Welcome to Carasent Q4 Report for 2023. For the first part of the conference call, the participants will be in listen-only mode. During the questions and answer session, participants are able to ask questions by dialing pound key five on their telephone keypad. Now, I will hand the conference over to CEO Daniel Öhman and CFO Svein Martin Bjørnstad. Please go ahead.
Hello, everyone, and a warm welcome to Carasent's fourth quarter report. My name is Daniel Öhman, and with me, I have our CFO, Svein Martin Bjørnstad. I will start with some highlights from the fourth quarter and the company update. Thereafter, I will hand over to Svein Martin, who will give a financial update. In the fourth quarter, we continued to improve our underlying profitability significantly, and also, we took many steps towards improving our growth. Especially, I would like to highlight that in the fourth quarter, we sold for more than in any quarter before. Looking at the summary, we had a growth of 15% year-over-year, but only in the quarter, only 8% was organic. But what we really focus on is our ARR, and, the recurring revenues grew by 13% in the quarter.
Our focus on recurring revenue hurts our revenue short term as our consultancy growth, consultancy revenue becomes lower. The reason is that we want to make it as easy as possible to change to our systems. It's a big hurdle enough to change HR, but we really want to make it easy, so we don't want a lot of upfront costs. So that's part of the reason. The other reason is that ARR is much more valuable to us than one-time incomes. So for Webdoc, which has no development for a specific customer, that means that we give a lot of rebates on education and implementation of Webdoc when a new customer comes in, but we give very little rebates, if any, on their monthly fee going forward.
And this is especially true for Metodika, where we have a lot of customer-specific development, where we now give all rebates and very little, or if any, on their recurring revenues. And Metodika is roughly 50% of our consultancy income. Looking at our sales in a quarter, the most significant milestone is that our new contract with Volvat, which is one of the largest healthcare providers in Norway, it will give us a revenue of roughly NOK 7 million to NOK 9 million per year, whereof most of it is recurring revenue. It will go fully live by the summer 2025. Also, in the quarter, we signed an agreement with Joint Academy for Webdoc, which is another quite big customer, not as big as Volvat, which will go live later on in this quarter.
We also distributed a roughly NOK 250 million to our shareowners and set new financial targets in the quarter. Looking at our turnover, in the quarter, it was NOK 65 million. And as mentioned before, we had record sales in the quarter, but it takes time from sale to implementation, which is reflected in this number. If we're looking at EBITDA, you can see that we are capitalizing less than we used to. This, as a smaller part of development, is a new product. It is still, however, the case that even if you do not capitalize as much as before, the majority of all our spend is to increase future growth. It's not to keep present customers. Underlying the EBITDAC, so EBITDA minus capitalization, continues to improve. You can see that we lost a little bit.
We went from -12% to -13% in the quarter, but that's seasonal effect. The third quarter is always better from a profitability point of view for us, and that's the effect from vacation. So almost all vacation are in the third quarter. You can see the same effect in the third quarter of 2022, where we were on a downward slope, but that quarter, EBITDAC improved, actually, and that's because of the vacation effect. And then you have to give a brief recap on everything we've done during 2023 to address our financial and growth issues. So we have enacted a cost-savings program of NOK 40 million on a running basis. It's all of those costs are related to employees and consultants that we have, roles that we have taken out of the company. We also prioritized quite heavily among our products.
We used to have two international projects, one for Norway and one for Europe, Webdoc X. We couldn't continue both projects with high quality and costs in line, so to speak. So we chose to focus on Germany with Webdoc X and close down Webdoc Norway. Also, in the organizational structure, we have reduced complexity a lot. So nowadays, each product is its own P&L, and we have very clear lines of responsibility, where I can keep each head of each product responsible for their performance, both when it comes to growth and financial results. The most important part, I think, if we look a bit further ahead, is our focus on business with a strong sense of urgency through the entire organization. And of course, if you do a cost program as we've done, that helps a lot for this.
