Welcome everyone to the Sectra Capital Markets Day. My name is Max Rosén. I am the moderator today, previously a CFO of the company. Luckily, we have the present CFO here as well, and some other colleagues. We will get back to the presentations. But initially, since this is a sort of a pre-session, I, without further ado, leave the word to our group CEO, Torbjörn Kronander, to give the background.
All right. Thank you. My name is Torbjörn Kronander. We decided to do it like this because many of you have heard the old story many times, and then we said we will not repeat everything every time. W e did a pre-session on a little history on the basic culture, and then we will go into today's session, look forward, starting at 1:00 PM. I have an incredible amount of slides, so I will be quite fast. There will be Q&A sessions during the sessions later on. So I will give you a little introduction. Sectra was founded by a professor and three of his PhD students to solve encryption. Sectra stands for Secure Transmission. That was 1978, ways before I came into the company.
In 1983, it was decided by that group and one more person, Jan-Olof Brüer, who was also PhD student for the same professor, to try to make it a real company. In 1984, I started as a PhD student at the same professor, and that is how I came in. But the vision was from the beginning from these people to make it a product company one day, use consultancy finance, not have external capital, but finance internally.
I did some extra work for them, so I worked by the hour, I think 50 SEK an hour, because I understood the math behind encryption and coding theory, and that math is a little difficult, and if you want to write programs, customers got the consultancy reports, they did not understand how to write the programs when a plus and a times is something completely different with modular some large polynomial or something.
In 1989, I made my PhD, and they wanted me to come over. I did not want that. I wanted to work in medical technology. All my family are medical doctors, and I came to Linköping to study medical technology because medicine is too much for heart, and I love computers. But then I did my PhD in something completely different, signal processing mainly, but I want to go back there to medical. Then we started medical at Sectra, and that was a teleradiology project, moving images instead of a 24/7 taxi that drove film between Lindesberg and Örebro from the beginning. In 1993, we got our first PACS, and PACS is actually also archiving. It gives you all radiology images in a computer. That was in Mjölby, and a very enthusiastic medical doctor who thought this was fun.
Now, when he had film, he came home to his family at 4:00 P.M. With the digital, he came home at 7:00 P.M., but he was happy. That started it. Then we got Visby, and we got Örebro, which is a big system of many hospitals, three hospitals, Tønsberg, Norway, and from there we have grown in the medicine field. In 1997, we teamed up with Philips. Actually, they found us. They needed a PACS partner, and they thought we were good because we had built it on general available technology instead of special systems. We got the first U.S. project together with Philips of Riverside, California. In 2000, we want to do something. We didn't really trust Philips. So we want to do something else that didn't hurt it.
I met a guy from KTH in Stockholm, Mats Danielsson, and we heard a fantastic detector of X-rays, photon counter. We started a project around that, microdose mammography. We built absolutely the best mammography system in the world, but it took a little time. We also met Epic. That became a good partner going forward. It's the largest medical record system in the world, 2004.
That started with Philips telling me, because we were told that Philips worked with both us and Epic, but they said to me, because I said, "We have to meet them if you work with them as well. These systems need to work together to create an efficient hospital." Philips said, "You're not allowed to meet them." Then I said, I called Judy Faulkner, actually, who's the CEO and owner of all of Epic, and I said, "Philips doesn't want us to meet. Why don't we meet to find out why?"
She laughed, and we've been friends since then. Very good, I think, for both, but of course, very much for us. In 2005, Philips acquires competitor after five more less RIS/PACS . That was a big blow. 60% of turnover with Philips. They had a business plan. They were to get up for nothing in the fall. Our both turnover and our stock fell like a rock for a while there. In 2011, we bit the bullet, and we continued. In 2011, we sold mammography back to Philips in this time because they didn't have a mammography system. As soon as we got our FDA approval, hardware and software are very difficult to combine. The hardware companies are not very good at software, and software companies are not very good in computers.
It's very difficult to send an X-ray tube as an attachment to an email. People call us, and our service people say, "Oh, what should I do about this green algae growing in the system?" Yeah, well, you cannot fix software. So we sold that to Philips, and then we concentrated completely on software instead, which we know better than hardware. But when I met Judy Faulkner at Epic, she said, "If you want to be big in the U.S., you need to fight with customer satisfaction." She has done that. She wins a lot the Best in KLAS every year. KLAS is an organization in Salt Lake City, Utah, that awards or they do customer surveys of quality in software. I bought two big bottles of champagne this size. I put one in Linköping, still there, but empty, which is good.
And one in Shelton, Connecticut, our office in the U.S., said, "We will open this when we're number one in KLAS." It took a few years, but 2011, I think it was, under the guidance of Marie, did a great job there. We won the happiest customers in the U.S., and that was an extremely important thing. First year they said, "Sectra?" That's a true conversation against Bond. How can they win Best in KLAS and the gold in India ? But second year and third year, we won it 12 years in a row. Now we're recognized as a very good and viable partner for hospitals in the U.S. A very important thing. Today we're the fastest-growing PACS vendor. PACS is actually taking care, picture archiving and communication system. We're the fastest-growing in the world.
I think we later talk about that we are primarily the fastest-growing in the U.S. Our philosophy with shareholders from the beginning has been that if you start with a rational strategy in a growing market, you don't want to own gas stations right now because people are getting electrical cars, right? Owning a gas station, the only thing remaining to fight with is price, and that's a tough market to be in. You can succeed here, but it's a tough market. It's much easier to grow in a growing market. So you select markets that are rational and growing. Then if you have happy customers, and in order to have happy customers, you must have happy employees. There's no way you can have happy customers without happy employees. People think like that, think you can, you can't. That's expensive when you're worth it.
If you have a high value to provide customers, you need to get paid for it. Have reasonably cost control and some stubbornness, then shareholders will be happy. That is very important, but it comes in this order. We'll be fine if we have to take down the results for a quarter in order to keep customers happy, because that's the best for shareholders long term, and that's the basic rationale how we work. I will not go into the cybersecurity market here, but we're looking into medical with RIS . This is the population pyramid of Germany. There are way too few people that are young, and of course, this will work. You see, they're still working people between 65 and 65 in Germany. But when they get old, they get dependent. There will be very few people take care of these people.
Germany is kind of the locomotive of European economy. It will be tough when the demographics look like that. Japan, the other after Second World War economy in the growth tiger, even worse. In the fall last year, I was in Tokyo on a trip organized by SEB. There was a professor of national economy that spoke about 40 minutes, and he said, "While I speak here, Japan will become 500 people less." These are not small problems. In my eyes, European Union should look at nothing else. This will be big problem. Yours is a little bit better. Huge demographic or ethnicity change or culture change, I would say, because the people have a lot of children in the U.S., it's not the people who make the most money or most well educated, but they have a better structure.
Now we see if the administration answers all of these out, it will become more like it looks in the Western world. This is a site on the internet, U.S. Bureau of Census. I found this. This is not really important for this one, but you can see a very interesting observation. Just share it with you because it is interesting. This is Russia. If it looks like that, you are in deep trouble. Look at anyone below, there is no kids. Very interesting on the big stage, not for this session, but I thought I would share it with you because it was interesting. Add that we live longer to this demographic situation, and you have a rising trend of healthcare cost. This is a prediction.
