And then everything gets integrated into a middleware and the data gets captured. And right now we see private [to our] [ph] middleware going in hospitals on average are only getting around 30% to 40% of the scans that they take are actually make it all the way to being claimed for reimbursement. And that’s because so many of the individual ultrasound devices that have are not tied into their EMR and are properly documented. We’ve seen that when people implement Compass and implement our middleware, that our middleware is not just Butterfly. It works for all the other devices as well. So it’s not just a proprietary thing for Butterfly. When we put our middleware in the hospital, we see the amount of scans that they file for reimbursement go up.
They go up because they feel more comfortable, they go up because it’s easy, it’s integrated into the phone where they’re looking at the image, and the whole process allows hospitals to grow their revenue. So as we go into 24, our salesforce is out now talking to all these accounts, saying we have this middleware, we have this killer all-in-one probe that now has this awesome image quality that can live inside the hospital. Let’s talk about a larger deal. Let’s talk about standardization. Let’s talk about converting out your existing products because this is the true way to new point-of-care ultrasound.
Heather Getz: And Joe, can I just add to that, to Josh’s question? So Josh, around, we added people mostly in the second half of the year. So when one of the data points that we talked about was the increase in revenue related to our direct sales force and we saw a nice bump both in the fourth quarter, in the full year, around 10% and 11% respectively for those areas and that’s the place that we’ve invested and they’re the ones who are calling directly on these hospitals and systems. So as we go into 2024 and those [soaps] [ph] become fully efficient and ramped, we expect to see a benefit from that. And as the year progresses, we plan to look at each of these areas and territories and add resources where appropriate. We just don’t want to get ahead of ourselves and we wanted to be efficient with our use of capital as we’re investing.
Operator: The next question is from the line of Shaymus Contorno with Oppenheimer.
Suraj Kalia: Hey Joe, Heather, it’s Siraj. Can you hear me all right?
Heather Getz: Yes. Hi, Suraj.
Joe DeVivo: We hear you just fine, Suraj.
Suraj Kalia: Sorry, I was having technical difficulties. So Joe, on RoHS, how would you gauge the probability of various outcomes? Can the goalposts be changed now to require some comparative assessments between analog and digital devices, eventually with a roadmap to phase out analog? I guess rather than having a puristic view of lead versus non-lead, can the goalpost now be changed? How are you all looking at the various outcomes and when do you think we would know more about what’s next on the horizon?
Joe DeVivo: Well, thank you for that question, Suraj. I just don’t know. What I do know is, they have received two sets of exemptions. What I do know is that they are up for an exemption now, and we are trying to intervene. If you look, I think, we can debate numbers, but handheld ultrasound in Europe has to be a fraction of the overall, [Technical Difficulty] ultrasound and overall revenue, the political blow back for the European Commission, I believe would be very low. If they said we are taking Piezo handhelds off the market and we are going to only allow those who meet real house standards to be on the market, or else what’s the purpose of having a standard? If there’s equivalence in a device and it meets the standard, then why have a standard in the first place?
But truthfully, we are actively in retaining lobbyists. We don’t have the resources to fight big ultrasound, but I think there is not going to be a very good argument on why a Piezo-based handheld device that’s compatible to our device. There’s not going to be a good scientific or clinical reason why they should. So if it stays on, it’ll purely be political. If it stays on, it won’t be based upon, I mean, we’ll go through whatever evaluation and assessment, but I would love to see that the standards upheld, of course, it’s in our favor. And it’s consistent with what we believe. But honestly, I don’t have a read on the politics. If you read the regulations, if you read the intention to preserve the environment, if you read the desire to hold all types of electronics who use raw earth materials or who have either manufacturing toxicity or disposal toxicity.
You know, the legacy piezo crystals, you know, they have not proven to scientifically meet the threshold of that directive. All we do. So I guess the question really is how serious are they on the directive? And we look forward to educating them and advocating our position.
Heather Getz: And the other thing too Suraj is, let’s say they do a phase in. If you’re buying devices, are you going to want to buy a device that meets the standards now? Or are you going to be willing to buy a device that doesn’t meet the standards and potentially have to remove that from the market? Right. So I think it regardless of, if they do a phase in or if they do an absolute renewal, exemption it benefits Butterfly.
Suraj Kalia: Fair points. Joe, in your prepared remarks, you mentioned — you highlighted the results of the survey on iQ3. So Joe, admittedly, it’s just been two weeks since you all have commercially launched it. So I don’t want to go into how many sold and accounts and whatnot. Joe, at what point in the, how many quarters down the line, would you say we would have enough visibility to quantify iQ3? Whether it’s in terms of velocity of sales, systems per account, how are you thinking about, at this point in time, iQ3, this would give us a real good idea that what we are seeing qualitatively, now we are seeing quantitatively also. Thank you for taking my questions.
