Hello, everyone. Ooh, good morning. My name is Claudia Thomé. I'm responsible for investor relations, together with Frederic Freischel, who's sitting over there. On behalf of the managing directors, we welcome you to the CompuGroup Medical Capital Markets Day. It's great to have you here, and also welcome to all of you listening on the webcast. The entire video is webcast live today and will also be available for replay later on, so please keep that in mind if you ask questions later on. The webcast will pause for the lunch break. Should you need anything during the day, those of you here in the room, we've got our colleague, Stefan Herkommer, Head of Treasury. Stefan, if you could just stand up. Yes, Stefan. Please turn to Stefan for any questions.
For the buy and sell side, investor relations, so Frederic and myself are here for your questions or anything you might need. And this is necessary, you know, so please note our safe harbor statement that applies to all the presentations that we show today. Please take note, especially with regard to any forward-looking statements. And with that, let's turn to the agenda. We've got the morning session, starting with CEO and CFO, Michael Rauch. He's talking about the strategy and also about artificial intelligence, the big topic of our time. All of the presentations will have elements of that today. Then we move on to one of the great growth areas at CGM, the hospital business. Hannes Reichl will be speaking. And another great growth area, the data business, and Eckart Pech will give an update on that one.
We will then have a joint Q&A session at the end of the first session, so please save your questions for all three speakers until the end of the first session. We're happy to include also questions from the webcast, so please, those of you listening on the webcast, please email any questions to Frederic and myself, and we will include those also in the session. Please let us know whether you're happy for us to state your name, and otherwise, we can also ask your questions on a no-name basis. We'll then have the lunch break, and in the afternoon session, we will go into the ambulatory business. Speakers include Ulrich Thomé for the DACH region, Emanuele Mugnani for Europe and the pharmacy business, and Derek for the perspective from the US. And this will again be followed by a Q&A for all three speakers.
And with that, I wish you an exciting Investor Day, and, I would like to hand over now to our CEO and CFO, Michael Rauch.
Thank you, Claudia. Good morning, and warm welcome also from my side. Dear shareholders, potential investors, analysts, banking community, rating agencies, every interested party here in CGM, we welcome you to the Investor and Analyst Day here in Koblenz and also via the webcast. It's probably going to be a hot day. The sun is out there, and we have some great and hot topics for all of you, so very much looking forward to a great day with you. Actually, me and my colleagues, we are super excited and very thankful to our employees, to our more than 9,000 employees at CGM, that executed already on numerous growth initiatives, which we're going to display to you throughout the day. But in essence, and Claudia mentioned that, we are at a historical moment.
So let me pause here and start with a sentence: Every company has its defining moments, and so do we at CompuGroup Medical. First, the strategic decision in the late 1980s to prioritize practice management systems, and since then, it has always been about empowering doctors, starting in the dentist and ambulatory field. From 2006 onwards, also expanding into the hospital field. In 2011, CompuGroup Medical entered the pharmacy space, complementing the target groups of healthcare practitioners and facilitators. And then again, a big moment in time. In 2017, we spearheaded and facilitated connectivity in healthcare, enabling a faster and secure interaction between all participants in the healthcare sector, being the pioneer in telematics infrastructure.
Driven by the purpose, well defined by our founder, Frank Gotthardt, we strive to ensure that nobody shall suffer or die because at any point, some medical information is missing. And that, again, is motivation for our more than 9,000 employees to be at the forefront again. And here we are, boosting e-health with artificial intelligence. And we experience lots of tailwind on the artificial intelligence wave. Let's start on the patient side. How do patients position themselves in the context of artificial intelligence? The majority of patients tend to trust artificial intelligence to support the doctor, and would be willing to share their data for this purpose. So you can see here on the chart, 66% are willing to rely on the use of AI in medicine.
75% comfortable with a doctor helping AI for making a diagnosis, and 73% would be willing to share their health data with a learning system like AI. We help making the difference with sophisticated tools, with improved healthcare management solutions, and by freeing up more time for patients. However, there's much more to gain for our direct customers, for the dentist, for the doctors, the pharmacists, the paramedics, and all other healthcare providers. Artificial intelligence helps them to mitigate and improve efficiencies, faster and better decision-making, more targeted diagnosis, benefiting both physicians and the patients. Our core CGM AI fields range from chronic care management, prevention, diagnostics, population health management, to improving operations and resource management. And we already, at CGM, have a very diverse range of employees, skilled employees with extensive experience in cutting-edge technologies.
Our artificial experts work intensively with natural language processing, machine learning, neural networks, data analytics, and image processing. These are in-house capabilities recruited already over the past years. Hence, let me be crystal clear here, we do not plan an additional investment initiative for AI. We already have today the competencies on board. So what do we do? We actually work in our initiatives on four defined core areas where we combine our artificial intelligence forces. First and foremost, to build value-adding products and solutions for our customers. Secondly, we are reallocating our existing R&D staff, thereby improving efficiencies. Third, we're going to boost service and support functions, and I'm going to explain more about that in a moment. And fourth, last but not least, improving our internal processes will make our business operations even more efficient. Now, I'm not talking about dreams of the future here.
Already today here at CGM, this is reality. Our AI talent is already reflected in our current product landscape. Think about Clinical Notes, AI Marketplace, Therafox, GHG Praxisdienst, or Medical Brain, just to name a few. That actually is just the beginning. We have many more exciting AI-based solutions in development. We are working on virtual user assistants for practice employees. We're working on a chatbot for CGM Messenger and a voice bot for schedule online appointments with CLICKDOC. All of that will not only benefit our customers with better products and solutions, but it also will help boost our own efficiency. Let me be concrete. The AI impact on software development will be, and I'm fully convinced of that, so sustainable, like the introduction of the internet or open source technology availability.
It is here to stay and to transform. AI is no longer a niche technology, but a mainstream tool. Generative artificial intelligence will give us time to focus more critical tasks and to help us create systems more advanced than ever. It is transforming how we develop software already today, and it will change and is changing our company, our work, and will have an impact on our lives. We will embrace that change. We will use it to our advantage with ChatCGM. So we've introduced our own proprietary generative artificial intelligence tool, ChatCGM, that is based on Azure OpenAI, but it also is able to integrate other generative AI solutions. It has started internally to be rolled out to our CGM employees, so all of our employees have access to ChatCGM, and the core units have already been working with it for some time.
We have dynamic growth ahead of us. Artificial intelligence will help us grow more efficiently while providing added value solutions to our customers. It is, as I said, a game changer for the whole company. It will really transform the way we operate inside and across the various areas of our company. From R&D, over service and support, towards the business operations. It will be an excellence driver for our customers, but also for us internally at CompuGroup Medical, clearly underlining our overall ambition: we are the leading medical software company. Let's be clear, no other company serves all healthcare practitioners along the entire value chain as we do.
Ambulatory information systems, hospital information systems, laboratory information systems, pharmacy information systems, consumer and health management information systems, the connectivity in a very safe data environment between all healthcare practitioners, and last but not least, the data solutions developed from key insights along the patient journey. Again, we are the leading medical software company. Talking about that entire patient journey chain, the journey along that. Already today, we support our customers along that patient journey with physicians, again, physicians, serving as the ultimate navigator of channeling the patient through the individual steps. And we support every patient and participant during the entire patient journey. We do so with multiple touchpoints. Think about the magnitude and size here CompuGroup Medical has.
More than 100,000 doctors within reach in Europe, more than 60,000 ambulatory providers in the U.S. more than 2,000 hospitals and social care institutions we cater in Europe, more than 10,000 pharmacies in Europe, and more than 2,000 laboratories in the U.S. and in Europe. Our broad range of touchpoints in healthcare is unique. Why are we perfectly positioned to also succeed in the future? Well, because we are relevant in the markets we play in. We have a strong footprint across Europe and the U.S. You can see here numerous number one and number two positions in the markets we operate in, and you can see also already a sizable number four position in the very large U.S. market, and I'm sure Derek will talk more about that in the afternoon. Our relevance is really paying off.
And how does that really pay off? Well, double-digit sustainable profit growth, pushing CompuGroup Medical to more than a EUR 1 billion company. In honesty, this is not a snapshot, this is a trend. Look to the last 12 months bars here on the chart, and you can see the trend, and that trend will evolve ever stronger. We will see an increase in the share of recurring revenues starting in the second half of 2023. The reason being the shift to the TI flat rate. Everything else being equal, this can increase our recurring revenue share by up to 3 percentage points, and my colleague, Ulrich, will for sure go more into detail this afternoon. You see here a trend of a highly professional company in leading positions in the healthcare market, with a clear strategy for further growth.
This growth, by the way, is not dependent on acquisitions. Yes, we have benefited a lot in the past from acquisitions, and we will continue to look at acquisitions. However, focusing on our core competencies, supporting healthcare practitioners in the digitalization in the healthcare sector, we already took organic growth to a completely new level. From 2015 to 2019, CompuGroup Medical grew between 0% and 3% organically. So if you exclude the one-off spikes from telematics infrastructure, which from time to time happen. We deliberately decided to build up resources for higher organic growth and managed to increase the level of our organic growth significantly. This is my fifth Capital Market Day.
So when I joined in 2019, I still remember one of the larger investors sitting in the audience and asking me at the break, "Michael, actually, any percentage point, a single percentage point you can add to the growth on this revenue level now," and that was 2019, "is of great value to us." Well, we have delivered, talking from 0%-3%. Now we are around a level of 5% continuously. So a big, big, big thank you to our more than 9,000 employees worldwide. You're a great team. Thank you. And not only did we improve organic sales growth, but we also managed a significant step up in operating result. The adjusted EBITDA has increased steadily, and we are now beginning to see the margin extension.
Even short-term seasonality, which we might see in the third quarter of 2023, compared to the first half of this year, will not weaken our trend. We are fully geared toward achieving our full-year targets year by year. So even with a seasonally weaker Q3, and a stronger Q4 ahead of us, it will not change our guidance for the year 2023. And the turnaround in improving adjusted EBITDA is also reflected in our multi-year view of R&D expenditures. So we are visibly moving out of the investment phase. After leaving the core investment phase, behind us last summer, the personnel expense ratio is moving toward the pre-investment phase level. And not only the personnel expenses are well under control, so are our R&D expenses.
After ramping up the R&D intensity since 2020, the total R&D expense and % of revenue is managed closely back to lower level now. That is another proof point that the path we've taken is the right one. With everything on board, it takes to see a further significant improvement in adjusted EBITDA in 2023 and beyond. We are continuously also increasing our free cash flow in a multi-year comparison. So yes, we know the year 2022 was influenced by one-off effects, but we are back on track this year. Already in the first half, 2023, we achieved a higher free cash flow than in the complete year, 2022. Hence, we confirm our guidance to achieve a free cash flow of over EUR 100 million in this current fiscal year.
Following years of sizable acquisitions, which we all enjoyed and have been part of, we have started to deleverage with attractive financing conditions in place. We do realize the synergies from those acquisitions to increase the EBITDA and the free cash flow further as we move into the future. Based on continuously growing revenues, strong development in adjusted EBITDA, and combined with ongoing growth opportunities in the market, let me assure you, we confirm our 2023 guidance on our midterm targets. With our highly motivated colleagues around the globe, focused on supporting healthcare practitioners and bringing more digitization in the healthcare sector, we have the clear goal to deliver an organic revenue growth of around 5% on a CAGR basis until 2025.
Revenues will be generated with a high quality, leading to a recurring revenue share of more than 70% in the year 2025. I mentioned earlier the introduction of the TI flat rate, which will, in the second half of this year already, be a major step towards our midterm ambitions in terms of recurring revenue. Combined with increased efficiency, this will increase and expand our adjusted EBITDA margin to around 27% by 2025. Summing it up, CompuGroup Medical is well prepared for the next level of digital boost in healthcare IT. We are at the forefront of technological developments, servicing our customers with ever better products and solutions. Thanks to a skilled and highly motivated employee team, we will deliver on our mission: We create the future of eHealth.
With that, let me close my presentation and wish you all an insightful analyst and Investor Day, and let me thank you for your interest in CompuGroup Medical. And now I hand over to my colleague, Hannes, to explain to you more about the hospital business.
So wow, Michael, that was an exciting intro. A warm welcome also from my side. I'm Hannes. I'm heading the HIS operation within CGM. And in my presentation today, I will give you some update on the execution over the last 12 months, but as it is mentioned in the headline of my presentation, I will focus more on the growth opportunity we have in front of us. The market, the HIS market, which is the market for the large health providers, is in an unprecedented race to catch up in terms of digitization. And only if we look into Germany, a lot of initiatives are ongoing. Is it the hospital reform and upcoming digitization act, the well-known Hospital Future Act? Those are all triggers which are giving us a lot of dynamic and growth opportunities.
If we look on the Hospital Future Act, I think, this initiative is driving us forward. I will give you an update on how we are executing so far. But it's not only, initiatives driven by governments, it's also the market dynamic, which we clearly see as a growth opportunity for us. There is a big market consolidation ongoing, which brings us a lot of opportunity for net new win and increasing our market shares. The exciting presentation of Michael around AI is also true for the hospital segment. AI is a big ticket for hospitals, and we see a lot of upside and value which we can give to our customers. But let me get started and get into an update on how we executed so far over the last 12 months.
Reflecting what Michael said on the growth of CGM, we see clearly that the hospital business is a growth engine for CGM. We delivered a 22% growth rate over the last five years. And looking on the organic growth, if I compare the first half year 2023 with five years ago, we have an 8% organic growth, which makes us very proud. Only the first half year comparing with the last year, we see an organic growth of 10%, and I'm rather optimistic, looking forward. In our base business, which is the business of cross and upselling, where we have a lot of strong IP businesses, we deliver a lot of value. We cover uncovered areas in terms of digitization.
We are really able to convert those businesses into recurring revenues, which brought us to the level of 69% recurring, which shows that the business is out of strong substance, and we increased the share by 4 percentage points only over the last 12 months. Another big initiative which kept us busy is the Hospital Future Act. We overachieved several times our own guidance, and we reached now a level of EUR 140 million of order intake for the next years to come, and we are still confident that this is not the end of the journey, but I will give you more insight into that later on. Let us now look a little bit on our position on the market. We are the well-known number two on the European and also on the German market.
And you see a 75% share on the DACH market, which will be in the focus of my presentation today. But let me also reflect a little bit on the business outside of the German or the DACH market. In countries like Sweden, Poland, and Spain, we are running very strong businesses, and the growth is even stronger in those countries compared to the DACH market. But also in terms of profitability, these businesses are doing quite well, and to be honest, if I look into the initiatives customers are driving, we can clearly say that those countries are partially ahead of Germany. Is it analytics? Is it BI? Is it integrated care, data analytics, population health? There are very strong initiatives going forward in these countries, also backed up by EU fundings, which will keep us busy.
The customers rely on our strong product portfolio and services, and we see growth in a similar level in all our geographies. Another view on our position is the different customer segments. Here I would like to reflect a little bit how we are positioned in the market and how we extend market share. We have been quite successfully in the last 12 months and achieved a net new win of 170 new logos, which is also based on a fortunately relatively low churn. So in the acute space, which is the biggest part of our business, we have been able to win almost 10 net new sites. This is in highly competitive environment. We are fighting against all the big players on the market, Dedalus, Nexus, but we still win and extend our market share.
We are the clear number one in the rehab space in Germany. But still, we are gaining market shares. We have won more than 40 new logos over the last 12 months. In the area of lab and radiology, and keep in mind, this is the area where we don't have a lot of regulatory tailwind, we are still growing. Customers are investing, and we won almost 70 new customers over the last 12 months. Last but not least, I reported a little bit last year on the acquisition of KMS and m.Doc. We formed a very strong business unit out of that, and we won further 50 new sites. So in total, we are really proud about to expand our market shares with a plus of 70 new customers.
Talking about growth, I would like to give you a little bit of insight on how we think or how is our growth thinking, and I reduce that to the five core initiatives. I call that the growth DNA. Let me start with the bottom line, which is our base business. We have a very comprehensive, very complete and strong product portfolio. This covers the full patient journey for large health providers. We position ourselves as a so-called one-stop shop. We are strategic partner to our customers, and they rely on us. We help them to take their challenges in the present, but also in the short, mid, and long term. That works quite well.
