Stereotaxis, Inc. Q1 FY2020 Earnings Call

Good morning. Thank you for joining us for Stereotaxis First Quarter 2020 Earnings Conference Call. Certain statements during the conference call and question-and-answer period to follow may relate to future events, expectations and as such, constitute forward-looking statements within the meaning of the Private Security Litigation Reform Act of 1995. Such statements involve known and unknown risks, uncertainties and other factors, which may cause the actual results, performance or achievements of the company in the future to be materially different from the statements that the company's executives may make today. These risks are described in detail in our public filings with the Securities and Exchange Commission, including our latest periodic report on Form 10-K or 10-Q. We assume no duty to update these statements. At this time, all participants have been placed on a listen-only mode. The floor will be open for questions and comments following the presentation. As a reminder, today's call is being recorded. It is now my pleasure to turn the floor over to your host, David Fischel, Chairman and CEO of Stereotaxis. Please go ahead, sir.

Thank you, operator, and good morning, everyone. I hope you and your families are healthy and well. We last spoke two months ago in early March. Since then, the tragedy, disruption and hardship inflicted broadly across society by COVID-19 has been extraordinary. For Stereotaxis, this period has been challenging, but it has also been an invigorating time of creativity, progress and positive change. On today's call, I want to provide transparency into the commercial impact we are seeing from COVID-19. I will then discuss the ways we are responding to the challenges and our approach to successfully navigating this period of uncertainty. Let's start with the commercial impact. Stereotaxis' hospital customers are on the front line in the battle against the pandemic. As an acute reaction, hospitals globally have dramatically reduced procedure volumes in order to lessen infection risk, preserve vital equipment and focus their resources toward battling the pandemic. The reduction in medical procedure volumes is unprecedented. With various surveys documenting 50% to 90% reductions in a broad range of procedures, including those that would not typically be considered elective. The field of electrophysiology has not been immune to these procedure declines. Up through the first week of March, we experienced procedure volumes in North America and Europe that were consistent with expectations. Our procedure volume in Asia had been down over 50% compared to the prior year, but that decline was isolated to China and the impact was modest to our overall global business. In the second week of March, we started to see a sudden and steep deceleration in ablation procedures across North America and Europe to levels approximately 70% below normal. The decline was felt across hospitals, with most severely curtailing their procedure volumes and others stopping procedures entirely. Over half of our hospital customers that performed procedures in the first half of March did not perform any procedures in the first half of April. Stereotaxis earns approximately half of its recurring revenue from disposables used in these procedures. The majority of the decline in recurring revenue observed in the first quarter was due to the decrease in procedure volume across geographies. We have begun to see indications of a gradual return to activity as hospitals feel better prepared to navigate the pandemic and the extended shutdown impacts both patient health and hospital operations. Our procedure volume in China has returned to pre-COVID levels. Several U.S. and European hospitals that were almost entirely shut down in April have initiated steps for partial reopening in May. While we are hopeful for a return of activity, we are cautious in drawing conclusions from short-term data as there remains large volatility in daily procedure numbers. The expectation is that reduced procedure activity will persist for several months, with the duration and slope of the recovery impossible to estimate with confidence. In addition to the acute impact on procedures, travel restrictions had a temporary impact on our ability to complete certain service activities at the end of the first quarter. While the vast majority of our service revenue is earned from long-term service contracts, about 10% of service revenue in a typical quarter is earned from project-specific billings not covered by contracts. Not being able to complete work on two specific such projects accounted for 30% of the decline in revenue observed in the first quarter. That is not lost revenue, but rather an issue of timing. We have restarted those service projects over the last few days and barring any negative surprises, we expect to complete them this quarter. Service revenue comprises just over half of our recurring revenue and is primarily driven by multiyear non-cancelable contracts. We view this revenue as a source of stability for Stereotaxis and largely protected from COVID-19. We were proud in early March to announce FDA clearance of our novel Genesis robotic system. On the heels of that approval, we projected that this year would see significant revenue growth driven by adoption of Genesis. We were confident in that projection as we had already received two purchase orders and there were several additional orders both to new and existing customers that were in late stages of negotiation. Progress on the two purchase orders that were already received continues without interruption. The first system is in transit to Europe as we speak and the second system is expected to ship in the coming weeks. Both are expected to be installed and recorded as revenue early this summer. The pandemic has unfortunately disrupted the progress on several purchase orders we expected to be able to announce on this call. While the delays are disappointing, we continue to expect a return to robust robotic system sales as the pandemic recedes. Replacement cycle projects can be delayed, but not indefinitely and we continue to receive very positive feedback and inbound interest on Genesis. The impact we are observing from COVID-19 is largely outside of our control. Our response and how we navigate this period, though, is fully our responsibility. I'm proud of the way the Stereotaxis team has