Hi, Stian.
Hi, Stian. I think we're live now.
Yes. So it's 1 o'clock and warm welcome to the first Trading update from Patience Guy, since we got listed on Euronext Growth. Super excited to be here and also to share Our numbers for last year and also the guidance for 2021. So flip slide. So I don't think we're going to spend a lot of time on reading the disclaimer.
You will have it in the presentation package. You can read If you want, so we can go to the next slide. So I'm Johan Setterstrom and I'm the CEO of Patient Sky. Together with me on the call today I have Stian Hoezweig. Dion.
So let's Dion introduce himself shortly. And who is?
Thank you, Johan. I'm excited to be on board and part of the Patient Sky journey. I'm currently here on an interim basis from Cardo Partners and with experience from Nordisk Bank Investment Management
Thanks, Dion. So I've been with the company since last year. We've had a quite a journey since I came on board. We've Raised capital with listed companies, so super excited to sort of give you this presentation. So we can go to next slide, Sia.
So looking at Patients Sky from a sort of a helicopter view, we were founded in 2014. We're around 170 employees in 5 offices across the Nordics. We're at the run rate of 100 and SEK 75,000,000 in annual recording revenue. We have 40% CAGR from 2018 to What we estimate in 2021, 4,900,000 people have sort of used Patient Scan Services Over the years, we also have an app that is downloaded over 2,100,000 times. That's Quite incredible since it only lives 5,400,000 in Norway.
Last time we sort of Talked about partners. We had 10 partners on the platform and currently we have 15 and we also have a backlog with that. 90% of our revenue is recurring. So we can go to the next slide. And Maybe I should also say that you can write questions in the chat box.
So then Stian and I will answer them the best way we can. So last year, key highlights. We landed on SEK 14,600,000 in MRR. So we also did an acquisition. H2 was slightly lower pace for us, Partly during COVID that slowed down our sales and migration efforts.
The outlook for this year Sia. We see that we will increase the speed of migrations from to the cloud from the legacy systems. That could be Legacy system that we own or from competitors. We also added Last year, strategic customers like Kri and Doctor. Draupen in Norway and we see that we have a few of those similar opportunities coming to us.
And we also will try to expand with new types of larger partnerships and or joint ventures. So last year, we actually focused on getting all the building blocks in place for our global pass opportunities That we see ahead of us. And we also get new inquiries on a weekly basis. We also established an office in Finland. We also launched in Finland.
We did that in record speed. So we're going to use some of the proceeds That we got from our shareholders to accelerate the PAS initiatives and we're targeting more PAS revenue for this year. And we will also see the first revenue coming from Finland during this year. We spent significantly, You know, both resources and efforts on sort of trying to complete and perfect our Patient 360 platform, so It's ready for this year. We also did significantly improved and rolled up video and other sort of COVID Friendly features and functionalities for GPs and non GPs last year.
So what we're doing this year, We are setting a new org structure with business units, so we can even be more focused when it comes to The PaaS opportunity or the SaaS business we have and also we have dedicated business unit for the app. And we also will establish a vast business unit, that's value added services. That's all the modules that sort of make up our SaaS business. We need to make sure we can capitalize them and have them Outside sort of the Norwegian business also. Last year we established a group level management and We will continue this year to build up that organization with adding more senior people and also key personnel.
So We have Heidin Pedrazel as Chief Marketing Officer and also Heidin Ergiel Nafilhoven to be the Chief Commercial Officer for App. They are already on board and driving further improvements initiatives. We closed the Infodoc deal in December And they are now part of our family. And we're also working on the post merger integration. And of course, Interloc will deliver synergies and revenues to follow that.
And of course, we will continue to look at For more potential acquisitions since over the years and the history has shown us that We've done them successfully and they really, really work for us. So we can just go to the next slide. So if we just look at the sort of the adjusted EBITDA, that's a solid 170% increase From 2019 to 2020 and that is despite COVID and some unforeseen revenue events. And I think Steen will sort of guide you through the more details on this slide.
Thank you, Johan. If we start by looking at the left hand side, We see our cost base taking us from an adjusted revenue of €145,000,000 to an adjusted EBITDA level of 46 600,000 or 32 percent EBITDA margin. Also here, it's worth noting That's the scalability of our cost base, which is reflected, as Johan said, by the high year over year growth in Adjusted EBITDA. Moving to the right hand side, we show the bridge from our previous guidance of 49 point €5,000,000 The revenue is roughly in line with our guidance adjusted for delayed project. The COGS came in slightly higher due to an increase in log in activity from patients.
