Butterfly Network is a healthcare technology company on a mission to transform access to medical imaging around the world. Butterfly has transformed complex, expensive ultrasound into a durable, affordable, portable, connected system that can fit in every doctor’s pocket. The company went public in February 2021 with a valuation of about $1.5 billion. Pulse Writer Lauren Gardanier sat down with VP of Global and Enterprise Marketing, David Silk, to discuss how their products are enabling access to ultrasound around the world.

David Silk, VP of Global and Enterprise Marketing at Butterfly Network

The Pulse: You’ve worked in a variety of technology environments – including pharma, tech, and now medtech. Could you share a bit about your career path and what brought you to Butterfly Network in your role today?

Silk: I’ve always looked for the opportunity to improve the way care is delivered. I began my career in the health policy space. When I look back at major initiatives in health policy designed to drive care delivery improvements over the last 20 years, increasingly they have been technologically driven – the HITECH act, the 2008 Affordable Care Act, etc. These policies were geared towards the digitization of healthcare, but with the goal of using the data generated by that digitization to drive improvements in care delivery and outcomes. Technology can be a powerful and effective way to move large groups of people to do things differently. Throughout my career, I’ve worked more and more on the technology side, bringing together health policy and technology to advance care delivery in this country. Most recently, I was at Google where I ran Google Cloud’s healthcare and life sciences marketing team.

What excited me about Butterfly and what brought me to a smaller company was the opportunity to drive change firsthand, have ownership over products brought to market, determine how and in what context to bring those to market, and influence decisions from  commercial strategy all the way to implementation. Butterfly began as a company focused on individual physicians buying the Butterfly probe online. We’ve evolved into a much more complex company with software and hardware offerings. Our software platform is designed to be the operating system behind the use of ultrasound at health systems. The idea of contributing to the evolution of our commercial strategy excited me as well.  

The Pulse: Can you tell us about Butterfly Network’s mission and the technology you’ve brought to market so far? We’re interested to learn how your technology advances the standard of care for ultrasound imaging.

Silk: Butterfly began by changing the way that ultrasound can be used by putting the core technology of ultrasound on a chip. Traditional ultrasound uses crystals, which are fragile, and require multiple different probes to place an ideal ultrasound wave into a different part of the body. Butterfly put those crystals onto a chip, creating an ultrasound device that is more durable, cost-effective, and flexible relative to traditional ultrasound machines. That’s where the innovation at Butterfly began. Right now, we have 20+ presets, and ultrasound waves can be adjusted easily to go from scanning one part of the body to others. The device connects with phones and runs through an app, which we constantly innovate and update each month. It’s a totally new model for an ultrasound device. 

Where we’re truly changing the game is the insights one can get from ultrasound. Because of size, weight, fragility, complexity to operate, ultrasounds are fundamentally underutilized as a tool for diagnostic and procedural support. For example, take a simple thing like putting in an IV. In most cases, it’s not an extremely complicated process. However, for various reasons – underlying health conditions, weight, dehydration, etc – putting in an IV can be very difficult for some patients. Getting jabbed repeatedly over and over is a terrible patient experience. Most hospitals have specialized care teams that can do difficult vein access, but there might be only 3-4 of them for the entire hospital, leading to long wait times. The simple insertion of an IV can have drastic ramifications on patient experience, provider experience and how long a patient is in the hospital. Ultrasound-guided IV placement is a standard that many healthcare professionals can learn. By putting an ultrasound in providers’ pockets, difficult vein IV placement can be done easily, changing the way that type of procedure is done. This is true with many different types of diagnostic exams.

Our goal is not to replace the $100,000 ultrasounds. We don’t think of ourselves as an ultrasound company. We think of ourselves as an insights company that can get diagnostic insights and provide procedural guidance. We believe that we can change the way people practice medicine and patients get diagnosed, in addition to enabling access to ultrasound in places where there is zero ultrasound today. 

The Pulse: Central to Butterfly Network’s mission is to democratize access to medical imaging – how do your products position you to make an impact on access? Are there ways you are focused on meeting the needs of underserved communities with historically lower access to medical imaging?

Silk: Part of our value proposition is our price point. It’s public on our website. You can buy our ultrasound device for $2,399. In the world of medical devices, that’s a relatively affordable medical device. The portability of our device and ability to plug it into your phone fit very well with how medicine is practiced in more rural areas. There is a tremendous opportunity to increase the access people have to ultrasound everywhere in the US and outside of the US. 

In rural critical access hospitals, sometimes a physician has five minutes to determine whether they need to order a plane or call the ambulance 1.5 hours away to take this patient to a main acute care facility. Some of these rural facilities do have ultrasound devices, but they may be older ultrasounds, they might not have ultrasound technicians, or the ultrasound technicians may only work in the daytime. The ability for critical access hospitals to have five devices and have physicians trained with how to use them allows quick determinations to initiate those transfers sooner.

The three ways we think about expanding access are our affordability, ease of use / portability (multifunctionality), and removal of barriers for physicians and other healthcare professionals to feel comfortable using ultrasound. We believe that part of Butterfly’s job is to take on the burden of using the technology and AI with ultrasound to make it simpler and easier for physicians to learn and use.