rapidly adapted to the new challenges and realities. Our primary goals during this period have been maintaining support for the patients and physicians that rely on our technology, maintaining smooth and efficient operations, ensuring continued rapid progress in our strategic innovations and protecting the financial stability of the company. I will briefly expand on each. First, supporting patients and physicians. Stereotaxis' technology is used daily by physicians all around the world to treat patients suffering from dangerous arrhythmias. Our technology plays a key role in enabling treatment to be delivered safely and effectively and in treating patients who cannot be treated well or at all without robotics. We recognize our responsibility to continue providing clinical and technical support to the physicians and hospitals that rely on us. We have complemented our in-person support with an aggressive build-out of a telerobotic support capability. Dozens of Stereotaxis' team members now support robotic procedures remotely, using proprietary connectivity technology. Robotics is an ideal platform for telemedicine and Stereotaxis has established unique capabilities that aggregate all cath lab procedure information on one large screen display and then allow for that display to be remotely accessed, viewed, and if needed, controlled from afar through secured networks. We have seen broad acceptance, interest, and use of telerobotics support over the last weeks. The importance of our technology and our telerobotic support capability was highlighted a few weeks ago when one of our sales directors remotely supported a physician in the southeastern U.S. who was treating a 27-week pregnant woman with dangerous ventricular tachycardia. The procedure was successful, had no complications, and no fluoroscopy was used, so the baby was not harmed. We continue to perform telerobotic support on a daily basis and expect that the technology will take on an increasingly important role, even post COVID-19. We are proud to be pioneering this technology, maintain an open hand to sharing our capabilities with others during this time of need, and we'll continue to advance telerobotics as a key cornerstone of robotic surgery. Maintaining smooth operations, despite transitioning the vast majority of our team to working from home, has required significant effort across the organization. I want to particularly thank our IT team for rising to the immense challenge of rapidly enabling a distributed team to continue collaborating effectively, efficiently and safely. Our operations across all aspects of the company have functioned without interruption. We continue to engage with our supply chain partners and believe we are managing well the supply of key inventory. Our team has adapted creatively to the new environment and remains passionate and committed to advancing Stereotaxis' mission. As an example, in order to continue accommodating physician interests in viewing our Genesis system, we launched telerobotic test drives. From their home or office, interested physicians receive a tour of our headquarters, a live demonstration of the Genesis system and are able to take direct control and drive a catheter with Genesis. Over the last three weeks, I have hosted individual tours for 51 physicians from 29 hospitals. It is often said that during times of crisis, there's increased ingenuity, openness to change, and increased appreciation of what is possible. I see this every day across our team. We continue to make progress on our strategic innovations. Most importantly here is the progress with our next-generation magnetic ablation catheter. Since we last spoke two months ago, Osypka and Stereotaxis teams have continued to make minor refinements to the catheter design to optimize performance. We recently received refined prototypes and leveraged telerobotic test drives to receive feedback from several KOLs who were able to navigate the catheter in a phantom. The KOLs provided us with glowing reviews on the navigation performance and how the design is expected to improve clinical outcomes. We look forward to finalizing the design in the near term and transitioning into the next stage focused on establishing and refining the manufacturing processes. In tandem with the engineering efforts, we've begun preparing our regulatory strategy for Europe and clinical strategy for a U.S. IDE trial. Beyond the ablation catheter project and into larger innovations, the Stereotaxis R&D team is spending significant amounts of time on a second wave of innovation, both within EP and beyond. These efforts give me confidence that we will continue to creatively redefine robotic magnetic navigation in ways that meaningfully enhance its capabilities and accessibility. As described earlier, the financial impact of COVID-19 on Stereotaxis is primarily felt in the reduction of disposable revenue and in the delays of robotic system sales. Financial prudence has been a hallmark of our management of Stereotaxis. It is important at all times, but particularly helpful to weather shocks and black swan events like now. Financial stability is important for all businesses, but particularly important for Stereotaxis. Our physician and hospital customers need to feel comfortable investing in equipment that will be used for many years. Strategic industry partners need to be confident in our long-term trajectory and reliability as a partner. While none of us are able to confidently estimate the trajectory of the pandemic and its extended broad economic implications, it's incumbent on us to plan for a disruption that will persist for an extended period of time. Accordingly, we have worked hard to reduce expenses across the organization. We are doing this in a delicate, surgical fashion that maintains our organizational capabilities and does not harm or slow our progress. Kim and the finance team worked hard navigating the Paycheck Protection Program application, and I want to thank and congratulate them on their efforts, which helped us receive a $2.2 million forgivable loan. That funding has allowed us to avoid additional reductions in expenses that would have otherwise been necessary. We are in the process of pursuing similar more modest relief from various European countries. I will now pass the call over to Kim to discuss our financial results in more detail, and then I'll make a few final comments and we'll open the call to Q&A.

