I think that's important. That's why we also want to put together the Q1, Q2, look at our growth in context here. To start with the highlights before we go into some details. First of all, we are growing faster than we need to to follow the plan. We are supposed to grow at about 40% annually to reach our target. In the H1 year, 2021, 6% revenue growth is fantastic. We're proud of that, it shows that our plan is realistic and that we're moving on. Not only that, the very robust growth in recurring revenues. 60% also there pro forma, put together with our recent acquisitions. These two numbers, 56%, 60%, really shows what this is about.
Then again, to the expense of course, the EBITA margin when we acquire companies, as we have done three this half-year, and those are, of course, sub-performing or sometimes below zero as well. We put those together with our current profitable business. Of course, it will hit the EBITA margin a bit. That means we have 13% EBITA margin in the Q2. All in all with the H1 year, it will be 16% EBITA. Then of course, most importantly, we are about to grow in different areas, and we have also created a new niche, called Health Analytics, and that happened through an acquisition. I will go through today what that means to CSAM. Also in the Q2, we acquired a company called Optima.
A fantastic company also, put together with the MedSciNet here, these two are type of companies that have been working for many years with analyzing data, focusing on healthcare data, which is a growing area among our customers. The mix there is fantastic. Not only are we growing fast, but also we have done the right things when it comes to creating the future for the company. Of course you can see that we've been working hard the Q2. You saw subsequently after the Q2, we had a big win. What does that mean to CSAM? To win such a contract, national contract, in Denmark shows the viability of our systems, the need for our very important niche solutions, and they will be integrated with a lot of different systems in different regions, in Denmark.
I will go through what that means in a bit as well. These are the highlights, and these are very important in the development of the company. As you know, to reflect on that, what is really CSAM about? I think you have to mark the three first words every time you think about CSAM, eHealth, niches, and software. As long as we stick to that discipline, we have been able to create a position. We are the leading one in the Nordics. We are gradually now going out in Europe and also the rest of the world. I think our disciplined strategy is part of the reason why we have had success so far and why I think the plan is good, and also, as you see from the growth numbers, we are soon there.
Of course, what is this about when it comes to CSAM? CSAM was created by a hospital, and of course, this is all about patients. It's all about the solutions and what they do. Most of our people, our employees, our experts, are coming from a healthcare sector and understands why we're doing this. That is the foundation of all of our business areas and all of our types of software. I'm going to go through these areas now just to summarize roughly what has happened in the Q2. Let me go through, first of all, the Medication Management area has been existing for decades in the Nordics and is a de facto standard how to handle medication and oncology treatment. These systems, we won a tender last year, so a new Nordic region adding to our current portfolio of customers.
There we are also developing systems, new versions, new add-ons to continue growing organically as well. Again, also here, recurring revenues over time, low churn. Same here, with the Women and Children's Health, we are the definitive leader in the Nordics when it comes to these types of specialized components. It's important to secure healthcare around babies and their pregnant mothers, and I think this area is also a typical CSAM area where decades of development and user groups have created systems that are viable over time. Also during the Q2, we are now preparing emerging systems to create more efficient add-on components over time for our customers.
Then we have Medical Imaging, is also a lot of smaller components put together to help specialized healthcare doing the work, integrate those again with the different types of EPR systems around the Nordics and also other places. These are also things that we are developing, delivering now, putting together new components on top, and also merging components from earlier acquisitions. That is how buy, integrate, and build is working. We are creating new components and merging things and getting more efficient and then also, of course, increasing the EBITA margin based on that. Then Connected Healthcare, what is that?
That is our second biggest business area. It doesn't look like it is, in a way, a medical thing, but it is because all our customers, all these hospitals around the Nordics and also Europe and other places, they have their different type of system stacks, a lot of different systems, and we have to integrate with those. That means our current business is to make sure that all our niches are fully implemented into these stacks over time, and that is where our components are coming in that integrates. These are software components as well, with long-term recurring revenues and also with add-ons as we go to secure organic growth. Put together those four predictable recurring revenues, decades of history, viable components. To more specifically go into happenings in the Q2, we created a new niche. Why did we do that?