But despite higher COGS, It's a good sign that the patients are engaging more on our platform and our app. On the OpEx, we're slightly higher due to new feature requirements introduced during 2020. On salaries, we came in roughly in line with our guidance And this leaves us at a $46,600,000 adjusted EBITDA level, which is, as Johan mentioned, Very healthy 170% increase year over year. Going to the next slide, We see that our KPIs continue to signal strong commercial momentum into 2021, which is why we're positive on the outlook. To the left, We can see that the MRR grew by 60% year over year, giving us a solid base to continue to grow from in 2021.
In the middle, you see a strong upgrade speed of new clinics to the PSS system and platform. This is slightly below Our guided SEK 600 from the IPO, and this is mainly due to the COVID restrictions making both migrations And sales activity slightly more difficult during 2020. We expect the upgrade speed to normalize again when COVID conditions ease during 2021. To the right, we can see that we continue to deepen our penetration with Clinics. For example, Clinics with video has increased almost 500% or above 500% During 2021.
Over to you, Johan. Yes. So This year we're guiding at $240,000,000 for 2021 with also strong traction on new pass With the starting point of the SEK 145,000,000 plus the full year effect Since we're a SaaS business, we're at the SEK 175,000,000 in MRR. We will continue to upgrade And that will add another SEK 25,000,000 to the business. Then we have around SEK 20,000,000 in non recurring revenue that could be governmental projects or consultant income, so there's no recurring revenue.
And then we have The new potential sort of past partnerships that we're working hard on to drive some revenue on the platform. That takes us to 2.40 And then we have the additional sort of upside and potential. That could be joint ventures on the platform. It could be other sort of initiatives that We might fulfill to do. We're sort of working hard on trying to sort of Figure out how we can monetize on the traffic we have on the app.
Then of course we have the M and A That sort of could sort of raise our guidance significantly if we Do 1 or 2 or 3 M and As over the year. So that basically is our guiding for this year. The business is in really healthy shape. We have quite good control over the most things And super excited to sort of having that Growth from 2020 to 2021. We can go to the next slide.
So why should you sort of continue to invest in patients, Kaj? Of course, we believe that we are the leading eHealth SaaS provider in the Nordics. We have a proven track record of upgrading customers from our legacy systems Into higher ARPU. We also have the advantage that we're the 1st Mover with a fully serviced scalable platform, so you can almost say that we're a one stop shop When it comes to GPs and non GPs in Norway, we doesn't see any competitor that can sort of offer Everything that we can. And still we believe that we are the only player in Europe with an eHealth landscape that Can offer both SaaS and PaaS solutions and soon also app and VaaS when we continue to build out those business units.
And of course, we have the opportunity to expand throughout our SaaS offerings or sort of agreements with partners On our highly scalable platform and we will come back later on this year with this, We'll be good. And our long term goal is to be the operating system for healthcare. So 3rd party vendors can come in and build apps on the ecosystem and also as a standalone solutions. We'll go to the next one. Just to reiterate, if you haven't seen this slide before, but why is our platform different to peers in the market.
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the left hand side, we have our competitors, they also have a web browser, the web application and then they have all the modules and that could be the EHR or the journal system or could be billing or online video modules or whatever it is and then they run it On some hosting infrastructure, we have the similar setup, but we've taken the majority of the logic to put it in the service You're here. So our modules are thinner because most of the modules are based in our service layer. And we also built our own hosting services and there's a lot of people wondering why we have done that and not using any of the American players that is both for regulation and sort of legal and compliance because we would not be able to sort of Respond on a few tenders if we can't control where the data actually resides. And of course, in healthcare, there's 2 things that you have a lot of, that is you have a lot of data and you have a lot of traffic And that is the American player sort of business case. So we think we can actually do this more economically than sort of ran on another sort of a service provider.
So we can go to the next slide. So how do you benefit from the network effects that is initiated by the SaaS users And that will enable our long term growth trajectory. New users on the platform that increase platform traffic. And with platform traffic, we will attract more partners because they want to sort of piggyback on that traffic that we have. And in Norway today, We at least have around 60% of the GP market, so we have a lot of that traffic that we can capitalize on.
And then those partners will join us on the partners and we will grow with them. So their success is our success. And then it can lead us into new verticals. So if we for what let's say we want to Enter a new segment, let's say the DMT segment. We have identified that we have 5 or 6 modules that we have already built that will fit perfectly for dentist clinic.