Thanks, David, and good morning everyone. Revenue for the first quarter of 2020 totaled $5.8 million with recurring revenue of $5.5 million. Recurring revenue declined by 18% from $6.7 million in the same quarter last year, primarily due to lower procedure volumes and delayed service activities following the COVID-19 outbreak. Gross margin for the first quarter was approximately 83%. Operating expenses in the first quarter were $6.9 million, down 11% from the $7.7 million in the prior year quarter, with the decrease predominantly driven by the timing of R&D projects and also by pandemic-related reductions to sales and marketing activities. These cost reductions were partially offset by increased noncash general and administrative expenses. Operating loss and net loss for the first quarter were $2.1 million and $2 million. Negative free cash flow for the first quarter of 2020 was $2.2 million compared to $1.8 million for the first quarter of 2019. At quarter end, Stereotaxis had cash and cash equivalents of $28 million and no debt. I will now hand the call back to David.

Thank you, Kim. Given the impact of COVID-19, we believe it is prudent to suspend our guidance of robust double-digit revenue growth for the year. The uncertain duration and scope of both the pandemic and its economic impact make it difficult at this time to reliably provide alternative guidance. Despite the uncertainty and challenge, we are comforted by a few key observations. We have technology and a team that positively impacts patients, physicians, and medicine. We are creatively responding to our new reality with differentiated, elegant capabilities whose adoption will be accelerated in this environment. We are continuing to energetically advance all critical innovation, commercial and operational activities. We have an innovation strategy that is clinically and commercially sound, which will transform Stereotaxis over the coming years. And we continue to manage our financial position in a prudent fashion to ensure we can invest in progress while weathering a potentially extended period of broad global disruption. That concludes our prepared remarks. Operator, can you please open the line to questions?

And your first question will come from Josh Jennings with Cowen.

Hi, good morning. Thanks, David. I wanted to ask about the multiple Genesis purchase orders that you mentioned might be announced this quarter. Can you provide any additional details? Are these orders currently on hold? What do you think will be needed moving forward? Will there be opportunities to cross-sell again, or can you resume contract negotiations where you left off? Also, could you share whether these potential orders involve new centers or are they replacement orders?

Thank you, Josh, and good morning. Historically, we have been conservative with our guidance. When we provided our last guidance, we were confident in our ability to meet it based on the interest we observed in the Genesis system from various hospitals. This interest includes both replacement cycles for existing customers and new system sales to new customers or additional labs for existing customers. We have not received any reports of project cancellations. However, starting in mid-March, it seemed that most hospital administrators were completely focused on COVID-related activities. Their attention shifted to responding to the pandemic, preparing their organizations for COVID patient intake, and sourcing necessary materials to combat it. As a result, there wasn't much capacity to focus on our systems or equipment. Now, most hospitals appear to have completed their initial scramble to prepare for COVID patients. There is still some uncertainty about their financial situation and how government support will be implemented, including the timing and nature of payments they will receive. However, we believe we can start to reengage with these administrators, though it remains unclear how this will unfold or how quickly it will happen.

Understood. Thanks for that. And then a follow-up, I know it's hard to forecast how elective procedures reopen and their ramp back to historic levels. But in some of the states that are currently reopening and some of the executive orders from governors that have been removed and with hospitals starting up elective procedures again. Have you received any insight from your customers about how cardiac ablation procedures could potentially ramp up? I know there's wide variance probably in every state and every center. But any high-level commentary you can share that you received from your customers?