This base business is fueling growth in a quite high level, and on top, initiatives like the Hospital Future Act is giving us a very good confidence that we keep this growth up on a very high level, 6%-8%, which is in line with our guidance, which I hereby can confirm. But that's not the end of everything. We even see strong initiatives coming up beyond 25. I talked a bit about this upcoming market consolidation already last year, and this hypothesis became fact. After a very important announcement of SAP at the end of last year, the market consolidation has started. There are hundreds of customers out there into a procurement for new hospital information systems. I will get into more detail later on. Our go-to-market in the social ambulatory space with our SaaS-based product, VIU, was quite successful.
We won 60 new sites already in the first year, which is a quite strong success after having started the development only 2.5 years ago. That was a very, very intensive and successful go live, and we see a very long-term substantial growth also on the recurring side with that product. Last but not least, AI. As I said, this is a very big ticket for us. We see a lot of value, and the good thing is, as Michael figured out, it's not vision, it's not something we are in research. We have ready-to-scale products out in the market, and we see even on top of that, further things to come.
So talking about growth and a long-term future, I would like to pull out some concrete examples, real facts, what we so far winning or delivering and executing on the market. In the last month, we were able to win very new large projects. I talked about Visus last year. We have been able to convince the Sana Group, which is one of the most or the biggest hospital groups in Germany, to take Visus, the platform of Visus, to a central documentation management system. This is more than 40 sites we are implementing right now. In the rehab space, another big private hospital group, Asklepios MEDICLIN, decided on implementing our CGM REHAB product, where we are very proud about, and we will digitize their workflows and bring them up to a new level. You heard me talking about very large hospital projects last year.
We won the University Hospital San Carlos and also the Pomorskie, the regional project. Those projects are finished. We went live in the Hospital San Carlos, beginning of the year with a big bang. Thousands of users in one day have been switched over from the old system to our new system, where we can really proud about. Those are very, very complex projects, and this underpins also our execution strength. The detail project in the social area, one of the biggest elderly care providers, went live with our products in the first quarter, in time, in budget. This is a beacon for us in the meantime, and I think as a reference site, we will be able to win further projects of that size. I talked about the view that makes me so proud.
We managed to go to market, and it's one of our first real big SaaS products, which is running quite well. We are quite before the go live in the University Hospital in Hamburg-Eppendorf. We have been working on this over several months, and this has the potential to be a real game changer on the market. Looking on the market consolidation, on the vendor market consolidation, our brand-new product will be very well positioned to bring us a lot of new clients. Last but not least, in the rehab space, we just learned in Q1 that the government has strong interest also to bring the rehab customers into the electronic patient record based on the TI. This is a co-funding program, and we have just started a new campaign, and we see the first successes coming in. We won first new contracts.
That will bring us a lot of new potential also for the next year. Let me now do a little deep dive on the Hospital Future Act to bring you back on speed. The program is a several billion EUR funded program from the federal government and the counties. It consists out of 11 streams. We have strong products to address 6 streams. You see here on the chart that there is a clear focus on treatment documentation, which sees that the program is effectively working, so we are covering uncovered processes and workflow. Also, medication, emergency and so on is quite strong. There is an area which is brand new, which is not a commodity. It's the patient portal area, so the patient empowerment. We are here talking about a B to B to C process. Customers have been quite hesitant with their procurements.
There is still a lot of room, and we see significant potential going forward. As you heard, we have recently taken over mDoc. The combination of mDoc with KlickDoc creates a quite convincing and compelling product portfolio as we are able to play the full game from the outpatient area with KlickDoc, referring patients into hospitals and back, and we see very large potential coming up in here. We reached a level of EUR 140. We hereby can increase our own guidance up to EUR 160. As I said, there is still potential out there. The program runs until end of 2023, so customers are still in procurement processes. Recently, the Association of Hospitals agreed on new terms with regards to delivery. At the beginning, it was foreseen to have everything implemented 2024.
So resource is short, both on our and on, customer side. And I think that is a very good signal for us, because we are now effectively able to utilize resource in a much better way to deliver more over more time and with higher value. I still see the big bunch of the execution until end of 2025, but there will certainly spill over some things into 2026 and 2027, until the sanctions, which are part of the program, will finally get into full effect. So that is a very good signal for us on the Hospital Future Act. Coming now to the market consolidation, and let me frame a little bit. The products we are running, in the hospital space are confronted with an enormous high demand and requirement. We see a lot of technology-driven demands. Is it AI? Is it telemedicine?
Is it user experience, speech recognition? You name it. On the other hand, there are increasing requirements from the area of standardization, interoperability, IT security, data protection. This is a never-ending list of very important requirements, which lead us to very high R&D expenses. Regulatory-driven demands is also fueling that. We see enormous efforts in quality management systems, things like the medical device regulation, ISO standards. In Germany, the critical security standards. There is many things we have to cope with, and looking on the market, there are a lot of products out there being there for more than 30 years, sometimes on a fairly old technology and architecture.
The hypothesis is only those who are technically, and from the software architecture, modern, and on the other hand, have the right scale, the right critical mass to economically afford those efforts, will survive. You see here the question mark under the others. You see the biggest portion of the market is still very small vendors, summarized under others. My hypothesis is that even after the announcement of SAP, other vendors will follow and deprecate the systems. But getting into the announcement of SAP, we learned in the late autumn that through the migration of the SAP landscape from ECC 6.0 to S/4, SAP decided to withdraw their industry solution health from the market. They set an end of life date, 2027, with the possibility to extend until 2030. The product portfolio, i.s.h.m ed from Cerner, is entirely based on that systems.
That leads to the similar technical consequence. So we are talking about hundreds of hospitals being out in the market and searching for a substitution in the area of administration reimbursement, but also for their clinical system. We are prepared quite well. We started anyhow the development of a reimbursement system 1.5-2 years ago, so we are quite advanced. And on top, we are in a partnership with SAP in order to integrate our products deeply into the ERP on the one-hand side, but on the other-hand side, to create methods to migrate smoothly without big disruptions. So that leads to a very large opportunity for us, which we see predominantly 2025 and beyond. We will see a shift in market shares, and we expect a single mid-digit percentage point as a market share, which we will gain from that.
Coming now into AI, and Michael impressively figured out what we are doing here. Let me give you a little insight on some key elements in the hospital space. There is a study made by McKinsey for the U.S., which actually stated: If you take what is there, so existing products, and do a math, what you can save, they came back with a 5%-10% cost savings for the U.S. hospitals, which leads to a $60 billion-$120 billion amount. That is certainly maybe not serious to do a one-to-one derivation into Europe. We have different systems and so on. But, and here is the but, it is true that solutions are out there ready for scale, and we have a strong product already there for reimbursement, which is totally AI-based and out in the market and running.
Another big area, and Michael said that we are developing products, is in the space of clinical analytics. This has, of course, the highest potential. This was also underpinned by the McKinsey study. And here it is about helping doctors to gather data in the context of their treatment, to save them time, and to give them decision support. There is enormous potential in terms of quality, in terms of efficiency and giving back the time to doctors for the treatment of the patients. And we are pretty much convinced that we will come up with strong solutions over the next years and, beyond 25. And here is the concrete use case from meta KMS. We have an intelligent case control and case-based DRG coding system. This is an algorithm we trained, and it is also trained by the collective intelligence of customers.
This algorithm helps to collect data out of the EMR automatically in the background, and it creates reimbursement proposals. That saves a lot of time for the administration and a lot of time for doctors, which are typically doing that coding. But it not only saves time, it gives a high quality based on the intelligence of the system, and it finally secures revenue. So time, quality, and money. All three value categories are totally underpinned by this perfect use case. We are just starting to bring this use case beyond Germany and we will see and have a lot of fun with that product, I think, in the future. Turning now from the very strong sales-driven initiatives into operational excellence, we of course continue to focus on our profitability.
As I figured out, we will and we have to continue to invest into our products in order to keep track with all that requirements, and I named a lot of examples. You can see them here. But we see in total, the sum of our R&D spending is not growing anymore. I'm referring back to that, what Michael said: We have seen that already in the first half year, 2023. We reduced our R&D expense to revenue share by two percentage points, and I'm very optimistic to see that going forward. On top of that, we had some one-time investments for large projects in the first half year of 2023, in a high single-digit million EUR amount, which will not come back any further.
So I'm pretty confident that we will improve our earning power strongly in the second half of this year. So let me summarize. The hospital market, the HI-HIS market, is still very highly driven or big potential market in terms of digitization. All initiatives I figured out today will keep us busy until 2025 and beyond for a very long time. The Hospital Future Act gives us the security to deliver on the guidance in terms of growth. We have a strong backlog we need to execute. We have the people on board. We are totally ready. The market consolidation gives us a very strong opportunity beyond. In 2025, we will see market shares shifting, and we are very well positioned with our products and with our teams. Our best-in-class product portfolio is ready also for AI.
It can be easily adopted, and we have ready-to-scale products in place. So I confirm our growth guidance of 6%-8%, and we on top see significant potential to increase margin as our R&D expenses and operational excellence will kick in. We are right at the time to start that. Thank you very much. And now I'm handing over to Eckart.
Thank you. Dear investors, shareholders, and stakeholders, today, I want to take you on a journey that is about two things that drives myself personally and every single team member I have the honor to have on my team in CHS. On the one hand side, it's growth. We are all geared, and we are motivated every single day we get up to build a strong fourth pillar inside CompuGroup Medical. Besides the great job, the colleagues in AIS, HIS, and PCS are doing. The second is purpose. Very, very closely tied to what our founder, Frank Gotthardt, has once stated, that nobody should suffer or die because of missing medical information. We feel that we are on a very exciting journey, and I want to take you on that journey today, looking into the rearview mirror.
I've been on that bus pretty much since late 2019, and also want to look through the windshield together with you, what's ahead and what's going to happen in the next month and years ahead. Overall, the times are really, really exciting for data. There's a lot of regulatory tailwind, such as the European Health Data Space or the Gesundheitsdatennutzungsgesetz that has just been approved and ratified. There's also enormous competitive dynamics, which we welcome. It shows us that we are on the right track and that we're doing the right thing. There is, as our CEO, Michael, and also Hannes mentioned, the rise of AI, which is a powerful game changer that only happens every 20, 30 years or so. We also see that based on what the market gives us as feedback, that we are addressing the right topics.
In the market, we are among the most advanced and really, and certainly ahead of new competitors. But let's quickly look into the rearview mirror. Growth. 2019, we started to embark on our data journey. At that time, it was a business of about EUR 40 million, give or take. Since then, every single year, we have grown, both organically, and 2022 was the big year of transactions, with three major M&A transactions. Bringing us to a situation where the 45 year, 45 million euro business is now transforming into a three-digit million euro business. And this is going to happen this year. So a 25% CAGR, both organic as well as based on great transactions that we have been able to execute in the past year. Over the first half of the year, our growth is between 3% and 5%.
But what is also important, with the acquisitions, we were able to massively improve our revenue quality. Historically, we've largely been relying on one-off revenues, which we are now able to transform, and now we are in a position that our recurring revenue exceeds 80% in InsideHealth. And this, of course, is contagious for the other businesses that we have assembled under the data umbrella. Smart M&A clearly is one of the key ingredients here. The companies that we've onboarded are a phenomenal fit. The economic surroundings are getting tougher, and we see that our customers not only look for messaging in the AI systems, but they also look for measuring the effects, and that is a capability that we have now onboarded with InsideHealth. And last but not least, what is also very, very important and dear to us is our high levels of customer satisfaction.
Across the data business units at CGM, we have a customer satisfaction level that is exceeding 50, so a very positive NPS. I mean, we always are humbled by this, and we have to not lose focus, but I think that's a solid foundation for further growth. So much to the look into the rearview mirror. But now, given this track record, I also want to share with you our core beliefs and some customer-driven examples of what we are doing and what we see on the road ahead. So more to this great opportunity ahead. When we embarked on that journey, it was about building the foundation, combining the assets that we have on board, such as our Intermedix business out of Munich or our doc.metrics venture that is offering, operating out of Berlin, where we are gathering data, healthcare data.
Now, we are in the middle of horizon number 2: growth. On the back of systematic integration and M&A transactions, such as INSIGHT Health, Gotthardt Healthgroup, and the partnership we've entered with New Line in Italy, we are boosting ourselves into a new league, both in terms of size, but also in terms of scope, capabilities of the team, and portfolio. The portfolio that originally was just founded on 1 pillar, communication solutions, now is augmented by 2 additional pillars, namely analytical capabilities and medical capabilities. The medical expertise, we believe, is a very crucial and strong foundation whenever we correspond with healthcare practitioners, who are the source of extracting data and injecting data. Why is that important? We have to deliver meaningful content at the point of care to them, so that they can take better decisions based on data, empowered by AI, and based on real-world evidence.
But clearly, there's more. AI is a catalyst for everything that we do at CGM and for the business as a whole. So today, there was also a study published that already every fourth healthcare practitioner is experimenting or toying around with AI, and I think it's a powerful tool, but it's also a dangerous tool if you just rely on it in an unsteered manner. So allow me to give you a little more context in terms of medical relevance. I believe the combination of data and AI will evolve to be extremely powerful. First of all, a couple of years ago, we've seen the breakthrough in DNA sequencing, and what it illustrated is that no one is like another one, pretty much. So there is clearly a need for individualized medicine. This is very much illustrated by the relevance of rare diseases.
Or also, if you look at cancer treatments, tumor boards treat every patient as a segment of one. But let me look and tap into rare diseases again. Rare diseases affect 2 in 10,000 citizens. Examples: sarcoidosis, Asperger syndrome, Morbus Duchenne, and others. So far, we assume that 6,000 of those exist. By the way, worldwide, 400 million people are affected by a rare disease. But isn't ultimately the majority of the diseases and the sicknesses a rare, a single and a unique or rare disease? So the lack of knowledge that we have in that field largely stems from the lack of data and the lack of integration of medical knowledge that is exploding as we speak, every two minutes, another medical application.
So from our point of view, AI will be a massive game changer to process all that information and to make it available at the point of care, where the poor practitioner only has between 5-7 minutes per patient. How can you process all that knowledge in a digestible manner, which is so dear to us and everybody who has a relevant sitting in front of a doctor, when it sometimes is a life or death decision? So AI tools will be enabling a major change there. But now let me look at a very specific example that is also dear to me and dear to us. Treatment of cancers. In a given year, there is 500,000 new cases of reported cancer cases in Germany. There's 220,000 fatalities from cancer.
The number 2 in males is lung cancer, and it's the number 3 in women. The nasty thing about lung cancer is that it accounts for 50,000 new diagnosis every single year, but for 50,000 fatalities, so it's extremely lethal. If you treat lung cancer by the book, you go to have your diagnosis, chemotherapy, and then your regular scans to avoid a relapse, which happens every five or four to twelve weeks. A study that was recently published by the National Cancer Institute illustrated that regular checks and balances are so vital in detecting relapses way earlier. There was a group of 133 patients.
67 of those, or about 50% of those, went through regular treatment, and 50% went through a treatment that was based on PROM, Past, Patient Reported Outcome Measurement, or in simple, in a simpler form, on a weekly basis, you fill out a questionnaire with 12 questions: Weight. Are you coughing? Are you coughing blood? How's your voice? How's your appetite? 12 questions every single week, so a lot of data was created. Out of the 133 patients, 50% or 50 relapsed. Out of the test group that went through the standard procedures, 26 passed away very fast, and out of the one who participated in the questionnaires, 11 passed away during the period of the study.
Maybe their life was prolonged because that's one of the big things in cancer, but they still at least were able to live a life and have some quality of life for an extended period of time. I know cancer is a very nasty treatment, but that to me is a proof point that data is of the essence, and speed is of the essence. And our mission and purpose at CompuGroup Medical, as you know, is to make sure that this data is available at a very, very early stage, and that is a proven point on the purpose side. So symptoms do not develop by the book, and we have to ready our customers, our dear customers, healthcare practitioners, to really apply what is state-of-the-art there. Let's look at rare diseases again. Rare diseases, I mentioned 6,000, about 4 million patients in Germany.