I did not find many curves on the net, but as you can see, there is a prediction with 19.3%, this is U.S., 19.3% of GDP would be spent for healthcare. 1/6 in healthcare. That did not materialize. I looked up the real figures yesterday. The cost per capita is what it was predicted. The percentage is a little less today, but still 17.6% on payroll. Sweden is about half of this. Most European countries are about half of this. But it shows a trend, and the derivative in all countries are the same. This won't last. This won't work. If you split this down into age bracket instead and say, what is the cost per capita per age bracket? You see that for children, for small children, and anyone up to at 50, Germany spends more money in healthcare than the U.S. does.
But after the age of about 60, every country explodes. It boom. It is interesting, the yellow curve there, above 80, we in Sweden tend not to tend much for people obviously, because after 80 the curve is flattened in Sweden, but that is the only country I know of where this is not monopolistic growth. Anyways, this shows where you have to do. If you want to do something, because healthcare won't work in this environment. You need people building cars and producing food as well. A friend of mine who is the development manager in Countervast in Sweden, had calculated that if we are going to keep a relationship between a working person and a patient in numbers, so one working person healthcare takes care of so many patients.
If we want to keep that relationship, I think 2035 or 2040, not that far away, every kid that leaves high school in Sweden needs to go to healthcare, every single one. That won't work. So something needs to happen. If you are going to address this situation in the market, you have to concentrate on the ages of the elderly, because that is where the cost will be. These are neurodegenerative disease, Alzheimer, MS, Parkinson's. It is cardiovascular disease, it is cancer disease, musculoskeletal disease, which is grossly undervalued because it is very expensive, and vision and hearing. If we can sort these diseases out, we will save society from not being able to cope with healthcare in the future. That is where we are concentrating in our efforts. We do imaging for everyone, but we will be very good in these areas.
This leads to a business area in medical, which is increased effectiveness of healthcare while maintaining or keeping quality. We very often increase quality as well while we do things, but the main thing we can sell today is efficiency increase. It is very interesting, before the pandemic, we did not see this so much in the U.S. In Sweden, it has been the case since the 1990s, but in U.S. we did not see it. Now, almost every customer we talk to in the U.S. is very concerned about efficiency, workflow, and stuff like that because they have the same situation. It is a little later, but it basically, it is the same situation. So we are well-positioned as a market, healthcare IT and cybersecurity, which we are not speaking. We will have another capital market day for cybersecurity somewhere in the fall because it is completely different subject.
Both of these are growing markets where a recession will not affect the growth because people get sick in either direction. So if the society booms or busts, healthcare and cybersecurity needs to grow. So we are in a good place market-wise. So that was the first condition on this story. Next checkbox was happy customers. After the first win 12 years ago in Best in KLAS, most happy customers of all vendors selling into large hospitals in the U.S. We have continued to win that. We have won the large hospitals in the U.S. for 12 years in a row. Last year, we just came back from being awarded in Las Vegas. We won eight of them. So both large and small hospitals in the U.S., Canada.
We won in pathology, which was a new category, only recognized in Europe, and in Middle East, and with Canada and Northern and Southern Europe. So we have the happiest customers in all these sectors. We are second in a few more. This is what long-term drives our growth. KLAS Research also does executive deep dives, and the reports they sell to hospitals and to analysts and stuff, and you can buy them. We also buy them. I will show you one slide. The new one is not out yet, but this is from last year. Actually, our major competitors in the U.S., this is the U.S. market only. This makes me proud and happy. 98% of our customers would buy again from us. We are so high above all competition that we are the only one above the average. All else is below the average.
Only question, would you buy the same system again? This is what drives our stock value, and also our joy of working, because it is not only about money, you need to have fun as well. This makes me very happy, very proud, and we will talk a little more about when Isaac talks about it later. This is one year old. There is a new one out. I am not allowed to show it yet, but it is not worse. It is better. This is a lot of customers in the U.S. Checkbox three, happy customers, is only possible with happy and motivated employees. We are very careful about employing and recruiting. My saying is, if we get the wrong people on the bus or in the company, I can be the best manager on the planet. It will not work anyways.
If we get the right people on the bus into the company, I can be the worst manager on the planet. It will work out anyways, because they will not care if what I say is something stupid, and they will do something good. That is how we recruit. We are very careful. To some frustrations, sometimes with our middle managers and managers, because it is a slow process where I still meet every single one, and I say no to about one out of 5, and it is very embarrassing when I say no, so it increases the bar for everyone coming in. It begins there. It begins with, and we hire for attitude and ability. They need to be smart, and they need to be a good person.
My theory is that if I like them all, they will like each other, and that will be fine, and customers will like them. Then if they know everything when they come on board, if they are smart, they will learn fast. We all live in an area we have to relearn everything about every 50 year anyways. Then we work a lot with culture. Culture eats strategy for breakfast. I think it was Marie who gave me that slide first. I still do not remember who said it, but it is a quote, it is not we who invented it. But we work a lot with culture. In a very fast pace, you cannot have rules for everything. You cannot have a manual that thick how you should behave in a certain situation. People have to know by heart how the company operates, otherwise it will not happen.
The biggest frustration if you have a customer is a frustration. I agree. It does not work. I have to call, and you come back one later with a reply. We demand the only action not allowed of our employees when a customer is in trouble is no action. They have to do something. That means sometimes they do mistakes, that is fine, they did something. They have to explain the rationale, of course, but they better do something than sometimes say they are not doing anything. I think we have got that operational. A good company culture is quite simple. We also teach people that if you just remember this rule, do unto others as you want them to do unto you, we will be fine. People forget the oldest rule of humanity, finding all religions.
I am an IT manager that is saying, remember what has been said in humanity for 10,000 years, and we will be fine. Some companies forget. So philosophy shareholders start with a rational strategy in a growing market. Then if you have happy customers, happy employees, dare to be expensive when you are worth it, reasonably cost controlled, shareholders will be happy. This is the financial trend, Sectra since 1978, when it was founded, up until now, the curves are okay. That concludes my introduction of the history and a little about the culture of the company. Anything about that? Questions? We will make a little break here, and you can ask there, and we will have a Q&A session later on.
Sectra, my name is Max Ros én, and this is our Group CEO, Torbjörn Kronander, who was previously the Chief Financial Officer, and we have the present one here as well today. This is the agenda for those of you who might not have picked up the agenda out in the coffee room. We have a full-packed day, which means we have to have a tight schedule. This is for the medical IT section only, quote unquote, "only" in Sectra, not the cybersecurity part of things. With that, I will introduce the speakers. If no one knows, this is our group CEO, Torbjörn Kronander. We have Marie, President of the Imaging IT section, and Fredrik Häll, who will also hold a presentation within short. Fredrik Gustavsson, CTO of the company, also presenting today. Isaac Zaworski, Head of our U.S. Operations, our North American Operations.
