Faster, Better, Smarter, Cheaper With MacuLogix’s Bill McPhee

Even the most groundbreaking device won’t go far if doctors can’t easily adopt it into their practice.

PODCAST EPISODE 306

Click here to watch the video version of this podcast.

MacuLogix cofounder and Chief Technology Officer Gregory Jackson, PhD, developed a novel device, AdaptDx, that could detect early-stage age-related macular degeneration (AMD) by measuring how quickly a patient’s vision adapts to darkness. But it took a major design overhaul and the addition of an artificial intelligence–based testing agent named Theia for doctors to incorporate that device into their practices.

The current version, AdaptDx Pro, has performed more than 1 million diagnostic tests to date. The company’s success stems from its customer-service focus and the commitment to deliver a product that’s “faster, better, smarter, cheaper,” says CEO Bill McPhee.

With host Paul Karpecki, OD, FAAO, McPhee chronicles the evolution of AdaptDx, which shrank from a 45-pound desktop instrument to a 1 -pound headset with a virtual assistant. McPhee also discusses how he helped MacuLogix overcome its commercialization obstacles and the lessons he learned along the way.

Listen to the podcast to learn about:
• Dr. Jackson’s research, which led to the discovery of dark adaptation as a biomarker for AMD progression as well as the development of the AdaptDx prototype.
• How the physician shortage led to a subscription model and the multilingual virtual assistant, Theia.
• The marketing message that resonates with early adopters and early majority (they’re not the same).
• What led McPhee to become a six-time start-up CEO.

Click “Play” to Listen.

TRANSCRIPT:

Paul Karpecki: Hello and welcome to The OIS Podcast. I’m Dr. Paul Karpecki practice in Lexington, Kentucky and have the honor of getting to be a host of OIS Podcast and the great privilege of being able to interview incredible entrepreneurs, innovators, leaders, and CEOs. And today we have one that might fit all of those. Mr. Bill McPhee. Bill I’ve known for some time, and I’ve had the pleasure of getting to spend time with him. I’ve been fascinated by the fact that he’s been through and worked successfully in over six startups to date. He is the CEO of a company called Maculogix. And I really want to, you know, pick Bill’s brain really an understanding kind of that process of how do you get successful in startups? And how do you create paths and new fields and understanding that the step from innovators to early adaptors, we’re gonna go through all of that today, so should be a great interview. Bill, thank you for making time in your busy schedule to join us.

Bill McPhee: Oh Paul, thank you, it’s always a thrill and OIS has been a tremendous asset to our community. So it’s always helpful. It’s always wonderful to be able to contribute a little bit of our history as a company and to the extent we can share stories that make each of us better, it’s a good thing.

Paul Karpecki: That’s exactly the theme. So thank you for summing it up. So well. Let’s get started with for people that don’t know you even going back through the years but walk me through a little bit of kind of your career path, your background where you grew up.

Bill McPhee: My father used to say that it was confused, I will use eclectic as a more appropriate adjective, but grew up in Montreal, and so Canadian by birth. So yes, I do play hockey. And went to McGill University in Montreal. Both of my undergrad actually was a premed program. And my honors thesis and undergrad was focal electrical stimulation in the mesencephalon inducing analgesia in rats and cats. So that was a long time ago, and a place far, far away, got accepted to med school and law school went to law school. And so my mother was not amused by this choice that she always wanted to have a doctor in the family. But as the first kid to go to college, from our family, it was like a pretty big deal. I ended up working in law originally as general counsel for PepsiCo Canadian operations, and then ultimately ran in franchising for pizza and talk about Canada. get recruited to Bain and Company in Boston, when Bain was only, I was a 75th employee at Bain, which has now gotten 10,000 alumni at this point. And was there for a number of years Jerry’s during its go-go growth years. And from there, I ended up doing a bunch of entrepreneurial stuff. Small companies usually doing turnaround sometimes. And then got back into the strategy business and under an organization called Lucas McPhee and we did a lot of international stuff, mostly in the UK and France. And really what’s now most of the European Union, a lot of M&A work, advising on that. And as I went through that process, I ended up back in healthcare because one of our biggest clients was the University of Indiana med school. And we help them with their strategy for managing the integration of the hospitals and the sales and hospitals and growing practices and create the first this is just back in the Hillary care days, created the first really in a sense a Medicaid HMO system for Indianapolis, and built a primary care practice that had at that time. Alright, with 200 180 200 faculty members, those are go-go times pretty exciting. And as I got more back involved in healthcare, I just realized how much I loved it. It’s kind of why I applied to med school in the first place. So ultimately, my wife’s American and so she, as my father also noted, it was a reverse brain drain. If I’m getting new, it’s gonna be a good idea. So anyway, I ended up stateside Boston for 35 years. We’ve been married for 43 To the best gal in the world. Two kids, both of them are on the West Coast. Both of them are entrepreneurs. My eldest daughter sold her first company before she turned 30. So it’s the tree is producing a few other apples. And so that’s kind of the big picture of a background and but ultimately, in 99, I started a venture capital firm that was focused on imaging, particularly in radiology, and got involved in the venture space. Our big home run was a company called Super dimension, which was Poppin Aptronics with $300 million dollars in those days it was and it was a pulmonology navigation system that you can basically find cancers, cancers and other nodules in a woman’s without Having a go transthoracic you could actually do it down the throat into the bronchus. So it was pretty cool, pretty cool way advanced stuff. And then in that timeframe.

