Exo Imaging: Executive Summary

Michael Adjei-Mosi, Sarah Besnainou, Rachel Curry and Stacey Gouker

Overview

Exo recently released its Point-of-Care Ultrasound (POCUS) ecosystem, and wants to get it into the hands of as many physicians as possible, with the ultimate goal of standard use in PCP settings. Our task was to move past the beachhead of emergency departments and identify in which physician population and for which cardiac disease states Exo’s ecosystem should be deployed next.

Problem Summary

POCUS is not currently part of the standard of care in many clinical settings, and Exo strives to cross the chasm and drive wide adoption of POCUS. We needed to determine where to dedicate Exo’s resources in terms of who should adopt POCUS next and what technology to prioritize for that physician population.

Solution Summary

Drive further adoption of POCUS to detect cardiac disease by selling Exo’s ecosystem into Inpatient Hospital settings, a logical next step after EDs. The primary Exo ecosystem users in this setting will be hospitalists, intensivists, and residents, some of whom will go on to become primary care practitioners. Prioritize the technology to produce 5 key findings in the following order: pericardial effusion, all valve function, RV & LV size, fluid & CVP estimation, and wall motion. Focusing technology on these findings will help with the detection of 8 key disease states: myocarditis, pericarditis, pulmonary embolism, cardiomyopathy, heart failure, endocarditis, cardiac tamponade and heart valve disease.

Market Analysis

The inpatient hospital physician population was selected based on a variety of factors including current ultrasound adoption, the number of physicians currently trained in POCUS, and the level of clinical evidence already existing. After outlining barriers to adoption and opportunities, it was determined that emergency departments were already competitively penetrated, urgent care centers were inconsistent with treating cardiac disease, and there were too many clinical and operational gaps to go straight to primary care. Therefore, the inpatient hospital physicians present a strong initial target population that also provides a bridge to primary care providers.

We started with a list of 70 cardiac diseases and narrowed it down based on prevalence, ultrasound detectability, and patient value. After analyzing each disease, we came down to a list of eight cardiac diseases. To provide concrete recommendations for Exo’s AI technology, we selected six ultrasound findings that were high yield when evaluating the eight cardiac diseases with POCUS. Then, we ranked the six findings based on the overlap between the eight diseases, in order for technology development.

Impact

We provided Exo with an estimate of the value they can deliver to Inpatient Hospital settings. We concluded Exo’s ecosystem will drive a 20% decrease in average length of hospital stay, achieve up to a 95% decrease in the time required to get clinical answers from imaging, and deliver cost savings of $0.9M - $1.8M per year in Inpatient Hospitals who adopt the technology.