We also have additional colleagues present, and please stand up so we can all see you in carne, in life. Several of these colleagues will also have moderation presentations later on out in the coffee room. That is about that. Now, safety instructions, regulatory information. If we have to exit the building for fire or any other urgent reasons, follow the green signs. The first one is there. That one now I feel like a flight attendant, but go back where you came from in the coffee room and do not use the elevators. Fire extinguishers, we have the first one behind there and the other one in the fika room. The defibrillator, or hjärtstartare in Swedish, is on the ground floor and at the third floor. That is pretty much it.
If you are not comfortable being on a photograph, because we will take some pictures, I urge you to contact Helena, Investor Relations Officer, in the coffee break, and we will sort that out. You should not have any concerns about that. Also, we will have Q&A sessions, so please have a bit of patience if you have questions during the presentations. We do the presentations, and then we can have the questions at the assigned time for the Q&As. That is about it, and other practical details, I do not have any. Restrooms are behind the closet outside the coffee room, if no one has been able to find that. That is what I can say about that. With that, I leave the word to Torbjörn again. Thank you.
This will be a lot of slides again, so high speed. There will be a Q&A session afterwards if you have questions. A little about myself. I am the Founder of medical side of Sectra, as I said. I am CEO President since 2012, but I have been running the medical side since we started up 1990. I have been with Swedish Navy for 3.5 years as a service officer. I grew up in Gotland.
I am a PhD in MBA, sailor, most things that float. Pilot for most things that fly, I still fly helicopters quite a lot. Also the largest shareholder. As for market data of the image business, our main business, that is 85% of what we do in the whole company and 90%+ of what we do in medical. Marie will discuss that, so I will not discuss the marketing details in growth here. I will not do many financial figures either.
I will just go through what we are in finance after the quarter three , and again, explain our economical targets. We are a trust business. The CIO of Stanford University, Michael Pfeffer, told me that he has about 1,085, I think he said, IT systems in one hospital. They ranked them all for importance for the hospital, and the PACS that we deliver came out top. It is the single most important system they have for running business. The EMR, of course, is more important on a general long-term business, which is a full system in Swedish. But if our system stops, the acute intake stops and the hospital comes to grinding halt. EMR cannot take air force very often. You do not buy that from a company you do not trust, and that is also the case in cybersecurity.
You do not buy systems that keep the most important secret in the nation secret from someone you do not trust. Trust can mean a price premium as well. We also need to be trustworthy financially. We cannot borrow a lot of money. They need to feel that we would be there in the future with them as well. They cannot buy otherwise. Stability is important. Equity assets ratio should be above 30%. It is a hygiene factor, it is currently at 47% after Q3. Profitability, that has been a dispute with some of you over many years. I maintain that 15% is enough. That is a hygiene factor. It is not what we make our money on. That is important. I can double margin all of a sudden. We probably can, for a short while. That will ease our future growth.
If we had double our margin and increase our margin a lot 15 years back, some people suggested we would, we would not be where we are today. It is another hygiene factor to have a reasonable margin to prevent you from doing stupid things. But the main target when the first two are fulfilled is growth of EBIT per share, and we choose per share by intent because sometimes I would not do it, I am a large shareholder, but successors of me might be tempted, and it is quite common that companies buy each other for the ego or the management more than the use of the shareholders. Then you buy with your own shares, it is not even visible, and you do stupid things for the shareholders, but the ego or the management grows.
You cannot do that if you have a target of EBIT per share, because then what you buy has to be at least as good as yourself. That is why we have that one. That is our main target. That should be about 50% compounded over five years. It is currently 121%, so we are well above that. If we ever are going to change any measures or targets et cetera, we do not do that very often. It would be the third one we change. The main business lines of Sectra is Imaging IT Solutions, that Marie is heading, and Secure Communications, which we will not discuss here. We will have another capital markets for that in the fall, headed by Magnus Öberg. Actually, the cybersecurity now is our by far fastest- growing area.
It grows a lot, not the least because security situation in the world is a little concerning, but also because we have a very good management there and we have maturity in our product that we developed for many years. We will not discuss that further here. I will discuss a lot on this session about non-financial things, and that is mainly what we do besides Imaging IT, which is the main business. What do we have as growth opportunities? What will become the big things going forward long term? We have a few of those organized in a unicorn business innovation. Medical education, headed by Johan. There is Johan. If you want to know more about education, you can ask Johan. He will also be in Denmark here. Orthopaedics, headed by Gustaf Schwang, sitting there. Genomics, Fredrik Lysholm, sitting there. Our newest area.
We have research, and Claes Lundström is Research Manager, he is not here today. Mainly doing research in AI for medicine. Then we have a lot of growth opportunities that we do not discuss very often, but I will mention here inside Imaging IT, and that is pathology, for instance. Elin Kindberg is not here. She is managing that. That is microscopy, which is another type of images. I will come back to that. Cardiology, Björn is here. Hello. Björn Limber, heading cardiology, another type of images. We have AI platform headed by Nynke Breimer , and she is actually in the U.S., so she is not here either, which is our app store for AI applications. I will come back to that. We did a strong performance in all operating areas and in all markets, which is nice.
We are rapidly transitioning to SaaS as a service model, and you will hear a lot about that today because that has been going on for seven years. It will go on for one or two more years as well. That is a tough thing to change because you lose all that nice front-end income, and you spread it out. After a few years, it is better, but during the transition, it looks not at all as good as it would have looked if you continued in the old way. We are growing a lot. We had a very large order intake, especially in Imaging IT implementations. We do have high customer satisfaction, as I discussed before, the past year.
This is an interesting, if you get paid per exam, which we do, you get paid for every exam passing through, the number of exams needs to go up if you are going to grow. This is the number of exams, and this actually tells more than the financial figures now because the change of business model kind of put that initial thing and flatten it out there sort. This is actually what is going to pay it, and you see there is no flattening out there. We are growing a lot. In the world, it is typically so, a little more than a year. In a year, they do about two radiology procedures per capita per year. In Sweden, it is a little about one. Most countries, it is about one. So each person in the country generates about one radiology exam per year. This is radiology only.
That means that we are act as a primary radiology system for somewhere between 110 and 150 million people, which is quite a lot of people. If they go to a radiology exam, we take care of the images. An interesting fact, we do about 4.8 exams per second. So 4.8 final exams done by radiology saying, good or bad, what disease, each second, day round, year round. This is per country or per sales group. You see that there is not a coincidence that Isaac is here from the U.S.. U.S. is by far our largest market. About half of volume today is in U.S. and Canada. Then we have the other countries of which U.K. is the biggest one. Partner sales is increasing a lot. Partner sales is interesting.
We sell through distributors in countries we do not prioritize highly, or we do not see we can afford to do it ourselves. Sometimes we buy our distributors after a few years. That was the case in Denmark. That was the case in Netherlands. Both of these distributors we acquired after a couple of years, and we are now doing very well in both of these. But we have distributors in the Middle East, in a lot of countries around the world. That is quite interesting business because that is still an income-per-license sale in the beginning. We will transition to a service as well, but it is not there yet. Growth comes from three factors, adding new customers, of course, normal growth, new growth by selling more. But we also grow with our own install base because healthcare grows by itself.