Paul Karpecki: Fascinating and that neat, I love how that’s passed on to your children. And they’re all doing great things too. And so there’s obviously a lot of lessons that have probably come from that we’ll definitely want to get into some of those as well. But to kind of start basis of it, you know, for some listeners, we have a nice mix of listeners, we have ECPs, of course, arch percentage, we have investors, industry, all of that. So for those who may not be familiar with Maculogix and AdaptDx Pro, for example, can you tell us a little bit about this innovation? Sure, technology.

Bill McPhee: So I’m Maculogix roots go back to the PhD thesis of our now our Chief Technology Officer, Greg Jackson, when he was in University of Alabama, I happen to be on the board of this company, because I found it intriguing, but at the time, it was pretty much a capital equipment company, because it’s a very different company now. And what Greg did was he was looking at the impact of aging, on vision, in particular night vision. And the question that was posed to him by many patients who are coming through his lab was Dr. I can’t see well at night. And but you tell me, I’ve got 2020 vision, what’s going on? It was the beginning of a realization that there was a concept of dark adaptation, the speed with which the retina responds to improving, you’re improving acuity in with night vision, that might have some predictive power in terms of disease progression, make a very long story short, 42 published peer review papers later, it was shown that dark adaptation is in fact a biomarker for the progression of AMD. So the longer it takes you to dark adapt, the more progressed your disease is likely to be, was an extraordinary insight. But an insight does not create a product takes a hell of a lot of time, money and risk taking to do that. So early in the company’s Genesis challenge was how do we create a clinical tool that’s automatic and measures dark adaptation. And from the period of about 2010, 2011, 2012, Greg and a small group of engineers built a prototype, which became what we call the AdaptDx, A DA PT – adapt as in darkness, and Dx as in diagnostic. And it was a 45-pound instrument looked like a visual field. I mean, it was like Humphrey reborn. And the concept was to create it. So make this familiar to eyecare practitioners as Humphrey might be, make it as easy to use the whole thing. And like most engineers, and scientists, and they thought that the core marketing program would be effectively build it, and they will come. I mean, its great technology is the best in the world is the only Darphin autometer. That measures things automatically, you know, it’s spectacular, right, we developed what’s called a rod intercept, which is the amount of time it takes your eyes to darken. Well, of course, everybody thought that the marketing plan was simply going to be getting a deli, you know, those little number generators in a deli, and then they were just lined up by? Well, the phone’s not ringing off the hook, as you can imagine. And began to realize that there was a real big issue around marketing. And one of the big challenges I think, for all of us in innovation, in medicine, in particular, is that you’re always dealing with existing standards of care. And eventually thinking about a new standard of care. And often the standard of care in some diseases is doing nothing. Which sounds bizarre, but we were just talking before, before we got on live here on the OIS podcast, about how when you were going to school, and you were talking about age related macular degeneration, which by the way, affects 200 million people in the world, 14 million in the US alone, what we discovered was the existing standard of care, there’s no really easy way to monitor the progression of this disease defined in the first place, or monitored over time. You were saying, heck, we you know, we basically if it’s early stage, never mind, late stage, so sad. The anti VEGF techniques and pharmaceuticals began to give us some hope. But the challenge was, can you get the patient to the right retinal specialist for the right injection at the right time and you preserve as much sight as possible. And so what we were trying to do as a company was to figure out how do we play in this space. And as it turns out, ironically, when I first joined the board, my dad was diagnosed with AMD, and ultimately was blinded by it not withstanding that, and in between appointments with this ophthalmologist, his vision deteriorated dramatically from about 2042, almost 2100. And it was extraordinary how quickly it happened. So I have a dog in the fight, of course, and that makes me very committed to it. But going back to the story, you know, we’re thinking about how do we penetrate how do we provide better patient care. And the journey is complicated. So we found that that are 45-pound instrument that gets bolted to a table in you know, an exam room. And, Paul, you have one of our instruments to borrow tabletops. It’s a honker, I mean, and the thing about our test is that it requires it be a totally dark room because you are doing dark adaptation. And of course, then you have to have a technician with the patient in the room, the cut point for disease, no disease, about six and a half minutes. Well, how many technicians want to spend the day in the dark. And it was harder for patients, people are afraid of the dark sometimes. But practically speaking, it meant that they couldn’t do other tests was occurring. So this was a big problem. We had an automated dark edited that could do great things. It didn’t mean it was easy to implement.

