Elaia | The story of Sonio: how one deep tech CEO built her prenatal care startup from idea to exit
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The story of Sonio: how one deep tech CEO built her prenatal care startup from idea to exit
A few weeks ago, Cécile Brosset, CEO of Sonio, prenatal ultrasound AI software company, sat down at the Elaia offices with Elaia Investment Director Céline Passedouet, and Venture Partner Sacha Loiseau, to discuss the relationship with Elaia and the road to Sonio’s acquisition by Samsung Medison, one of the group’s healthcare subsidiaries. Here are a few key learnings, from surrounding yourself with the right people, building your board, and identifying a clear — even if risky — go to market strategy.
Elaia was lucky enough to be part of this fast-paced adventure, from the 2022 seed round to the sale to Samsung Medison in August 2024. We would like to thank Cécile and the entire Sonio team for their confidence in Elaia for this exciting journey!
Sonio is a perfect example of the type of investment made by our deep tech funds at Elaia: a project initiated in the best European research laboratories, with a team combining science, tech and business, to bring unique value to a major market.
The following conversation has been condensed and clarified for editorial purposes.
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Céline Passedouet: Thank you Cecile for being here with us! Let’s start at the beginning: what is Sonio? What challenges does Sonio address?
Cécile Brosset: Sonio is a software company that incorporates AI to assist with prenatal diagnosis. Concretely, what we do is assist the doctor who performs the ultrasound exam during pregnancy.
This kind of ultrasound is one of the most complicated imaging techniques yet it’s vital to monitor fetal development across the pregnancy duration to detect any diseases through early malformations in the baby’s organs. It is also a way to diagnose issues concerning the mother.
It’s extremely complex and few people have tackled it. We found that while AI was entering the radiology market, maternal and fetal health imaging remained separate from radiology.
There’s also a significant legal risk because it’s easy to miss things. About a third of congenital malformations are heart defects, some of which are perfectly operable.
If heart defects are detected early enough during pregnancy, the mother can deliver at a hospital reputed for the surgery. In the first hours of the baby’s life, the surgery is done, and the baby can live normally to adulthood without any problems. If not managed properly at birth, the baby dies within the first few months.
In the case of the mother, placenta-related issues can cause hemorrhaging and death during childbirth. There are 300,000 women who die annually from pregnancy or childbirth-related issues, and 3% of babies in developed countries have congenital anomalies, half of which are not detected during the ultrasound. So, it’s quite substantial. These are the challenges Sonio addresses.
CP: And what a challenge. To tackle this problem, can you share more about Sonio’s go-to-market strategy?
CB: I will say it wasn’t an obvious market. The idea behind Sonio was a vertical play, addressing the needs of this industry of women and children’s health. Positioning AI-software add-ons is difficult as clinics already have an ultrasound machine, so why buy additional software? How can Sonio fit into this market?
One of the reasons Samsung Medison became interested was how we positioned our go-to-market strategy and how Sonio integrates into clinical workflows.
We realized that there was clinical reporting software that was becoming obsolete as it wasn’t cloud-based or user-friendly. The idea was to integrate our AI into clinics by replacing this outdated software.
It was an ambitious goal, but it gave us a clear commercial strategy. We could pitch directly to doctors to stop buying outdated software and instead use Sonio, which would likely cost less and include AI, increasing efficiency and providing clinical reassurance by having a second look at the images. With this value proposition, we quickly signed our first partnership with Pediatrix, a major player in the field of maternal health in the US, last year.
CP: Sacha, you were present from the very beginning of Sonio and Elaia’s story. How did you decide it was time to fundraise and approach Elaia? As it’s MedTech, the journey must have been long, and fundraising can be complicated.
Sacha Loiseau: Cecile and I met on previous adventures in the startup ecosystem. I knew from these interactions that Cécile had the clear potential — and desire — to become an entrepreneur. She had the drive and the guts.
During our discussions, Cecile arrived with a new project which wasn’t yet called Sonio. I started looking into this project, which had good foundations and originated from top research institutes and hospitals. It became immediately clear that Cécile had a talent for surrounding herself with the right people. However, we were not quite there yet — which is normal at such an early-stage — and so we iterated quite a bit over the next 18 months.
In early 2022, Cécile shared a revised idea, and that’s when we really got close to the current story of Sonio. At the time, I felt there was a real alignment between an exceptional ambition & team, a desire to have an impact, and a rational market, business model, all this with a great initial execution. We knew that now was the time to accelerate and find the right financial partners for Sonio. We raised a €5M seed round in 2022 with Elaia, OneRagtime and French tech seed fund from Bpifrance. Then, things moved quickly, with a 2023 Series A with CBIV, a Canadian fund specialized in children and women’s healthcare, and the EIC.
CP: As Sacha mentioned, Cécile, you always knew how to surround yourself with the right people. Besides financial support, what else did the board provide? Were there key issues you could discuss with your board members that were foundational for Sonio?
CB: it’s essential to find trustworthy people like Sacha, whose feedback helps the project evolve. Like for many entrepreneurs, there’s a real question of resilience and taking feedback positively. The pre-investment feedback is essential to understanding both how to deploy an operational strategy and to develop a pitch that makes sense for investors. This was a breakthrough moment for me, as I didn’t necessarily understand at the very beginning, and I think it’s essential in investment stories.
It was important to define the main strategic directions. Each funding round allowed us to focus on our future milestones, for example, distribution strategies and markets. I’ve always been very pushy about going to the US, but it’s expensive. It appears to be paying off now, but it was a risky move. The debates with the board were necessary, especially their feedback from other companies they had financed.
If it didn’t work, we moved on to something else. What I appreciated was this ability to debate and test, all backed by trust.
CP: Trust and experience.