Well, it's not only because of an acquisition, but as you see the development within healthcare, you take care of your data. You want to analyze the data to create a better business, and that is what Health Analytics is about. We acquired a company here, which is a major stepping stone, so now we'll go through that in more detail. Of course, our biggest niche or business area, if you will, is the Public Safety area. The Public Safety area is really going to grow. Through the Q2, we made another acquisition, the June 30th, actually, of Optima. I'm also going to go through that specifically, which is a very important thing for Public Safety. It's important for our customers, and it creates possibilities on the income side.
Both of those have created new Health Analytics, a new niche, and Public Safety has gotten a new area when it comes to Health Analytics as well, or prediction, if you will. I'll go through that later. The last one here, the seventh, Blood Management, that is also, in many ways, defining CSAM. It has a 40-year history. User groups have been working together for many, many years and created these software types that, put together, are now 100% market share in Sweden, and now after our contract mentioned with the NOK 100 million contract with the Danish authorities, we are also 100% market share in Denmark.
These are very important stepping stones for CSAM, and the Q2, of course, was hard work for all the people in the sales department and within this niche business area to secure that contract, which happened subsequently just after the Q2. That's roughly the summary of the business areas. They're all performing well with positive EBITDA. They're all performing well when it comes to recurring revenue and low churn. Let me just summarize the acquisition part of CSAM, which is extremely important. Just to remind you, we were created by a hospital. We were a small Norwegian company with some Swedish customers in 2010. In 2015, we started accelerating our merger and acquisition history together with the private equity fund, Priveq, from Sweden.
As you see, when we IPO'd last year and until today, after Q2 2021, you will see that this slide and these logos are getting busy and busier, and that is what CSAM is all about. Because to get these market shares, to get these recurring revenue streams, put them together, all this competence, all these customers, and different components, and create one business, that's really what this is about. I will go through these specific acquisitions we did the Q2 in a minute. Of course, as you see, the number of employees have increased dramatically through this history. Of course, that is also defining us when it comes to growth. Experts on each of these niches and working efficiently together in one organization.
That is what made our success so far, and that's how we're going to do it in the five-year plan I referred to, NOK 1 billion in 2025. Let me go through specifics here. MedSciNet, what is that? Well, it is about clinical trials. It started with the professors in the Karolinska Institute trying to find out how to support these clinical trials with data and quality. Then this type of approach to healthcare data is important to all types of providers today. That means this is a growing area in itself and not only as a software area.
When we initiated this, we see that we can get these Health Analytics components to help us get also more out of our other niches, because the data there and this analytics platform and this clinical trial framework put together as a SaaS-based service, cloud-based service is, of course, a modernized way to offer our customers a better future when it comes to handling their data. This software as well has a history. It's technology. It's proven security, integrity, and focus, and is also compliant with the most important, of course, standards needed to be a serious provider within this area. All in all, this has also strengthened us more in the Nordics and also more in the U.K. and also in the rest of the world. Put together, well, it's a small company, 14.4 million SEK in sales and 11 employees.
Important, SaaS-based, and a very good thing which helps the other niches that we already have. This is a successful acquisition as we see it, and that's also with the second one that we did the last day of the Q2. Optima, owned by the big company R1, that is also the same history. A highly specialized component type, then again, working with decision support and has done that for many years. This is helping these type of providers to actually plan their operations and to secure prediction and real-time analysis. Put together, you can create a better healthcare business, especially within the Public Safety area. Also that means that resources across the healthcare systems, you can use these data to create a better healthcare business as well, which is important to all our customers.
That means that this component, this service, is highly important for our current customer within Public Safety in the Nordics and in Europe. This is going to be a good add-on for CSAM. This is not a new thing for us. It's important to say, since these are people coming from other places in the world, it's not new to us. We've been cooperating with this company before. That means we know the components. It's already installed with our major customers like Oslo University Hospital. This is the way we think is a low-risk approach to get new customers, new components, and new experts and employees. It's been a successful transaction for CSAM.
This is creating a new value chain because we have a lot of support for control rooms, for the ambulances, and put together for the management here, where you can actually use that data to create a viable business, which is more efficient, that is valuable to all our customers. That's a new value chain for us as well. Very important. Customers, it strengthens us here as well. They have already customers here in the Nordics, also other places in the world, meaning that we are also more customers in Europe and also outside of Europe. It's gradually getting there, and in a way, I think it's the best way to manage risk. This is good news for a growth company like CSAM. The question, we have made two of these acquisitions in the Q2.