Bill McPhee: So in 2017, I became CEO of the company, the company was struggling, it was really struggling with commercialization. We turned a lot of that around, we had this initial technology, which was as I say, kind of a Humphrey look alike button, this instead of glaucoma. We’re looking at an EMP. And I sat down, and I said, look, here’s what I want you to do. I want you to take this 45-pound instrument, I want you to shrink it to one pound and put it on people’s heads, I want you to do it in a way that they can have a private dark room, because we’ll put eye cups on it. And guess what, they won’t need to be in the darkness. And that means you can test people anywhere, anytime. And so what happened was, and I don’t know whether the camera will pick this up. But this is the result of roughly $10 million of effort over about two to three years on the AdaptDx Pro it head mounted mobile, it is totally mobile, you can test patients in a nursing home or an assisted living community. During COVID, we had people testing people in the front seat of their cars when they were using the parking lot as a reception area. So all of a sudden, we began we just changed the whole paradigm. And I think that’s part of what has to happen is as we listened to our customers, they said Look at this big honking tabletop, it’s really hard for us to implement in our practice. And so as we listened to folks, and it’s hard to listen, when it’s your big honking piece of equipment, because you love it right and you’re proud of it. And I said to my guys, I said, Okay, we’re gonna toss this thing up, we’re gonna start over, we’re gonna take what we know about the physics and dark adaptation, apply the intellectual property, and we’re going to create this brand-new headcount of technology. But that’s not enough. We needed to also have something that offset the reality that in most practices, staffing is at a premium. So we incorporated for the first time, I believe in ophthalmology and optometry and artificial intelligence-based test agent called fear. And fear does all the testing. Once the patient puts the unit on their head, fear takes over the entire test. And the first thing of course, Paul, your dad, and I remember this very clearly was you close your eyes, so that you could see what you could fake out there. And she was gently nudging you not to be an idiot. And you started laughing. I remember this. So we created and incorporated artificial intelligence into the testing process. Because practically speaking as optometry takes its rightful place as managing most of primary eye care in this country, Process Automation is going to be critical, because productivity is going to be a problem and look at the issues we’re facing as a country on staffing. Generally, never mind just in technicians and folks in the practice. So we were a little bit prescient, perhaps, but COVID basically proved to all of us the importance of being able to do things faster, better, smarter, cheaper, and that’s what we created.