People are getting sicker and sicker and older and older, so they grow 5%. So we also grow with our installed base. So our growth is double, both selling more, but also that our installed base is growing and doing more patients. As we get paid per exam, that is a thing, it increases our income. Then, of course, if you are selling as a service, you cannot lose customers. We have a very low churn, about 0.5%, which I jokingly say that is an average stay time for each customer, 200 years. So 200 years later, they will still be there. But that is of course is joking a little bit. But it is very low. That is important because if you lose customers, that software as a service model become a bad business model, but we do not. Example of growth outside of the main business.
I will not talk about Imaging IT, Marie will do that. But I will talk a little about the little seeds we have here and there that I spoke about, and just brief. All of these that I will now mention will not make it, may not make it, but some will. None of them are small. They are opportunities. We are like a greenhouse. We have good ideas that we will use that extra margin, about 15%, to invest in these future businesses. So far, we have done right. All have revenue, all have positive growth. Sorry about the spelling error. I did that yesterday and late. I will talk medical education. Medical knowledge, and that is interesting. In 1960, the doubling time of medical knowledge was estimated about 50 years.
If you came out of medical school and you knew a lot of things, 50 years later, you needed to know about double as much in order to practice medicine well. That's a lifetime. What you learn in medical school, it takes forever to learn all your life. Things are changing. In 1980, it was estimated to be seven years. The doubling of knowledge needed to practice medicine on some form doubled in seven years. In 2010, estimated 3.5 years. In 2075, 73 days. Today, so much research is done in medicine that in 73 days, two months, little more than two months, the medical knowledge needed to practice medicine doubles. That means your knowledge when you leave medical school is already obsolete. That creates a situation little like us engineers. You have to relearn. What I learned at university, people don't even know the name of it.
I say Swan-Ganz, and they look at me and say, "Well, that's a cat or something?" The medical professionals are coming into, like we in engineering have been for a long time. They have to learn anew. This creates both areas where you need to learn medicine from the beginning, but you also continued need to renew the knowledge. That has created an area, a market that's growing very much for tools. We have now in Imaging, under Johan, a portal, educational portal we can subscribe to. You can also have those large tables that we have shown historically. We can teach patients. We started with autopsies because it was difficult to find people who wanted to donate their grandmother to be cut up by students these days. Still do it, but not as many.
When you learn in universities, you cut up one patient or one person, a course, you learn how that course was, but you don't learn how the variants are. If you have it all digital in three-dimensional, and we'll show that here, you can see that you variant diseases much better for learning medicine from the beginning. We started there in the initial medical school. Now we have expanded into both teaching our customers in Imaging that, if you want to do the latest and the greatest in medicine, you now have a photon counting CT. How can you use those images? We have a portal that international. It's our first really cloud business we did, and definitely our most international business. These are medical schools or universities and clinics around the world that use the systems.
In fact, the only thing we have in China, for instance, and we're all over the world, South America. The interesting thing is that students do this. In Sweden, they don't say we're going to do an autopsy or anatomical lesson. They say, "We're going to do a Sectra lesson." Now, 10 year, 15 years from now, they will be decision makers. They will have seen Sectra in their entire basic training. That's a huge synergy there. The growth is good. This is only cloud business. This is the revenue per year, the growth, and this is the usage, and confident number of logins, and you see every of these curves is growth per year. In March here, you see that the growth is quite large. They pay per month or per usage as well.
Not super large today, but very interesting because this need of continuous education will continue and grow. There is also a lot of synergies with especially Imaging, I think. Orthopedics, we have a special angle. Remember the old people's diseases? We will kick them off here. Musculoskeletal disease. The challenge here is that 1.7 billion people have musculoskeletal conditions. I guarantee that some of you have a piece of metal somewhere, and some have a lot. My mother-in-law, she has replaced both hips and one shoulder. We have become a replacement people to some extent, right? It is a leading contributor to disability, and disability is expensive. 30.5 million orthopedic surgeries annually done all over the world. That is a lot. 30% to 40% of all medical imaging is used for muscle skeletal disease. It is the third largest healthcare cost on the planet. We do pre-operative planning.
What prosthesis, there is like 60 or 100,000 different prosthesis available. Which one should go into you when you need one? When my mother got the prosthesis, her leg ended up like half an inch shorter than the other leg, but she was happy anyways because she did not have pain anymore. Now, the people who get the new hip, they are going to run a marathon next year. So the demands on the having exactly the right prosthesis is going up, and we do planning for that. We do follow-up after. That is the growing, a very interesting area, because you do not want to replace the prosthesis if you can avoid it. It is very complex and for man, quite dangerous operation when you take out an old one and put in a new one.
We have special tools to detect if you do not do that, unless you really have to do that. The estimated growth per year is about 6% for orthopedics as a whole, and the usage in our environment is quite good. If you look at the last curve up there, 3D plans as a new. Before you did that planning and what prosthesis should I put into this patient, we did that in 2D, so it is a flat image.
Today, you increasingly do it in three dimensions, much better because it is a three-dimensional body, right? We have all these plans or the templates as CAD drawings from the vendors, and we can plan so you as a patient get exactly the best prosthesis you need. 3D is the new, and that grows a lot right now. We are doing 30,000 per year, and we have about 5,200 active users.
We come to genomics. The challenge in genomics is that in cancer especially, the use of genomics and planning for sequencing is The survival rates in cancer have gone up tremendously. Anyone here or my age or above, I think every one of us knows someone who died from malignant melanoma, for instance. Malignant melanoma, skin cancer, it was almost 100% deadly disease only 20, 25 years ago. Today, 65% survive five years with malignant melanoma. It is enormous change that has been made possible by precision medicine and immunotherapy, which means you actually use your own body's immune defense against the cancer. You teach your own internal police to fight the cancer instead of just trying chemo stuff. But then you need to know what cancer it is and what immunotherapy will work and which will not. That is increasingly done by DNA sequencing.
You measure the DNA of the cancer, what's called somatic genomics. We were contacted about 2.5 years ago by one of our customers, University of Pennsylvania in the U.S., who wanted help because the volumes had gone up so much that it was intolerable to continue. They kept track of the mutations. In the old days, I have a friend who's an oncologist. She said that 20 years ago, five mutations. Most people have heard of the BRCA gene. The BRCA gene is a bad thing if you're a woman. It will, with very high probability, cause breast cancer or ovarian cancer. If you have the BRCA gene, you need to know it, and it's inherited from the female side of families. Most women who have that gene will take away both breasts and their ovaries to just prevent it for reasons.
But that, and a few other genes. Now it's like 500 genes you need to track, keep track, and no human can keep that in their head. So you need tools for doing that. You need tools because it's becoming production. Perhaps you did five sequences per week a few years back. Now you're doing hundreds or 500 per week. This area needs industrialization, and that's what we're good at. We are doing industrialized medicine, and it sounds hard and bad, humans and cancer, but what is industry? It's doing the same thing with predictable quality at the lowest price possible, lowest cost possible. That's exactly what medicine has to go through. Otherwise, we can't handle with that demographic situation. We need to industrialize medicine. Best possible and predictable quality at the lowest possible cost. This area is exactly there right now.