But also we continue to push this, and everyone in the company knows that what we need to do is to improve growth and keep costs flat. That's the focus of what we do every day, increase growth and keep costs flat. And finally, we have improved our capital structure with the distribution of NOK 250 million to our shareholders. That's a little bit of what we have done. After the end of the fourth quarter, we have sold Confrere, and the most important reason why we've done this is to reduce complexity, and this allows us to focus on our larger products. It will also improve our financial results quite a lot. Confrere had a turnover of NOK 9.3 million in the last twelve months, and an EBT effect of NOK -1 million .
They also had a negative growth of 18% year-over-year in 2023. So it was a part of Carasent that were going down in size, losing money, and not an important part of the entire product. And now we can focus on our core with sticky products with minimal churn. Standalone video solutions is an area with low margins, high competition, and high churn, so we don't see it as a very attractive niche. The financial impact of the sale is, of course, that our results will improve both from a turnover point of view, that we will start growing more rapidly, but the bottom line will be more profitable. We will have a write-off approximately NOK 5 million because of the sale.
This can improve if Compodium, the buyer of Confrere, is successful in transferring customers to their platform. Now, I will show two new slides, where the goal is to increase transparency on how we are progressing. First of all, here, we look at the full year of 2023, and the first column here is what we call operations. So it's all our products except HPI, Ad Opus, Confrere, and Webdoc X. And what you can see here is that the majority of Carasent is doing quite okay. So 84% of our revenue is in what we call operations. We have an organic growth of 15% in that part of the business, and an EBITDA margin of 23%. So we have a core that's doing quite okay. We are not satisfied where we are at the core.
This is where we need to increase our growth and keep costs flat. Then we have our area with products, which are a little bit more of a challenging situation with HPI, Ad Opus, and Confrere. This is only 16% of our revenue. It does cost us quite a lot when it comes to growth and also when it comes to EBITDAC. We have now sold Confrere, which will improve this part of the business quite a lot. HPI is doing better and better, and the same with Ad Opus, because we have lowered costs quite a lot in the fourth quarter within those two businesses. Webdoc X is our new medical record system for Germany, and my view is that this part of Carasent has the potential to be much more valuable than the rest of Carasent combined.
The reason being that Germany is the largest healthcare market in Europe. They are far behind Sweden and Norway when it comes to EHR systems. They've just opened up for cloud solutions and there is no strong incumbent there. There are just a lot of really, really old systems. That's our competition in the country is milking, so to speak. So we believe very strongly that there is a big amount for us to take in Germany. And finally, we have the head office. And looking at the entire year of 2023, as you all know, we have lowered costs by roughly NOK 40 million on a running basis. But if we would have done that cost-saving program before 2023, the results in all this column would be roughly NOK 20 million better than what you can see here.
So the EBITDA too would be roughly NOK 32 million. Looking at the same structure for the fourth quarter, we can see that we still have the core, which is doing quite okay. The growth is a bit disappointing, as I mentioned already. We sold for more than any quarter before, but actual revenues that coming in in this quarter are a bit lower, and that's mostly because of the consultancy being lower, and Svein Martin will go into that in more detail later on in the presentation. But we continue to keep costs flat and to grow. When it comes to HPI, Ad Opus, Confrere, as you know, we sold Confrere. HPI has been growing quite a lot lately. That's why we now have organic growth of 0%.
In this part of the business, and HPI's new product are actually growing exponentially. And that's what we typically see when we have a new product of this sort, is that you first get one user, then you get two users, then you get four users, then you get eight users, and so on. So it's typically that you see an exponential growth. When it comes to the new products within HPI, it's from a low base, but if that trend continues, it will look very promising. And it seems like it. The customers are happy with the product. They want to implement it, so I have strong faith in HPI. Ad Opus, we will see that they continue to lose customers and lose revenue during 2024.
The reason being that, the contracts within Ad Opus are one-year contracts, they always end at New Year. We had customers who signed from Ad Opus during 2023, and that will take effect during 2024. However, now we have the new Ad Opus Web that's been live for a couple of months now, and which has strong interest in customers. So I expect to see Ad Opus start growing by the end of the first half of the year of 2024, and otherwise, we'll have to take further actions. Well, Webdoc X is now at the run rate it should be, roughly, and also will reduce cost in at the headquarters quite a lot compared to where it used to be. And in total, you can see that we're much better than the same quarter last year.