Paul Karpecki: It’s fascinating, incredible release and to do it that quickly and frankly, quite linked such a lean approach. If you think about Yeah, I would have to go into I mean, how many parts would be in a device so

Bill McPhee: We have 172 unique parts. This is not a VR head virtual reality headset or something like that. The thing about Man looking for as you know, so Well, we’re looking at a macular disease. And so the the instrument has to focus on each pupil independently. And so within this instrument are four servo motors, managing a whole family of optics to make sure that we have the right presentation to the patient to test the patient that there isn’t any any errors. It’s really complicated technology. And we were able, I mean, when I first became CEO in 2017, we had 12 people in the company in our to shy of 80. And we built an engineering team, we had a we invest in a lot of outside consultants and engineering consultants. But I spent a lot of time on the design side, I had been CEO of a company called East site before this, I’ve built electronic eyewear to let legally blind people see again. And so I had spent a lot of time with a couple of design firms on the West Coast. And how do you make something fit on someone’s head that’s comfortable, that doesn’t make them feel claustrophobic or in a cage. It’s very complicated the human dynamics and, and the ergonomics of it, every critical. And one of the things Paul, you and I were talking about when we’re going through this process was, you know, when you think about someone, my mother in law, for example, who is almost 98, sticking her chin out, and getting her forehead firmly against that strap and holding it is really hard. With our technology, she can sit in a lazy boy and put her head back. And you know, it’s a whole different experience. So I think from a practical point of view, the big lesson here is what did we learn from our customers? Didn’t we listen to our customers. And we worked really hard to do that. But there were some fundamental things that I did not really understand clearly enough, in this entire process. And I think you were part of our advisory board meeting, I think it was in 2020, in January. So just before COVID, we were up in in Hershey, Pennsylvania, our headquarters. And what I started to hear from people was how hard things are to implement and practices. And one, come on, guys, you guys are all smart, you’re all capable of what. And as we listened more, we began, I had learned that this was going to be really hard. And again, blindness created by this is the greatest technology in the world, right? So build up new will come very dangerous. So what I discovered was the single biggest impediment to adoption was not the technology per se, we had to create awareness of the relationship between dark adaptation and EMP. Of course, now it’s 88% of OGIS are aware of that relationship. And we had 20,000 odds go through continuing education this year. But even though we have 1000 of units in the marketplace today in practices, the real challenge was implementation in the practice setting aside COVID All the staffing problems, it was how do I incorporate a new test for disease I historically have not managed into a practice that’s short staffed for chronically understaffed. And so fear was part of the solution. Because we didn’t have to have a while the test is being done. A technician can do other things like enter data into the EHR, sanitize the next the equipment for the next patient, you know, that kind of stuff. But we had a great we had to go out and talk to practices that were just doing a lot finding a lot of AMD enterprise is 30% of their patients over the age of 50 were failing. And we had to learn what it would take to implement. I would argue, and I think this is important for the entrepreneurs in the audience, that the minimally viable product were so fond of talking about me in the old days as a venture capitalist or as an angel investor. That minimally viable product also includes implementation. So we did something radically different. We actually haven’t talked to the customer and found out how they did how our best 20% use the technology. And then we codified it into a program. And I think the thing that was most surprising to us was that some of the lessons were simple, but not simplistic. So for example, in a practice, which skews more geriatric than not, the scheduling is incredibly important about how many you don’t want 385-year-olds back to back, were using walkers because of what it does to the lane, right. So we began to understand how we had to fit this in, oh, you want to use this after an optimum, there’s an optimal cause and bleaching problem with our technology, because you have to have, you’re retina pretty much unleashed at that point before we do the bleaching with our technology. Oh, we can fit that in now. And so we’ve it’s been a learning process as we collaborate with you and now almost 850 physicians who use our technology across the country,

Paul Karpecki: Phenomenal, I love how the granularity of which you got to really figure it out, I think those are the steps that now sounds so obvious when you hear it, or why we really success, but it’s not something new inherently think about. And what a difference now you’ve had over a million diagnostic tests complete.

Bill McPhee: We hit a million in the first quarter. And the first next year.

Paul Karpecki: Yeah, that’s fantastic. I mean, I’ve technology I know found it to be incredibly health, I love the mobility of it, we have three offices, I can rotate it through, they all do.

