Echo IQ’s EchoSolv usage surges as US expansion reaches a crucial test

EchoSolv utilisation accelerates in the US

Echo IQ Limited (ASX:EIQ) is entering the final quarter of CY26 with a striking usage increase and enough cash to keep funding its US push. The company processed 9,697 EchoSolv AS assessments returning full results during the September quarter, up approximately 193% from 3,312 in the prior corresponding period. Including limited-data results, total quarterly assessments reached 12,345.

The nine-month comparison is even more pronounced: 29,117 full-result assessments versus 5,759 in the corresponding period of 2025, an increase of approximately 406%. Echo IQ says the growth reflects expanding clinical utilisation across its US customer base, but the filing does not disclose customer revenue or say how many pilots have converted into contracted recurring subscriptions. That distinction matters as the company shifts its focus from usage growth to commercial conversion.

Enterprise pipeline becomes the commercial test

Echo IQ is increasingly pursuing larger deployments with US healthcare systems, academic medical centres and integrated hospital networks rather than individual installations. Its VIEW program lets prospective customers test the technology against historical echocardiography data, while SHADOW runs alongside existing workflows without influencing patient management. The company says both programs are intended to help institutions assess clinical and operational value before broader adoption.

The commercial infrastructure now spans seven US sales regions, supported by implementation and clinical teams. Echo IQ is also working on integrations with imaging, reporting and clinical workflow platforms, which it says could reduce installation friction and support wider distribution. The earlier A$110 million institutional placement is now providing the financial capacity for that expansion, although the next evidence investors need is signed enterprise contracts and recurring revenue rather than pipeline activity alone.

FDA appeal keeps EchoSolv HF unresolved

Echo IQ’s FDA-cleared AS product continues unaffected, but EchoSolv HF remains subject to the regulator’s Not Substantially Equivalent determination. The company says its review identified issues relating to the statistical analysis supporting clinical validation rather than the underlying technology or core functionality. That is Echo IQ’s assessment, not a reversal of the FDA decision.

As reported in the FDA supervisory review, the regulator has accepted Echo IQ’s administrative appeal and an FDA meeting was expected before the end of October. The company is also considering other potential routes, including engagement with the FDA Ombudsman and a new 510(k) submission. Echo IQ says clearance remains achievable, but both timing and outcome remain subject to FDA review. Some prospective health-system customers were initially attracted to the combined AS and HF offering, creating a commercial question the company is attempting to manage by establishing AS deployments first.

Capital, data and partnerships broaden the runway

Cash and cash equivalents stood at A$107.8 million at 30 September after the A$110 million placement at A$1.45 a share. Operating cash use was A$5.876 million for the quarter, while investing outflows included a A$500,000 payment under the Advara HeartCare data licence. On the reported quarterly burn, the Appendix 4C shows 18.3 quarters of estimated funding, though that measure will change as Echo IQ expands its sales, implementation and research operations.

The company executed convertible note and option agreements with Pro Medicus Limited (ASX:PME), advancing a proposed investment of up to A$20 million and a potential US commercial collaboration. However, the initial A$10 million secured convertible notes had not been issued by quarter end and remained subject to execution of a reseller agreement. Separately, the Advara agreement provides access to between 500,000 and one million de-identified echocardiography studies, subject to ethics, data quality and delivery conditions. A new non-executive director, Scott Wilkin, adds long healthcare and investment experience as Echo IQ develops its broader cardiovascular AI platform.

The December quarter therefore carries several distinct tests: whether sharply higher assessment volumes become contracted recurring revenue, whether the Pro Medicus financing and reseller arrangements are completed, and what practical route emerges from the FDA meeting. The company has bought time with its capital raise; the next phase must show how effectively that time converts into deployments, regulatory progress and a wider product platform.