We will continue to show this structure, this setup, so that you can see how we are improving in the different parts of Carasent. I hope this is a good way of showing how we are actually doing. Looking a bit ahead, I mentioned it a couple of times now, we have a strong focus on growth. What I would like to highlight, especially, is that we've been working a lot with sales during the last four to five months. We now have in-house digital marketing in place. We're getting better and better at doing those videos. I hope you've seen some of them on LinkedIn with our customers explaining how very happy they are with our products. The next set of videos will focus on that it's much easier to change system than you believe.
Most caregivers, I was one of them, really think it's so difficult to change systems, but it's not, and if you're looking at our customers that have changed, switched systems, they are really happy. So we hope to get some strong testimonials on that. We have implemented a CRM system in the fourth quarter, giving us much better visibility on how we're progressing. We can really see the funnel and how we're moving forward, which will allow us to act quicker. It also allows for our sales people, but also support and implementation, to work with existing customers, to have a good overview of what they have and what they don't have of our products. We will also be able to much better target potential customers than we used to be.
And I would also really like to highlight that we've changed the remuneration model for our sellers. They used to have 90% flat income and 10% group bonus paid out by the year-end. Now, they have 70% fixed salary and 30% flexible salary, which is dependent only on your individual performance and is paid out after each month. So giving much stronger incentives to really push forward and seek out new customers with the help of a CRM system and everything else we do. And this should be seen in addition to all everything we do to improve the product. e-referrals in Stockholm is now live with the first two pilots with good reviews. What we haven't spoken about in this type of forums before is that we also have our archive module up and running.
And the point of that is that when you change to Webdoc, you will be able to see the medical records from your previous system within Webdoc. And this is really important because it used to be, if you don't have this type of setup, that you have to run double EHR systems for roughly two years. And the reason being that when patients come in to see the doctors, the doctor need to know about the patient's medical history, and it takes roughly two years to have everything in the new system. So, with this, you can close down the old system, and, more importantly, your staff only needs to log into one system and can work with it in one system, being much more efficient. So that really eases the change part.
Coming around the summer, autumn, we will launch the surgery module, but so far we have really good collaboration with our existing and potential customers for that solution, so it looks really good, I think. When it comes to efficient use of resources, as I mentioned before, we aim to keep the cost flat, but there are always new demands. For example, we're investing a lot now in compliance and IT security, so that will increase costs. Then, that means that we also need to take out costs constantly within the organization. So for example, at the moment, we are looking at reducing roughly eight roles within the organization at different levels, and that's to make room for other roles. So we're working very hard to keep staff costs flat, even as we're growing and doing more things.
We also work at optimizing our cost base. It's a lot about prioritizing what costs can we actually take and what can, can't be prioritized, and we are improving procurement. An example of this is that we have now procured new hosting in Norway for our Norwegian products, and that cost, that have diminished cost by roughly NOK 2-3 million per year, and we're now looking to do the same in Sweden for our Swedish products. And finally, we're focusing on launching Webdoc X, which, as I mentioned, my view is that potential to be more worth than the rest of them combined. The present focus in our development is for certifying the system for Germany, and that means so to certify it for the insurance market in Germany.
And what you then certify is the billing module, which has to fulfill, I don't know, roughly 200 different demands. So that's a lot of the work now, and that's really the big hurdle for Germany. Other than that, there is very little specific needs in the German market. There are much more specific needs and requirements in, for example, Sweden and Norway. And I think we have good initial dialogue with potential partners and acquisition targets in Germany, and that's where I and some of my colleagues will put a lot of the efforts, the coming months. So having said this, I will hand over to Svein Martin.
Thank you. So looking at some of our key financial highlights in the quarter, we had revenues of NOK 65 million in Q4. Of this, more than 90% was recurring revenues, and our ARR was NOK 239 million at the end of the quarter, growing 13% year-on-year organically, and a net retention of 108% shows that the position we have as business critical systems for our customers. We have also taken steps in the right direction on the profitability side. The cost savings program we did in Q2 is starting to show results, and we had an EBITDA margin of 10% in the quarter, and EBITDA minus CapEx margin of -13%.
