Hello everyone, and welcome to Carasent's presentation of the report of the fourth quarter. My name is Dennis Höjer, and I'm the CEO for Carasent. With me today I have Svein Martin, our CFO, who will go over some figures in this report. As a summary of the fourth quarter, we had a great revenue growth of 97% and an organic growth of 90% for the group and 26% for Evimeria and Avans Soma, which we were in line with our last guidance for 2021.
During the fourth quarter we have also made our Webdoc platform ready and prepared for a Norwegian launch for the smaller pay-out-of-pocket customers, which we're looking forward to taking some markets in Norway. We have also decided to ramping up investments in our Webdoc X project, which I will go over some later in the presentation. We made another acquisition of the Swedish company Medrave, which we signed in December and closed early January this year. You can go to the next slide. We are still showing a good track record of our growing plan with 73% revenue growth, of which 30% organically.
We still show a great pace of our net retention rate, and this is figures from the Evimeria business. The overall market trends remain intact. In fact, even though we have been suffering some from the COVID effects due to later harder dialogues with the larger customers and also been affected by a large pipeline of unimplemented customers due to COVID. We see that the pandemic has been an accelerator for the demand of digital tools within the market. We think that we are in a great position to meet this demand in Q4. Long term we think that the pandemic will be a good thing for Carasent.
We are continuously working towards the strategic direction where we want to become one Carasent and one platform. The rationale behind this is of course that it will significantly lower our maintenance costs since one platform is easier to maintain than many. Also it gives us a better place to scale from when we're growing and we are addressing more market segments. A few words about our Webdoc X initiative. We are going to ramp up the investments, as I said, for Webdoc X, which is our new offering to meet the demand in the European markets, where U.K. is the first target market for us.
We have during the year of 2021 had a collaboration with the Swedish caregiver Mindler, and it's processing according to plan, and it also gives us possibility to get our offer accepted in the needs and the demands of the markets. We plan to launch the product commercially in 2023. A few words about the acquisition of Medrave. Medrave is, as I said, a Swedish company which provide healthcare software for clinical performance analysis to primary care and the secondary outpatient care market in Sweden and Norway. Medrave basically have the whole primary care market within Sweden, which gives us great potential in cross-selling since that's a targeted segment for our platform Webdoc.
Also it strengthen our offer when we are entering the Norwegian market since it's a demand for those kind of solutions there as well. So we're looking forward to work closely with the Medrave within the Carasent Group, going forward. You can go to the next slide. Our path to growth, just summarized overview, we are still doing initiatives to be able to grow organically like we have, going forward. We see great potential in growing through M&As like we have done for the last 12 months. We want to harvest synergies between the companies, and we are building structures and organization enable to do this so that we will be able to boost our growth even more within the group.
You can go to the next slide. I say thank you, and I hand over to you, Sven Martin, for some figures.
Thank you, Dennis. Having an overall look at the Q4, the strong revenue growth continued in this quarter as well. We delivered quarterly revenues of NOK 40 million compared to NOK 20 million the same quarter last year, which corresponds to a revenue growth of 97%. We also delivered quarter-on-quarter growth of 8.5% compared to Q3, which was driven by a combination of acquisitions and organic growth. EBITDA margins was slightly down in Q4. This was mainly because of the dilutive impact of the acquisitions of Metodika and Avans Soma, which currently has a lower operating margin than Evimeria. The headquarters also increased the cost somewhat within the quarter, while Evimeria continues to demonstrate scalable margins. The group grew organically by 19% in Q4.
In 2021, we have delivered an organic growth of 30%, which is in line with the updated guidance provided in Q3. The organic growth is driven by a combination of our existing business and winning new customers. Firstly, the growth on existing business continues as there is a strong underlying growth in the market, and our ecosystem of product and services continues to expand both through third-party services and through our own developed offering. This combined with price increases, low churn and underlying patient growth for our customers is driving our net retention rates, which ended at 214% within the quarter.
Also, we had a very strong growth in terms of new sales, where we signed 35 new clinics, units in the period. For the year, we have grown our customer base organically by 25%. If we include the effects of the acquisitions completed, the number of units has increased by 71%. The performance in the beginning of 2021, we provided a guidance of 35% growth and 40% EBITDA margins for Evimeria and Avans Soma, the business units. In Q3, we revised the guidance on revenues due to delayed implementation of new customers that had been signed but not onboarded yet, given that the customers prioritized pandemic-related activities.
That caused us to revise the guidance to 30%-35% revenue growth, and the performance ended in line with this updated guidance with revenue growth at 30% and EBITDA margins at 39%, 39.5%. The margins for the group was slightly down in Q4 as mentioned, mainly because of the impact of the recent acquisitions, which currently has a lower operating margin, due to the business model and product characteristics with the on-prem solutions. Our plan is to shift these customers from on-prem solutions to the web-based and scalable Webdoc platform, which will also impact margins positively. With that, I'll leave the word back to you, Dennis.
Thank you, so Martin. Going forward, you can go to the next slide. As I mentioned a little bit before, the organic growth has been impacted by the pandemic the last years, but the long-term prospect remain intact. As I said, in fact, we believe that the pandemic will be a long-term good positive effect for Carasent. For 2022, we aim to achieve NOK 200 million or above, excluding potential from additional M&A. The group EBITDA will be in line with the ones we had in 2021. We will continue to execute on our growth plan, where we want to expand in the dimension where we want to expand our product portfolio.