It's growing like crazy, and it needs to be industrialized. The growth drivers is increased usage, as I said. More and more cancers are sequenced, almost all. Some very famous institutions, they sequence everything. Everything that's something. You need to reduce your cost. You need to get the speed up, and it's very seldom acute, except for a very few cases. This is things that can take a week or two, but it's a rapidly growing area. We were contacted by University of Pennsylvania on this one. They asked us, they had a home-built system that they had built by a doctor, but that's scary if you're a big hospital, right? It is packed by Bill. If Bill is run over by a car or a bus, it's a bad thing for the hospital. So they wanted an industry partner to build a really productive system for them.
Fredrik ran that group, and in 1.5 years, we built something, and that they now have been using almost a year, and they're very happy about it. It doesn't do everything genomics, but it does the industrialization, the workflow very well. You see that the estimated growth in genomics is 10%. It's a big underlying growth as well, in addition to the growth that we will have when we begin to sell it. Amplifier. That's another of those new things. The challenge here is that there are thousands of AI applications for medicine. It's not ChatGPT, it's image analysis and other things, ChatGPT is coming also as well, but that's not what we are addressing here. We're addressing things that can detect cancer or detect disease in images that help out the medical doctors.
Rapidly growing demand, difficult business case because each of these companies, thousands of companies around the planet, very smart, very well-funded, but they cannot afford to do the sales call because they get so little per procedure that the sales call will take their revenue for five years. It is very difficult. They need to have other channels out to the customers, and we are already there. We said that instead of building all that knowledge and competing with thousands of companies, we build a so-called app store that you all have for your iPhones and Androids, and sell it to them. It is also integration complexity when you get such a system in. Just to get access through the firewalls of a hospital takes forever. Administration, how do you invoice so small sums in a reasonable way for a hospital? We include that in Sectra One.
This is a real high-growth area, it is 35% estimated for AI use in medicine. We only do the epsilon part of it, but we charge a percentage just to manage the invoicing and installation and integration in this area. Today, we have more than 100 AI applications in radiology, pathology, and radiology, and we have about 40 partners providing those through us. That, of course, makes life much easier for the hospitals. They will get one invoice, however many of these they use. This is quite new business. It is not spread out yet, but we are growing. Some of the famous ones are Barnes-Jewish in St. Louis, U.S., Greater Manchester in U.K., Northeast London, big customers, Northern Ireland, and Region Hovedstaden in the U.K., and then smaller hospitals in different places. The amplifier usage per month.
Note that the scale on the x-axis is one per year over here, and then it is per month. So it is a linear scale on the x-axis here. But you just see the last year, see the growth is very large in the usage of this area. It is part of the practices. It is not a thing that it is a unit that will make money all by itself, but it is a very strong argument for buying the PACS business for us because we can provide this from anyone. Digital pathology. The challenge there is the microscope needs to be digitized. There is a lot of benefits. Workflow and cooperation, they want to ask a colleague, and they want to work from home as everyone else wants now and then. Telepathology and working from home, as I said. Teaching.
Teaching pathology has been, look in a microscope, and then they tell the student, look there on the, because there is only one, right? No, there are multiple head microscopes, but not many. H ow do you discuss when you have to explain, look there under the lower right of the corner. You cannot even point to what you mean. So for teaching, this is big in pathology as well. We have teaching and education portal as well. So you can have thousands of cases that demonstrate for students how it is done. That can only be done in digital. High need for AI. This is probably one of the biggest areas for AI because it is a lot of boring pieces that are counting 200 cells that have a special structure or a special color. That one could be done by a machine in milliseconds. Very large data size.
It's not easy. This has to be built like Google Maps. You don't have the entire map of the entire planet, but that's there in your phone. Your telephone speaks to the big service and gets exactly what you see downloaded, and we build this in exactly the same way. Image viewing is completely different from radiology, but the workflow component is very similar, which meant we could take a lot of things from radiology and just reapply it in pathology. We change the viewer. This is a good thing for us also. We're in pole position. Sweden was a pioneer country in the world on this. We were awarded to build the demonstrator that it could actually be built at all. These images are huge. We did that with the research team. Sectra and Sweden lead. We have almost all resources, not all, but most of them.
We lead the market here. Sweden is by far the most digitized. It's a little like mobile phones for us in the beginning. Sweden is trigger happy, right. We like new things. Terribly bad. Sometimes it is bad, but then we change our mind after a while. It's an easy market to start with technology. Rapid growth in almost all countries. We moved it from research into Imaging IT because it made more sense. It's more of a package that fits into Imaging IT with all the infrastructure we have there. We are the only vendor with pathology and radiology in the very same system, and I'll come back to that later. The number of IT systems is a problem for hospitals. They have too many IT systems, it's too expensive.
Now we can reduce them at least one, just when you have pathology and radiology into one system. It very often is that we go in with either radiology or pathology, customer is happy, and then we get all the way with that going on. This is where we are today. This is number of labs. It's a very early market in the U.S. because the FDA was a little slow about approving this. We have very interesting growth in the U.S. as well now. As you can see, in Korea, for instance, we have 14 installations, and in Korea, we couldn't go in with radiology. They have a good local vendor. But we can come in with pathology, same as France. Then, of course, we can add up with more ologies later when they want to buy radiology as well because it's the same system.
This is the growth we see today, and this is viewed images per month. You see we're up to around 3 million, 3.5 million images viewed every month in our system. Heavy growth. A little about cardiology, another of those disease areas. Cardiovascular disease is the single leading cause of death in the world. It's about 2 x much as cancer. The single largest healthcare costs in the world. You use a lot of images in it. It has been special systems dedicated for cardiology before, but now we have it in the same system as everything else. Cost in the U.S. for this disease is too predicted to quadruple in the coming two decades. Because what happens is that new technology decreases mortality, but the aging population compensates for that and more. So it's a growing area of concern for this society.
And we have special units. Again, we run it in the same system, which is very beneficial for most hospitals. They do not want so many IT systems. There is a lot of correlation between genomics and heart disease as well, because the cardiologists want to see the risks of these different diseases, and they see that on gene profiles of people. The current state, we have been working with third parties earlier in this area, but now we are building more for ourselves, and we are building it for the cloud from the beginning. Focus on the daily workflow, and that is what we do. We are industrializing things, right? We are making production go up. We are making it efficient. The very esoteric thing you do on one patient per million, we will find a partner for those. But we do the production.
And we are very flexible to adding other subspecialties. With that, my session is over, this one. I just want to go through and show you all the interesting things we are doing. All of these are selling today. Other ones are not selling. We are not discussing those. Every one of those is bringing in money today. They are at various stages. Everything works. With that, I will leave the word to Marie, who will tell you about the largest areas, which is Imaging IT, which is mainly radiology, but also pathology.
Okay. Thank you, Torbjörn. Hello. Nice to see you all. I am so happy to tell you a bit about Sectra Imaging IT Solutions. Today, I will have the opportunity to talk a bit about the organization, because I see the questions beforehand, and there was a lot of people wanted to be more educated. What do you do? How do you deploy? How do you sell it? What do you do? In which countries are you? That is what I am going to focus on today. Yes, Marie is my name, and I have been working at Sectra a very long time, almost 30 years now. I surprised myself. Time flies when you have fun, and I have fun at work. I joined Sectra in 1996, so that was a long time ago. I always had working with healthcare.