And the average number, and maybe Julia Jaeger in the break, can also share some more details with you. The average number, it takes a decade or so for this to be diagnosed. This has two very nasty factors. For the patient, the clinical status may deteriorate over that time, over the long duration, if it means remains untreated. Secondly, it also takes a huge toll psychologically if you wait for your treatment. And then thirdly, there's a big cost associated to the healthcare system. In the U.K., in the year 2018, it was calculated that the cost of misdiagnosed or undiagnosed rare diseases on the healthcare system was GBP 3.4 billion pound. So, big—we're talking personal suffering, we're talking curing people, and we are talking a true value lever for the entire healthcare system that we are holding in our hands.
Medical imaging, gathering of symptoms, lab data, optical use cases, we have a powerful proof point. So rare diseases is a topic that is very dear to us and has been dear to us for many years, and we are seeing tremendous success there on the back of the data that we collect, but also by empowering our tools through AI. But let's review the potentials of AI on a more general level first. I like to refer on the technology side to a very powerful and unique cocktail that we have in our hand. First of all, we have artificial intelligence, which in principle is stating that a computer can do what a human can do. But then you also have machine learning. That machine can learn 24/7, doesn't need a break, doesn't need lunch, doesn't need dinner, doesn't need breakfast, doesn't need sleep.
It can process now, with the rise of AI, natural language.... So text, pictures, any shape or form, and create, based on statistic algorithms, large language models that are very, very good to digest and very, very useful. So that's a powerful combination. And we believe this can evolve and will evolve, powered by our solutions, to becoming a very, very powerful co-pilot for our customers, for our healthcare practitioners. Not the pilot, the healthcare practitioner remains in charge. But how about we augment his or her capabilities to detect rare diseases on the back of access to global diagnosis? How about making sure that drug safety checks or therapy checks can be performed much faster than ever before? How about we do what Hannes was just alluding to, the clinical decision support, right information at the point of care when you really need it.
And last not least, this is a very, very vital point, in particular in markets that are very cautious when it comes to data protection: the creation of synthetic data out of real-world patient data. And on the back of synthetic data, creation of digital twins or performing simulation of certain treatments, which is extremely vital, for example, in cancer treatment. But how does that change what we do and how we work at CGM? My friend Derek always says, "Eat your own cooking." And I think it begins with getting your hands around AI yourself first. So when we first learned about AI, Michael triggered all of us to have a discussion on that in the board, and we said: What are we gonna do with it? So we all got our own instance.
We played with ChatGPT and not, and then we said, "But we need to move this to a different level," not by building an ivory tower of people, but by really infecting the entire organization and putting this tremendous power at everybody's hands. Which is why we incepted ChatCGM. We only incepted it six weeks ago, and we have 1,300 internal users, and every single month, the number of users is doubling. So that's a very, very powerful tool. Some of the solutions in CHS, and the colleagues are going to talk about what they do in their respective segments, are being augmented on the back of AI as we speak. Terrafox, which is our rules-based engine on top of a database, performing safety checks on drug interactions. And these rules historically had to be generated manually.
Now you can generate such rules and get suggestion for such rules by browsing through the richness of medical information and creation of those rules in a much faster manner. DRG Praxisdienst, I'm going to talk a bit in more detail about in a second. Also, a very powerful tool. By the way, during the break, Julia will give a presentation on the Praxisdienst. The Praxisdienst is also there to act as the co-pilot I was just mentioning and alluding to for the healthcare practitioner. Also here, processing the vast amount of medical data is a big, big change here. Medical Brain, another example, clinical decision support, where we will inject AI capabilities to allow for better recommendations and decision-making at the point of care. doc.metric, our data venture out of Berlin, clearly a catalyst here, synthetic data. And stay tuned for a couple more minutes.
I'm going to talk about our health or medical intelligence suite shortly. But what would it be without some specific examples? I've shared with you, and that was almost like a red line across all the presentation I've had the honor to give during the past four years of the Capital Markets Day, the absolute imperative to collect data. When we embarked on our data journey, we said we want to build a very, very powerful healthcare data lake that is specialized on healthcare data, based on latest and greatest technologies, and will form the basis for anything that we do in data analytics. Our data lake is now the richest in Germany in terms of healthcare data. We have now assembled over 8,000 healthcare practitioners on a daily basis, contributing data, and we still add about 200 every single year.
That's a growth of 30% year-over-year. We have over 5 million so-called longitudinal patients. Well, it was 900 the year before, and per month, we assemble 30 million health records. Besides GPs, we are now also venturing out into other target groups, such as cardiologists, pediatricians, gastroenterologists, at a later stage, oncologists. The pharmacy panel that we had was already massive. With the addition of INSIGHT Health Group, we are the largest in Germany with over 7,000 pharmacies. So zooming in on AI, that rich data pool is a fantastic source for doing what everybody out there is talking about because AI or data analytics in healthcare is nothing without data, and we have the hands on that treasure and on these nuggets that can empower our customers, our healthcare practitioners along the line.
But it also empowers customers of ours, industry customers, to give patients access to meaningful medication at the earliest possible stage. So let me share with you one example here. We work closely with AstraZeneca, who is famous, became famous during the COVID vaccination, but they have other interesting products in their lineup as well. So, does anybody have relatives or probably anybody, somebody has relatives who are some suffer from chronic kidney disease? Globally, about 700 million people are affected by chronic kidney disease, and we all know the progression through the five stages, which ends up with dialysis. The good side to dialysis is you can continue to live. The flip side is, it's very painful to go to dialysis every other day. I'm not talking about cost, I'm talking about the personal toll it takes on human being.
The nasty thing about chronic kidney disease is that the 700 million I was just mentioning is just the tip of the iceberg. People who already develop symptoms and who move in this direction, that sort of dark number of affected patients is much, much bigger. In 2021, AstraZeneca came out with a drug called Farxiga, and received admission to apply this to chronic kidney disease patients. The trick again is to find the relevant patients and making sure that you slow down the progression of the disease, thereby improve the quality of life for the patient and at the same time reduce the cost on the medical system. So we help AstraZeneca in analyzing the data. We help them to find patients that, based on medical scoring, who have the criteria but may not yet be diagnosed with chronic kidney disease.
So we can enable chronic kidney disease on the basis of real-world evidence and risk scoring at an early stage. And also give the general practitioners and all other specialty groups the right information at the point of care to say, "Okay, maybe there's a suspicion that you may suffer from a chronic kidney disease. We have to make you aware of that, what that means, what that could entail," and at the same time, also to give the relevant information to the healthcare practitioner. So that is one case in point where what we do in data translates into value for patients, value for healthcare practitioners, but also for the pharmaceutical industry, and helps them to spend their R&D dollars much smarter on the back of our solutions and reach.
But besides that, let me give you a glimpse, and I said, we're gonna look through the window screen, what we have in our portfolio. Praxisdienst, this is just the teaser for the presentation during the break, is a tool that we acquired at the heart of the Gotthardt Healthgroup acquisition. Praxisdienst will become our linchpin for data extraction and injection to the healthcare practitioner. And why will the healthcare practitioner even take a look or consider looking at Praxisdienst? Because she or he receives a ton of relevant information, such as medical scores, such as patient information she or he can deliver to the patient when a certain diagnosis is likely. Such as the rare disease finder, a $400 billion market in the year 2030, by the way. Such as clinical studies.
So the eligibility to enlist in a trial that might give you fast access to better treatment. And if you look at cancer, for example, research-wise, this is a field that is exploding, and you wanna make sure that you get your hands on the best possible treatment as fast as possible. But let me give you two specific examples along the patient journey here. So first, let's take Mark, a consultant with a consulting firm. He sits in front of the computer just like we do most of the time, but he also likes to go hiking, he likes to go mountain biking. He gets back pain. Everybody gets that, who sits in front of the computer too much, or you need a pair of glasses.
So Mark comes and sees the doctor, and the doctor says, "Well, you've got chronic back pain, you need some painkillers." Mark explains his symptoms in more detail, and then the doctor says: "Well, Mark, you may qualify for a study. May I propose you to enlist in that study?" As an option, it turns out Mark is eligible, and as an alternative treatment option, gets enlisted in a trial with cannabis as part of the treatment. So of course, Mark takes that route. Who wouldn't? And of course, hopes for improvement there. So the upside for Mark is he gets access to a better treatment. For the healthcare practitioner, he can prescribe a better treatment, but even for the identification of the patient, she or he will receive a reimbursement for finding the patient.
The pharmaceutical industry is happy for finding trial patients, so there's a win-win-win. Secondly, rare disease, lupus. Anybody heard about lupus? Probably you've heard about lupus. 5 million people suffer from lupus worldwide. So there's Mary, 39 years old. She reports hair's getting thinner, feverish, tired, loss of appetite. Doctor says, "Okay, you probably need to change your diet, and you probably need a couple of painkillers." As she takes on board those recommendations, the symptoms develop and become worse. So fever, tiredness, muscle pain. And fortunately, based on some triggers that we have in our Praxisdienst, the doctor is able to detect this may be a lupus.
This is so relevant because then Mary can be helped, and she doesn't have to go through the journey of up to 10 years to be misdiagnosed with a worsening or deteriorating clinical study, and receive an applicable and good treatment. That's remarkable, and that's important because, the likelihood of lupus patients dying is 3 times higher to other, or to normal patients, so to say, and the disease often goes along with kidney failure and other things. Here's the great vision, the copilot, the Health Intelligence Suite. We are going to combine our drug database, MediCenter, the Praxisdienst suite, Terrafox to measure counter indications, Medical Brain and Medical Decision Support, and doc.metric to track how am I doing as a practitioner in comparison to my peer group? What else could I prescribe? What else could I use?
So on top of the horizontal solutions that we built from Anamnesis to prescription, we now add a vertical layer, which is the Health Intelligence Suite, which we are going to put into the hands of our healthcare practitioners. And as we speak, the centerpiece of this solution, the Gotthardt Healthgroup Praxisdienst, is being rolled out to the entire German base of our customers. MediStar is coming first, Turbomed, ALBIS and MEINS are going to follow over the course of next year. But we've also made... And here I'm sort of closing the look through the windshield a bit. I also want to reflect a bit with you on the M&A side, because 2022 was a big M&A year for the CHS team. We've gone through three acquisitions.
InsideHealth is changing our game, and it's confirming our investment hypothesis: that communication and analytics can work hand in hand and really, really make a difference to our customers in the industry. In Italy, the minority stake in New line is a nice addition, and we are also supporting the Italian Intermedix business with a partnership where we now have access to analytical knowledge as well as communication knowledge. Also, you heard me talk about Praxisdienst, who is a centerpiece of our Health Intelligence Suite for healthcare practitioners, but is also the engine of our business architecture to extract and inject data into the patient-healthcare practitioner dialogue, so meaningful medical data. So what does all of that add up to? We are geared to build the fourth pillar inside CGM. While we thus continue to work, our colleagues, my colleagues, have built a great sector reach.
Over 1.5 million healthcare practitioners leveraging and using our systems on a daily basis. We have injected analytical capabilities into our scope. We are unifying our product suite with the Health Intelligence Suite. We are starting to build a Pan-European footprint. I elaborated on New line. In Austria, please note this, we also have an InsideHealth business, and we're there, we will leverage the combined power of InsideHealth and Intermedix. AI, I spoke about both internal adoption as well as adoption in our product suite. And last but not least, a great growth story. So in summary, CHS is a story of growth and purpose. Over the last four years, we've already grown, we've started to shape the sector, and now we are entering the third horizon, scale. Stay tuned. The best is yet to come. Thank you. Back to Claudia.
With that, we move into the Q&A session. Thank you, Eckart. If I may ask all speakers from the first session on stage, so Michael, Hannes, and Eckart, here we go. And, yeah, as we move into the Q&A, for those in the room, if you want to ask a question, please raise your hand. Ideally, Frederick has two microphones, so if the first one raises a hand and then maybe the second one already, so I know who's coming next. I already see Martin wanting to start in row one. For those on the webcast, I have received a few questions already. I will read those. If you have some more questions, happy to send those along. I guess with that, we can get going.
So, Martin and everyone else, if you please ask all the questions you have in one go, and so we can then after that move on to the next one. And yeah, so here we go. Martin, the floor is yours.
Yeah. Hi, Martin Jungfleisch from BNP. I have one question for each of you, please. First one is for Michael. I mean, you have reiterated the margin target for this year and also for 2025 today. But given the still needed investments for the next couple of years, and also the dilutive acquisitions, you have higher growth in the lower margin hospital business. How should we think about the drivers for the margin target by 2025, and also what that would. Would the AI opportunity not impact the margins and investments going forward? That's the first question for Michael. Then on the HIS business, please. So you have obviously upgraded the revenue target again today for the KZG business.
There was some news, I think you touched on it, that it's, that this timeline has been extended a bit. So how should we think about the revenue phasing from the Hospital Future Act? And then you mentioned this 6%-8% CAGR growth, but given that you have the KH, KZG, or Hospital Future Act, plus you have the Oracle replacement, wouldn't that be a bit too conservative to target the 6%-8%? And then the final question is on the CHS business and the AI. So obviously, on competition, maybe a bit, Epic has already in the U.S. launched this business with, I think, a partnership with Nuance and Microsoft and so on. So how should we think about competition? And then maybe also on monetization of this.
I mean, obviously, in Germany, a lot of that healthcare is government funded or is public insurance. So what's the incentive for the doctor to actually buy this solution? Thank you.
All right. I guess I'm okay to start with your first question, Martin. I appreciate that. The question was regarding the-
Yeah
confirming of the margin target for 2025. You also alluded to 2023, so I want to start with 2023. You might know that for 2023, we gave an explicit range for EBITDA, and that range is from EUR 260-EUR 300. So everything within that range is possible, and we are not yet at the stage to narrow the range, which means we will come in within that range. Your broader question in that context was, okay, Michael, regarding the about 27% for 2025, how are you going to achieve that? What are the levers and the drivers?
Like we said already at the last Capital Markets Day, and I keep reiterating that, and all of the colleagues that have presented this morning already mentioned it, particularly Hannes also said that, we will actually keep our R&D spend on absolute amounts, on the level as it is today, which means with the growing sales, the percentage will go down. Your angle to that question with regard to artificial intelligence, that indeed is some extra spend for products and solutions, but at the same time, we're going to reallocate R&D resources and become more efficient with the tools we use in-house. Which means, again, the absolute level of R&D spend will not increase from that, but we will just have different, activities going on within our R&D.
Additional levers, as you know, price increases will always help, and we will continue to watch very closely cost. The biggest source for us is knowledge, and that knowledge we have with more than 9,000 employees. But we have the knowledge in-house, we have the knowledge on board, so we don't need to dwell on like we did in the past for external contractors, and we can keep our personnel costs well contained. Hannes, you want to continue?
Yes. Thanks for the question. On the Hospital Future Act, the revenue phasing, so the overall order intake, there are different elements in this backlog, where one part is a one-off part, so project revenue, non-recurring, and the other part is recurring. So we are talking about roughly 40-50 non-recurring, the rest is recurring. So to answer your question, how that kicks into or phases into the revenue, you can still assume that the biggest part of the non-recurrents will be 2024, 2025. A little spillover now into 2026, as hospitals will take their time to phase that in. The recurring part is basically on five years, so that's how we look at it.
On your CAGR question, the CAGR of 6-8 doesn't necessarily mean that there will be not a single year being higher, but it's an average over the next years.
And as much as, if I may compliment that, as much as we love your question and we love to play offense, let's also be cognizant that we play game after game. So there might be some years where we see a higher growth rate, and then we will see where we come out 2025, 2026 and beyond.
So I think-
Yeah, you were.