We want to expand our products to address new segments and also the geographical dimension. We will continue to do this organically and also throughout M&As. We see great potential in continuing this growth plan in Q4 and looking forward to a great 2022. With that, I say thank you, and we open up for some Q&A.
Yes. There is no questions posted yet in the platform, so we can give it a few seconds, but please post questions if you have any. There is a slight delay, so we'll wait half a minute to see if any questions pop up. Yes. We have one question from Mark at Redeye. Could you expand a little on the cross selling potential for Medrave, Evimeria? How will you approach the primary care providers in Sweden? Given that Medrave has been a part of Evimeria's ecosystem for quite some time, how is the adoption rate among specialists? If it's relatively low, how come? Maybe Dennis, you want to take that.
Yes, I can do. First of all, we have had an integration to the Medrave software for a couple of years, although it hasn't been included in our revenue stream, in our ecosystem. What we see in front of us is, of course, together with Medrave, approaching the primary care customers that they have, together with our Webdoc offer, to be able to present the Webdoc offer. It's a way into this segment, a warm way for us into this segment, showing our offer.
Great. Next question. On your career page, one can see many new job openings connected to Webdoc X. Could you talk about the project with Mindler and its progress? How are you getting paid? Is it a revenue share agreement per user? In general, what is your medium- to long-term plan with the Webdoc X? How do you envision to launch in 2023?
I can elaborate a little bit about that. As Mindler is a digital caregiver which provides patients with psychological services. The platform that we aim to build together with Mindler is due to that based upon the needs for paramedical care, which is the category of psychologists for us. We have been developing the system together with them for a couple of months during 2021, and it's working accordingly. They have also tried out the functionality, which they are very happy about and pleased about. In order to address the wider market and also psychologists, we have some more things to do in order to do it properly.
There are some local integrations in the U.K. market as well, for us to adapt to in order to address the broader markets. That's where we are right now. The Mindler agreement is that they provide us with the information and the need on a free basis, and they get to use the system on a free basis as well when we launch it together with them for a period of time. We haven't yet decided what kind of pricing model we are going to use for the system, but it's probably going to be per user since the targeted market that we want to address with the product, they mainly are smaller offices where there only are one to two doctors.
It's also to compare our offer to other vendors in the markets.
Yes. Great. Next question, Dennis. How many sales people have you recruited in the last few months? Are they going to be both in Sweden and Norway, or focus on one geography at the time? How come you see opportunities to increase your focus on outbound sales and marketing going forward now? Is it more than just the M&A and broadened product portfolio?
Let's see if I can try to remember to answer all the questions. If we start to look at the amount of sales personnel that we have been recruiting for the last month, we have been increasing our sales force within Sweden with approximately 30% the last quarter, which is three resources. We are continuously developing our sales team to work more outboundly, which have been showing effects. We are going to intensify that approach during the year. In regards to the question if the sales personnel is going to sell in both geographies, the answer to that is no.
We're going to have one sales force in Sweden and one sales force in the Norwegian markets. We have done some key recruitment in the fourth quarter in the Norwegian organization where we are going to start to intensify the recruitment within the Norwegian market in order to increase our pipeline of customers and also to approach them.
Great. How many of Metodika Swedish customers have converted to Webdoc? Do you see Metodika returning to growth in 2022, or will the transformation affect it short-term?
We do not see that the transformation will affect us negatively within the group in the short term. Probably it will affect us in a good way, but you won't see any great effects of this during 2022. We will be able to achieve some migrating during the year, but it won't have any large effects on the P&L. What we see is that when the customer is onboarded to the Webdoc platform, we also are able to provide the customers with the ecosystem integrated to Webdoc, which they don't have the possibility to within the Metodika platform.
Great. We have a question from Emilia Enginatti in B. All clinics on Avans Soma onboarded, or will this continue to impact 2022 revenue growth? I can take that one. The large contract that we signed in early 2021 had a planned onboarding throughout the year and that will also continue into 2022 as a large project where several of the units will be onboarded. The run rate of this will also impact the growth in 2022. One final question from Matthias Silva. Can you give some reasoning behind the declining revenue per clinic year-on-year for Evimeria, decline for Webdoc, and growth slowdown for integrated services? I can start on this one.
The decline in revenue per clinic is mainly driven by the new clinics that we have signed and onboarded a bit smaller than the existing clinic base. That also has to do with what we mentioned about the delayed implementation that several of the larger customers and clinics have been delayed during the year. The clinics that we onboard typically show an increase in revenues from the first year to the second year, which is also driving the net retention rates. Another question there. The ratio of license and integrated services was 1 to 1 in Q4 for Webdoc customers. How satisfied are you with this, and what is required for you to double the ratio over the next five years?
Maybe you can start, Dennis.
Yeah. Of course, we want to see this ratio grow. We are not that satisfied with this, although due to the circumstances, we are satisfied with it. What we do require in order to double it the next five years, it's through establishing new partnerships and also continue to develop new add-on services. We also see that we are able to do this through M&As, where we want to. Historically, we have been mostly doing acquisitions of vendors that provide the EHR platform. Medrave is the first one to provide us with a new add-on service within the group.
We see great potential in strengthening our whole digital offer, which including add-on services, which will also gives us possibility to increase this ratio in Q4.
Great. That was the last question. Thanks all for dialing in.
Thank you all, and have a great day. Bye-bye.
Okay. Bye-bye.