I have a computer science as my background, but I was interested in medicine as well as Torbjörn, choose between these two areas, and I could combine them. Before I started at Sectra, I was working as a developer and working with EMRs, medical records, and developing them. So it has always been my interest and driving forces to do something good for society as well. Swedish Royal, I am a member of Royal Swedish Academy . I am proud of that, but unfortunately, I do not have time to spend that much because traveling is taking a lot of my time, and I should travel because we have, as I will show you, people out there serving our patients and our customers in many countries. Yes, Torbjörn talked about KLAS, and I also am super proud of our Best in KLAS award. Super proud.
I personally go to U.S. together with some member of my team, including Isaac, and talk to this institute KLAS, and they tell us what we have done good and what we maybe could improve, the trends. We listen carefully to this every year. They also go to our headquarter in Linköping, and this year they were there, and we focus on, in this case, Germany, U.K., and Sweden, and listen to them and what the customers says. They interview thousands of customers, and we got their comments regularly that all vendors can get this, so it's not only Sectra. We really listen carefully to this. This is something I'm very proud of, and I'm eager to keep and work with our people so we understand the importance of this. I'm going to start with current state, and I think Torbjörn mentioned quite a lot about this.
Enterprise imaging. Yes, we were super early out for this. We started a long time ago. I don't think we have reached the market totally with our message. We could do much more there because we are unique in having one platform with all of this in one place. They don't need to go to different workstations, our users. They don't need to draw menus or spending time flickering between. We have one platform for our product. The second one with the big trends that we see is digital pathology taking off again. Yes, Sweden were early out, but now it's taking off in U.S. and all the other countries. Super important. Isaac and his team will have a good job trying to sell that to our U.S. customers. Brilliant workflow.
That's something Fredrik Häll will talk later about when he talks about product, or at least a bit, I do hope. This is important, and that was also something we understood very early, because if you're going to be efficient, you need to have the right workflow. Not clicking in around, not looking for new features. It has to be there for the customer, for the end users. So it's easily to find, and also that we understand in what way they're working through our products, so we can confirm and optimize our product accordingly. Very important. That's something we focus a lot about. Lisa here, she's an expert on that one. Yes. Consolidation. This is going on not only in Sweden.
We are consolidated in U.S., there were thousands of hospitals, there's still thousands of them, but there's not that many because they form groups, private groups, change, or they go together into one hospital. That's what's happening, is we see it in U.S. coming very strong, and this is there in the middle of it, but it's also coming in all countries. Even in Germany, where there's many mid-size hospitals, they form and start building groups. That's perfect for us because our platform is built in a way that you can easily scale out and add on new sites. That's how we built the whole architecture. AI, don't even need to mention it's essential. But for us, it's not only in our product, it's also how we work internally. I'll talk a bit later about that, how we can use AI as a tool.
Then, of course, as Torbjörn said, software as a service. This has been a paradigm shift in our organization. It is not easy to go from delivering licenses and the customer take care of the platform, you do not have to bother. When you have delivered the licenses, installed the training, you do not need to bother that much. Today, we have to be there for a customer 24 hours a day, every day in a year. Every minute we have to be there for the customer. We are their IT department. Delivering a SaaS, a service, is something completely different from delivering licenses and then going back now and then. We have to be there. I will talk a bit about how we work together with our customer regarding this. Numbers of exams, yes, Torbjörn showed as well.
I just want to show the growth, and you can imagine our job is to make sure that these users, we have more than 350,000 users in our universal view, meaning the labs and the techs and the referring physicians, and we have more than 300,000 users in a diagnostic workstation. Our job is to give them tools so these people can be effective and serve the patients. That is our job. That is quite a few. They serve, what is this? 160 million patients. So we made them assure that they are effective, and that is the job. I am going to talk a bit about how we do that. We have, since a couple of years back, we formed in three regions. One is Scandinavia, one is North America, and one is rest of the world.
Where we do not have our own subsidiaries, we work with partners in certain chosen countries. We have a big world, we are not everywhere, and we have picked the regions and areas where we think our offering and our product fit the most, the best. That is how we picked this. In places where we do not have our own subsidiaries, we work with partners. We have around 20 distributors, partners, in 26 different countries, serving more than 400 customers and handling also lots of exams annually. In part, even in U.S. and in Canada, we could work with partners, and they can take the customers that we do not think we have the perfect fit for. They could be too small or something like that. Then we work with partners, and we cooperate with our partners. So that is how we can do this.
We really believe that this is a strong growth potential in areas where we decide not to have our own subsidiary, and also when going cloud, because it is easier for us to control that the core for our product is okay, it is safe, it is set up in a way that we can guarantee the quality, and the partners can work with the end customers. That is a way for us to grow, and I think we will see more about that in the future. Highlights in North America. I will not mention much about U.S. because that is Isaac's job, and he is doing it very well. But I will talk a little bit about Canada. I think most of you know that we have recently in Quebec, that was a big deal. It was the biggest we ever had. Starting off very good.
I was there myself just two months ago in Montreal and talking to the customer. When you are running these projects, this is what I will talk a bit about as well, you have to be extremely structured. You cannot handle such big size and go into the country, "Hey, how do you think we should deploy this project?" You have to be super structured. You have to have good methodologies, otherwise you will not succeed. We also see that it is more replacement sites coming up in Canada. As Claes said, they have never seen such a fast replacement market, today we have a very good position, I would say. Our brand is good in Canada. This is what we have today, 14 installations where we had 12 on-prem and two cloud. The latest one is cloud installations.
We serve today 4 million patients, that means approximately 8% of the market today. But wait, Quebec. This is before. Today, when we have Quebec starting the installation, we are not yet there. We have started it up, but we have not yet brought in that many patients. We have three cloud, where we have a super big one, means 12 million exams. Now together, we have 16 million exams in Canada, or soon we will have, where it means that we are going from an 8% market share to a 30% market share. It is very good, we have a super good team in North America, cooperation with the U.S. team as well. We can share specialists, we can share the burden, we can help out when we have peaks. Canada is run by our President for Sectra Canada, Nader Soltani.
Highlights in Scandinavia, then. Scandinavia is a home market, as Torbjörn mentioned about Mjölby and RIS/PACS and all this. I was not there at the Mjölby time, but I was almost there, that one. We just have a very, it is not 1.5 year. We won Region Hovedstaden in Denmark, Copenhagen, that has been a very successful project. It is very fun to run it. These customers are super happy as well. We see that there is still growth, especially in Denmark, but there is also a lot of add-on sales in Scandinavia. Most of the sites have radiology, maybe something more orthopedic they have usually, but we have ophthalmology, cardiology. There is still a lot of things to do in the Scandinavian market, even though that most of them have our radiology products.
All new sales, I will say, in Sweden, we have been there, has been cloud, but our private cloud. We have two platforms, private and public cloud. I think concerning the climate, the global, what is happening in the world, this could be maybe quite good to have already had two platforms, both the private for Europe and then the public one. You never know what is happening. Anyway, in Scandinavia, we have our private platform, most procurement, of course, in Scandinavia is European Union procurement. That is complex sales, I will get to that as well here. When it goes to rest of world, we have six countries, U.K., DACH, France, Benelux, consisting of the Netherlands and Belgium. Iberia is mostly Portugal, but even Spain, and then Australia and New Zealand. That is the six countries. We call them rest of world.