What we don't have is the general system or the EHR for the dentists. So in terms of that, either we can go and do a partnership with a vendor that has that Geno Assist of Dentist And then we can operate in different new segments. And at the moment, we are Compared to our peers, we operate both in GPs and non GPs and Most of our competitors, they operate in one segment, either they operate in the GP space or in the non GP space. So we can just go to the next one. So what are we doing?
We try to future proof the organization, so we can capture the full benefits of scalability and synergies in the years to come. So the light blue we've already done, that's Establishing the sort of the group structure. Now we're in the process of implementing the focus business units. We're sort of in the finalizing of that. And then next We'll be capturing the benefits of the scalability and the synergies.
So that is what we're working hard on. So we can go to next one. We also initiated a few important projects for us that is having 1 unified ERP solution. We also identified that we're doing a data management project, So we actually can consolidate data across all systems we have, so we can make smarter decisions based on all that data we have. That's also in sort of the start phase of that project.
And we also invested in a new CRMmarketing tool, So we can actually start to nurture those leads we have and also giving the right tools in the hands of our sales people, so we can actually start to close even more deals. Next slide. And we'll also be contributing to sort of the society during COVID. So just one example, we've Delivered free video consultation software to all our clients that want to use it For the 1st months of the year and that has of course helped us when we drove up the number of sort of Uses on the video. And we can go to the next one.
And that's it. We've got a few questions here. So I can just answer the easiest question here, what CRM system did you choose? We've chose the HubSpot. So that is from marketing and for the sales team.
And then another question we got here. How has the development in Finland proceeded? Did you see any increase in churn in H2? Two questions there. So The development in Finland has proceeded according to plan.
We've launched Patient Scale Lite And we're working on sort of adding more functionalities to that service. We did that in record time. Took us just over 6 months from start to sort of having something up and running. That's quite unheard of in healthcare. If we saw any increase in churn in H2, not a dramatic increase in churn within C.
Stian. Maybe you have some of the other questions here also. Stian, that you might want to sort of answer.
Yes. So on the EBITDA margin for 2021, Our plan is to come out with the guidance for this on our full year reporting on April 15. We'll come back to that one there. And there's also A question on the rational cash flow and free cash flow after investing. And We can come back to specific numbers when we do the full year.
But what I can say is that on the R and D capitalization, this is roughly in line with what we've guided for before. And we'll be reporting the figure Net of the rebates from the government.
Do you want to take that EBITDA question?
The one from Oliver? Yes. Okay. So the question is, Oliver says he thinks we've guided EBITDA around €67,000,000 for 2021, including Implot. How do you see EBITDA outlook for 2021 under the new revenue guidance?
And The answer here is similar to the previous one that we're working for EBITDA guidance that will On April 15, but we're very positive to the development and the synergies that we see in Infodoc. We'll come back to specifics on the EBITDA margin and cost level in April.
So another question is that we said 200 For 2021, before we went public, and now we're guiding at €240,000,000 Including the sort of acquisition on Infodock, since we had a slowdown in H2, We lost some sort of momentum during the COVID. And it's not all those SEK 57,000,000 that is recurring revenue from Infoblox either. So that will take us to the sort of revenue goal of SEK240.
There's also a question here about special costs For 2021, including incentive programs, recruiting and so on. In terms of incentive program, This will be lower going forward due to the fact that some of the incentive cost For 2020 was related to the IPO. Going forward, we'll have the normal management incentive program, which is an option based Non cash expense, which will continue as normal. And then there will probably be some normal recruiting, but we don't foresee Any major costs there?
Got a question on new partners for app creations or creation And how many creators do you have working on AppSec for the platform right now? And how much has this increased since the IPO? And how does the cost structure for these creators look like, revenue share or per app creation? So the last question, that's sort of our different commercial setups against those partners. It could be revenue share by what they actually own or it could be a cost For them to sort of accessing our platform through the APIs and the SDKs.
Today, we have around 15 partners On the platform, and one of the reasons why we're splitting up in business units is that we can focus even more On sort of onboarding more partners easier and faster. So I think that was most of the questions. And for those that wants to go into more details, we are of course prepared to And set up individual meetings where we basically can discuss things in more detail On Tuesday and Wednesday.
And that's just to reach out to us per email and we'll try to schedule you in. Perfect.