Bill McPhee: Exactly. But I think the other thing that we did, which was pioneering was we also move to a subscription model. One of the things that’s associated with a head mounted technology is you’ve got this piece of equipment is someone that had dropped it. And we designed it to be able to be dropped from nine feet and survive. But it’s not something you encourage your staff to do. It’s not meant to be a football in the office. And practically, what we said was, there’s a couple of things Doc’s really get concerned about one is obsolescence protection. One is downtime. And in contrast to every piece of diagnostic equipment, maybe except for the time that this is not bolted to a table, this is in the hands of technicians and patients. What’s the odds of it fall, we started talking about that. And then we also learned that our Doc’s wanted some time to get the the instrument in their practice Incorporated. And particularly before we had our AMD excellence program or implementation program, kind of crystallized, they wanted some time to get this in the practice. So we created a subscription model, where we effectively guarantee 100% uptime. The big difference between shipping a 45 pound answer that sit on a pallet in order not to be disturbed. And this instrument is this thing can go in a FedEx box, I can happen to you tomorrow morning. So if one of your text drops it, all they do is they call our service desk, and we get it your new one so that you’re not down, you don’t have to reschedule a whole bunch of patients, you’re not out for two weeks for a service. And we don’t care what happened to it, if you have one of our subscription agreements. It’s kind of like my iPhone, it’s like, you know, it’s Apple Care. And, you know, I cracked my screen, I don’t know, probably quarterly, and I get new one the next day. And so that’s what we want, we were trying to take business to consumer concepts of ease of use innovation. Really 100% uptime, if you will, because all of us are accustomed to having it whether it’s Amazon or Apple, I mean, we’re used to having it now. And that the nice part about this technology is that it can be FedExed. And so I can get you something in 24 hours, that changed the nature of customer service, it also is much, much cheaper, and I don’t have to have a fleet of remote technicians in the field to service equipment because I just replace it. It’s much more cost effective.

Paul Karpecki: That’s brilliant, really whole different way of looking at it. So it’s one of the interesting areas that I’ve always been fascinated by companies that have come into a field perhaps within IQ such as AMD, as I mentioned, he mentioned earlier, you know, when I went through school, we told patients, you know, either had the bad kind or the really bad kind, you know, one was slow, it’d be blinding the wet form. And we’d really think of anything we you know, eventually got to take a vitamin, an urge to formula and that was it, how much your time has to be spent in educating about the technology compared to educating about the ability to impact this disease state which we can today in many ways everything from what we prescribe and vitamins to wet AMD treatments and monitoring overtly, all the way through to even you know how what blue blocking some glasses certain vitamins at different stages of the disease and now have in the new year some general treatments for geographic atrophy so obviously we can have a huge impact on this disease state but I don’t think that was inherent to doctors. So here you know if you can’t treat it why would you test it now that we know we can treat it we see this the technology is invaluable couldn’t really manage this disease state without it but how much of a work was it in educating that part?