We are market leader in U.K., and I will show you some numbers soon there, Portugal, and the Netherlands. We have a very fast cloud adoption in U.K.. U.K., it's NHS that decides what they should do there, and they have been quite strict. First, they say okay to private cloud, and now they say okay for our public cloud with our preferred partner, Microsoft. NHS give these directives, and we can act accordingly. They were early out as well, as well as Scandinavia, with cloud. In DACH, meaning Germany, Austria, Switzerland, Belgium, Spain, Australia, and France, we see a huge growth potential. We are not market leader there. We have way to go to get there, but we have a good position and we have a good brand in these countries as well.
When I just mentioned it before for Scandinavia, most procurement are European Union procurement. That means quite complex sales. Takes a long time, tough to sell, but when you have got the site, it's long-term profit. Also in the Scandinavian countries, we have our RIS/PACS. That means we have a very broad solution. RIS is Radiology Information System that control and administrate, it's not only the images, also the referrals and the requests and whatever goes with it, the booking and everything. That is needed in the Scandinavian countries. That makes even more complex sales with that broad offering from our side. Just two examples. I think the clock is up, but I think I have some minutes to go. 10 minutes. Yes. Good. U.K. and DACH. This is just two examples of how we are positioning ourselves.
As you can see in U.K., we have a big share of market in radiology and even more in pathology. So there's more to do, but we have a good market share. If we take another country then, Germany or DACH, Germany and Switzerland. We have a quite small market position in Germany, as you can see here. Switzerland a bit more. The pricing in Switzerland is higher than in Germany. But here we have a huge potential. We changed leadership there for a bit more than a year ago, so we have a very strong leadership and today in Germany, a good position with a good brand. So that was our operations in different countries. How do we do then when we install? How do we work with a customer?
First of all, when we grow, we realize, and that's also something Claes said to us, you need to keep the close contact to your customers. You cannot lose that when you're growing. So we form portfolios where a dedicated team work with dedicated customers. That makes it possible for our team to get to know the customer and know a bit more instead of them having a, and the customer, when they call us or mail us or chat with us, they don't get a new face for every call. We know them, and we can plan for them. We can be there with them. So that was a really big change for us, forming these portfolio teams. We do that in the same way globally. We work with the same process, the same methodology, and we have the same kind of organization. Almost. Not exactly, but almost.
That is so we can form our quality systems accordingly. We have frameworks for how they should work with the customer, how often they should talk to them, at least regularly, which report they can use to see that the performance are okay or there is any trend that performance goes up and down or whatever. We can see how they use our product and help them. We have customer success managers that work with the customer and have discussions with them regularly, say, "Hi, we see a trend here that your performance is getting a bit slow. What can we do about that?" Or, "Seems like your people have not gone on training. What can we do with that?" So that is something we work daily with our customer with. We have this meeting.
What the trend we saw when we introduced these portfolios in KLAS, again, said to us they had never seen such a big change. The customer was even more positive, and it was really going up like this because they felt that we know them, even though we were growing, because earlier we saw that this was a downgoing trend that they thought we were not that personal anymore. They did not get contact with us, and that totally changed when we introduced ePortfolio. We started with that 2021. I say in U.S., we are totally done there, and we are working in all countries we have that, but some has been a bit slower than U.S. When we talk about customer success and how we work with the customer, we called it the Sectra One journey.
It starts when we luckily get a deal, sign a contract with a customer, then we look, how do they look like? What can we do with this customer? How should we start deploying this customer? So we have our best practice we work according to, and we have blueprints. Five, six years ago, we were more open when we came to a new customer and asked them, "How do you want to work?" Now we use the experience, and the customer ask us to use our best practice, our experience, so we can make them as effective as possible. Because as Torbjörn said, that is what matters. You have to help them be more effective. Then Fredrik Häll and his team could also steer, so they are doing our product accordingly, that a certain workflow fits best for our customers. So that is what we do a lot.
Then this is a wheel. We do the upgrade, we are coming back, we talk to them regularly. That is the Sectra One journey. We are with them all the time doing this. The future state then. We have three pillars. We work with OKR, objective and key results. One is sustainable growth. Whatever we do, we cannot grow that much that we lose quality. That is number one. Super important.
Customer success, whatever we do, we cannot lose our customer satisfaction. The third one is cloud first. We need to go to a SaaS organization. We are already there. We need to continue working with it, and we need to get our customer on cloud, all the current customers as well. So, yeah, that was one. So we also have a five-year vision that is mainly internal. To reach this goal, we need to guide our people. We are quite many.
We are more than 2,000 people. How do we make sure that everybody is running in the same direction? You need to have goals. You need to have goals for each country, for each organization, each department. This is a five-year vision we have. This vision is made internally because we could have said money, but we have took a goal in double the number of exams. It could also be, and that's what we really mean, help twice as many patients, because that means something for our people. That's what they are running for. That's what they care for. According to this, you can see it's going better than we even expected to help twice as many patients, because that's what it's all about. We also have a wanted state. Where are we going?
We are going to help large organization, that's what we are focusing on, to be as effective as possible. That's our wanted state. This drives the goals we have. How do we get there? You cannot just say, we want to be there. We have to have measurement, and we have to have initiatives, so people know what to do. That's something we work very hard with. So this is our wanted state. When it comes to our product here, SaaS is, of course, our future. That's the platform. Amplifier, yes, of course, we need to continue working with that. Also understanding how our customer are working in our product. I think you will mention a bit about that, Fredrik. Yeah. That we see the usage. Are they doing it in the right way? Are they using our product in the wrong way?
How could we help them to be more efficient? That's the wanted state and the strategy about the product. When it comes to technology, we need to use AI, of course, not only in our product, but also when we are working with support, installation, automation, whatever we do. Customers, we focus today, as in U.S. and Canada, all is cloud customers. But we also need to convert our on-prem customers. We have hundreds of customers that needs to go from their on-prem platform to the cloud platform.
That's a job we have planned for, and we are starting that journey to help them and make plans and a structure, a process to help them go cloud. You cannot take them one by one and doing differently. We need to have a methodology there as well, and that's what we have. About 2 minutes? Yes, I am well done. Thank you.
It's so fun to tell you what we really do because that's something I am super proud of. Whatever we do, again, we cannot lose our customer satisfaction. We have a very low churn today, and we want to keep that. The customer journey, I told you about the Sectra One journey. We need to do similar processes with all our customer, otherwise we cannot control it. Otherwise, we cannot do it in a good way. We have to do that. That's why we have a global and aligned organization where we have a matrix organization, where we have specialists all over the globe, but they are working together to form this. Yep. The last one is true SaaS again. We are going to a DevOps organization, and again, cross-functional team. According to product, yes, technology and AI needs to go together.
We need to handle our customer in the right way, and we need to know where to go, otherwise we will not get there. To summarize, global organization, efficiency and Best in KLAS guides us and our customer so we can help them be effective. Sectra One Cloud, which Fredrik Gustavsson will talk more about, is the business model we use. You cannot have different contracting and different legal agreements for all our customers, that will be a mess. And least but not last, customer success. So together, patient in the center, that's what we care for, and there's a lot of new things you can work when you can talk about oncology, as Torbjörn said. You need all information available to take the right decision about a person's future, a patient future.