In total, our revenues grew 15% year-over-year, and this was partly driven by the acquisition of HPI in November last year, and partly by currency. But our recurring revenues, which was 91% of total, grew 13%, which is quite in line with how the growth has the last 5-6 quarters. Our key strategic focus, as Daniel mentioned, to grow this going forward as well. Total organic growth was 8%, which is slightly lower, as we saw a decline in consulting revenues. Metodika is basically around half the consulting revenue, revenues we generate, and Metodika was very much focused on winning the Volvat tender process in Q3 and Q4, so that also impacted the consulting revenues, I would say.
So as mentioned, our recurring revenues grew 13% organically. We have a very strong basis with the high stickiness and low churn. Our net upsell was 11% year-over-year from existing customers, and churn was very low at 3%. And the little churn we have is really not coming from the core. Our two smallest products, Ad Opus and Confrere, generated almost half the churn that we see in the Q4. Confrere is now sold, and Ad Opus, we will face some headwinds from January, but we all are also seeing very promising signs from the market that we are able to turn this trend going forward.
Excluding these two products, churn is basically around 1% to 2%, and that includes involuntary churn, so people going out of business, going, retiring, et cetera. So the voluntary churn for customers leaving our system are very close to zero, actually. So this clearly demonstrates how business-critical our systems are to our customers and the very strong position we have to build from, for all of our products, basically. A new customer growth was 5%, which is in line with the previous quarters, and currency effects and M&A brought the total growth to 21%. So our ARR was driven by the same organic trends as the reported recurring revenues. However, we are starting to see that our investments into new sales is starting to generate results...
If we look at the orange part of this graph, it shows the ARR we had signed, but not yet implemented as of year-end, so basically our revenue backlog. This figure was NOK 8 million at the end of 2023. The same figure last year was under NOK 2 million. So it basically shows that our backlog has grown four times in size since last year. Also, if you compare that backlog of NOK 8 million to the total growth from new customers during 2023, it was NOK 10 million. So this clearly shows that we are starting to build a very solid foundation for a step-up in growth going forward. It is, of course, boosted by the Volvat agreement, which will have a main impact in 2025.
We are also seeing promising signs and an increasing amount of promising dialogues, I would say, on the sales side, for Webdoc particularly, but also for our other products. Finally, we are also seeing that the profitability is improving gradually. We see the effects of the cost savings program we completed in Q2. The cost base remains high compared to our revenues as we invest in future growth, but as we have shown, we strongly believe that this is the right thing to do in the long term. Going forward, we basically aim to grow our revenues and keep our cost quite flat.
And if we are able to do this, we have a gross margin of around 80%, which can basically be translated directly into our cash profits going forward, if we are able to keep operating costs flat. We are also working on optimizing the cost base in general, and we monitor all parts of the organization very closely so that we develop according to our plan. And if we have this very high predictability and stickiness in our revenue stream, so if the growth we plan for does not materialize, we are also able to adjust costs very quickly to address that. So with that, we are done with the initial presentation, and we can open up for Q&A.
If you wish to ask a question, please dial pound key five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial pound key six on your telephone keypad.
We have gotten a lot of questions here on the chat, so we can start with those. Firstly, from Redeye, could you expand a little about the investments you make in existing markets, the new surgical module and e-referrals, and so on? What do you expect from these in 2024?
Yeah, I think these are extremely important parts of increasing our growth going forward. e-referrals in Stockholm is now live for the first two pilots, meaning that it used to be that when you got a referral in Stockholm, if you didn't use Stockholm system Take Care, then you had by hand to transfer those patients to, for example, Webdoc, and then you had to transfer them back to Take Care when you were done with the patient. That's a lot of manual work, really lowering our possibility to sell in Stockholm. Stockholm is by far the largest private market in Sweden, so we were, to a large extent, locked out by it, from it.