My question is the last one on monetization of data. We have four angles for monetization. First of all, healthcare practitioners, who get those powerful tools. Right now, Praxisdienst, TeraFox and others into their hands as add-on components, which will subsequently evolve into the beforementioned Health Intelligence Suite. Secondly, patients, where you can also introduce, which we already have in place, such with our app, Arznei-Aktuell, where we have a patient version of this. We give it into the hands of patients, and sometimes we have freemium editions where we inject some advertising. Thirdly, institutions, governments, who are also relying on healthcare data. I think there's hardly anything in the past that has proven that to be more than relevant than the COVID pandemic. And last but not least, the pharmaceutical industry and the insurance industry.
Both are multibillion-euro industries in the German market, who have a very, very massive appetite for data on the pharmaceutical industry. The time to admission of a drug, we can shorten that and increase the relevance of certain drugs, and we can also help the insurance industry to sort of drive the, the prescription patterns or behaviors that we see in the practice.
these are the four angles or five angles.
Super. So maybe before we go to another question in the room, let me throw in a few questions from the webcast. We've received questions from Laura Metayer of Morgan Stanley. Her first question is on artificial intelligence: Could you please quantify the potential benefit from artificial intelligence at revenue and profitability level, and the expected timing for these benefits? Is it accretive to your previous midterm guidance expectations? And another question she asked has actually already been answered, also asked by Martin. This was about the his CAGR, whether that isn't too conservative, and how much buffer is in there. And then the third question was on the hospital business. You mentioned that you are the number two player in the DACH region.
Where do you think CGM is stronger and weaker than the number one player, Dedalus, and how can you get to a number one position? So maybe Michael to start.
All right. So Laura, thank you for your question. I'll start with the artificial intelligence one, and I wanna go back in time. I wanna go back to the year 2020, when we were thinking diligently on what basically is going to come and going to hit the healthcare IT arena space. So the whole team was thinking at that moment in time already about voice recognition, right? Nuance was mentioned already earlier, so there are a couple of companies out there that we saw already, visited and talked to. The team was thinking about natural language processing. So yes, some of the large language models that were just released in November last year were maybe not known, but the idea was already there, so it doesn't come anew. So many of the initiatives we started, where we brought talents on board...
Yes, an abundance of talents. Quite a few people we brought on board in 2021 and got criticized for that, but it was good because we invested, and we got talents on board that helped us actually already develop the solutions. So Laura, to your question, we already are on that track, and it's part of our guidance for 2025. And yes, we will see some reallocation of funds, but basically the growth targets are already banking on the investments we took in 2021 and 2022.
All right. Do we have another question in the room now? Who is it? Ah, Andreas. I'm sorry, Hannes. I'm sorry for that, Hannes.
Hannes.
Please go ahead.
Yeah, the question, I think which is open is, the why number 2, how we become number 1 and how do we position ourselves? Thanks for that good question, which I could talk very long about, but to make it clear, where do we feel ourselves stronger is, we have a brand-new product portfolio where we believe, looking on the customer side, if they are investing now, this is a partnership for 20 years, 30 years even sometimes. So customers will consciously think about what type and what level of technology they will procure, which holds for the next three, 30 years. And as we have a brand-new product, I think that is a clear plus on us.
Playing on the full patient journey game as CGM, I think we have something which maybe Dedalus doesn't have, which is our access to the outpatient area. The market is turning more into an integrated care system. The ambulatory space is getting more and more importance. Hospitals are thinking about how they can manage the full chain from outpatient into inpatient, rehab, and so on. And I think we can play on the full journey because of our strong footprint in the area of our AIS systems. And how can we become number one? I think that you win is the answer. There is a shift ongoing, and if we win more, we will be number one, and I think that is what we are approaching with all that what I explained today.
Thank you, Hannes. Another question? Ah, Andreas Wolf. Go ahead.
Hi. Thank you. It's Andreas Wolf, Barclays Research. I have one for Eckart. You've mentioned the practitioner as a potential buyer of the solutions that you've presented. Are the health insurance companies also supporting the deployment of the solutions that you are offering to the practitioners, or what is the incentive for the doctor to buy and deploy those products? And the second is for Hannes. You've mentioned the algorithms for coding support, for instance, as an additional solution that you will be offering going forward. Could you speak about the volume of the addressable market, and is there a possibility to provide the solution, e.g., via maintenance upgrade, to justify potentially higher maintenance prices? Thank you.
Should I start? Thank you for the question. So three answers to that. First thing that is relevant to the healthcare practitioner is compliance. So how can you be compliant against 720 medical guidelines, each containing 200 pages plus in a 3-5-minute dialogue? And that is the first one. Other markets outside of Germany are much more rigorous when it comes to compliance with medical guidelines. Take the US market, for example. Second, clearly, and I think people sit on the university bench for 10 years or more for a reason. They are driven by giving the best possible treatments to their patients, and we wanna add this copilot, which is of value because you cannot or you can impossibly process all the information. And third, a financial incentive.
For example, when you find patients that are eligible for studies, you can get rewarded depending on the disease, depending on how applicable the patient may be for a certain clinical study. Which then, on the flip side, and this is why it's attractive for the pharmaceutical companies, too, it can help them to expedite their time to market for the new drugs. So it's a win-win for the practitioner as well as the pharmaceutical company.
Hannes?
Yeah, so that's a tough question on the total market potential. The way I look at that is, the product is at the moment, ready for, about 2,000 hospitals, in Germany. Our next step we're gonna be to extend that into countries where we see, a very good starting point for scale. For instance, we are already talking with our friends from the U.S., who are dealing with a strong RCM business. I guess we will hear a little bit on that, in the afternoon from, from Derek. So the potential basically is very large, taking the full reimbursement volume, of the German hospital market, and taking the value, we are delivering by that. I think, it's easy to see that we are talking about a, a very, very high volume here.
The solution can be upgraded. It's part of when I was talking about our RCM solution, it will be fully integrated in the stack of the RCM and be part of that, but it can be also adopted on, let's call them G2 solutions, being out in the market. So they are agnostic and very easy to be integrated, and therefore, we can play different business models in just putting in into the recurring stream as part of the maintenance or do upselling that differs from customer to customer group.
Thank you. So before we take another question in the room, let me throw in some more questions from the webcast. We've got questions from Knut Woller, from Baader Bank. First questions go to Michael. First one is: Are the targeted efficiency gains by using AI already factored into your midterm margin targets, or is there even upside looking beyond the approximately 27% target for 2025, also helped by new AI-based software applications to be brought to the market by CGM? And another question for you, Michael: How should we read your comments on a seasonally weaker Q3 2023? Should we expect margins to decline year over year in the third quarter? Then question to Hannes: To which extent is your G3 product helping you to win market share? Do you have a time lead here against competitors?
What margin levels are reachable in this segment in the coming years, and how long is usually the ramp-up phase in the hospital segment until a larger project helps get margin positive, or is it already positively contributing to margins from the start? And two more from Eckart, as we know our friend, Knut. What kind of organic growth rates are achievable in the coming years, particularly given the expected AI tailwind? And then how do you intend to monetize the data gathered in your data lake? Michael?
Okay. Well, thank you, Knut. Thank you for following us, also so closely and listening so carefully. I will mention that again when coming to addressing your second question. I want to address the first question again, because similarly, it was asked before here in the room, or actually, we tried to answer that when Laura posed a question also, and Martin alluded to that. Let me just go back to what we do here. We are one of the few companies in healthcare IT that are stock listed, and at the same time, we did something very new in 2021. We gave a five-year guidance for the year 2025. So we are, as a management team, firm believers in delivery. We don't wanna overpromise, we wanna deliver.
If there's one thing out there which is a bit also weighing on the stock price, that is, make sure you achieve your 2025 targets. So let's make sure we achieve our 2025 targets before we even talk of what we could do in addition to 2025 or overachieving on 2025. Again, I love playing offense, but you also need to understand we are in a regulated environment with lots of regulatory impulses and impacts. And I just wanna go back a year ago when it was not in our hands to get the approval for the software upgrade for the connector. And we had to go out in November last year with a profit warning just because of a delay with the approval, which was not in our hands, right?
And we got criticized like crazy for that, to say, "But why didn't you factor that into your guidance?" So let's, let's be cognizant here of a long-term guidance was 27% by 2025. If we achieve that, I think, the market is not yet believing that the market and the shareholders in general will be happy. Which does not mean that, of course, we will not do the utmost in order to sell fantastic AI-driven solutions to our customer base, and at the same time, also utilize all of the benefits across the four levers which we have pre-presented here.. on artificial intelligence. So, that is my long answer to your first question.
My short answer to your second question is, as much as we love that you, now also try to deep dive us into, selected, quarterly guidance for Q3 and Q4, I will of course not comment, on the marginality for Q3 expected versus Q3 last year. Just for the benefit of everybody, Q3 last year, we were at 21%, return on sales. And what I said earlier is between Q3, Q4, Q4 is stronger than Q3, so we'll see where we come out in Q3. But I confirm EUR 260-300 million EBITDA as a full year guidance for 2023. Thank you. You want to go next?
I'm taking over on your question note. You ask what is is G3 an advantage? And, for instance, do we have a time lead? Yes and no. I think in general, the time lead is not that important. What is important is that we have a brand-new product, and I explained that a little bit before. I think there will be conscious decision on this long-term aspect on with regards to the investments. Another aspect which is quite important is this specific customer group of ISH Med customers are a bit special. They were running SAP-based systems, which are highly configurable.
From the beginning, when we started to develop clinical, we considered that as extremely important, that we give the customer the flexibility to do an own configuration of their system, to implement own ways in treating their workflows, in documenting their medical processes. I think that is a similarity with even if it's based on new technology, which plays an important role when it comes to decision of that customer. I think from a product point of view, we have a lead. Concerning your matching questions, we are approaching or heading towards 20%. This is the short answer. How long is usually the ramp-up time until a project contributes to the margin? The answer is, it depends. There is very large projects, there is very small projects.
Very large projects, they run 5 years. Very small, they run, they run 1 year before they are in production or even shorter. So, I would say there is no easy or clear answer. In a normal way, a project already contributes to the margin. In a, I would say, very competitive, project, it also depends on the pricing, then it might take, a time until it's, it is in production before it really contributes to the margin. That could be 1, 2 years then.
So my question was, A, on the guidance. I confirm the mid-term guidance of 8%-12% that was given last year for the data business. Secondly, the monetization vectors, healthcare practitioners, patients, institutions, governments, and industry, are these the four pillars of monetization for the data solutions?
Do we have another question in the room? Okay, then we've got more questions from the webcast, and the next one is from Wolfgang Specht, Berenberg. First question to Michael on financing: Can you please update us regarding your financing facilities? When are larger facilities maturing? Do you plan larger refinancing measures in the short term in 2023? If so, do you expect an increase of the average interest rate going forward? Second question, on R&D and capitalized R&D: Can we expect that a falling R&D intensity will allow own cost capitalized as percentage of sales to also fall going forward? And on the hospital segment, how is the pricing environment developing when pitching for new deals? Could it make sense to sacrifice margin in the current market grab following the pullback of SAP Cerner?
Could CGM be interested in buying smaller software developers? Michael.
I'll start with the first question. So many thanks, Wolfgang, for your question. I have to. As a CEO, I have to appraise the finance department. They're doing a great job within the company, and so early on, they saw the interest rate hikes, so they bought a cap, which you might know, right, in order to cover us for the exposure which we have on the term loan. So interest-wise, actually, we are well covered. We also have a swap on the European Investment Bank loan, so that's why that one is also very good covered. So protected versus rising interest rates to a high degree. Your question on maturity of the financing instruments, I want to be very precise. So the EUR 400 million term loan runs out in January 2025.
The revolving credit facility of EUR 600 million runs out in 2027, and the European Investment Bank in 2028. However, and that is market knowledge, as we also have some people from the banking industry here in the room, we have just started early on to refinance our EUR 400 million term loan, and as soon as that transaction... It's in the making right now. As soon as that transaction is closed, we will also update you on how we're going to replace that EUR 400 million term loan. Who wants to go next? Hannes?
I'm next. Yeah, on the basically two questions. So how I look at this is, currently the demand seems to be higher than the offering. Several hundreds of customers have to replace systems within a short period of time. Don't forget, almost every hospital works on things on the Hospital Future Act. So, does it make sense in a competitive environment, how you phrase it, pitching for new deals with low margin or sacrifice margin? I would say there are reasons for doing that in case. If you look on the life cycle of a customer, 20, 30 years, we have a big portfolio. Margin will grow over time.
Looking on what's going on on the market, the hospital reform, big hospitals, will be in a more driver seat in the future, in some regions. So that indicates a bit on a long-term view, what might be important or a good reason to sacrifice margins. But in general, I wouldn't say no, and this is at least when it comes to our guidance priced in, in the, in the margin development. Would it make sense to buy smaller? As always, we will look on all possibilities and decide case by case, but in general, we feel strong with our products at the moment to organically win market shares without buying further smaller vendors.
Super. And another question from Aurélien Sévignon of Oddo in Paris. First question was answered already. That was on the Hospital Future Act. And then can you provide us more granularity on the R&D investments trend to consider for the next years? Do you think it is achievable by 2025 to get back in line with CGM's R&D historic normative pace, so below 18%? Or ongoing programs in addition to AI effort, will limit the leverage in a certain extent. Guess that's one for you, Michael.
Yeah. I was just doing the math here with taking your 18% and estimating about what our sales level in 2025 is going to be. Hopefully, we play offense, so it's going to be very high, which means 18% might be a bit too high, even. We'll see on how far we can go in terms of sales. But, to answer that very concretely, I said it, we want to keep the absolute spend of R&D frozen, so we don't want to increase our absolute R&D spend, which means in relative terms, the number will go down, and whether we end up at 18% or 70% or whatever the number is going to be, that really depends on the magnitude of our sales efforts and achievements in 2025.
Okay. And, a few follow-up questions from Laura Metaya, from Morgan Stanley, for Eckart. So on the data business, could you give some color on the revenue split within the data business? How much comes from products sold to insurance and pharma companies versus products sold to practitioners? And how do you see this split evolving in the future? And she also tries to get a sense of the addressable market and revenue potential for the data-related products. Is the addressable market the existing AIS customer base, or do you also target your non-AIS customer base that uses your competitors for their practice management systems? Do your competitors provide similar data-related products, or do you consider your products differentiated?
Could you give some data around the attach rate of the data products, proportion of AIS customers purchasing data products currently, and of your existing CHS data customers, share of the ones that are your existing AIS customers and non-AIS customers?
Okay. Wow, 4 questions in one. Let me go through. So what is the revenue split between healthcare practitioners and industry? That's about 80/20. So 80 industry, 20 healthcare practitioners. The addressable market, of course, incorporates current non-AIS customers with a clear intent to converge them to become CGM customers on the back of our great solutions. And what levels of penetration do we currently have? That varies across the different solutions that we have. If we, for example, take Terrafox over the penetration rate that we had last year, we are now running at, we have grown this by about 20% over the numbers that we were at last year. And the fourth question was?
The fourth question was, could you give some data around the attach rate of the data products, proportion of AIS customers-
Competition.
Ah, competition.
Yeah.
Okay, okay, okay. Sorry. Thank you.
Yeah.
That again depends on the products, but we see levels of up to 20%.
Great. So is there any other question in the room? Looks like everyone is looking forward to having some lunch. Okay, then we close the Q&A for the first session. Thanks, everyone, for the vivid discussion, also to those of you who are following on the webcast. We're now going into the lunch break. For the webcast participants, we're planning to resume presentations at 3:00 P.M. German time or 2:00 P.M. UK time, and we're very much looking forward to seeing you back then. And for everyone in the room, we've got one hour planned for lunch now. All the speakers will be available for lunch. Lunch is taking up upstairs, taking place upstairs. After the lunch break, we have prepared some breakout sessions for you. Ooh, flashlights.
For the breakout sessions, I don't know whether you noticed, you all on your name tags, you have a little number. So those of you who have the number one, they will be with Stefan Herkommer, our Head of Treasury. And the ones who have the number two will be with Frederick, and the ones who have the number one will be with me, obviously. And we will gather you at two o'clock after lunch up there, and then we will take you to the three breakout sessions, which we have on the topics of m.Doc and- Hello again. So let's see whether that mic is working. Yes, it does. Hello again. Welcome back to the second session of today's Capital Markets Day at CompuGroup Medical. I hope you had a nice lunch break. Also, welcome back to those of you on the webcast.