The Pulse: I read that Butterfly Network signed a partnership with Caption Health, which offers AI-driven interpretation of medical images. How important is this role of interpretation of the images to providing access to communities in need?

Silk: When it comes to ultrasound, the goal of a Butterfly is not to replace a very specific $100,000 ultrasound machine. It’s designed to help a physician see what they otherwise could only hear to determine a course of action and treatment. For example, ER physicians might be looking at whether the ejection fraction  (a measurement of the percentage of blood leaving your heart each time it squeezes (contracts)), is good, bad, or really bad and how confident they can be in that determination. Caption’s interpretation does that and assists the healthcare provider in making that quick determination about what to do next. 

Caption offers an interpretation and guidance tool. The guidance tool helps physicians with less ultrasound experience to properly place the probe and get images capable of being interpreted. The interpretation software then provides the measurement, such as an ejection fraction, with a confidence interval around it. Caption is a great example of taking the burden of knowing how to perform an ultrasound and interpret results off the end provider and instead putting that burden on the technology.

We are proud to partner with Caption. The combination of our affordable portable device with Caption’s complex AI-based algorithm is a powerful combination that will help bring the power of ultrasound to many more patients.

The Pulse: What type of providers and care setting(s) are you seeing become early adopters, and which providers and settings(s) do you aim to reach over time? What types of adoption challenges have you tackled so far?

Silk: We’re increasingly focused on health systems as customers. We have a health systems solution that we recently made public called Blueprint. It’s the combination of hardware, software, and customer implementation / care teams. It was designed to help systems to combat some of the challenges of implementing ultrasound at scale. We believe that a Butterfly device in the pocket of every physician is the best way to have the value reach its full potential to improve patient care. We recognized that to achieve this vision there are a number of critical areas where we can help – data integration with EHRs and other hospital systems, quality assurance, education, documentation, etc. Our software platform is designed to bring together all data from all ultrasounds throughout the hospital and allow an individual to oversee it throughout the facility. Just recently we announced a partnership with the University of Rochester Medical Center. Their intention is to fully deploy at scale and provide all their physicians as well as their medical students with Butterfly hardware and software.

Additionally, there are groups of non-hospital-based specialties that could benefit from portable ultrasound – home health organizations, long term care facilities, primary care facilities, MinuteClinics, etc. I believe we’ll see increasing comfort and adoption from providers in these care settings using Butterfly as a diagnostic and procedural tool. When we first began, primarily Butterfly sold to healthcare professionals who already knew how to use and were comfortable with ultrasound. Part of the next step for Butterfly is to help more providers feel comfortable using ultrasound, through both technology and education. This is a key part of our expansion strategy to new care settings.

The last horizon we talk about is the home. Putting ultrasound on a chip enables us to think differently about deploying ultrasound to specific patient populations for self-monitoring or remote monitoring. While Butterfly is only approved today to be used by healthcare professionals, you can imagine a world in which patients or their caregivers could use  a probe, scan themselves – supported by a live physician or by technology. This is part of the Butterfly story.  Both Butterfly and our partners like Caption Health are building products designed to reduce the amount of training and education required to feel comfortable with image acquisition and even image analysis. Obviously, going into the home in the future and enabling patients to scan themselves will require a very high bar for the technology.  But that is part of the fun of Butterfly.  We’ll continue to work with partners like Caption Health and others, as well as develop capabilities internally, to enable the broad scale adoption of ultrasound as a diagnostic tool.  Because we believe that ultrasound deployed at scale has the ability to be transformative.

Despite our ambitions, we are still a small company. There’s a lot we could be doing, so the constant challenge is balancing development in stepwise fashion and thinking further ahead. What you want to bring to market two years from now must be started today to be clinically valid and meaningful two years from now.  At the same time, we must aggressively drive improvements in our products today.

The Pulse: As you think back on your experiences so far, what advice would you have for MBA students looking to work in the medtech space?

Silk: All experiences are good experiences. In your MBA, you get bolus of information about how to potentially deal with complex business situations. After your MBA, it’s about getting experience and developing that real world set of case studies. 

I always like to think about “what skills does this job give me that will position me well for my next job?” If you’re growing, learning, and acquiring useful skills, there is no wrong job. I never thought I’d have a sales job, but I did 3 years of Sales at Google. It was such a valuable experience for me. I barely knew what cloud computing meant 6 years ago.  Yet I took a job working at Google Cloud, and I learned a lot about what is now the underlying technology behind much of the technology being developed inside (and outside) of the healthcare space.

For students who want to be a commercial leader or general manager, it is valuable to get a variety of commercial experiences in the different functions that interact with general management roles. In many companies, marketing can serve as a decision making hub across many functions, which is why it can be a great general management training ground.  But if your goal is general management and senior commercial leadership, it is important to get experiences across the organization – in IT, sales, operations, product. Getting experience in, or working closely with, those teams will better help you to understand and eventually lead those teams, as you progress in your career. 

Interviewed by Lauren Gardanier, January 2022.

—

Join us at this year’s WHCBC! On Feb 10-11, 2022, Wharton is excited to feature more expert perspectives at our annual Wharton Health Care Business Conference. This year’s conference is virtual and themed ‘A Fair Shot at Health’. Tickets available here