable if you get it all the way to commercialization, but there's also risk of not getting it right and, you know, draining your resources for a path that is undefined. So, you know, again, we can We can stop or go at any point in that chain. Yeah.

So the business model is— there's really two business models. There's developing your own products and then products for partners. And where do you see that going?

Is it—

are you always going to be bigger on your own products or—

I mean, where do you see it? Yeah. I mean, we're going to win in minimally invasive orthopedics. We're going to build out— a space that has lots of procedures using small cameras and ultrasound on the tablet. And we're going to extend what that tablet can do, what the cameras can do, what the ultrasound can do, extend our portfolio of procedures and devices. So that's going to be— will always be the day job, so to speak, of Trice. And outside of that, You know, we have— you talked earlier about what are the biggest challenges. Our challenges, our biggest challenges are also our biggest opportunities, which is picking the right lanes, picking the right deals, resourcing them appropriately, and making sure that we get value for our shareholders. So, lots to come on that front, but I foresee a future where we've got a large business in small orthopedics. As well as fantastic partners outside of orthopedics that we're able to leverage our engineering capabilities, which also adds to our scale for some of the products that we do launch in orthopedics.

Wow.

So what else should—

I'll let— probably need to let you go, you're stuck in the car. What else should the listeners know about Trice?

Well, I think that you should know that it's a great place to work. So if you're an engineer out there, or a sales rep in the US, we'd love to hear from you. But fundamentally, I want you to know that we are more than just a camera in the office. We are a platform technology that has not only small cameras but also ultrasound on this platform. Tablet. We're advancing into small procedures, and we're having a great time doing it. So I really appreciate your letting us tell a little bit of our story, and obviously it goes without saying that we appreciate your support. One of the key parts of building a business is having talent. We talked a lot about the talent piece, and your organization is also really helpful on that side as well. So making sure that you can attract, retain talent for the long run, making sure that your recruiters can, can really maximize the story, understand the story, and help you target to build that family that you can build around. And you've been really helpful for us on that end as well. So I want to thank you again. I appreciate that.

So what's the, what's the best way for somebody to find more information about TRICE or— could maybe even contact you?

So I'm very active on LinkedIn. It's been a great tool for us. It's a great way to get physicians across the world to see the technology. So please contact me on LinkedIn. Mark Foster is the name. The website is tricemedical.com. It's a really robust website that has not only information on cameras and ultrasound and carpal tunnel, but informational reimbursement, lots of procedural videos, how to get up and running. And please, you know, we'd love to help you, and we'd love to hear from the physicians out there that have other product ideas as well. Terrific.

Wow, well, thanks for your time, Mark, and safe travels. Really appreciate it.

That's a wrap. Thanks, Tiger.