We made a big one in the Q1, Carmenta Public Safety. Put together those three into our H1-year numbers. What happens then? I guess you all will see the mathematics that most of those companies are underperforming and of course, put together it will affect our EBITDA. What do we do then? I think we’ve shown you before, we call it buy, integrate, and build. I think if you look at the facts, the numbers, the CSAM numbers, 2019, 2020. We did a lot of acquisitions. We integrated 5 companies in 2019. We had an EBITDA below 20%. We did this buy, integrate, and build process. What happened in 2020? Back to 30% margin, EBITDA margin. That is the craftsmanship of this.
That's why we're not worrying about the EBITDA quarter by quarter, as long as we acquire companies with these recurring revenue streams and put together in one organization through buy, integrate, and build. That is what this is all about. Again, it's a good quarter and it's according to our plan. One thing is the plan, and then secondly, we have the ambition. We like to say, and I think based on where we are at the moment, I think that from 2005, being created by a hospital, and if you look at it now, well, we have become the leading player in the Nordics when it comes to focus on these niches. What is the plan really about? One thing is the numbers. Secondly, as long as we can stick to that strategy, we don't have that many competitors doing the same.
We think it's realistic to become a champion in the European area, focusing specifically on these types of systems and being the leading player there as well. Of course, in the rest of the world, we have started, and I think that we will also over time be a notable international player. That is CSAM's ambition, and the only way to do that is of course to grow. We've shown you that 56% growth pro forma, including the M&As in the H1 year, should really show you that we are on our way.
You also see from the numbers, of course, in the H1 year here, you see that we have 7% in the rest of the world, and you see that we are becoming stronger and more mirroring the Nordic market as well, being stronger in Sweden, because Sweden is bigger obviously. I think now with a huge diversification you see in our recurring revenue streams, and when they are put together like this within different countries, different regions, different hospitals, different departments with different niches, it's highly diversified and a very good position to be in. Having said that, I think I will bring my colleague in here to then show you the numbers behind the quarter, and then go through these before we have a Q&A just after Einar is finished with his presentation.
Thank you, Sverre. Good morning, everyone. Let's go through the numbers. A mix of the quarterly and half-year highlights. We have tried to put everything into context for you. We've also done some pro forma calculations to make it easier. First and foremost, the revenue growth is 56% for pro forma for the H1-year. We are ahead of our communicated plan, growing 40%. Even stronger is the growth in recurring revenues, almost 60% growth in recurring revenues. That, as you know, is really the backbone, the core of our income. This is at the expense of the EBITDA margin. As we have said before, when we acquire businesses, we acquire and we look for the quality in the potential, and then we try to acquire them at reasonable terms, and then take out the synergies and realize the synergies. On the way, we dilute the margins.
We have communicated that clearly before, and you see that demonstrated in the H1-year and the Q2. The reported EBITDA is NOK 10 million in the Q2 at 13%, 16% for the H1-year, and you clearly see the effect of the dilution. Bear in mind also that the EBITDA is impacted by the high M&A activity in the quarter and in the H1-year. As I said, we are growing ahead of our communicated 40% per annum. You see there quarter-over-quarter from comparing on the left chart, the Q2 of 2020 with the Q2 of 2021. You see a demonstrated growth of 33% in the reported numbers. 56% in the pro forma numbers. That is, if you include Carmenta, MedSciNet, and Optima for the first full half-year.
You also see on the right there, the growth in the recurring revenues, growing more than 40% reported and 60% pro forma. Recurring revenues, the proportion of the sales and the quality of earnings, if you like, is improving as well from 72%- 77% of total sales. Very high-quality earnings. Let's take a deeper look at the recurring revenue amounting to NOK 61 million reported in the Q2. What you see here is a chart that we've shown you before, and that is the last four quarters development in the recurring revenue. Growing from around a little more than NOK 70 million in 2017 to actually surpassing for the first time in company history, more than NOK 200 million based on the last four quarters. That is a great comfort to us and to bondholders and to shareholders.