CB: That’s what I find very valuable in an experienced board, both listening to the management and asking the right questions. Elaia was a board member, and Sacha played the role of advisor/entrepreneur on the board, so slightly different but complementary roles, and I found it extraordinary to have both perspectives. It’s good to be able to turn to someone who understands very well what it means to be an entrepreneur and who, at the same time, can translate an investors’ concerns.
CB: Elaia and the other investors were great in managing the board. There was good communication between the historic investors which helped a lot when our new investors CBIV and EIC joined during the series A. We weren’t in a position to raise funds at the time, the opportunity came sooner than expected, and everyone was able to be agile and efficient in this operation.
CP: It was indeed a very functional, balanced and efficient board. we can also point out that the majority of the board was feminine, which is rare in deep tech!
Today, where is Sonio located? Without talking about Samsung Medison yet, but in terms of company size, clients, geographical reach, regulatory marking.
CB: Today, we are a team of about fifty people. We are remote-friendly, so we have people in the US, France, India, the UK, Spain, in the tech parts. We have a major American customer, Pediatrix, a group of about 100 American clinics, that we are currently rolling out across different states in the US.
As we have received two FDA Clearances since the Series A, we officially launched commercially in the US. Now we are in a commercialization period, working on going after the whole American market beyond Pediatrix. We keep investing to have the most usable product with increased addressable market segments, while managing thoroughly sales and service costs..
CP: Within Sonio, things move fast, and it is the same with your clients. Pediatrix, Sonio’s first major US partner, was one of the biggest partners you could have signed. You started out very strong!
CB: That was sort of the idea. We wanted a flagship account. It was also love at first sight. It’s a real opportunity to be able to work with them right now, because we understand a lot about the US market thanks to them. Their teams provide us with a lot of guidance and feedback even though they’re one of the biggest clinic groups in the US.
CB: After 7 years at Bpifrance’s incubator, helping companies to scale, I was convinced that to make great healthcare software, you needed to know the healthcare space; but you need developers who don’t come from healthcare. That’s because healthcare software innovation is not yet state of the art. I preferred to hire people who knew nothing about healthcare but were great developers. Deepak, our CTO, and David, our CPO at the time, brought this unparalleled skillset to Sonio.
Deepak designed an architecture that was very relevant from the start, and made specific choices to enable real-time processing. Sonio needed to be able to connect to any type of machine. Without David and Deepak, our tech duo, it wouldn’t have worked.
CP: It’s true that the arrival of Deepak, David and Dagmar(head of business development)took Sonio to another level. Their skills are very complementary to yours and Rémi’s (Sonio’s CSO).
To continue the story of Sonio, what has your approach been to pursuing innovation while respecting regulation in healthcare? Especially in the US?
CB: We are building the next generation of AI. We have been strategic in approaching regulation, which is both necessary and a major barrier in the AI medical market.
We’re in the process of developing the next version of our medical AI, pushing our clinical claims even further, in terms of value for the practitioner, but we must follow regulatory guidelines. To that end, we are lucky to have an excellent RAQA team led by Florian Akpakpa and we’re in frequent contact with the FDA, which has given us some advice, and which we’re following. They’ve helped us a lot with our regulatory roadmap, which is why we’ve already had two FDA clearances.
CP: Besides Pediatrix, what partnerships did you pursue?
CB: A key asset was the link with the Hôpital Necker-Enfants malades. One of our scientific co-founders is the head of obstetric gynecology at Necker, Professor Ville, one of the top five global leaders in this discipline.
It gives the company a lot of legitimacy and opens important doors with key opinion leaders worldwide. We also had access to significant data via our partnership with APHP, the first university hospital centre in Europe. Data in this field is rare, which made it a unique asset for us. Now that we’re expanding into the US market, we’re also collecting data there to broaden our database. This is a strong barrier to entry for any other players.
CP: Let’s talk about Samsung Medison and their acquisition of Sonio. How did you start working together and how did the deal materialize? What do you think was the most interesting part of Sonio for them?
CB: Our relationship dates to day one of Sonio. It was part of the work we did with Sacha on what an exit could be. You have to ask yourself the exit question very early on as part of long-term planning for any scenario. This means that in the early years, you need to think about who might be interested in your product and build relationships and partnerships with them. They need to know you and of course there needs to be a good fit.
From the beginning, we thought Samsung Medison was the ideal partner, as a challenger on the market. Dagmar, with her past experience at a reporting software acquired by GE, helped us connect with the manufacturers of the field and build great relationships. We had a very good feeling with their team in France. We had ties through an initial distribution partnership with them for the French market, and some Samsung team members had joined the team, both in France and the US.e. Our products are highly complementary.
At some point, Samsung Medison had decided to acquire a reporting solution. They began looking at the market and heard from US opinion leaders that we were the most innovative solution. At the same time, we were getting to know their sales teams better, working and meeting with them more frequently.
Which leads us to today!
Sonio’s next step will be with Samsung Medison, and we’re counting on them to help us grow, so that together we can become the world leaders in obstetric imaging.
CP: This really helped throughout the process, being aligned with Samsung Medison’s sales team and having them push for Sonio’s products to be integrated. They were super eager.
CB: Exactly.
CP: What are the next steps with your new family, Samsung Medison, over the coming months and years?
CB: We are only four years old and still have a lot to build with a young team!
The idea is to maintain our independence. Sonio will continue to grow its business autonomously while developing products and services that are compatible with all ultrasound equipment manufacturers. Sonio remains committed to supporting all healthcare professionals and patients. Our mission is still to ensure equitable access to cutting-edge technologies and high-quality maternity care around the world
As CEO, my job is also to ensure that the merger goes well, for each individual and at Corporate level, and that we continue to create value, both for Sonio standalone and for the Samsung group to which we belong now. I’m now also based in the US to develop Sonio commercially there.