We do have customers in Stockholm who have chosen to use Webdoc anyway, so they did do this, all these manual transfers, just because they like the efficiency of Webdoc much more. So you have to remember that Webdoc, if implemented fully, will be roughly 2% of your revenue. The rest of it is mostly fixed cost compared to that's related to staff, meaning that if our system helps you be a little bit more efficient, it will easily pay for itself. Now we take out a lot of what the manual work, and you can now, if there is a patient transferred from a Stockholm clinic to a Webdoc clinic, it will transfer automatically. So I think that's very important. We have two pilots. It seems to be running well.
What I also really like with it is that we have done it without any work from Take Care, because they don't want to connect to us. So, that means—that's what I think we have to do with multiple systems going forward into the future. We will have to make sure the systems speak with each other, even if we do not have access with it, to their APIs. So I think that will help our sales in Stockholm go for quite a lot. The archive module I explained earlier, where you can see all your previous journal notes, will also help quite a lot, when it comes to new sales and really support our customers. The most important part, I think, is still the surgery module. A large part of private healthcare in Sweden is surgery.
So you have orthopedic surgery, you have general surgery, you have plastic surgery, and so on. And these areas, a really important part, and the most important part of the business, is to plan your surgical theater. Today, Webdoc has very little support for that, and the only systems you have that are really old and not good at all. So I think we can quite easily beat them. The other important part when it comes to this is that when Stockholm will now over time, in 2029, is the plan now to replace Take Care. With the new system, they are not buying a surgical module, so all surgical clinics will need to have a system which supports their surgical planning. So that's a good position for Webdoc there.
But also near term, I think we will be able to take quite a lot of customers, and we have every second week, we have a joint meeting with potential customers around this, and the interest is really high. It's quite a big build, but it will also give very good returns.
Next question. You write that we have developed new functionality that allows users to access their old records directly in Webdoc when switching. Typically, all users which switch systems have had to use dual systems for about two years. Has this been a big hurdle for you in sales process previously?
So I think it's part of why you are very reluctant to change systems. So it's not enough for our systems to be a little bit better than the old systems. They have to be so much better because changing systems is a lot of work. There are a couple of issues when it comes to changing system. One is the upfront cost, and that's what I explained earlier. We try now to push that down. It hurts us short term, but we gain from it long term. The other part is that the business will be slower for a while, while you implement, then you educate the entire staff, and that costs you a lot of money when the business is a bit slower.
I think that most customers are, and myself did also, overestimating the impact of this, and we can see that from our customers that have changed systems; we're now measuring their happiness. Right after they have implemented the Webdoc, we ask them when we're done with the implementation, how happy are you with the change? And on a scale from one to five, we are around 4.5-5.0 each month. So they are extremely happy with those who have changed, and we need to spread that word. So that's, I think, the marketing will be an important part with testimonials. And then the last part, which makes you very hesitant to change system, is that you will have to run double systems for quite some time, typically. And now you don't have to.
To say how much each of these three hurdles, which one is impacting the most, is a bit difficult to say. We try to push all of them down, and I think that that will really translate into more sales.
Next question. What led to Metodika winning the Volvat tender, and how will the deal impact consulting revenues in 2024, given rebates and so on?
So I think Volvat is a great system for any large enterprise, customer. So Volvat, the strongest customers, they have is Aleris, Norway, now Volvat, Norway, and Avonova. Those are big, big healthcare providers, occupational health providers with multiple sites. And Metodika has a very strong functionality supporting multiple sites. It also have a lot of functionality to support different types of care, including the occupational health, and very few system do this. And it also supports all your commercial processes, and that's the most important part, I would say. There are other systems supporting big healthcare providers, for example, hospitals, but those systems are typically done in the Nordics for nonprofit, so government use, public use, so they do not support your financial processes or commercial process in a good way, which Metodika does.
I think the reason that they won is that they can support all parts of customer like Volvat with multiple sites, many different types of care, including occupational health, and it will be replacing a lot of existing systems. I also think it's, you know, our focus on the customer, that we're there for them, that we listen to them, and we understand their needs. I think they felt that we really are a good partner, and the other really large private provider in Norway, Aleris, are happy with our products. I think that's a big reason. Consultancy revenue, so Metodika had a lot of consultancy revenue in 2023. It will have also a lot of consultancy revenue in 2024, but we have given a rebate on that.