Sure. So in all of our telerobotic test drive discussions, we ask a similar question. And it is, like you inferred, there's a huge amount of variability, a huge dispersion in the responses we receive. We do get from many hospitals both in the U.S. and Europe a feeling that there's a desire to open up much more fully not just from the physicians but from the administrations and that there are plans in place to open up much more active ablation practices. We also hear from some that still feel that there might be a reduced level for several months. And, obviously, it's not fully under the control of the physician or the hospital; it's also going to depend on the confidence of patients to come in for ablations. And so I think there is still a huge amount of uncertainty, even by those closest to the situation; they're not sure exactly how it's going to progress. But there is definitely a feeling, again similar to the comments on the capital sales side, on the procedure side, where in the beginning everyone was busy and nervous and scared just scrambling to respond to the rapidly changing reality around us. I think that now there has been a settling into this new normal. I think most hospitals are confident that they're not going to be overwhelmed with COVID patients and that they can start to go back to operating regularly in a more restricted, cautious environment. But again, exactly how that plays out in the numbers isn't easy. In the second half of April, we saw about 10% more procedures than in the first half of April, so again, I see signs that we can see growth from here and that what we saw in the beginning of April, end of March, was probably the worst of it. But again, there's so much volatility in daily procedure numbers still, it's very hard to give good, confident guidance off of short-term data.

That makes sense. And just one last question. You referred to some of the R&D efforts your team is working on internally. I just wanted to make sure we were not missing opportunities here. Anything deeper on the pipeline, both EP-related work as well as non-EP-related projects that your team is moving forward on? I'm not sure if this is the appropriate time to get a little bit more color, but just want to make sure I ask that question. Thanks for taking them.

Sure, thank you. I won't detail specific projects, but you can refer to the slide in our investor presentation on our website. Historically, we have focused on five core technologies essential for robotic cardiac ablation procedures and four guiding goals for our innovations. The five core technologies are the ablation catheter, mapping system integrations, x-ray, robot, and the user interface for physician interaction with the robot. All five technologies need continuous advancement, as they are critical to robotic cardiac ablation procedures. The four guiding goals for innovation are to enhance patient care, improve the physician experience, make the technology more accessible and affordable, and foster an open ecosystem around our technology that supports physician choice. This framework for discussing innovation still applies today. We've expanded on this since the beginning of the year by demonstrating to the investment community and physicians that we can innovate across all five core technologies. We have also introduced two additional areas of innovation: one is digital surgery, which covers telemedicine, navigation automation, and incorporating patient-specific data into procedures. This is similar to our previous collaborations with preoperative imaging companies aimed at integrating more patient-specific data to assist surgeons. The other area involves applications beyond electrophysiology, including endovascular and endoluminal solutions. These categories reflect our focus, with the core technologies first in line, followed by digital surgery, and then applications outside of electrophysiology. I hope this provides some context on how we approach innovation, even if it's not very specific.

That was helpful. Thank you.

Thank you.

And your next question comes from the line of Frank Takkinen with Lake Street Capital.

Good evening, and thanks for taking my questions. Just a few for you guys today. Firstly, on the 51 hosted physicians and 29 hospitals, what was the mix of new versus existing prospects or customers?

Hi, Frank. Good morning. So it was a mix of both. The majority of the physicians and kind of hospital customers would be existing customers. So those that have a Niobe system that might be either interested in a replacement or might be interested potentially in a new lab at another location or we're just engaging with because that's the right thing to do, because they're existing customers of ours. A significant minority of the customers have been kind of completely new customers that don't have a robotic system that are engaging with us for that purpose.

Got it. That makes sense. And then also on virtual tours, given you're able to get a little bit better, you're likely able to get a little better EP mind share given the procedural delays and impacts right now. Do you see there being potential for a little bit stronger than anticipated rebound to a full replacement cycle post-COVID-19 as you're able to fill the top of the funnel right now?

So that's really driven by hospital budgets and administrative budgets. I agree that in terms of engagement with physicians, the last 2.5 weeks have been extremely busy and exhilarating due to the number of discussions and visits we've had. To some extent, this has been a highlight of that period. During times like this, we often refine solutions that are great for the long-term. For instance, telerobotic test drives will be implemented permanently, even beyond COVID-19, because they work so well in allowing personal engagement with physicians. It provides them a great opportunity to experience the technology and navigate a catheter from hundreds or thousands of miles away. As for how this translates into a replacement cycle, that's largely out of the physicians' control and more in the hands of the administrators. We do sense an openness, and replacement cycles have to occur eventually. If they have a catalog, they will need to replace their x-ray or redo the lab. However, I still don't have enough information to detail how that will play out. We are just beginning to reengage with administrators in a meaningful way and learn how they are managing their own businesses and when they plan to proceed with the projects we were anticipating.