Bill McPhee: You know, the legendary Sisyphus rolling the rock uphill. I think this is a challenge for everyone who is introducing new technologies and new way of managing chronic disease in particular. And, I mean, you were trained the way you were training because at the time, there weren’t a lot of options. And let’s face it, diagnosing AMD based on a background classification of drusen, sighs, location color is a structural assessment, that’s hard. It takes a long time, it takes great training, you have to be really looking for and it’s really hard to do. I mean, in our clinical trial, we asked for this 380 patients that were referred to us by into the trial by optimal outcome, just not Phonologists 50% each. And we told them send this patients who don’t have AMD, because you want to follow them for the next three years. And send us your retinal imaging, so that a retina panel can review the date, this is published in JAMA in 2019 25% of these patients have visibly envy. A third of that 25%. Frankly, we’re in serious yoga. And so even in a situation where really smart capable people are looking for this disease, it’s really hard to find. Yeah, so and it speaks to the issue of patients getting to the retinal specialist at a point in time when they’ve lost too much sight. I think that’s a that’s been the big issue or odd is getting a phone call from a retina specialist saying it got to there’s nothing wrong with this patient. They’re here too early. So here’s something that I think your listeners, again, who are thinking about technology introduction need to consider. At least it’s the lessons I’ve learned it at considerable expense and my dad, and that is you got to do a lot of customer research. We went out in 2017. The awareness between of dark adaptation and its relationship as a biomarker to AMD was in the order of 15 to 20% of Optometry. Mostly early adopters. Today, it’s 88%. But it’s five years later. And we’ve spent, you know, a small fortune, educating Doc’s educating the industry. And it’s not like you do it once. And it’s done. Because folks, you know, we’re trained as you were really not to pay a lot of attention to this disease. So it’s a battle, but who manages all go calm in the country? ODS, who’s managing diabetic retinopathy, ODs? Why aren’t they managing AMD. And that was kind of our battle cry. We ended up doing a ton of customer research. And what we discovered was in the adoption cycle of all technologies, there’s the early adopters who will put up with, you know, like me, the early mean, two things that never really worked very well. And you know, how many of us have a drawer full of gadgets we bought that really weren’t ready for primetime. And those are early adopters. And then they were very fond of our tabletop equipment. But the more conservative, early majority, when you cross the proverbial chasm in technology terms, and you begin thinking about crossing that chasm being to realize the messaging is very different. So for example, folks like you, Paul, you were really keen on managing patients, you want them to stop smoking, have a documented training diet, it was really a wellness approach. And you and many of your colleagues were saying, hey, if an error is formulation is good for intermediate stage disease, maybe I suggested patients take it earlier. So it was much more of an inclusive model was a wellness model. But it was about managing the patient’s health and buying them time as the disease progressed. The early majority feels a little bit differently, what we learned, and this is a minor, but very important difference, manage if you’re early adopters monitor if you’re in the early majority, because frankly, for a lot of physicians, it’s about watchful waiting and making sure they get the patient to the right referral point at the right time. And everyone has a point of view about errors that we’ve had these how many debates and we had about this over the years. But fundamentally, we want to preserve as much size as possible to do that you need to monitor the disease progression. The only way you can do that is using a darker parameter because we generate the rod intercept it gives you a number. A change in that rod intercept is not a good thing, and therefore might mean a more frequent amorphic quick checkup instead of every six months, perhaps quarterly. So it’s a different model. But, again, when you go and talk to the early majority, if you talk them about management, I don’t really know I don’t want to sell nutraceuticals, you know. But I do want to know how my patients are doing. I mean, there is this very kind of Joan of Arc, save their souls, sort of approach and optometry to doing right by patients. And so we learn that the message that work for early adopters wasn’t the same message for the early majority. And that’s forced us to rethink our marketing, it’s forced us to rethink how we work with with physicians after the fact. And it’s a really critical element of what we’re doing. That’s brilliant.

Paul Karpecki: And you know, is the early majority is just huge group and a bunch of be monitored in different ways. This can be good for everybody, though, because if you’re monitoring, you know, more now at this stage, and this is the larger group of primary eye care providers, you’re going to be when you see that change in rod intercept, you’re gonna bring the patient in now maybe that’s really the biggest indicator of who preserves division, yeah, either diagnose before they could go wet, or in the future, even some dry treatment?