So as we mentioned in press release, it will hurt the profitability of Metodika due to 2024, but on that other hand, we have given no rebates at all on DRR going forward, so we will get that rebate back many times over, and I really think that's the way to go. It builds more value over longer term, but it means that Metodika will lose a little bit of profitability during 2024. Other parts of Carasent will pick that up, and then Metodika will swing around and really add a lot to the bottom line at 2025 and forward.
Yeah, so consultancy revenues will be quite stable, but it will require more resources basically to generate- Yeah -the same result. Next question: How big is the expected drop in Ad Opus quarter-over-quarter into Q1 2024? So the drop is around NOK 2 million on an ARR basis, which is not that big of a drop for Carasent as a group, but it's quite big for Ad Opus. But we aim to win that back during the year, and we will, of course, need to see an improvement in Ad Opus in 2024, one way or the other.
I think we should clarify that it, it's the old Ad Opus product that have this drop. The new Ad Opus Web, which is a completely different product to use, which has been developed by Carasent for a couple of years, is a much nicer product, much more modern and support a much more modern work or way of working with your patients. So, we believe strongly in Ad Opus Web, but the ultimate proof is that customers actually start picking it up, and that's what we aim to see during the first half.
Next question. Net Retention Rate was 10 8%. What the price increases look like in 2024 on contracts? I can take this one. We generally have, or we have the, are doing inflation adjustments on all of our products. It varies a bit what index we use, but it's typically linked to our own production costs, basically, and salary increases. Next question, Max Gårdin: Looking at acquisitions in Germany, what size are you targeting? Please elaborate on your cash position and how much of it you intend to spend on acquisitions.
So when it comes to acquisitions, it's, you know, it's a bit of an unpredictable process. We have a long list of potential targets of roughly 20, more, a little bit more than 20, actually. Of that, we're working with a shortlist of few targets. And what we're looking for are a couple of different things. We want the product to be profitable. We want to, it not to have too rich functionality. What we mean by that is that we want to be able to replace it with our system, within not too long. And the reason we want to replace it is that when we move to the cloud, we lower the costs at the customer site, which will be our revenue.
So typically, historically, when we move to the cloud, we have been able to double the revenues from the customer. And we do not want to buy a too small system. We want to have at least 20 employees, I mean, in organization, otherwise, it's too small for us to work with. But we also want to afford it, and it's preferably not being too big. But it's we want it to fulfill all these criteria, and also, of course, we don't want it to be too expensive. So exactly which size it will be will vary. I don't expect it to use our entire cash pool. And what we'll do with the rest, we'll have to come back to later on. But it will be nothing more than that, at least. That's not our way.
Next question from Rickard. Could you please elaborate on the recent ownership discussions? Although there was a majority against an extraordinary dividend, it is clear that there are frustrations among a broad base of shareholders on the lack of profitability in the current business. Have you considered further cost savings and/or any changes regarding the planned German market entry?
So, what I mentioned in my letter is that I feel that we now have very good discussions with our three largest owners, representing quite a large part of the shareholders. I think it's worth noting that almost all of the shares actually voting in favor of the proposal at the AGM, they have now changed control to a new owner. So, I would expect that that vote would have been much stronger again today than it was back then. But for me as a CEO, the most important part is that we feel that we have the owners behind us, and that I feel strongly. When it comes to further cost savings, as I mentioned earlier, we are doing cost savings all the time, so we're looking constantly at what costs to take out.
I believe strongly that Webdoc X can be more worth than the rest of Carasent combined. I feel that we have our largest owners behind that idea. So I'm quite happy with the discussions we have with the owners and that we are now in line with our owners.
... Great. Next question. When do you expect to see improved organic growth in ARR recurring revenues? Are you concerned that you are yet to see effects from the initiatives taken during the last 12-15 months?
So, it takes time. As I mentioned before, we sold more than any, than in any quarter previously in Carasent history. So I mean, we are increasing growth. It's just that it's not been implemented yet, and that's what Martin showed earlier. I hope they will be able to show that, that, ARR, yet not implemented, will grow quarter-over-quarter. I would say that has taken a bit longer than I expected. It's a bit slower, the market. I think the reasons being a couple of different things. Carasent had very little focus on present customers, and it takes time to convince them that we're back and that they really feel it. The sales process are quite long. You never, or you almost never have to change systems, and you do not want to change systems.
