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GE Healthcare has recently entered into an agreement to invest up to $50m in ultrasound start-up Pulsenmore. The Israeli vendor, which offers a docking station allowing expectant mothers to use their own smartphone to conduct ultrasound examinations on themselves at home under the guidance and supervision of a healthcare professional, aims to allow women to proactively manage their pregnancy, and improve productivity by having more scans done away from the hospital.
GE’s investment is aimed at improving Pulsenmore’s global reach, as well as helping propel commercial expansion and securing regulatory clearance. In addition to the funding GE is providing, the international modality vendor will also partner with Pulsenmore to distribute its products in Europe and across the world, as well as collaborating on new solutions that also cater to the nascent home market.
The Signify View
Offering patients the ability to conduct medical imaging in the home has numerous upsides, from straightforward benefits such as better provision in remote areas, patients not having to travel, the reduction in no-shows for appointments, to advantages that are more substantive for providers such as reducing in-hospital appointments, and helping to reduce the number of false alarm visits to the ER during pregnancy, saving the hospital money. These opportunities have been understood for some time, but so too have the problems barring the technology’s uptake.
Among them, for instance, is the considerable faith required to be placed in the ability of inexperienced home users to properly carry out their own scans. Ultrasound is a difficult modality to use and an improperly conducted scan could result in images that are not able to be used for diagnostic purposes, or worse, missed or incorrect interpretations of medical images. These devices must also be able to provide information that is useful to a patient. Simple instruction depending on output rather than complex, subjective interpretation. A further challenge is convincing customers to pay for imaging tools. While some medical devices such as blood pressure monitors are cheap enough for the home market, medical imaging is an altogether more costly proposition, the cost of which is unlikely to be commonly accepted.
Pulsenmore has avoided these, and other challenges, that stymie the adoption of medical imaging at home through its usage model. Among the vendor’s customers is Clalit Health Services, the largest healthcare organisation in Israel. Clalit issues the devices to its patients, and guides their usage, making sure they are used correctly and ensuring that the devices are only used at prearranged times. Through Pulsenmore’s teleultrasound platform, interpretation will also be completed by experienced clinicians working remotely.
Good for Hospitals, Good for Patients
It isn’t just patients that could benefit from such an approach. One of the broader trends in medical imaging is the growing momentum towards value-based care, especially in single-payer markets and payer-led managed care health systems. Pulsenmore’s approach capitalises on this trend, with providers’ use of the devices hoped to enable patients to be examined at home; an option that can be far more cost-effective than bringing them into hospital for every single scan.
The cost savings for providers can be significant. As well as reducing the necessity for patients to repeatedly come into hospital for scans, by equipping expectant mothers with devices that facilitate more regular monitoring of their babies, Pulsenmore could also help reduce the number of emergency consultations, emergency imaging scans and other expensive procedures, by assessing anomalies or concerns more swiftly, at home.
Neonatal care is an attractive market for home-focused healthcare products, but it is far from the only market that can be targeted. A range of chronic health conditions such as those affecting the heart or the lungs, or even conditions relating to treatment such as dialysis could see benefits from better at-home imaging. These are all markets which, if Pulsenmore is successful, could become future targets. Another market in which Pulsenmore has already started to make headway is for follicle counting in IVF and fertility preservation processes. In January of this year it signed an $11m deal with Clalit for its new follicular tracking ultrasound device, the Pulsenmore FC. As with its pregnancy-focused ES device, allowing patients to conduct follicle counting exams at home will improve the patient experience, while also benefiting providers by reducing the number of in-person visits that need to be made and therefore saving hospitals and clinics money.
Free Reign
Such success, in the short-term at least, looks plausible, particularly given that, as yet, there are few, if any, direct competitors to Pulsenmore. Some of the specialist handheld ultrasound vendors have referenced the home market in investor presentations and the like, but these systems are not comparable. Aside from them costing thousands of dollars rather than the hundreds of dollars pricepoint that Pulsenmore hits, the pregnancy ultrasound device also has advantages in terms of scalability.
For the sales teams at large modality vendors, $3,000 scanners are not the priority when they can be focusing on $150,000+ ultrasound systems. Similarly, despite their best efforts, for handheld vendors sales can be resource intensive and difficult to grow. Pulsenmore sidesteps these issues by focusing on large deals, for large numbers of devices with providers. The agreements with Clalit, announced in August 2020 and January 2022 were, for example, worth $6m and $11m respectively. Deals of this size means that, assuming the devices are well received, business is likely to continue to be generated into the future.
There are opportunities for other vendors to enter the home market, with wearables noted as a likely next step by some vendors. Such tools could be particularly useful where more regular monitoring is required, such as for heart care, for example. These devices, like Pulsenmore’s scanner, could be manufactured cheaply enough to be viable for home use, be attractive to providers who have large numbers of patients suffering from heart conditions, and by offering constant or very frequent monitoring, help reduce the numbers of costly procedures required thanks to earlier detection.
A Pragmatic Approach
These possibilities illustrate some of the reasons why GE Healthcare has sought to invest, although there are also more pragmatic reasons. GE will be the device’s exclusive distributor in some territories and for some customers, enabling the vendor to sell as many as 50,000 units annually. The deal will also complement GE’s strength in ultrasound, with the international modality vendor occupying the top spot in terms of global market share. While the investment will initially benefit GE’s women’s health ultrasound business, over time it could complement its offerings in almost every ultrasound segment and represent a first foray, as the vendor expands into the potentially lucrative home market.
Beyond market entry, the collaboration could also see the vendors sharing capability. Pulsenmore’s devices, while already affordable, may benefit from the global supply chain expertise, the manufacturing capabilities and the distribution abilities of GE to further reduce cost and help the vendor scale production and sales. GE meanwhile could be eyeing Pulsenmore’s teleradiology platform. This is an area where GE is currently lacking compared to its chief competitor, so folding in some capability from Pulsenmore could quickly bolster the vendor’s broader offering.
GE’s investment is staggered, with $21m to be invested up front, another $21m when the vendor receives FDA approval and a further $8m if the Israeli vendor holds another equity offering. These caveats, however, should not diminish from the move. There have long been plans to increasingly bring healthcare into the home, but as yet traction has been limited. GE has taken a sensible approach. Pulsenmore’s strategy is well-considered and avoids some of the pitfalls of entering the market, which for GE means it can carefully, but confidently back the vendor. In short, it is a move that suggests the market might finally be ready for a large vendor’s embrace.
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This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. This content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify Research. To view other recent Premium Insights that are part of the service please click here