How Karmabot CEO Stas Kulesh grew Karmabot to $750.6K revenue and 350 customers in 2024.

hey folks my guest today is adi berenson he's the co-founder and ceo of claire labs prior he was three years as human interaction designer and prototyping at apple and before that eight years as vp of business development and marketing for prime sense the leader in 3d sensing technology behind microsoft connect and apple's face id cameras prime sense was acquired by apple audi are you ready to take us to the top yeah thanks a lot great to be here you bet so claire labs at c-l-a-i-r you're building contact-free remote patient monitoring systems what got you into that space so um actually it's all started from our work in apple uh which i cannot get too much into it so my my background is coming from consumer electronics but in my days in apple i got to work a bit with them on digital health projects that was back in 2017 and i realized what a monumental um challenge it is for modern societies and uh once i started getting into this and and learning about our old-fashioned workflows uh are there we realize that technology can make a huge difference i mean we we very very quickly even before we started the company we narrowed in on a horizontal workflow which is patient monitoring and i can get into it more but i'll follow you around yeah so patient monitoring there's sensors that are installed so there's is there an iot play here do you pay for the sensor installation so it is an iot play you got it right the unique part about it is that it is not touching the patient so clinicians are calling it passive monitoring because the patient doesn't need to do anything so contact free is not wireless it's actually collecting the signals environmentally without touching your skin um it's not about it what is it though is it like a lamp you sort of sit next to your bed like how do you think about it yeah it's a beautiful comparison it is like a lamp yeah so it does need to have some kind of line of sight to your skin okay and then by looking at your skin in two waves of near infrared it can see movements of superficial arteries so arteries that are very close to the surface by looking at those arteries we see volumetric changes and we see tone changes and then we are actually uh recreating or regenerating the plus signal pulse rate oxygen sat respiration rate and so on interesting what does the physical device cost okay so i'm not gonna i mean forgive me for that i'm not gonna expose our costs because we're not selling it to the consumer the way it works the business model is that our customers are providers or health care providers and they're offering it under i will call an umbrella of rpm remote patient monitoring services which is reimbursed by medicare and all major health care payers so it is a prescription service the device is fda cleared and the way it works is the payer is paying for it as long as you are recognized as a chronic patient or a patient at some kind of you know are you manufacturing it directly did you have to go source in china the manufacturing plant or is this someone else's technology like heart no no it's how hardware so we are it's our own hardware we are sourcing it exactly as you mentioned we're fabulous of course so we're sourcing it in china and we're building the device itself yes when did you ship your first device so we we are currently actually in clinical trials so the devices that we are shipping into facilities in the us for clinical trials are actually not built in china they're built in israel in a low volume prototyping facility uh the trials are going on for two months already um and so it's not in production how many have you produced for all the trials combined fifty five zero okay yeah five zero that's it it's very low volume yeah okay 50 for testing um got it and the healthcare providers are obviously the customers um tell me about how you make money from them what do they pay you on average per month so i'm not going to get into numbers but i'm going to get into the business model so basically the components that the payer is paying the health care provider is made out of installation is made out of the what the clinician is getting to review the material and is made out of the actual monthly payment for uh for collecting digitally collecting the signals from the patient i'm getting most of this now i'm i'm going to explain a little bit so i'm not going to get into my revenues but the way it works is that if you have a chronic i mean just be fair you're like i mean you're basically pre-revenue you're doing clinical trials right absolutely we're pre-revenue but we do have a plan so i can give you yeah i mean so when you say you don't want to get into your revenues and you just tell me your pre-revenue right that's a much better way to say it makes it very easy no no but i thought you were referring to what are our plans regarding revenue so today is zero yeah fair enough yeah but if you want to know how how how big is the market and what is our plan for future revenues and i can a little bit i can give you one data a chronic patient recognized as such under an rpm program can generate revenues for the care provider in the order of magnitude on of 150 dollars per month it makes out of several components so this is 1800 dollars per year we believe that we're going to get a big chunk of it that's the business model so we're not charging the provider for the the device itself we're actually uh getting recurrent revenues out of the reimbursements so let's just focus on israel for a second how many patients do you believe should have this lamp next to their bed right that should be sort of paid for with you know the government money right medicare medicaid whatever you guys have an integral for that so i will actually answer you in the in in newest numbers because that's the that's the uh that's the market that we analyzed and that's the market we're targeting so the way it works is that i can picture for you right now a dream of all the chronic patients but that's going to be a little bit superficial so there is for example one condition that we're doing active clinical trials on and we are showing act actual clinical outcomes which is copd for example so it's a respiratory condition i mean it's a chronic obstructive pulmonary this is there are 16 million patients um recognizing one six one one six zero okay no no one six one six million recognized as such there's a lot of um talk in the industry about the un uh yeah the undiagnosed but diagnosed there are 16. so you have 60 million people on you can get on an rpm program should you guys them should be all of them should be yeah sure sure so 150 bucks a month that's 2.4 million a month or about 30 million run rate for you getting 100 penetration of this market that's actually not that big right for what you guys are building that's very small actually i will i don't know how you got to it but if you have 16 16 million sorry sorry sorry you're right i missed a bunch of zeros there 16 million so so how do you the the test you're running right now on the 50 devices you're targeting the us market exclusively yes right now exclusively yeah okay okay got it um yeah sorry that map is obviously much bigger right so 16 million patients at 150 bucks a month is like 2.4 billion a month right exactly per month well the reason i bring this up right is that's almost 30 billion dollars per year right which effectively is going to come out of my pocket right it's me paying it's the u.s citizens paying into medicare medicaid or the us government printing more money to cover these expenses actually saving a lot of money and i will explain so an average copd patient which is diagnosed as such is having an average uh incident office hospitalization at least once a year and this hospitalization is costing 20 12 000 the reason why we are enrolling them on rpm programs is because we are showing data that we can raise the flag an alarm to the clinician taking care of them seven to eight days before such hospitalization event and with simple intervention of antibiotics or steroids you can prevent the whole hospitalization incident so it's it's a it's economically uh money-saving so how many hospitalizations are there right now in the u.s from copd patients exclusively every year 16 million because it's almost it's once a year yeah so every single sea person in the us with copd goes to the hospital at least once per year on average so some more some less that's the average rate yeah i i see i see interesting um what you're arguing what you're arguing though is that with your early indicators right via the veins and the skin and the early things seven days early you're basically saying no none of your you're not gonna replace all 16 million hospitals no no we're no no we're we're not and it's very it's going to be very irresponsible of me right now to say exactly how many we are but we are what we are showing and we're going to be very accurate with you nathan what we are showing is that we are raising the an accurate alarm flag seven to eight days before very i mean in very high rates like 95 percent okay 95 percent of the ex uh the the hospitalization cases of the clinical trials of the sample we we sampled we are showing a very obvious deviation of a score combined out of oxygen sat heart rate and respiration rate out of norm and and then and we know that there is an effective intervention uh so we believe there is going to be we believe and that's what we are pitching that there is going to be a...