If you have any excuse, you do not do it. So we really have to be there for them in all different ways for them to actually move forward. And that takes some time. But having said that, our sales were higher than any time before, so I think what we do are translating into higher sales. It's just not implemented yet. And for many of our products, it, from sales, implementation is quite long. That goes for all our bigger system. Webdoc is a bit different, where it's typically faster in implementation, but also there, it takes time for customers to feel that it's different, that they hear from our present customers, that it's working really well now, and that they have the time to hear and listen about what we are doing differently and the new functionality coming out.
But I'm confident that we are improving in a really good way and that we will see customers adding more quickly.
Next question. CapEx increased by almost NOK 5 million since Q3. Is this, is the level you are at now, the level we should count on per quarter going forward? Yes, the increase was basically related to holiday effects, as we talked about, as both CapEx and personnel costs are lower in Q3 due to the summer months. But the level we see in Q4 is, on the cost side, is basically where we are at now at the run rate. And then we, of course, do a lot of work on optimizing this cost base, both on the OpEx side, the COGS, and the personnel, which Daniel mentioned. But I would say this is sort of a run rate rate level we are at, at the moment. Same, next question from Adam.
Your net working capital has contributed negatively for the year as a whole. Are there any reason for this for the year? As a SaaS company, you should be able to leverage to operate with negative working capital. What measures are you taking to reduce your net working capital position? In general, we have a very attractive net working capital profile, where our customers generally pay either three months or one year in advance for basically all our products, and we pay our vendors after the work is done. So in the long term, our net working capital will be a very positive contributor to our cash flow. This year, it was negatively impacted by some large transaction costs in Q4 last year.
That was on the balance sheet as a year-end that we paid in Q1. But in general, we work closely on the working capital as well, and the profile is attractive in the long term. Then next question. One of your shareholders released a letter stating that they oppose proposed acquisition of around NOK 250 million in Germany. Is this the acquisition size shareholders should expect?
No, I don't think so. We do not know what acquisition we'll do, which one we'll do, if any. We will only do it if it's attractive. I think that's the upper end of a potential acquisition, but they do not have any more knowledge than you do.
Next one is, Germany is conservative around cloud solutions. What risks do you see of entering this market too early?
So I think it's very similar to when Webdoc started back in 2010. I wasn't part of Carasent or Webdoc back then, but I know what I've heard from the ones who worked within Carasent who were there then. There were a lot of discussions with doctors, nurses, managers at healthcare providers that, is the cloud really safe? Can we really trust the cloud? And so on. It's possible that Germany is back where Sweden was in 2010. I think they shouldn't be really that far behind because, I mean, a lot of all the other solutions they use, like we use, are cloud-based. I don't think they should be really that, but we have to expect a lot of those questions.
But having said this, I think that, I think that all of us are really happy that they pushed ahead with Webdoc back in 2010, and I think the same with Webdoc X now for Germany. But Germany is a much larger market, and we, we do not need to win like 10% of the market. We just need to, in the beginning, win the few really early adopters in the German market. So even if 95% of all German docs really do not want to go to cloud, 5% is more than enough for us. So, that's where we have to do a lot of work and to find them. But I also think that's why we want to do an acquisition to transfer existing customers. We have really good experience from that.
You have to do it in a sensible manner, but then you have customers that you can point at and can tell everyone about the solutions you have.
Next question from Eric. I noticed that Aeternum has been the largest seller in the open market after the EGM, pushing down the share price. How do you view this overhang in the share, given that they are your largest owner?
So, I also noticed that Aeternum pushed a lot of shares in the open market. I believe that that ended when they lost control of their shares a couple of days ago, and that the new management is not selling shares. So I think that's over. But I would say that long term, our share price is only dependent on how successful we are. We have been performing too poorly, but I feel, and I see that we are improving quite rapidly, and that is what will be reflected long term in the share price.