Hello. Let me remind you once again that the entire event is video webcast live on the internet and will be available for replay going forward, including the questions you may decide to ask. Let me point to the disclaimer once again. For those of you who joined just now, the second session, please note the safe harbor statement that applies to all the presentations, and please take note, especially with regard to forward-looking statements. With that, we go into the agenda for the afternoon. This afternoon, it's all about the ambulatory business. We will start with Ulrich Thomé, speaking for the DACH region, Connectivity, and KlickDoc, Emanuele Mugnani for European ambulatory business and for the pharmacy business, and then Derek Pickell for the U.S. ambulatory business.
Again, this will be followed by a question and answer session for all those three speakers, and Michael will be on stage as well. So please save any questions you have, for the Q&A for all three speakers. And, again, if you have questions out there following the webcast, please continue emailing those to Frederick and myself. Worked really good the first round, and we enjoyed the vivid discussion. And with that, let's jump into the first presentation, and I hand over to Ulrich Thomé. Ulrich, the floor is yours.
Claudia, thank you very much. Thanks for having me. Ladies and gentlemen, I'm starting with a disclaimer. This is week 5 for me at CompuGroup, and there's a certain likelihood that some of you are deeper in the numbers and figures than I am, but I will catch up quite fast. So I'm looking forward to questions, but I don't know whether I will be later on able to answer everything here. And I am, however, not at all new to the German healthcare sector. I was holding various positions in the last 16 years, working mainly in the administrative and billing area for various companies. It was always the triangle of doctors, patients, and then insurance companies, and basically the whole system that is around.
In the last two and a half years, I was responsible for strategy at the biggest European online pharmacy, and not only strategy, but also the development of digital products that face towards the customer. So I guess in healthcare, I know quite something. Let me start with something I've witnessed. 14 months ago, in Berlin, I attended a conference with a couple of hundred physicians, politics and healthcare professionals, and Dave deBronkart gave a keynote speech there. I don't know whether you know him. I would say he's one of the most famous patients we've got on this world. He got a cancer diagnosis, kidney cancer, spread to the lung.
His doctor told him, "Your median lifetime will be 24 weeks." And imagine you get that kind of diagnosis. That was back in 2007. And he said one sentence that really struck me, and that is: "Patient is not a third-person word. Your time will come." So I completely understand that your perspective here is a professional perspective, and all of what we talk about, you see from your professional angle. But at some day, all of this might become very personal to every person here in the room. I hope this is far away in the future, but that's life. That moment is going to come. And at CGM, we support healthcare professionals for that very moment. And if you look for purpose in a job, there it is.
To me, as something I've witnessed in the first five weeks working here, that might be the reason why we've got such a hardworking team. And I'm not only talking about those guys sitting here, but I'm talking about team leaders and everybody else at CGM. I've seen quite some companies in the past, but this is really a hardworking team, and I enjoy very much being part of this team. Now, let's have a look at what day-to-day life in the doctor practice is like. Basically, it's a permanent rush of patients coming in flow. Imagine you've got patients every eight minutes. Every eight minutes, a physician sees a new patient. Imagine you have any kind of service, and every eight minutes, a new customer is sitting in front of you.
You have to get to know him, you have to have, make a diagnosis, you have to look up what has been in the past and the records, and you have to decide, what do I do with that patient? And that's basically filling the whole day. And you have to rely heavily on your knowledge, on the one hand. On the other hand, medical knowledge is really exploding there, and to give the patient the best treatment, it's a question of whether physicians are able to grab that knowledge and really bring it into action. That is something that you can see basically in every practice in Europe, especially in Germany and the DACH area. The good news also with the sentence Dave de Bronkert gives is that we live in one of the best healthcare systems on this earth.
I hardly meet anybody that is questioning that fact. Some of the reasons might be that we've got a very high number of interactions between patients and doctors. It's in Germany, 1.2 billion per year. That's an amazing amount, really a lot. Of course, demographics don't stop at doctors and physicians and their practices. With more and more female doctors coming, and with more and more change in how young people think about how they want to work in the future, and whether they want to take the risk and buy a practice or step in or be an employed doctor, that is changing, and that comes down to concentration that we see at healthcare service providers. It is, of course, a highly regulated environment.
I, for myself, see that more as protection and tailwind if you are able to manage it, and I guess, and I know we are very good at managing this here at CGM. Technological process is something we have to deal with. We can use that for the better of the services and products we deliver, and also for everything the doctor can do with his patients. Then in the end, that's especially my sales heart. I'm more on the offense team. What I have to say is our customers are special. It's not the B2C customer, where it's about ranking an app high in app shop. It's also not a big company that has a big IT department.
It's small companies, enterprises, where you have to install technology in a certain way, and that is something we witness every day, and we have to cope with that. And being good at that, really makes success and the difference. Now, the ecosystem we are dealing with and we are servicing is really huge. It's not only physicians or dentists and the patient, it's also hospitals, it's laboratories, it's pharmacies, it's pharma companies, it's doctors' associations, it's, it's Kassenärztliche Vereinigung, it's gematik, it's the BMG, it's BSI, it's BfDI. We have to deal with all of that, and all of that is really intertwined. So you need to understand this to provide a good service, and we are servicing tens of thousands of practices here, and we are really good at that. Now, what is the product portfolio we provide?
I'm going to step into this in the following minutes. In the core of it, there are the ambulatory information systems we have here, surrounded by Telematics Infrastructure, which basically serves for sending information and data from one service provider to another. And then it's of course the patient perspective with KlickDoc and m.Doc, and I'll get to that in a minute. Starting with the core of it. You see here five brands that are our ambulatory information systems, and two of those, which are MEDISTAR and TURBOMED, are basically the flagship systems here. They have some 20,000 installations. You will hardly find any doctor in Germany who doesn't know those two, no matter whether he uses it or not. But go into a practice, ask them, they will know those systems.
All in all, we have a pretty good market share here, and basically, the whole practice is organized by that system. So incoming patients, scheduling, planning the resources for the team, doing the administrative work in the practice, documenting what you find as a diagnosis, preparing billing information, all that is done by our ambulatory information systems, and basically, it's the core and backbone of every practice we have. Now, stepping to more towards the patient side, the question is: if you have the backbone in the ambulatory information system on the one hand, why not use it to also help the exchange of data between patients and between the practices? And as I see it, that is something that really needs to be seen from a transactional point.
So when I look to doctor appointments, it's 1.2 billion appointments per year, as I said. Imagine those appointments have to be made in the practice. You have to pick up the phone, you have to call the practice, "Can I come at this time?" Or you can do it digitally, or you can take e-prescriptions and how that is managed. And that is some 520 million per year in Germany, and also that process at the moment is highly manual, and KlickDoc also helps there to digitize it. So just a short reminder of how the process looks in the practice, because that's not clear to everybody. Doctor has the diagnosis, checks the medication, puts it in the AIS, paper in the printer, printing it, signing it, or sending it to the front office, sending the patient to the front office.
There, he gets the prescription. Patient takes the prescription, goes to the first pharmacy. 20% of the medications you see in this country are not in the, in the pharmacy in the first moment. So patient then sees it, gets the medication, or needs to go to another pharmacy. Pharmacist takes the paper, prints something on it, makes the stamps on it, signs it, gives it to the patient. Off you go. Take into consideration that those persons that do this are highly trained and educated, and we would need everybody of those guys working on patients and making, and improving their health and not working at, in administrative stuff. So that is the purpose I'm talking about, and those processes can be fostered by our system. Switching to the broader picture and an even more holistic view brings me to the Telematics Infrastructure.
We have been the first mover in the telematics infrastructure, and basically, that's the general enabling of any information that is sent from one doctor to another, from one hospital to another. And basically, that is the start of every patient journey that we have in the statutory insured business in Germany today. We meet highest standards there, and we provide high security. And right now, while we do it, we are in a consortium with industry and research to discuss how TI 2.0 is going to be from 2025 onwards. And that consortium is based on a zero trust architecture, and we are defining with others in those consortium, what is the future in healthcare and the service we provide look like, and we want to be part of this.
That's also something where you can see how regulation needs to be used for a company as we are. I brought some numbers from the gematik there, and I have to admit, some of those numbers are impressive, and some of those numbers show an impressive headroom. When you look, for example, at the sick notes, in general sick notes, you've got 135 million so far. They are considered to be quite a success when digitizing healthcare in Germany, because as some of you might know, employers nowadays just get it digital, and that's, that make the whole process digital. When you look to e-prescriptions, it's 3 million here until now.
I would say in the whole timeframe where that was counted, we can say that the whole mass of e-prescriptions was something around 850 million. So the percentage is still low, but that is going to increase in the years to come, and starting next year, we will see how that turns out. It's quite an effort, and we will have our share in that. And of course, because that is the case, we have equipped our customers with the modules they need for communication and also for eRX and e-health records. When we look to the numbers that we find in Telematics Infrastructure, and especially at the recurring revenues and the share we have there, that really went up.
In the beginning, it was at around 10%, and you, looking from a capital market perspective, have witnessed in the past that we had more often one-time revenues. Now, while we like revenues on the one hand, one-time revenues are sometimes hard to predict because they are subject to delays, on the one hand, and on the other hand, it's not so easy to always do it in an operational good style because you have to deliver the services and the products to the practices for those one-timers, and that also brings one in a certain situation.
The Ministry of Health has introduced a TI flat rate within this year, and that will bring up the amount of recurring revenue or the share of recurring revenue to 60% for TI in the second half of 2023, and by 2025, we plan that the share of recurring revenues will be 70% or above. And that also gives a high resilience to our company from a financial standpoint. So getting back to the whole picture that we have here, this is not only about strengths and numbers. As I see it, this is also about us being the only vendor that has really all software and hardware in place to be in the whole end-to-end patient journey and to support doctors and patients in that journey.
You won't find anybody in this country that stands as broad as we do, and then patients and doctors will benefit from this in the future. Finally, artificial intelligence. You have heard some things about artificial intelligence today. For me, it's not a question whether doctors and also patients will benefit from it. For me, it's more a question, who is going to deliver? Because then again, we, as a big company, can use artificial intelligence quite easily for our own purposes, but the single practices being as small as it is and having that as a subject, that it's not close to them, that is a bit more difficult. And I see us here in a pole position, for certain things that we can give the practice, to use it effectively. First point is advancing usability of our software.
That is basically a no-brainer. No need to talk any longer about this. The second thing is, especially in radiology or anything that has images and image analytics in it, artificial intelligence will be of great help. Also, in the support, also in the decision support, artificial intelligence will play a big role, and there, the question for us will be: how can (and you have seen some examples of this from my colleagues before) we enable doctors in the practice in day-to-day life to use artificial intelligence when they are in those eight minutes to decide what to do with the patient and whatnot? And then the last point that is close to our very heart, that is, the whole administrative and billing topic.
It is quite an effort for today's practices to do the billing there and all the administrative work to do the documentation, and we can be sure that their artificial intelligence can be used to make the positions of doctors and practices even better. So what are the takeaways here? Basically, as I see it, it's a unique position we have. second to none. Second, it's a fantastic customer base we can rely on. It's a highly resilience we have with our recurring revenues, and it's a regulated environment, that is, to us, more protection and tailwind than anything else. And of course, digitization, connectivity, and artificial intelligence, those are the main topics and the main drivers for the future, and we think that it's us to enable those things and to use it for the better development in the future.
Thank you very much, and with that, I may hand over to Emanuele to give the European perspective and the perspective on the pharmacy.
Thank you, Ulrich. Good afternoon to the guests that are here with us in Koblenz, in our headquarters, and also to the ones that are connected remotely. I'm in the company since 10 years, so I lived part of the growth we had in these years with different roles. I am the Managing Director of the Ambulatory and Pharmacy Information System Europe since about a couple of years. This includes all the business we do with doctor, paramedics, nurses, therapists around all the European country, out of the German-speaking country, so out of the Ulrich responsibility and area. I have the responsibility of the pharmacy business and on the dental business all over Europe, so including Germany. Some numbers of the last 12 months. We met here 12 months ago.
The AIS business, the full AIS business, not only the one out of Germany and Austria, grew 2% in the first part of this year. Pharmacy business had great result for different reason, and our growth in the first part of this year, compared with the last year, was 8%, and we have a very strong recurring base because we have 74% of our revenues that is recurring. This give us a base to build on future growth, but be quite sure of a big part of the revenue and have the possibility to focus on new value for the customers and new revenue for us. We also went through, last twelve months, a very big transformation in AIS and Pharmacy Europe.
I will dedicate some time to this transformation, not only to explain you how we are evolving, but also because this is a transformation that allow us to create marginality. The revenue per employee increased 15% in AIS in last twelve months, and the revenue per employee increased 5% in pharmacy. Let me underline, this is because we are counting the last twelve months, and the transformation in pharmacy, that I will explain later, actually started end of 2022. From the moment we created the transformation in both area, the revenue per employee increased 15%, and this is clearly an impact on our marginality. We have a strong position around Europe. You have already seen this number in the Michael presentation, but let me focus on the area out of Germany.
We are the leader in each of these markets, and in many of these markets, we are present in different areas. Nobody has this positioning in our space around Europe. This allows us to leverage synergies we can create cross-country, and this allows us to follow in different countries the end-to-end patient journey. We will go more in detail in next slides to explain exactly what we are doing. We have a unique product offering. On one side, in each of the markets you have just seen, we usually have the leader, most complete legacy system. But innovation is a key success factor in our market, and we worked a lot to bring innovation to our customers in last years.
We are no more in the moment in which we say, "Okay, we are investing, and innovation will arrive." We delivered, in last 12 months, the three product you see in this slide, and these are not teeny little modules. CGM Stella is a completely new product for pharmacy that is going to substitute our core, core products in all our market in different years. It's been released in Italy. We already have almost 400 customers, parapharmacy, working on this, and will be released during 2024, completely in Germany and for pharmacy in Italy. CGM Studio is our new. Stella is a completely new cloud product, as CGM Studio. CGM Studio is the commercial brand of our new third-generation product for doctors, that we will roll out around Europe. This is live in Italy.
This have almost also, in that case, 400 doctors using that, a complete cloud solution, and we are already in an advanced phase in the project in France, and will be released in France during 2024. CGM XDENT is the new completely cloud and completely integrated with Clickdoc product, based on the same technology of Clickdoc, that we released for dentists. Same strategy, we will leverage on the synergies cross-country. This will be one product for the dental market around Europe, and we launched that in Germany. We are in pilot phase. And as I said before, we have a strong recurring revenue base, and we have a product for different areas. We have product for pharma, for pharmacy, for nurses, for therapists, for doctors, and so on. And this allow us to be the key player on the interoperability across the different market.
But also, we have complete product. We don't have only the AIS and the core system. We are, as mentioned by Anas this morning, the single point of contact for everything that is around IT, for the little entrepreneur that are the doctors, the pharmacy, the dentists, the nurses around Europe. And this is a huge value because they want a unique point of contact. They don't have a structured IT department that can manage different supplier. They are doctors, they are pharmacists. Deal with IT is not their core business. They want one contact, and we are the unique player that can provide that. We are around Europe, you know very well, in the best market in which we can be. There is increasing spending. In no market, we are in a trend of digitalization as the in e-healthcare market.
There are a lot of very little vertical solutions that are entering the market, and this player cannot enter the market alone. These players look for partnerships, and we are, in each of the country that I mentioned, the preferred partner for this little local solution that we integrate, and we bring to the market, being the cornerstone of this environment. Which are the main drivers of our growth in the environment that I just described? There are a lot. I will focus on the five main driver, in my opinion, that is sustaining our growth in last month and will sustain our growth in next months. The regulatory initiatives are a key drivers. They continue to sustain the growth, and they continue to be activated by country in different waves. There is a deep transformation of our European organization, and this allowed us to be more efficient.
