The Eyesight Sessions

Welcome to the Eyesight Sessions, a new series focused on the people in the Ophthalmology and Eyecare markets. These interviews are designed to focus on leaders in the space; their journey, their influences, what they are currently working on and their passions outside of eyecare.

In the fourth instalment, I spoke with Francesca Logan , Chief Commercial Officer of Toku from New Zealand. Toku Eyes are an emerging company aiming to provide accessible and affordable health screenings through the eyes. They have been featured in a number of exciting news posts over the last year so I was excited to learn more about this from Francesca.

Firstly, for those people in my network that are not yet familiar, can you give us a brief introduction to yourself and your current role with Toku Eyes?

I’m Francesca, I’m Chief Commercial Officer of Toku and I also sit as one of the Directors on the Board in the US and with the New Zealand subsidiary as well. I’ve been with Toku for 3 years which isn’t a lot when you get into larger companies but in start ups feels like a million lifetimes. In that time the role has moulded a lot, from when we were beginning with a tiny team of 8, I was the first non-scientific hire and so at that point I was doing everything – product, ops, sales, wearing many hats but since then we have matured a lot more and developed as a company hiring specialised people into each of those areas. Today the role is more focused on the commercial space so sales, commercial strategy, PR, marketing, and managing our commercial partners

It has become very clear over recent years that AI platforms are driving the future of healthcare and that the eyes really can be the "window to your health". This is something that Toku Eyes is a big part of. Can you tell us more about Toku's mission and the areas of healthcare that you are active in?

So we basically have this mission around encouraging earlier detection of preventable diseases and we are doing that through the window of the eye. We have this belief that routine eye exams can serve as a shield against preventable health conditions and ultimately, we are trying to spare people from suffering and at the end of the day save lives as well.

Today we have three key products, and all of these provide diagnosis or indications from the retinal image. CLAiR is our flagship product that tells you if you have an elevated risk of heart attack or stroke in the next 10 years. BioAge, is the wellness version of CLAiR and tells your biological age compared to your chronological age, so are you tracking as we would expect or are you better/worse and lastly our third product is MyKidneyAI which we have announced more recently to detect chronic kidney disease from the retinal image as well.

?Overall, today so many people are ending up in these end-stage conditions such as heart attacks, strokes or kidney failure without ever having any warning before that point that they may have been at risk and once they do get to that stage there are so many cases that are irreversible so we are really trying to intervene earlier and set them on the right path so that this doesn’t happen.

There have been a number of exciting news announcements of late with CE and UKCA marks being obtained. Which other areas of eyecare/healthcare are your researching for your technology and what's next for Toku Eyes in the global markets?

The last year in particular has been a whirlwind of news, which has been very exciting. We were never really in stealth mode, but we have come into the public a little more with an increased presence. We don’t yet have the FDA approval, but we do have two FDA breakthrough designations with CLAiR and MyKidneyAI which were a huge deal for us to get. As far as we are aware we are the only start up company (not just in eyecare) to get two breakthrough designations concurrently. Sometimes the big pharma companies can achieve that but it doesn’t happen at the lower level.

This has given us a huge boost and we are working with the FDA almost every day at the moment as you get a lot of support through the process with that breakthrough designation. We are pretty close to kicking off our clinical trial for cardiovascular and looking to get approval for mid-2025 and then we will switch over to MyKidneyAI through FDA.

In terms of the R&D team, we do have a whole lot more capability that we haven’t released yet and that is getting built out. Staying in the preventable disease space for now so we are looking at other products around blood pressure, cholesterol, diabetes. There is a new disease that the American Heart Association put out last year called cardiovascular-kidney-metabolic syndrome so bringing together all of those types of diseases into one category and we are trying to be the first diagnostic test for that new syndrome.

We are still pumping out research and papers, but in terms of the commercialisation side the big blocker is the regulation. It takes a long time to get products through FDA even with the breakthrough designation, so it is mostly a case of prioritising this.

It seems that partnerships with other eyecare companies has been a huge part of the Toku Eyes journey so far, ongoing relationships with National Vision and Topcon Healthcare, as well as more recently collaborations with Optomed and EyRis. How important is it for companies in the space to collaborate in this way to improve access and treatment for patients worldwide?

You are completely right; these partnerships have been the entire life blood of the company on almost every front but particularly on the commercial side. We got the investment last year from National Vision Inc. and Topcon Healthcare so with that they now sit on our board and are now integrated into our company. But because they were strategic investors we now also have a lot of relationships with them commercially.

National Vision is our biggest customer, and we are rolling out BioAge, which is the only product that has approval in the US, in their stores. We are in California and Texas at the moment and looking to increase that in the coming months.