Okay. Just two more for me here. Could you tease out in the first quarter of 2020 the different impacts of disposables versus service activities? And then, was there any service age outs as well in the quarter?

Sure. So if you look at the decline in revenue from the first quarter of 2019 to the first quarter of 2020, approximately 30% of that decline was due to the two specific service projects that were just kind of at the end of that quarter. In March, we had to scramble and our team had to leave those sites and we couldn't complete them. The remaining 70%, almost entirely is due to reduced disposable sales. In a geography like Asia Pacific, we sold almost nothing or a negligible amount of disposables in the first quarter. And then obviously, across the U.S. and Europe, at least in the back half of March, there were almost no disposable orders.

Got it. And then just last one for me, and thank you very much for answering all my questions. Can you talk a little bit more about some of the variable expenses that you could throttle back a little bit to weather the storm in the next couple of quarters if need be?

Sure. So we are – it's important to maintain financial stability for exactly the reasons that I described on the call. Our physician and hospital customers need to be confident that we are a long-term financially stable reliable partner for them, and so do strategic industry partners that we collaborate with. And so that's a key focus. We're proud that we've been able to maintain the financial stability of Stereotaxis and establish that good foundation. There are various ways to also reduce expenses. Now we're also cautious there to not reduce expenses in a way that would damage the company's capabilities or hinder our ability to make progress rapidly. We have kind of a relatively lean team. It's a good team and we have all internally our own sales teams in the U.S. and Europe and Asia. We have training, field service teams, manufacturing, site planning, and R&D in every type of R&D, heavy engineering specialty. We've also got finance, IT, HR, clinical, regulatory, and quality. So we have kind of a broad team and we want to maintain that organizational capability because that's really an asset overall to the company and to our progress. And so that's why the expense reductions we've made have been delicate and surgical in their nature. There are always ways to reduce expenses that include both within the team and externally in terms of consultants or other spending that sometimes you do in experiments to see how to improve. Again, I think there are a range of ways that we have been reducing expenses and can reduce expenses if necessary that don't harm the company. Obviously, the success in receiving a PPP loan was great and ensuring that we wouldn't have to do any partial furloughs of the team and that we wouldn't have to do more significant reductions in the team. Overall, I'm confident that given what I see today, we will end the year successfully and continue to run the company in a financially prudent manner, so that our physician customers or hospital customers will never have to have any concern about our long-term financial stability and long-term reliability as a partner.

Got it. Very helpful. Thanks for taking my questions.

Thank you.

And your next question comes from the line of Kyle Bauser with Dougherty & Company.

Great. Thanks for taking my questions. I hope you're doing well, David. Just a couple of quick ones, following up on previous ones. So digging back into the innovation strategy here, you walked through the five buckets. And how those kind of interact with the goals of improving care eventually to create a collaborative ecosystem? I'm wondering if, to the extent you can share, or you're willing to share, you could tie in kind of how we should be thinking about timing here kind of for each of these buckets? Any color would be great.

Sure. Some of them – I mean obviously the ablation catheter is the largest, most impactful innovation that is near-term innovation. And I described how we're finishing the design phase now and shifting into the manufacturing process and the regulatory path in Europe and the clinical path in the U.S. And so that's kind of the biggest innovation that will have both on our physician customers and on Stereotaxis, financially and strategically. That's kind of the one that is highest on our priority list and nearest term. Beyond that, what we have is in things like telemedicine, there are clearly – that is taking place. We have had physicians perform procedures from thousands of miles away from their labs. Our Stereotaxis team members that are supporting procedures daily are using telemedicine. There are ways to enhance that capability such that it's – I don't know if the term could be more consumer-friendly or more easily accessible, where it really reduces the barriers, sometimes the technical barriers or the setup barriers to broadly use telemedicine, not just by Stereotaxis team members but also in terms of peer-to-peer support and in terms of remote procedures. There are large tailwinds for that, particularly now given COVID-19 and particularly because of the desire to reduce the risk of infection which robotics already helps by reducing interaction between physicians and patients. But again, telemedicine can fuel that much further. In terms of kind of the other areas we’ve described in our innovation strategy, some, I think like automation, will actually be incremental and continuous progress through hundreds of little efforts that collectively come together to improve automation. And other things like applications outside of EP or kind of other types of technologies we might be working on will likely be announced at some point in the future. What you've generally seen is that we don't want to put a timeline on those. We prioritize fundamental progress for Stereotaxis, and when we feel that it's appropriate to share news on those specific projects then we'll do that.