For each of these topic, I will go more in detail in next slide. We are delivering marketing innovative product, not only the core product that I explained, a few minutes ago, but also we delivered on the market artificial intelligence solution. I will give you two examples to be more concrete on what has been described this morning by Michael. We want to follow the patient journey end to end, and as said before, there are no players that can follow the patient across all the healthcare players. I will give you a couple of example in detail, how we are doing that in some of the countries. We are not only provider of solution for each single healthcare player, but through our positioning in different countries, we are the enabler of the national ecosystem.
We are in strong contact with the national government, and we drive the change. About the regulatory initiative, speaking around Europe, the most important one is Ségur de la Santé in France. For us, and for in general, the French healthcare system has been a revolution, and for us, has been a huge project to deliver completely new product, completely certified for the Ségur de la Santé project. With new functionality and with completely new way of connection with the national healthcare system, was one year of product, 16 certification only for CompuGroup to cover 660 requirements. We have been the first company to be certified with all our products. The last product certified by CompuGroup was certified before the first product of any other competitor.
We have been the first provider to deliver, install, and train all our customers on the new solution in the French market. Why this is important? For two reasons. Programs like that are starting in all the countries around Europe, and these are all financed by the country, and this is a strong, continuous growth lever for us. These are programs that have waves. Waves in terms of innovation and new functionality, waves in terms of other healthcare providers that enter in the program, and it is already in deep definition, the next wave that will arrive between 2024 and 2025, that will have a second wave for the doctor, about the same complexity of delivery.... and the first wave for paramedics and nurses. We are strong with thousands and thousands of customers in each of these markets.
I spoke about the transformation, and I believe this is a great value for our company. I want to spend some minutes on that. We went between end of 2022 and the first six months of 2023, through the wider reorganization, I believe, in the history of our company, for sure, on the 10 years in which I'm here. We created all around Europe, excluding Germany and Austria, a unique product house. One organization, under one manager, under one VP product management, that design our product with one head, putting together development team, and this allow us, first of all, to have better dedicated managers. We had before, senior manager that had to follow the product side and the market side, but the capability and the skills of these managers are different. Second, this allow us to have a unique and consistent strategy.
Third, this allowing us to take the synergies we can have, not only creating one European product for the market, but also not doing multiple time the same things in different products. We created, aside the product organization, country-focused organization. Everything was launched at beginning of 2022 for pharmacy, the first of January 2023 for doctors and dental. In first six months of 2023, we not only increased the revenue for employee, creating synergies, but also we focused on the customer satisfaction. We increased the NPS of 20 points in six months, having more focused organization in the country. The third lever I mentioned is how we work on the product. We are not only simply launching products of new generation, we are consciously working on the streamlining of our portfolio.
We switched off, with no impact for the market and on the customer base, 5 core products in last 6 months, 1 in France, 2 in Belgium, 2 in Netherlands, migrating our customer to more modern product, allowing them to have a better experience, and allowing us to save cost, because maintaining multiple product in a country, being our market strongly influenced by the continued change in the regulation, is a huge saving for us. We work on the innovation. I explained before the new product we launched, but we also launched new models. We launched, end of 2022, a completely new billing system in France. Before, each of our AIS system had embedded inside their own billing rules. We switched off this, we launched a new billing system that is supporting all our legacy system, so we have to maintain only one billing system.
This is much better, so the experience of the customer is much better, and this is designed and implemented exactly on the technology of our G3 system, that when will be launched, as I said before, end of 2024, will immediately connect on our new billing system. We integrated, I will go more in detail on that, two artificial intelligence solution in our French market. We launched a new generation product, but I already explained that. Let me explain a little bit better the two artificial intelligence solutions that are on the market today. One here is Synapse Copilot. This is a solution based on natural language processing algorithm that allow healthcare professional to save time and improve their operations. This system suggests prescription, personalized and secure, interacting with the doctors. This is very important. The doctors take the final decision.
The doctor can interact with the system, change parameter, have different advice, and it's the doctors that define the prescription. But this is a huge value when the doctor have to prescribe something that is not the typical things he see every day. Connected to the prescription, there are medical recommendation, there is therapeutic monitoring, there is a full tracking of all the documents, and the system, based on the behavior of each single doctor, create daily scientific reports for the doctor to stay informed on the things on which he worked. And the system learn from the experience on what's happening on all the doctor using that. This is fully, completely integrated in our two core AIS system in France.
There is a seamless experience by the doctor, they don't have any view on the fact that he use, he's using a separate module, is completely in the flow of his prescription process. The second one is Bart Predict. This is an application that assists the healthcare provider to measure the warning sign of fall of old people. This takes the data for each patient from the clinical record of the patient, the strength, the robustness, measure that the doctor do when he visit the patient, and put that together with the data they collect from sensor. The old person, it's simply a bracelet, nothing invasive. There are sensor in the house that check the behavior of the person and detect, putting everything together, the risk of fall, even of elderly people that never fallen.
Elderly people representing a growing part and an important cost of the healthcare system, and usually when an old people fall, enter in a much more severe situation. By the way, this is not only to provide to our customer and to the citizen better experience, but is also for us, a strong growth forecast in next year. Because why we started in France? Because preventive action are financed at national level with a clear law. How we enable the ecosystem? It's true that we are used to speak about our core businesses, the doctors, the hospitals, the pharmacy. But if we want to enable the ecosystem, in particular, in area, again, I do a France example, where the e-healthcare space is changing. It's changing through polyambulatory that does not have only doctors.
So we need to provide to this polyambulatory, integrated solution that cover all the kind of healthcare player. And again, there are no other players in the market. They are all focused on one sector. We are the number one player, not only in doctors market, because we are the number one in doctors in France, but also in paramedics. More than 50,000 paramedics use our solution in France. A few words on Clicdoc, is a cornerstone of our strategy. What's new? First of all, in my opinion, it's new at functionality. At system level, we reached the level where we wanted to be. We are exactly at the same level of the pure-play competitors, but with the advantage of being completely integrated in the system of the healthcare player. We have, in France, more than 330,000 patients using Clicdoc.
We started the selling and delivering Clicdoc from the paramedics, and we already have 2,500 paramedics using Clicdoc in France, and we started the campaign on doctors in July. Why we started only in July? Because this system had to be completely integrated with the experience of doctor, and we knew Ségur is arriving. So we focused on the delivery of Ségur, on bringing the doctors to a normal usage to Ségur, and we released in July a solution completely integrated in the new Ségur experience. And now we are starting the commercial phase for the doctor. But even if we really have now very few doctors, hundreds is very few, and we are focused on paramedics in this moment, we have more than 70,000 booking every month through our Clicdoc solution, only in France. I spoke about patient journey.
I would like to explain you a little bit better what we do in Denmark. Last year, for the one that were here, I made the same for Italy. Why? Not only to explain you the values that we can bring to the market, but also the experience we have in managing this workflow in countries that, in some cases, are a little bit more advanced than our core countries in the digitalization of the processes. We completely manage, through app and portal developed by us, the contact between patient and doctors. In Denmark, we have more than 3.8 million of citizen, in a country that have less than 10 million of inhabitants, registered and that used our app and our portal. It's, there is a strong usage, much more in average than in another country, of video consultation.
We know how to manage it. Only in 2022, we had more than 5 million of teleconsultation inside our system, with the doctors that use our AIS and video consultation system. We managed, inside our system, and in the flow, more than 40 million of prescription last year. In Denmark, again, interoperability and exchange between healthcare player. There is a clear referral model for the specialist, between specialist and hospital, and the specialist receive money based on the referrals. In last twelve months, we manage inside our system, more than 1.7 million of referral, and we follow the same patient across this flow. And we also have a solution that manage the therapeutical adherence, where we have 180,000 patient daily using that. Just to remind you, and we are not doing that for a little part of the country.
We are by far the leader in the Nordic countries. We are the number one in doctors, we are the number one in therapists. We have the experience to be the player that follow together the patient and the healthcare player in one process. We are very good. We have revenue and growth. And also, thanks to the new organization, we put together people that had the experience to do that in one country, and we are now using that experience to replicate exactly the same solution in other countries. I will not go through again the patient journey in Italy, but this is another good example to explain how our experience can be reused and how our presence is huge. We are by far the leader in the market of pharmacy in Italy.
We have more than 50% of the pharmacy using our software, the core software to sell and to manage stocks and orders. But we don't do only that. We have, in Italy, a company that only provide telemedicine solution, and the pharmacy of service is one of the trend. The main customer for the telemedicine solution in Italy, for us, are pharmacy, that then provide that through the pharmacy of services, that is the evolution of the pharmacy to their customer. And we provide logistic services. FarmaUP is a company completely owned by CompuGroup, that provide drug deliveries from the pharmacy to the patient, manage the orders, including the prescriptions, and manage the delivery. We provide full services to the pharmacy. We contract the logistic providers. We help the pharmacy to be a player that can beat the online pharmacy.
We manage, in our application, 25,000 deliveries every month from the pharmacy to a citizen. This is based on our core system, and on top of that, we are launching new generation product, that we are migrating, not with big pressure, because we want the customer are happy to migrate, and in this moment, the customer are also very happy of our old system. But we want to be sure we are on the edge of innovation, even if we, where we have 50% of the market as pharmacy in Italy, but we cannot sit on that. This is why we said we need a new generation product. So to summarize, excellent positioning, strong customer base. Nobody's innovating like us across Europe. Yes, you can find one player in one niche market. Nobody's innovating like us across Europe, I'm sure about that.
We have a strong knowledge through our organization of every local market. Our margin is strongly increasing, and I show you some number. The only number you have not seen in my previous slide. We measure every year the satisfaction also of our employee, and this is growing. Starting from a good base, this is growing on any axis that we measure. Because they feel... the idea that they are part of a successful company, and they are part of the story of the company, that is really enabling the change of the healthcare in Europe. Thank you. I hand over to Derek.
Thank you, sir. Hello, everybody in the room. Hello, everybody out there in the internet world. My name's Derek Pickell, known fondly around these parts as the Crazy American, for some reason. I don't quite know why, but I joined the company with the eMDs acquisition, and I took over the American business, the U.S. and India business, in 2021. When I came on board, one of the things we did a lot of was integration, and you'll see that's kind of built into my slide here about integration and also about brand recognition. In 2021, the first thing we did, kind of similar to what Emanuele was talking about doing here in Europe, is we did an organizational restructure, right? So we brought all these various companies together.
So we spent a lot of time on putting leadership in place, bringing companies or, or organizations. So we had one support organization, one development organization, and we redid all of our go-to-market sales and marketing groups, so we come under one umbrella in that environment as well. Then in 2022, the whole focus was integration of the products, right? So we came on, eMDs had a core of solutions, and then CGM had some add-on functions, too. Of course, the two of them, when we started, didn't talk. So a lot of the time we spent was bringing those together and making sure that we can use the new add-on modules and build them into the core solutions.
And then recently, actually, we'll talk a little bit more about this, we introduced new releases of those core solutions, literally just within the last 60 days, and now able to bring all these add-on modules to market that we frankly weren't able to sell up until this point. And of course, now it's all about: How do we grow that business? How do we get those out into the space? So at a high level, just kind of bring it and narrow it down, too. Obviously, we grew revenues heavily from 2019 until now. Obviously, a big component of that was the addition of the eMDs business, but we tripled the revenue in the U.S. market over those few years.
Our organic growth for the first half of the year was just at 6%, which is what we kind of talked about, where we'd get to over the next five years when we started the five-year plan. Our business has always been highly recurring. We right now are sitting at about an 80% recurring revenue, and we'll see that growing as some things change within the business. One of the items that we talked a lot about over time, which you'll see in our growth slides, is the eMedix Clearinghouse platform. Very important product and a very important solution to us.
Just with the annualized rates of where we're sitting in the transactions in that business right now, we've increased that by almost 50% year-over-year, and we expect that to continue to grow at pretty high rates as we move forward. One of the things I'm going to spend a couple minutes on now is just our go-to-market solutions. And again, these are the four solutions that we really are selling net new, if you will. They're going out to new logo, they're being add-ons and the like. The CGM Aprima product, that's our fully integrated EHR practice management system that's offered to the U.S. ambulatory market, and that's really our key new logo solution, if you will. So that's what we're out there selling to replacements of other EHR companies. It's highly awarded, multiple times, Best in KLAS.
For those of you who don't know, KLAS is an independent organization in the US and also in Europe, actually. We have another one of our solutions, Visus, who was also best in class, so really doing well from that perspective. And then the second really key business, if you will, is the Aria Health Services business. This is everything about revenue cycle. Hannes was talking about revenue cycle. We'll talk a little bit more about how we may be trying to come together with what they're doing here and what we're doing in the US as well. But the Aria business is definitely and will continue to be one of our double-digit growth drivers over the course of the next three to five years.
The service is set up so that we offer revenue cycle management, we offer credentialing enrollment for providers, and we've branded this on its own. So although you will see CGM around Aria, when we go to collateral and the like, it's really Aria Health Services. And we did that because this is also a solution that we're selling in a B2B environment. So we actually have other EHR companies who we might compete with to go sell EHR solutions, but they're using us from a services perspective in a white label environment, and that's really grown pretty well. In fact, as recently as this past month, one of those EHR companies just added on additional business that within the next six months, should bring us an extra $1 million per year in annual revenue, just by the add-on business that they added.
So we see a lot of opportunity there. This is also the business where we have the big offshore presence in India. So we have over 1,600 employees that are in the India operation, and we continue to build there. The other two major offerings, we talked a little bit about the eMedix. eMedix is the clearinghouse business. Back in the day, there was a new regulatory requirement that the U.S. government put in play called HIPAA, and HIPAA mandated everything around patient privacy, things like that, but it also mandated electronic transactions in healthcare, which over the years have been extremely manual and paper intensive. So this solution is one that automates the transactions of things like finding out if the patient is eligible for the insurance and at what level are they eligible.
Once the patient comes in, it's generating a claim that electronically then gets sent to the insurance carriers. We can do an automated claim status checking to see where it sits in the adjudication process, and it also does the automatic payments coming back into it as well. The long story short of this solution, a clearinghouse solution, is every provider in the U.S. has to use a clearinghouse solution. So obviously, great opportunity, we think, as we start to bring this to market in a bigger way. Another product that we are branding separately, because once again, we have built the infrastructure around eMedix now, so that we can go to a B2B market.
So when some of these companies, and we're already talking to a few, where we're doing the RCM business for them in a white label environment, we're now opening up the opportunity to be their EDI or their clearinghouse vendor as well. So again, another B2B type environment. And then the last major one... Of course, we have a lot of other solutions that are out there, but I'm really just trying to focus on the four where we see growth coming into the business, is our lab business or our LIS business. And in that environment, LabDAQ is the main core laboratory information system that we sell into the market. we acquired SchuyLab a few years ago. What SchuyLab did for us is it gave us a Spanish version of an LIS, so we're able to sell that in Spanish-speaking countries.
We do a lot down in the Caribbean now, and we're trying to expand that as well. And then the Medicus solution, which we just acquired recently, is really a very far down market, very small, very small, practice offices where they're doing the lab work right there in the office. The excitement about that is they brought a bunch of additional distributorships, so they distribute that product, not directly, but they go through others to do it. So it's opened up some new distribution channels for us. So they're the major solutions that we put out there that we're bringing to market, that are really the high-growth solutions as we, as we move forward.
On the branding side, you know, I, I kind of laughed, I think, the last few years when I came and talked, because I come from a background—I've been in U.S. healthcare, IT, and technical services for over 30 years, know the business extremely well, have a ton of contacts in that business. And when we were looking at potentially going out to sell, one of the bankers brought CGM to the business. I said, "Who the hell is CGM? I never heard of them in all the years that I've been here." So, it's kind of interesting. So I was a little concerned about that, but what we've been doing over the last few years... I mean, the obvious things, right? I mean, we're changing websites.
We're doing collateral that's gonna have CGM in it, and everything else are wrapped around those kind of marketing materials. But what we've also been trying to do is win awards under the CGM umbrella. So this year, we're really excited, and, you know, very prestigious awards from Surescripts, which I don't know if you guys know Surescripts in the States, but it's—it's the big electronic prescription kind of central piece. So everything has to mostly go through Surescripts to get to the pharmacies, ultimately.