Bill McPhee: I think it’s got to be incredibly frustrating to be to look into for a patient to arrive with 20 at 2100 2200 vision. And knowing if you’d had them three months earlier, you might have done something, they might have had better vision. And as I watched my dad lose his sight. And the impact it had on my mom as a caregiver. And quality of life is just this deterioration, staggering. You know, talking about a Canadian guy who can’t watch a hockey game, or watch curling with my dad’s third sport, but yeah, it’s a big deal. So as we’ve looked at this, but the other aspect of this, and this is a huge shift, is because our technology is now cloud mediated, we can update it over the web, we can monitor it over the web. And so we just did an update earlier in the year fanout speaks eight languages. So if you have a practice, which skews Hispanic, for example, and you have a bunch of folks, perhaps English is not their first language. Why not do the test in Spanish? And if you have Spanish speaking staff, that’s not a problem. But if you have English speaking staff, we are able to talk to them in English and speak to the patient in Spanish. Wow. Yeah. So we’re now you know, we did this all over. Through the cloud, it’s all cloud media. The other thing that happens in our AMD Excellence Program, is that we monitor the instruments from afar. You know, when you get on a jet plane today, that jet engine, let’s say it’s a GT or Rolls Royce engine, they’re monitoring what’s working, what’s not working, what maintenance issues, there might be yada yada in real time, right? They got a satellite everything. So we do the same thing. And we also monitor and work with our physician partners, to say, hey, you were doing last month you did 45 tests this month, you’re getting 15? What happened? Is it not working? That it break? Did you lose staff, you know, was a scheduling issue? And so we get a red flag system that helps practices because we can say, hey, this is what we’ve seen, sometimes other practices, is this, what’s happening to you. And so we can take kind of the learning of hundreds of practices, and soon to be 1000s of practices, and develop best practice. So we can say, this is what works for practice of your type, your size, and this kind of location. And so that’s a huge shift, when you begin to think about mobile technology, cloud mediated, AI enabled, and most important, implemented in a practice in a way that works for that practice. And that is the goal. It’s and that is the hard part for most of us entrepreneurs to learn is the technology is just simply the price of admission. But the real show, is after you sell the unit to the physician, because they don’t have time to figure out how this is going to work in their practice. They get incredibly busy in the thick of your day. And they just want to know what’s going to work. And that’s our job. So as an industry, I think I can say with confidence that we probably have the highest net promoter scores for customer service, because you call us and you say this doesn’t work. My head mount instrument is not working the pros Not working. I’ll have you up and running in 24 hours, no questions asked. Because as part of your subscription, our job is to keep you up and running and to provide you a best practice. That’s what we have this thing called AMD Academy. Let me give an example. So the technicians are critical. Train training technicians finding time to train technicians. It’s so hard on a busy day in busy practice in particular now that we’re all short staffed. So we create a series of two-minute vignettes, little video clips, on a YouTube type apparatus, you can watch it on your iPhone, to train people, because you know, if you have your technician who typically does this kind of testing out sick. Well, some of the other techs man have been doing this a lot. How do they know what to do? So we created these online tools. And then what we also realized that you were part of the Advisory Board, Paulo’s gave us this terrific and important advice, which was, it’s about peer-to-peer activity.

Bill McPhee: And it’s not just physician to physician that’s critical. But it’s also tech to tech. And it’s, it’s come to our attention that you know, Fayette, who’s our artificial intelligence, the technicians do not refer to our product as the deputy expro. Much not much of the concentration of my marketing chief. They call it fear. And they plan the day as they look at which tests are being done with which patients what period of time and whereas though Thea is in the staff meeting in the morning. And so we’re beginning to see the mix of things we take for granted of I can order anything from Amazon and have it in an hour depending on the city here. Well, we’re taking that basic concept and putting into play in optometry and then ultimately in ophthalmology.

Paul Karpecki: So fantastic, amazing. Interview. So first, closer by talking a little bit about where you’re at today, in terms of the year, I think, are you in a fundraising stage. And I mean, obviously seeing the growth and what you’ve learned and the impact and even will experience with this. This is a very exciting company. So tell us a little bit about where you are right now and where in fact, the listeners might be able to help?