And we are working with Topcon Healthcare , Optomed Plc , EyRIS as distributors too. We know that Toku’s core competency is on the R&D and regulatory side, we have an amazing science and research team that is able to come up with this technology and a large regulatory team to get it through the processes but we have taken the decision not to invest heavily on the sales and commercial front and to work with partners and distributors who know these markets through pre-existing relationships. The amount that it would take to set up the huge sales teams in each target market would not be feasible at the stage we are at, so this approach has been going really well.

So you have been focused on eyecare with Toku for the last 3 years but you were no stranger to digital solutions in healthcare having come from the chronic care management solution space with Bablyon Health (now eMed Healthcare). Tell us more about your career journey into eyecare and who have been the biggest influences on your career so far?

My career has been quite varied, I did commercial law in university and went on to actually join the BAR as a solicitor and barrister in New Zealand. Then straight out of university I launched a business with a friend launching a line of travel gear for women. We ran that for a few years and then I sold out of that and moved to the UK which is where I almost randomly landed into the Ops team at Babylon through a contact I had there. That is where I was really introduced to tech and more specifically health tech.

Babylon was a great foundational company; at the time they were booming and although they called themselves a ‘start-up’ they were much further along and had around 1000 employees when I joined. It was incredible to be around that super high growth company and there were a lot of lessons picked up from this.

When I moved back to New Zealand I was pretty specific with what I wanted. I fell in love with health tech so wanted to be in that space but for it to be quite a focused problem that the company was trying to solve. At Babylon it was almost like they were trying to solve all of healthcare, which obviously isn’t possible, and that resulted in constant change in direction, strategy and products.

?I happened to get introduced to Ehsan Vaghefi who wasn’t actively looking to hire in this area, but we made the timing work, and I joined the team. At that time, it very much was me taking a chance on Toku in the sense that it was very early stage, they hadn’t fully worked out their market fit focusing on AI for eye diseases, but equally it was Ehsan taking a chance on me too.

?It has been really fun and in terms of influences, particularly recently, it would be Ehsan. We have both grown into our roles, him as CEO and me as CCO over the last few years and we have a really great relationship in terms of challenging each other’s thinking and pushing each other to improve so that has been a really positive experience. It has enabled me to have the space to really grow.

What do you love most about working in the eyecare sector and what advice would you give to people just starting out in the space?

I love eyecare because of the focus. It is one little organ of the body but there is so much that can be done with it and before joining Toku I had no idea of the number of diseases that could be detected through it. There are so many cool companies coming through in this space with so much room to grow. I love how much opportunity there is.

?I’ve also seen with the eyecare community that it is small and very close knit. When going to different events it doesn’t take long to learn who people are and I’ve found that everyone has been so welcoming into the space, even coming from New Zealand and trying to break into the US eyecare community, and this was so much easier than we thought it might be.

?For people starting out I’d say engage with those events and the community. If possible, find those key partners, ideally to invest, but even as strong commercial partners, which has been vital for us.

Looking at the wider eyecare/medtech space, which technologies and companies excite you the most? Where will we see further innovation in the next year?

In our niche of diagnosing conditions through the eye, I am really excited to see detection of neurological diseases coming through. So, companies like RetiSpec who are doing amazing work around into conditions like Alzheimer’s and there are many others who will be there in that space. Obviously keeping on broadening that diagnostic range I think there will be more advancements on the cancer diagnostics through the eye too.

?But outside of this area, generative AI is going to transform the space. In healthcare in particular there is so much room to improve workflows, reduce administrative burdens, improve patient experience and lower the cost of delivering healthcare. Before we get into a truly transformative place we need to go back and get the basics right and use technology to do that. I’m hoping that around the world we can use this to improve foundations and grow from there.

So of all the events you have been able to attend with Toku, which one has stood out the most?

My favourite event has been the Eyecare Innovation Summit which happens in Boulder, Colorado every year. We got invited to that last year and it’s a group with executives from all the large US eyecare corporations and they invite a handful of innovative companies.

?You have three days together and the whole event was focused around doing business outside, so we were doing hikes, ice baths and all the sessions were outdoors. It was really fun, and you were with C-Suites of massive organisations, but you were doing things like ice baths. It really helped to bond with people, it was so different and was an awesome event.

If you weren't working in the global healthcare space, what would you be doing? Would it have been more focused on your law background?

No, the legal culture wasn’t a good fit, so not that. I have a love for start-ups, they are so hopeful. A group of people trying to create a better world in whatever their particular niche is. The type of people that join them are curious and going into the unknown. So, I don’t know what in particular but I know I would definitely still be doing something with them. Maybe VC and investing, so the other side of it.

When you aren't working to bring new AI healthcare solutions to the world, where can we find you? Any interesting hobbies?

I do travel so much so when I’m home it is pretty quiet. Me and my partner have got a Golden Retriever puppy, so we like to get out and appreciate the New Zealand outdoors because it is very beautiful.

Huge thanks to Francesca Logan for sharing these exciting insights into the company and her journey in health tech. Make sure to follow her and Toku for further exciting updates in the future.