Each year, they have what they call these White Coat Awards, and this year, we won of the prescriptions that our physicians put out there, and also structured and codified Sig, which is all wrapped around being able to say when the patient goes and gets their prescription, all this structured data is in there to say, "Okay, you're gonna get, Lipitor," or something like that, and it brings all the patient education information as well. So anybody who goes in to get a prescription, you also get a printout of things you should know about that drug and that prescription. So two areas we're really trying in the U.S. You have to keep there until the end of the year, and then you win Best in Class for the year. So doing very well there from a, what the users think about us, right?
Independent organization that's saying we're doing a good job, high NPS scores, and so forth. And then one of the ones that's not on here, too, is about the employees, right? So we have really great NPS scores in our Peakon, which is an internal survey that we do, but also, we have something in the U.S. called Glassdoor. I don't know if you guys have it here or not, but Glassdoor is an environment where if an employee is looking to join a company, you know, they often will go to Glassdoor to see what their results are. And usually, the companies are... They're rated from 0 to 5, 5 obviously being the best, and right now we're sitting at, like, 4.4.
So, you know, when people wanna look, I think now the CompuGroup name is getting out there a lot more. We're hearing it. People kind of are calling us now, which is kind of exciting, right? We, we didn't have that in the past. So we get a lot more, we get a lot more activity, actually, on our website, looking for information about the business and about the company. Now, over the last couple of years, I outlined three primary organic drivers that we in the U.S. business have. Obviously, winning new customers, bringing those new logos to the table, key for us. We got to do it. We, we, as an organization, even pre-CGM, we didn't spend a lot of time looking for new customers because we had such a large client base, we could make so much money just in upselling into that client base.
But then it became clear we really should be focused on replacement market as well, because we believe there is a very large replacement market coming up in the U.S. for EHRs and practice management systems, for the practices. And then, obviously, retaining and monetizing the customer base. You know, I'm all about... I always talk to the team about, we can't have a leaky bucket, right? Leaky bucket, meaning we're having high attrition. If we have too high attrition, it's so hard to grow the business, right? So we're doing a lot of focus on retention and obviously finding ways to monetize the base. And then the last major driver from a growth perspective is taking that eMedix business, that clearing house business, and expanding it out through all of our systems and all of our organizations.
You know, of course, the most important thing on all of these is the execution, right? I can talk about this all day long of what we say we're gonna do, but until we show that we can execute on that, it's not really gonna mean anything. So what I wanted to do over the next few slides is really focus on the success of the execution of those environments, of where we are today and give you a little bit of an update. So when you think about this whole concept of winning new customers, I would say we've, in the past, we didn't win a ton of new replacement customers. The market really wasn't out there. And all of a sudden now, with the Twenty-First Century Cures Act, which forces more technology within an EHR solution, so that some of these older systems really can't...
get certified from a 21st Century Cures Act perspective. So in this last year, year to date, we've sold over 140 net new Aprima EHR solutions that we're in the middle of implementing as we speak. And these are people that are migrating away from older EHRs. We have a relationship and had a relationship with Quest, as an example. They had an EHR, and they basically came out, and they're sunsetting that, similar to what Hannes talked about with what's going on in the HIS market here. We're seeing a lot more talk about some of these systems that have been around for the long, long period of time in the U.S. going to be sunset, which we think is a great opportunity for us to sell new Aprima into the market.
Aprima also does a great job in what we call kind of the home care, primary care market, which is another big growth area within U.S. healthcare. That's the environment where physicians don't practice within an office any longer, right? They're out of the four walls, and what they do is they go out to assisted living facilities. They go out to the patient's home. They see elderly patients, they see chronically ill patients, and they do all that on the road. The product is set up extremely well for that, and we have three of the largest primary care, home care companies who are now on Aprima within the last few years. It's been going pretty well. We also, with the distributorship that we brought on with Medicus, we've been able to sell more on the lab side.
We're actually selling somewhere between 1 and 2 net new APe asy deals, which is the pathology piece of lab as well. We also have come out with some new releases within the lab business. Then also, if you think about the AR RCM business, again, like I mentioned, B2B business, a lot of additional add-on business in that environment. That's an area where this past year we saw double-digit growth, and we're seeing much higher penetration into our existing base. So to put it in perspective, we think if you look at the market and a lot of our competitors out there, if you can get to a 20%-25% penetration of each of your software platforms on RCM, we think you're doing pretty well. We're getting close to that on the Aprima side.
On the EMD's legacy product, I mean, we're literally in single digits. On the CGM legacy products, we're in single digits, and in the lab, we're in really low single digits. So the opportunity to upsell RCM into those is great, and we're really focusing heavily on that. We have a team, that's all they do right now, is they're out there upselling RCM into that base. And then we talked about the clearinghouse as well, and that's an environment, too, where we're branding that separately, and we also now have contracts that we've never had before, 'cause we never sold it in a B2B environment before, so we think there's opportunity there. And then when you look at that, kind of leads into the next area where we talk about retain and monetize.
Obviously, as I mentioned, first and foremost, we got to keep our customers. So we put in some new client satisfaction and executive sponsorship programs this past year. So every one of my executive team members owns a set of customers that they have to talk to, and the larger ones, they have to go visit at least once a quarter. It gives us an opportunity to really get closer to the customer, and we find out . . . I mean, I've been sitting with some. Everybody says they're happy, they're happy, and I go talk to them, and they'll say, "Well, now we're thinking about changing systems." So just by having that communication interaction, they're now looking to migrate one of the old legacy products that was in eMDs to the new Aprima product.
So we're now gonna save a customer that was a pretty big customer, that had we not been doing this program, we would never would have known that they were actually out there and not happy at this point in time. So excited about that. As I mentioned, we came out with these new releases of upgrades in Q3, both on the Aprima product and the eMDs product, and that's with the integration. That all came together. You'll notice there, we talk about an All-Star sales campaign. You know, in the U.S. right now, baseball's hot, right? So my Phillies are doing good, people are doing good, so we came out with this All-Star campaign.
The concept is, now because we have this integration available, we have 6 or 7 new add-on modules to each of these products that we couldn't sell prior to August because they weren't. They didn't work. They just didn't work with those core solutions. And actually, in August, we had our highest bookings month this entire year in upsells into our core base. So we're optimistic that that's gonna continue, and we're gonna see more of that between now and the end of the year. All those items that we're selling are all subscription, and they're all recurring revenue. So we think that's really gonna get us to the numbers we expect to hit in 2024 and 2025. So we're excited about that. On the lab side, lab is notoriously more one time.
They sell the software, they sell hardware, and we've taken the AP Easy product and turned that into a SaaS solution. So we now are migrating those, what would be on-prem type solutions into the lab environment. We've already migrated, or at least got contracts to migrate, 10% of that base. Again, that'll go from one times, and it'll move all into the recurring, which will help us get that 80%, potentially higher. And then on the rev cycle side, we talked about, we had a lot of focus on improved customer satisfaction. Our KLAS scores, I think, are proving that we're able to do that, and we're really doing well there. And we, again, like I said, double-digit growth in sales year-over-year in ARIA and also in top line.
One of the things that we've been focused on, you know, kind of like the data mindset of what we can do with data that Eckart's talking about, is how do we better monetize this big client base? We've been looking at very different ways. In healthcare in the U.S. right now, there's a big movement towards, I guess, what I would call value-based care. I don't know if you've heard of that in the States, but basically, you're going away from getting paid for a service, a fee-for-service environment, to now you're getting paid as a provider for the outcome, the fact that you're keeping patients healthy, the fact that if somebody's a diabetic or has COPD, you're following the protocols that everyone believes are the best protocols to keep that patient healthy.
Then, if you're part of this, you know, kind of this whole accountable care organization, there's big opportunity for bonus and for upside at the end of each year. So we signed up with the first one, I think we'll do a lot more. But the idea is, if we go up and sign up with these organizations, we bring our providers then to the opportunity to join these value-based care organizations. Everyone that we bring, this, this group, which we literally just signed last week, we have our kickoff in 2 weeks, for every patient, not provider now, so for every patient that falls into Medicare Advantage, that is a patient in the roster of that provider, if they sign on, we would get up to $10 per patient per month as a fee to provide our RCM services, too.
So again, I just give that as an example of ways that we're trying to find other areas to monetize the business. With the value-based care becoming such a big push in the U.S., we think there might be some great opportunity. We have another one on track to hopefully sign before the end of the year as well. And then, of course, we talked about monetizing data as well, and we're continued down that path. And then the last major growth driver that we talk about is expanding eMedix. So, we have the integration. On the Aprima side, it was a little bit easier for us to do because when we had Aprima originally, when we sold the product, we sold it with an EDI clearinghouse solution.
So the contract is directly with us, so we've been able to move 75% of that client base now under the eMedix solution from an EDI perspective, which will help us bottom line and help us top line. We still have third parties out there that are using it, but we should have everybody, mostly between the provider and a third party. So we have to now go out and show that our integration is so much better, kind of the old, somebody's kind of talked about it, but the one throat to choke concept, right? We're going to come in. Our systems are much better integrated. Why don't you just migrate to our EDI, our clearing house and use our-- you're using our PMS, our practice management system.
So we've come out. We just came out with that release as part of our phase two, and then phase two, we have a new release for the Medisoft and Lytec base. That's the base that, if you may recall, is mostly managed by our resellers, and that new release is coming out in December. So then we could start upselling into that, which is a very large provider base. We can upsell into that, the eMedix platform as well. So we're really excited about where we are with that, and we think there's huge upside, both from a top and bottom line, as we do more of the eMedix into these bases. Spend just a couple minutes going back to kind of the AI mindset, too.
I won't go into too much because it's very similar to what you've heard up to this point in time, but we've been using AI-type tools in the Aria RCM business forever, really, I mean, from that perspective, in some way, shape, or form. And we do everything from what we would say is, "Take a bunch of data," right? eMedix now has a lot of data on claims, on denial information, a lot of information that comes from the insurance companies that now we can use to, before we send a claim out a door, out the door for a provider, we can identify where we think there's going to be a problem or there's going to be a denial. So we use all of that data.
We use that, we make it intelligent data now, and it comes back to our team in the RCM side and says, "Hey, this code is probably going to get rejected. You better look at it, better talk to the provider and do something else." So we're doing that now. We're also doing a lot on document management. One of the things in U.S. healthcare that we've been trying to get away from is paper. We get literally hundreds of thousands of paper remittances every month for our RCM business. And we started this year, and we developed a way to basically take all that paper.
It gets scanned, it gets, you know, into a structured format, so that what was on a paper that we would need a bunch of people in our Aria business out in the India operation to manually look at it, and they would have to go in and type it in. 90% of that right now has now been moved from manual to being automated. The chop at, because there's easy answers, and with all the data we have, it's easy to put that into, into that format. And then the other one, I'll just, there's two other ones that I think are worth focusing on. The population health. I talked about this value-based care. There's much more opportunity to be able to do more proactive looking from a clinical perspective using AI. We're going to do a lot more around that.
That's going to be, I think, is really going to help us, especially in this era of value-based care that we're getting to in the U.S. And then the last one is voice documentation. We've talked to Nuance. We actually had them come in. We worked with them a little bit. We've been doing transcribing forever, right? I mean, going in and the physician speaks, and they type it. We're also looking more now at the environment where you have a microphone in each exam room, and as you're talking as a patient to your provider, it's taking all of that data, and then it ultimately is taking it and again, putting it into a structured format, which is what it's all about, to be able to enter it directly into the note.
So as opposed to your provider sitting in front of you and typing in information, I mean, he or she is really spending time directly one-on-one with the patient, and they can really... The patient feels better, right? That they're really listening to what they have. So another key area where we see it going in the future. Real-life example, I talked about this, I won't spend a ton of time, but basically, in this environment where we've been able to optimize denial management, we've been able to automate all this paper into automated posting. We were able to get a 10% improvement in really the whole productivity of that team.
So, I mean, think about it, as we continue to do more of this in an environment where we have 1,500 or 1,400, almost 1,500 employees now, if we can do more of that in an automated fashion, obviously, as we grow the business, we will not have to add as many people. It'll be extremely helpful from a bottom line... So if you bring it all together, workflow, the lab workflow is pretty easy from a patient journey perspective, right? Someone's sick, they go to see their physician. The physician decides in the office, they're gonna take blood samples, they're gonna take tissue samples, whatever. There then goes through our solutions. The solutions take it to the labs that actually do the test.
After they do the test and come up with the results, those results are automatically funneled into our systems. When she makes that appointment online, the system will also ask her for insurance information, and it will do a check on, is she eligible? Will the insurance pay for this visit? If not, how much will she owe? And we can actually ask for payment right there, too, because we now have CGM Pay, which gives her the opportunity to pay in an automated fashion right online. And then, of course, she comes in, it gets scheduled, she sees the doctor. Once she sees the doctor, again, there could be other tests that go on that comes through, and then the physician may prescribe a med. We actually do over 50 million electronic prescriptions right now in the business.
Why that's important is we get a piece of the action for every prescription that we put in, and there's other ways to monetize that as well. So really big. E-prescription in the US has been big for a long time. It seems like it's going more now, obviously, across the world. And then, obviously, then we have a claim that goes out. In this environment, we could be doing the billing and AR management functions of that. And then the other things that have just added this last kind of CGM connection and CGM pay, they are the new functionality that we didn't have last year, that we've now put out there. So it's the environment where now that Kim's done, she had her process, she saw everything, it'll go out.
We can do a survey to see how she liked the provider. That's becoming required in the US now, and it also gives an opportunity to remind her that, "Hey, you might need to go back for a visit in three months." It'll text her to let her know about that, and then once the bill drops, it'll send her a statement electronically, text or paper, or not paper, or email, whatever makes sense, whatever's gonna work, and let her know what she has to pay, and then at the end of it, be able to also know that she can pay online as she goes forward. So I think we're really ready to achieve all that organic growth that we said we would achieve over time, and also the margin expansion.
So if you net it all down, we've talked about this always in the past, I think the US healthcare market is poised for a lot of disruption. I mean, for those of you who may have seen yesterday, one of our biggest competitors up for sale got a reason to sell. Obviously, opens up an opportunity for us to sell on a lot of fear, uncertainty, and doubt. What's gonna happen to them? What's this new owner gonna do? We see a lot more of that. There is at least two of the larger ones that we know are up for sale. We have another one that's gonna go out and try to go public again. There's just a lot going on.
And then with the 21st Century Cures Act, that means that all of these systems that have been out there for a long period of time as part of meaningful use, which went back like 10, 15 years ago, those systems are gonna go out. So we think there's great opportunity in the market. Obviously, we have a large base, both on the physician and client side, and now we think we're a known brand in the U.S., a little bit better than it ever was before. So that brand recognition will bring opportunities to us. And the team, our executive team, I mean, we've integrated a ton of acquisitions over the years, right? I mean, as part of the eMDs world, before I became part of CGM, we did 4 acquisitions. We brought some of the McKesson business out of the U.S. from the ambulatory side.
We brought the Aprima business. I mean, there's been a lot of that, and we've done a pretty good job, I think, of integrating all those solutions. The team comes in an environment where they've been in U.S. healthcare for a long period of time. We're sticking to our guns. We're getting to that 6%-9% organic growth, and then ultimately, that's all gonna come, obviously, because of the significant upsell opportunity that we have into our base. So with that, I'm gonna pass it over to Micheal.
Okay. So if I may ask again, all the speakers from the second session on stage. Yeah, Ulrich, Emanuele, Derek, and Michael. And, yeah, so again, if I may ask you to raise your hand. I already see the first one. Please wait for the microphone. Please ask all your questions in one go that you have. And yeah, I already received some questions from the webcast, but if there are any more, please do email them to me. And with that, Martin, the first one again.
Many thanks. Many thanks. Yeah, a couple of questions, please. First one is on the TI. So what is the impact of this TI flat rate? I mean, and basically, would you expect the shortfall of the one-off revenues, and to be compensated by an increase in the recurring TI revenues? And basically, what's the timeline? So what's the break even for that? And then on the US, can you talk about competition there? I mean, how is competition if you're number 4 in the market, and how important is size really? And how much does it really take you to get to number 3 in terms of investments? Then also maybe on AIS, PCS price increases. You've obviously increased prices there this year.