Understood. That's helpful. And then you talked about being able to host 51 physicians from 29 hospitals. And you talked a little bit about the makeup of them as it relates to existing or new potential clients. Can you talk about how these sorts of remote visits have been in the past? I mean is this something that's kind of relatively new that you anticipate carrying forward and do more of in the future? Just kind of curious to understand how this level of interest has progressed over time? Thank you.

Yes. So this is actually entirely new. Historically, we would invite physicians to come visit us physically in person to view our facilities and to experience the technology in a hands-on fashion. And we had phone calls with physicians, but those were really phone calls. The team, like I mentioned, in periods of rapid change, stress, and challenge, our normal activities suddenly get put on hold. It creates a type of ingenuity that really is beneficial not just then, but also for the long term. We established a capability to host physicians, have video conference calls with them, and I can walk around the office in a fairly easy fashion, show them our office, our manufacturing facilities, our systems, and our lab with Genesis and Stereotaxis Imaging Model S. We can also allow the main large screen display that a physician would normally navigate on in the cockpit to be remotely accessed and controlled. That has ended up working very well. Again, we've started this only 2.5 weeks ago and has been a fantastic capability that we're continuing to do over the coming weeks. I anticipate that we will continue doing it forever.

That’s great. Well, thanks for all the updates here and for taking my question.

Thank you very much.

And you have a follow-up question from the line of Josh Jennings with Cowen.

Thanks. Just two quick follow-ups. I guess first, I wanted to ask about just data accrual for robotic navigation. And there's International VT Catheter Ablation Collaborative Group and their VT ablation database; like the magnetic VT study continues to enroll. Can you just talk about your sense of how impactful outcomes from these two trials could be? And then any other events, data presentations or publications that we should have on our radar for 2020?

Sure. I think those two that you mentioned are the most meaningful, as well as what we're anticipating is initiating an IDE trial or trials for the next-generation ablation catheter. In terms of outside of those trials, we do end up having in the order of about 30 peer-reviewed publications a year on our technology. Some are more meaningful, some are less meaningful, but we do share all of those on our website. We have a searchable database of all our publications on our technology. By now, we're nearing 400 publications in our searchable database on our website. In terms of the impact of the magnetic VT trial, I think that can have a very significant impact as it is a really unique trial in the field. It’s a randomized multicenter trial seeking superiority for robotic cardiac ablation versus manual cardiac ablation in VT patients. That type of design is unprecedented in the field, and its size is also kind of unprecedented. Most surgical specialty interventional procedures don't have that type of quality data generated. We have confidence in that data given some preliminary data that other sites have reported. There is some data out there—a meta-analysis in VT and other studies that have shown superiority both in terms of safety and efficacy for robotics in VT. We’re continuing to enroll in that trial, and sometimes enrollment is slower than we want; that's sometimes driven because physicians who are part of the trial don’t want to randomize patients. We hope to complete recruitment for the interim look level and potentially complete within this year; that would mean early 2022 could bring data from the magnetic VT trial. Again, if that shows positive results, it can hammer home the idea that this is a better way to treat patients.

Excellent. And then just on a follow-up. Thinking about your robotic EP fellows program, some of those fellows are graduating in the coming months. How should we be thinking about them as potential near-term or medium-term customers? I know that fellowship program has been growing over the years, but just wanted to check in on that and I appreciate taking the follow-up questions.

Yeah. Thank you. The fellowship program has really been a highlight of our commercial efforts. We have a little over 40 fellows now from over 20 hospitals that are part of the program, either graduating this year or next year. We do engage with them, and some of the physicians that were included in those numbers are fellows currently graduating. The fellows generally break down into three categories. Some of them stay on at sites that have our system, or stay at the same site that they did their fellowship in, and become continuous users of our technology in a day-to-day fashion. A second group might go to a site that has a robotic system that is underused, and we try to help them find jobs and help those sites find highly skilled electrophysiologists. Lastly, some receive offers at hospitals that don't have our system and are candidates for new greenfield opportunities. We view the fellowship program as a real strategic investment that we are making in ensuring we are working with the future leaders of the field.

Great. Thanks again.

Thank you.

And there are no further questions in the queue.

Okay. Thank you very much for your questions and for your continued support. We wish you all a healthy, safe, and successful coming months and look forward to speaking again in August. Thank you.

Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.