Then we have some questions from Amelia at DNB. First one, your guidance of more than 15% organic growth is for 2024-2026 on average. What do you expect for 2024? So we didn't give any guidance, like, per year when we stated it, but we are working, of course, on improving growth, but we are at a lower level than our targets in Q4, and that's where we are at the moment. But we are starting to see gradual improvements in that as well. Then what is the status on HPI, and what do you expect here going forward?
So HPI, we have lowered cost at HPI, and they are now at breakeven. They are growing quite rapidly, not as rapidly as we believe when we acquired them. But the new products within HPI are growing exponentially, and that's what new products typically do. And we expect that, or we hope and expect that that will continue, and if it doesn't, then we'll have to take further actions. It has every potential to be a very profitable growing business. We have the largest customer there is Avonova, which is one of the three large operational healthcare providers in Sweden and the Nordics, and they really want to implement it.
So just, I think two or three weeks ago, the HPI team were at their, internal conference, where all doctors and nurses were there, and HPI was given one hour to, explain to everyone how to use our new products. So Avonova management is really pushing for this product. They want it, they want to see that it can improve their, both the value they add to their customers, but also their internal efficiency. Healthcare is a very conservative business, for sure. So it takes some time to get new products out there, especially if it requires a little bit different, work patterns than you used to do. And in general, I think that everything we do within Carasent should support present processes of all our customers.
It should allow for future processes to be more efficient, but you also need to support present processes. That is a challenge with HPI's new structure or new products, but we see that our customers really want to overcome that challenge and want to implement it, and we see that the growth is exponential in those products. And if that continues, it's, you know, it's from a low basis, but a couple of months going forward, it would look really good if that trend continues.
What would you say is the churn risk going forward, given Ad Opus? What is the worst case?
So it's a bit difficult to say exactly. It depends on also your timeline. In general, you're really slow to changing systems. What the majority of the churn when it comes to Ad Opus is that a lot of providers in that market has joined forces and decided to use another system, basically a normal CRM system. And they formed this union, some of those from that union were our customers, some were customers of our competitors. And we do not believe that union will grow much further because they have one location at each part of Norway, roughly, and they don't want to compete with each other. So we do not expect any quick churn going forward, more than the ones who have already resigned.
We also believe strongly that the system they use is not what you can use. There's the same regulation in Norway as in Sweden, and it's the same for these type of customers as it is for healthcare providers. And we can also see that NAV, which is the one procuring services from our customers, they themselves use a CRM system internally, and you can check in with the newspapers. If you look at NAV and GDPR fines, you will see that they got the largest fine any public public, what's the word?
Entity.
Entity has ever gotten in Norway because they use the wrong type of system, and we believe it's the same for this, the system that some of our customers have migrated to. So best case, they're coming back. Second best is that Ad Opus Web starts winning a lot of other customers. Worst case is probably a little bit continued churn, and that if Ad Opus Web doesn't really take hold at all, and then we have to look for other costs.
It's worth noting also that the churn that we will see from Q1 in Ad Opus is around 1% for the group, and we are seeing no signs of change on all the other products, which are lying around between 1%-2% churn, basically all involuntary. In general, it's very stable and sticky, our revenue streams, and will continue to be going forward. Final question from Emilia, status on Webdoc X, any new customers?
So, Mind is now a paying customer, so that's, that's a good milestone to have the first paying customers. We are in discussion with some other customers, potential customers, who are also pure private players. So presently, we can only sell to providers who are not part of the public system or insurance system at all, and also it does not require too much functionality. So that's a very, very limited base. And also, we do not want to focus on selling to these type of customers because we want to focus on developing the product for those customers we aim to have, not for the one we can get at the moment. And if we try to get too many customers of the wrong kind now, that will steer our development in the wrong way.
So our aim is really to get the system certified in Germany so that an insurance, I mean, Germany is an insurance-based system, and we need to get into that system. And that's the aim of the development, is to get that. And our aim when it comes to users is to get pilots that are that type of users, because those are the customers we want to have long term and where the big potential is.
Great. That was the final question, if you want to wrap up, Daniel.
Yeah, then I would really just like to thank you all for listening today. Just, you know, contact us if you have any questions or comments, and I look forward to seeing you all in the future. Thank you.
Thank you.