What is customer feedback, and what magnitude should we expect in terms of price, price increases there next year? Thank you.
Okay.
All right.
Yes.
I'll take the first question on the TI side, because you asked a comparison with the historical pattern and the pattern going forward. So one needs to know that we had one-timers in the Telematics Infrastructure, particularly at the very beginning when we introduced the connectors and sold the connectors, 2017, 2018, and then also later on for the pharmacies in 2020. And again, we had those one-timers starting in September last year up until March, kind of like when we resold basically the connectors and exchanged those. We have a second component of one-timers in the Telematics Infrastructure. That is the software updates on the connector, which typically there was almost one per year. We missed one last year. We talked about that, which we had also coming in this year...
So if we exclude the hardware component, we just talk about the software upgrades for the connector, then basically the idea is that the flat rate encompasses that and compensates for that. Still, if you want to do a number calculation, you always will have some one-timers, for instance, additional card readers being sold or exchanged, if practices change or things combine. So these will not go away. So, maybe more specifically, because we already know there's one question coming up on the web regarding the TI flat rate, can you help us somehow, Michael, gauge that? What is the magnitude of the flat rate? So we have been introducing the flat rate starting second half of 2023, and currently, we charge a price of 147 EUR per month. That's very concrete.
Okay.
In relation to competition, a little different from solution to solution, of course, right? So if you talk about just the AIS, EHR-type solution, I mean, the big competitors to us are people like athenahealth, which is about a $1.2 billion organization. We see NextGen, which is about a $650 million-$700 million organization. We see eClinicalWorks, which is a privately held organization. Hard to say, our guess is they're somewhere in the $500 million range. And then we have a bunch of others like Kareo and Elation and things like that. Very small in that kind of environment. They're probably $10 million, maybe $20 million. For us to get to number three, would have to be, frankly, through acquisition. I mean, it would be very difficult for us to grow.
I mean, we literally would have to grow our business pretty significantly year-over-year. But, you know, that's kind of where the market is right now. On the lab side, it's a little bit different. From a number of customers perspective, we're actually number one, but because our customers are so small, the revenue is lower than what somebody like an Orchard, which is one of our competitors, which is a PE-backed firm, which they really go into the much larger environment, so they're a little bit larger than us. Their revenue is probably in the $50-$60 million range for lab, just for lab, though.
Okay.
Towards the question of price increase, how direction is in this year, and what is planned to be to happen next year? But first of all, one has to say that if there is a general environment of price increase and an understanding at the customer side of price increase, I would consider it to be now, and that is the reaction that we get. Of course, nobody says hooray when there come price increases, but it's a sticky market, and that is something that helps us there. So there's a certain pricing power, and we will see how we are going to use that next year, too.
Super. Thank you. Then I will throw in some more questions from the webcast, and already, we had the first question from Knut Woller already answered, and he has another one for Emanuele, which is: in terms of revenue opportunity, can you provide more insight into the expected impact of the second wave of Ségur in 2024 and 2025? And we've got another question for Michael, which is: You mentioned that you intend to keep R&D stable in absolute terms, while you want to reallocate resources towards AI in the coming years. Listening to Emanuele streamlining the organization in AIS and Hannes' new modern G3 product available, to which extent are these efforts behind us, helping you to reallocate R&D resources?
I go with Ségur. The definition of the wave two of Ségur is not complete. It's under definition by the national government. So we can have, I believe, a reliable forecast, but not secure data. We expect that for the doctors, the funding of wave two will be aligned with wave one. So we expect to have about the same revenue. For the paramedics, that will be part of wave two, the expectation is that the funding by healthcare provider will be lower, but the number of healthcare provider we have is much higher. So we expect the impact on the healthcare provider that will be on top of one of the doctor, will be between 60% and 70% of the impact we had for doctor wave one.
About the timing, this is more difficult, because the French government really wants to see the full implementation and result of wave one. The discussion now is if the deadline will be end of 2024 or mid of 2025, and this is really a question mark.
I'll continue on the second part. In order to keep costs constant, you either need to reduce number of contractors or your own personnel, or basically reduce salaries, which we don't want to do. So that, that means we need to reallocate staff, and, the examples that were given today from Hannes and from Emanuele clearly show the direction we're moving into. But let me be also crystal clear. We have been over 36 years in existence because we have excellent staff working on research and development for our customers, and we will continue doing that. So keeping our costs flat is already a saving, which we commit to. We will not overcommit.
Okay, so is there another question in the room right now? Andreas? Okay.
Thank you. I have three questions. One is for Emanuele. If we look at the revenue per doctor before La Ségur and now, how has it developed? I would assume that would also measure the level of digitalization that La Ségur has brought. The second is for Ulrich. The revenue per doctor is presumably still the highest in the Nordics. What would you consider to be the drivers to further increase the revenue? And this would also relate to digitalization per doctor in Germany to the same level. And one for Derek. I remember that when the U.S. business was acquired, profitability was somewhat lower than in the rest of CompuGroup. Where does profitability stand today, and do you see potential to improve it further? Thank you.
I go with the first one. First of all, remember, Ségur is a program only in France, so I will refer to the revenue per doctor in that specific country. We had a booster on the revenue per doctor that is one-time revenue for the national funding to the service of installation. But then we provide more value for the doctor, and this allows also to increase our price. And after the Ségur project in France, our revenue per doctor increased about 10%.
Yeah, for the future increase in increasing of the revenues per doctor, I would see at least two things. The first one is the quality that we provide in support and in service. Raising that is helped by customers, and that is something that brings you to a price raise and customers understanding it. The second one is what value can we bring to the table with additional modules that we offer and with additional services, and we have to work on that, and we are working on that. And that also is a good argument for doctors to have price increases and accept them. And then, as I said, the general mood of it, as you see it in a practice, prices are raising, and that's the same here.
I would consider this to be the same thing in the next 12 months, and we are confident that this is going to work.
Yeah, in regard to the business, I think when we first talked, we were just above 10% from a margin perspective in the U.S. business when we brought the businesses together. This year, we should end in the high teens, possibly into the twenties. And our commitment to my friend here is that by 2025 we will get up into the mid-twenties. And we feel pretty confident with all the add-on business that we have that has minimal cost associated with it, that'll help us get there over the next two years.
Okay, thank you. Then we have more questions from the webcast, from this time from Wolfgang Specht, from Berenberg. The first question is on the AIS business. What is the reason for the rather poor organic revenue growth of AIS, 2% in the first half, 2023, and the declining EBITDA margin, given high stickiness of customers and pricing power, how has churn developed over the past two years? Second question to Emanuele: How will the price points for the SaaS solutions, Stella, Studio, extend in relation to the existing solutions be? Is a further phasing out of the on-premise solutions targeted? And while we are at Wolfgang, he handed in another question for Eckart, which is: How is the monetization of the health intelligence suite planned working? Maybe Michael, to start?
Ulrich, is it okay if you allow me to, because he was addressing first half, so next time you take that question. Wolfgang, that is right. We were showing that 2% organic growth for total AIS, for the first half. One has to see that always in comparison to the first half of the prior year and always in comparison to what's going on in the business. So those of you that have been following CompuGroup for longer know, in the moment in time when we have a connector rollout, like the one in 2017, 2018, we really put all feet on the ground, making sure that we get everything done with the connector rollout and exchange, and that was the same case here.
So from September 2022 until basically March-April 2023, everybody was focusing in the AIS Germany space on making sure that we get the connector exchange. And with that, there's obviously less sales effort than also happening at the same time with the practices and with the doctors, because it is the same person that you're talking to. You're burdening already, the MTAs, the PTAs, the whole team with the connector exchange. So then the second question was regarding, or second part of the question, was regarding the margin. And here, that is one example, for instance, where we are investing, right?
You saw Emanuele talking about the migration from G2 to G3 in various fields in his area, and obviously, we're doing the same also, not only in Emanuele's field, but also in Germany, where we are migrating towards G3 technology, and we're doing that also in the US, as Derek was explaining. So that has an impact on the margin. But going forward, we want to bring the margins up. Derek mentioned it already, the other two would have mentioned the same. So I'm very confident that we will bring up the margin and also organic sales growth will improve. We are going up against lower comparables for the fourth quarter of this year.
Plus, we actually also benefit, for instance, in Germany, from the introduction of the TI flat rate and the way that basically the reimbursement rules work, because that causes many of the practices to say they still need to buy some add-on modules and download functionality in order to benefit from getting the full reimbursement in place. So actually, we also see regulatory tailwind here. That makes us very positive regarding the second half year.
I will go on the SaaS questions. In Europe, the pricing point of our SaaS solution will be substantially higher than the price we have today. But let me better explain this, this topic, because it's very important. Selling a SaaS cloud solution includes the hosting. That solutions that is on-premises does not include. And this bring us in very different situation, because in a different market and in the different countries, we have area where we are the provider also of the hardware to our customers, and area where we are not the hardware supplier. They use it to buy from us software and to buy hardware somewhere else.
We are defining in general pricing point that allow us to have, from a SaaS solution, the same revenue and the same growth in the years that we are having now, where we have software and hardware business. We expect, we are quite sure based on the calculation we have done, that instead, where we will migrate customer from on-premises to the SaaS solution in the market where we don't sell hardware, that delta that will be allocated to the cost and to the correct marginality in selling hosting, will be upside for us in term, in term of revenue. About the phase out of the product, again, we are speaking of a very heterogeneous and different market. We have markets where we have multiple AIS system. Some of those have hundreds of installation.
We have market where with multiple 10,000s of installation on one legacy product. We clearly will focus first on the migration, where we have in the market, where we launch product, on the migration, where we have low installation, to be ready to phase out that specific AIS in Italy that have 500 customers, to phase out that in months, even not in years. We have situation where we will have to migrate 20,000 customers, and we believe the right approach is not to force the customer to migrate till the very end of the life of a product. We have an estimation that in this case, we count in years, but for that case, we still don't have a clear phase-out plan.
We need to study the adoption curve on the first months and first year of the product before defining where we can phase out the product, where we have thousands and thousands of customers.
Good. I have also a question from Wolfgang, which is related to the monetization of the Health Intelligence Suite, which basically happens in three stages: freemium, conversion, and scale out. The freemium is happening as we speak. I alluded to the fact that we are rolling out a version of the Praxisdienst. We call it the Praxisdienst Light, as we speak to our MediStar population. Based on that platform that we are building, also into the other AIS channel, we will convert those customers to a full version, that we then will start to monetize. And believe it or not, the first 300 pilot customers, already 10%, have asked for the upgrade without even advertising it.
And then we will go full scale and sell the whole suite to the customer base, which is likely going to happen in Q3, Q4, 2024. Secondly, I have a question open from Laura, Laura Mataya, which I didn't get fully in the morning. She was asking about the competitive dynamics in the data field. Yes, we have other competitors in the market that have a similar or that, that have a reach that is lower than ours, who are mimicking our approach, and they are about 2, 3 years behind of what we are doing.
Super. Thank you. As for now, is there another question in the room, please? No? Okay, then we've got a final round of questions from Laura Mataya from Morgan Stanley. And thank you, Eckart. The first one is on the US business: Are there any regulatory programs to boost health tech adoption in the US? If not, would you say increased efficiency is the main incentive for the purchase of add-on modules? Second question, also on the US: Could you talk about the competitive landscape, which players you see the most in your market, and what do you think CGM can do better? And the last question for the PCS business: Can you remind us, please, what has driven the organic growth acceleration in recent quarters, and if you expect growth to go back closer to historical levels in the next quarters?
I'll start with the competitive landscape, which I think we touched on a little bit with one of the other questions here. But the companies that we see typically in the EHR now, you know, it's a different space, right, than what is on the revenue cycle side or what we have on the lab side. But in that environment, we're typically seeing the Athenas of the world. We do see some smaller kind of upstart companies as well. We do see NextGen, we do see Greenway. Not as much these days, Greenway, probably more of the eClinicalWorks, more of the Athena. And as far as what we can do more in that environment.
I think the fact that we're now able to come out with a more full suite of integrated solutions makes us much more competitive against a lot of those in that environment, so we feel really good about that and what we can do. There was a question, I think, about regulatory. I don't know if that was specific to the add-on modules or just in general, but the Twenty-First Century Cures Act is a regulatory requirement, and it's all wrapped around newer, better technology that has an opportunity to be more interoperable with other systems, so being able to talk to the hospital system, being able to talk to the lab system. That is an environment where we think that will generate more opportunity for us.
As far as the, kind of the push for regulatory, the HIPAA environment, from a clearinghouse perspective, mandates that everybody has to use a clearinghouse. Now, we have to obviously replace some of the ones that are sitting out there, and we think through the integration of the product, we can have a much better solution, frankly, at a lower cost than what they might have to get it from a third party, 'cause there's a lot of interfacing and the like that has to happen on that side as too. So we think there is some good opportunity to push more of this upselling of more of our new solutions as we go out the door. And one of the other ones that we just came out with, which I didn't mention, is something we call CGM Measures.
In the US, again, it's all wrapped around value-based care. It's all wrapped around how are your outcomes, and it's clinical measures that have to be provided to the government by any provider who wants to be part of the governmental programs. CGM Measures, we literally just announced that, and it's now integrated in with the eMDs product and also with the Aprima products. We think that'll really push, too, because everybody's got to get it done and get it up and running before the end of the year, and they have to report in the first quarter of the next year. We have an opportunity now, but then we'll have another bigger opportunity even in 2024, because we'll have to do the same kind of reporting for 2024 into 2025.
At that point, we'll have a lot more experience and a lot more, I guess I would call it, good references from that perspective.
Pharmacy growth. About half of the growth we had comes from price increase. In pharmacy, we are slightly increasing the number of customer around Europe, and this also allow us to grow. 2-3 percentage points comes from growth of hardware selling for, some specific campaign or reason to substitute hardware. It will be challenging to consistently maintain the 8% of growth. It is a very strong growth, but we believe we are consistently that the very low digit, one digit growth we had in the last, in the last years. I believe we substantially improved our positioning. Again, 8% is very challenging year by year, but this will not be much lower than that.
Just if I may comment to remind everybody, we set out a growth target for PCS of 0%-2%, so the gentleman is very humble. It's an excellent growth with 8%. Congrats.
Okay, and since there are no further questions in the room and also not from the webcast, thank you all for the lively discussion, and we're closing the Q&A. Thanks for all the questions, and I would like to hand over to Michael for the closing remarks.
Yeah. Thank you. Can I ask my colleagues to come on stage? You are all here in the room, and you've been spending with all of us here the whole day, and I appreciate that a lot. Thanks, first of all, to everybody who's physically here. We really love that active interaction, which we have been experiencing here today. It hasn't been as hot as I assumed it would be, right? It was warm, but it's still comfortable, so hopefully, we can enjoy some drinks afterwards. It's great, on how you challenge us with your questions and how you accompany us. I also wanna thank everybody who has been participating over the web.
We do know that the turnout traditionally over the web is a bit higher than the physical presence, and we will have to think about the best formats to cater for all of your needs. I wanna go back to the inaugural moment of talking about the pivotal moments for CGM. This is a very relevant moment in time where we are in. The year 2023 will be the year when we will look back in five years from now to say, "That really changed and transformed the way we operate at CompuGroup Medical." We shall never, ever underestimate the chances and opportunities that lie within all of us on artificial intelligence.
You heard it already on what CompuGroup Medical has basically done in all of the segments over the past couple of years in order to prepare for that moment in time, and we feel best equipped. We want to thank you all for accompanying us on that journey. As you can see here, the whole management team is very confident that we can achieve our 2025 targets. With that, we want to invite you to stay on that journey with us and enjoy then a good moment in time, come 2025. For now, we will focus on the next quarter to put it into the books. Many thanks to all of you, and many thanks for the organizational team.
I want to give a big hand of applause to Claudia and her team, who have done a fantastic Capital Markets Day, and also to Frederick. Thank you. And with that, bye-bye to the webcast, and thank you all here in the room. Thank you.