Keep in mind that these are the last four quarters. The run rate is of course higher, NOK 61 million in the Q2 alone, and multiply that by four and you have the run rate. It's actually a very, very strong growth and a very, very strong fundament for future growth. Again, almost all the customers, they are in the public sector, very little churn, and very high visibility going forward. I mentioned that we had some costs related to the M&A. Sverre also said we have completed three acquisitions thus far in 2021. That has an impact on the cost base. We see that the personnel expenses increase, and so does other costs and COGS. A lot of those costs, they are temporary.
What we will do, as we have done in the past, is to make sure that we right-size the total cost base with the M&A activities and the expected sales growth. We see that it is a huge increase in FTEs. You saw from 168- 262, so almost 100 new employees over the last acquisitions. That is, of course, driving the cost base on the salary and personnel up. We see the other costs. That increases again as a consequence of the higher M&A activity, coupled with some one-off integration costs and also, bear in mind, more extensive use of external consultants in some of the acquired companies. They have a different approach to CSAM. CSAM typically insource such costs and activities, and we can also benefit from economies of scale.
Again, the improvements will not be made overnight, but you will see them as a part of the 24-month buy, integrate, and build plan activities. Last but not least, you will see that the COGS have increased as well, mainly due to higher third-party software in acquired businesses. Again, as a part of the buy, integrate, and build process, we will work hard to replace such software with internal offerings whenever and wherever possible. Again, it's not done overnight. It's a part of the process. When we have acquired a company, there is a lot of work to do, and don't worry, we will do it. You also saw that the EBITDA margin is reduced as a result of higher M&A activity, and part of that is also reduced CapEx.
You saw that the CapEx is going down from 10%- 6%. This is because the CapEx in the acquired companies, they have a different investment philosophy than we do. Remember that CSAM when we have CapEx, you just don't transfer some cost from the P&L to the balance sheet to get rid of it. It's actually investments that are identified. When we develop software, there are actual people working actual hours being in a cost bracket, that is the reason and the fundament for those things put on the balance sheet. It's an investment. We invest in software that will pay money back to us for many years to come. Acquired companies, they typically have no scheme at all or don't have the same system as we do.
Until we have our system put in place in the acquired companies, most of these costs are expensed in the acquired companies. It has an effect on the reported EBITDA, but of course, less so on the cash EBITDA. We will also see that, compared to the Q2 2020, keep in mind that that was a very well-trimmed company. We hadn't done any acquisitions for more than a year. We were entering the late stage of the BIB model. That is the numbers in a nutshell. Let us take us back to the big plan. We said when we IPO that we were around NOK 200 million in sales. We ended last year just south of NOK 230 million. We are now growing more than 40%, 40% is what we need to grow annually to reach the 1 billion in sales in 2025.
We are growing ahead of that plan. We will continue to work very hard to continue this pace also going forward. again, being in the same business, focusing on eHealth niches, and continue to focus relentlessly on recurring revenue from well-reputed customers in the public sector and elsewhere as we move out into the world. That was that. Just before we continue on the Q&A, let me just give you the opportunity to, if you want to stay ahead and up to date on what happens in CSAM, subscribe to our news. You find that on our webpage, and you can subscribe to our news and also follow us on social media. To the questions. Let's move on to the Q&A sessions. We are ready to roll. First question here already from Eddie. Presentation.
With investor presentations, when they do an acquisition, like we had a presentation on MedSciNet and Optima. When it comes to analyst coverage, we are working hard to increase that. If possible, we would love that. Currently, Carnegie is covering us, and we hope for more. We are not stopping it, for sure. All right. The next one, again from Eddie. What can you say about organic growth in the quarter? I guess that is one for you, Sverre.
Organic growth is what we see. Maybe less some quarter, maybe more another quarter. It was different between first and Q2. To us, that is not the main thing. That's the main thing I would say about organic growth in our plan.
Question.
Objects that are either smaller, it's irrelevant to many, or they are complex, like the one we did with Optima. There's always competition, so far it's not increased too much on those type of objects that are relevant to us. I see that the game in Europe and the world, it's accelerating also here in the Nordics. I think that is a good thing for the business. It's a good thing for the market.
Quarterly presentation then.
Most probably.
Okay. We can wait a few seconds to see if anything pops into the Q&A box. Doesn't seem so I'll hand it back to you, Sverre.
Thank you, thank you all for watching this quarterly presentation. We are looking forward to seeing you soon again.