Bill McPhee: Well, we’re at this point in time, like so many people were coping with, you know, is this a new normal post-COVID, Pre-COVID, New COVID delta omega i don’t know, all I know for sure is that it’s had a material impact on practices out there, our customers, and it’s had, obviously a material impact on our economy. So we’re out raising $30 million to continue the growth of the company, COVID has probably pushed us back 18 to 24 months, just because jobs and survey 46% of OTS did not want to see a sales rep mean they were really becoming affected or affecting their staff. And I perfectly understand that. But at the same time, it impacted us incredibly. So as we’ve gone through this period of time, we need a little more dough to get us over the hump if you will into becoming a profitable company. And I think the other aspect is that, you know, we have learned, we have 1000 of our of our instruments currently in practices out there. One of the things we want to spend money on is how to do a better job supporting people in the field. supporting our customers improving our customer service, even though it’s it’s good can always be better. The other area of spending money is looking at new innovations. What can we do to make this instrument and the management and or monitoring of AMD, faster, better, smarter, less expensive, less impactful on flow in the practice that kind of stuff? One of the things I’m very much looking forward to is being able to think about how do we think about helping physicians like you to monitor a patient over time. So the UK just pull it up? You know, my iPhone tells me how many exercise sessions I’ve missed. It kind of reminds me of those more often than the second exercise session, they’ve actually executed. I think apples got it in for me, but we want to be able to treat the let’s say, Mrs. Smith, I just want to show you that with what you’ve done. You stopped smoking and your rod intercept is flat for the last two years. That’s the kind of information you don’t want to have to dig around in EHR. You don’t want to have to have you know, you’re I’m saying is how do we make this impactful for you? How do we make this impactful for your patients? How do we help you create a stickier practice with better technology and better-quality Customer and better emphasis on customer and patient satisfaction? And I think that’s where I’d like to spend some time because optometry, in my view, has to become the home of primary eye care in the United States, the role, there’s not enough ophthalmologists, there’s just not just aren’t enough. And we have an aging country there. They’re 14 million people, they can detain us by 2050, it will be 22 million, who’s going to take care of all these people? And so we’ve got to figure out how does technology and the way smart folks practice to figure out how we’re going to absorb the demand for service? How are we going to make that happen in a world of increasingly more common chronic diseases as we grow older? So that’s kind of the mission here. And I think for the entrepreneurs out there, it’s really a question about working with physicians and saying, Guys, you guys are brilliant at what you do. How do we help you do it faster, better, smarter, cheaper, because you know, what you want to do with your patients and how to do it? It’s our job as innovators to say, what if we did it a little bit this way, and you’ll go down, or, well, that’s not a bad idea. I think that’s going to be the challenge in the future is how Process Automation improves flow through and practices and improves patient satisfaction and eliminates the barrier of communication between patients and physicians. And we need to be a part of that solution. Rather than being part of the I would argue, in some cases, instruments can get in the way. But I will leave that to smarter people than me to have a discussion about.

Paul Karpecki: That’s terrific cow. So certainly fantastic interview, incredible number of insights. Or whether you’re a CEO or on a way to it or an organization, whether you’re a physician, you understand the big picture, and even the new onset, how you change marketing messages as you go through the different stages of each doctor in terms of how they look at things, whether they are an innovator, early adopter, or early majority. And so it is fascinating to see that and then of course, very exciting company with great growth prospects. And I think the future is only brighter, especially as it becomes more and more treatments for macular degeneration, we need to identify sooner prevent blindness.

Bill McPhee: Well, the geographic atrophy area, it looks like it’s burgeoning. You know, and it’s inevitable that we’ll see something for dry India at some point in the cycle. But it’s interesting. Paul, you were talking to me earlier about raising money. And you know, in 2018, we brought vivo capital in as our lead investor backing up rush ventures, which had been in our in funding our company for now, seven years. But in 2018, we went to raise money, we didn’t have the AdaptDx Pro, we adapted point in time, we still haven’t proven that we knew how to help Doc’s implement this, we didn’t have as much knowledge about the needs of physicians by segment in terms of adoption curves. And now as we go out to raise money, it’s a growth stage company rather than an early-stage company. I mean, I had really realized that we had 25 people. And now you know, during COVID, we built a factory we staffed it, is ISO 1345 certify which folks in the audience that’s like the pinnacle of quality. And we’ve now sold in the last, what, in the middle of COVID, last year, about 500 practices now have our AdaptDx Pro, our newest head mounted artificial intelligence driven technology. So it changes and it’s really fast. I guess it seems fast to me, I would like it to be faster. And I think as we talk to your audience, big lesson is it always takes longer. It always costs more money. And there’s always surprises. And last but not least, no we didn’t figure out there was going to be a pandemic and what that was going to do to us in the process. But thank you for the time and it was very helpful to you took me down and some memories that I had totally forgotten about as we evolve as a company.

Paul Karpecki: So awesome. Well, you’ve taken us through a lot of great insight, so I thank you for that. How can our audience people are intrigued or even investors get in touch with you?

Bill McPhee: So it’s BMcPhee@maculogix.com Or on LinkedIn just look up Bill McPhee and or just go to our website, Maculogix, all the contact information is there. Delighted as people might want to join our you know; our vision is to eliminate blindness caused by AMD. That’s what we’re trying to do. We don’t have the, We don’t have a cure but my goodness we can certainly preserve an awful lot of sight for an awful lot of people.

Paul Karpecki Thank you, great interview Bill really appreciate you taking the time.

Bill McPhee: Thanks Paul Take care now.

Paul Karpecki: You too!

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Ehsan Sadri
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