Our job is to deliver these tools to the end users so they can help patients. That's what we care for. That's where my heart is. And who is building all these products and who decides what will be in these products? That is Fredrik Häll and his team, and he will tell you a bit more about that. T hank you.
We started our journey within radiology and breast imaging. That's where we grew up, that's where we came from. But over the years, we found that we can extend our platforms into other ologies, leveraging our assets and providing benefits for the customers from the heritage we come from. So growing that into pathology and cardiology and then most recently also into genomics IT. How does that relate to what we see in the competitive landscape around us? Are we the only ones that are seeing that this makes sense for health systems? Of course not. Where I see us being different from the competitive landscape is in two facets. One is the width of the portfolio. As Torbjörn mentioned, there are things that we do that are unique to the market.
No one else is able to provide the width of the portfolio, including pathology and genomics, into the same infrastructure. That is something that is unique to the market. The other element is to the degree that this is all in a shared platform. So take, for instance, Fujifilm as one of the Imaging IT Solutions competitors. They have one platform for radiology and cardiology, and then they recently acquired a company for pathology. So yes, they could offer pathology, but that's a completely separate platform, separate IT and infrastructure. Looking at Philips, one of the other big players in the industry, they have one platform for radiology and breast imaging, another platform for pathology, another platform for cardiology. So yes, there's a single vendor able to provide a wide range of IT services, but it's not a single platform.
I will get back to some of the benefits that we do see for the customers of providing that single platform. A couple of things that are possible to realize with one integrated IT platform for multiple ologies is increased return on R&D investment. This is good both for the customer and for Sectra. Let's say we are investing in improving the way we present the patient overview. We build that once and we can leverage that benefit both for the radiology customer and for the pathology customer and for the cardiology customer. This means that we get leverage for our investments and that the customer get more value for their money. Another facet is savings. As Torbjörn mentioned initially, there are significant life cycle costs for our customers in managing these disparate IT platforms.
They need to make sure that each platform integrates with their EMR, that it is safe from a cybersecurity standpoint. They need to manage and maintain each system. They need to train their staff on each system. All of that compounds, so that if you are able to consolidate them into a single platform, these are pretty significant savings from a TCO perspective as they are able to consolidate these platforms. These are some of the same rationales that customers are already used to driving consolidation of EMRs and creating cohesive platforms for the medical records. Finally, this also means a reduced time to value. This is beneficial for Sectra in terms of getting our product into market, but also for the health systems.
If you look at the alternative, for instance, if they want to digitize pathology, their option of procuring a completely separate system, designing that, integrating that, deploying that, training users, versus extending and enabling a component within a system they are already used to with a vendor they are used to, with a service organization they are used to, this will be a much faster and much more efficient journey for the health systems to take. The first topic was related to providing that consolidated platform. Who do we try and provide those systems into? We focus on the largest health organizations in our market. We have shared that earlier that there are benefits of consolidation that allows our customers to service a larger patient audience, and we find that we are an excellent fit for those large customers. Today, we are leading in providing solutions for large customers.
In the markets where we are active, if you look at the largest health systems per those markets, you will find them to be Sectra customers. This is what we strive to do, and this is what we do well. If I look at the differentiation from competitors, I think this is something that influences what are the competitors that are able to service on a national scale or to the left, for instance, in the U.S., multi-state actors that work on a large portion of the U.S. That is a difficult problem to solve. Not a lot of vendors on the market are able to address those customer needs. If we look in Europe and in New South Wales to the right, quite commonly, there is a demand to also include built-in reporting.
And if you look at the vendor landscape of who is able to provide solutions on a national scale with built-in reporting, that is going to be a very short list. So what does that mean from a competitive standpoint? It allows us to differentiate and create opportunities for Sectra in the market in three ways. The first one I have already touched. This is a high bar for competitors. It means that the bargain basement companies that primarily compete on price, they cannot service this segment. It means that the providers that do provide quality products at a nice market price. So this is something where there is fewer competitors and an ability for us to differentiate in an excellent way. It is also an excellent opportunity to upsell.
If you look at a large geography or even a national installation, as they consolidate their own radiology and breast imaging, which is usually the starting point, when they see that the time is right to go from 30 different cardiology systems and try and consolidate those, this is an excellent area for us to upsell consolidation of additional ologies. So it is a great arena for us to work with and upsell towards those large installed customers. And the last part is these form long-lasting customer relationships. Assuming we do a good job to provide happy customers, these will be customers that are going to be with us for a long time, providing low churn and nice long-term revenues.
Because if you do a good job, the political decision that those customers need to take to potentially replace you is going to be a very difficult decision to make, to drive and organize a reprocurement from a system that works on a national scale. So the last part relates to what then do we try and do for these customers. As Torbjörn mentioned initially, there is a huge focus on the healthcare industry to try and do more with the resources they have. So I think the radiologist in the image over here looks fairly happy. Unfortunately, that is not too common these days. There is tremendous productivity pressure on all markets, scoping with increasing data volumes, increasing study complexity, and diminishing payments and diminishing staff resources. So there is tremendous pressure to increase the productivity, which is an opportunity for us to help accomplish that for our customers.
If we can be more successful in providing productivity benefits than our competitors, this is an attractive landscape for us. One of the ingredients for productivity is performance. There is an old saying, speed is king, and I think providing top performance, there is nothing that frustrates users more than watching an hourglass just turn and turn.
So providing top-level performance, regardless if we are talking a thin- slice CT containing 10,000 small images, or if we are talking digital pathology with huge, huge images, or cardiology within Björn's domain here, watching beating hearts circling at 100 frames per second in multiple views, you need a performance system regardless of the domain. Doing all of these things well, that is a high bar for others to pass and something that we have as a passion and a competence with us. The last part that Marie touched briefly is related to workflows.
You can have the fastest car in the world, 1,000 hp, but if you can't get it around the track, if you go off the rails in the first turn of the corner, you're not going to get much done. Being able to provide smooth workflows is perhaps an even bigger productivity benefit than the raw performance alone. This is something that we invest continuously in, and if you'll have the opportunity to walk by the demonstrations, I'm sure that all of the workstations that we demonstrate will provide ample opportunities to show how can we bring productivity through efficient workflows. Providing a full solution with built-in nice workflows doesn't mean that we do everything, building everything in-house. It's a wide market with lots of specialty companies. We strive to build the best solution for the customer.
Sometimes that means that we build things ourselves, and sometimes that means that we partner with other vendors. One recent example is that we are working together with Siemens, that produces the top line CT machines in the industry, to be able to do post-processing directly within PACS from their flagship modalities. Lisa will be able to demonstrate that if you're interested in the details of that. But this is something that is unique to the industry and a good example where Sectra and Siemens, that could be seen as competitors, work together to provide benefits for our customers and a more efficient workflow for the end users. Another example of this is where we've worked with GE that provide advanced visualization capabilities for the niche workflows, and we embed them into our product.
For the end users, that means that fewer clicks, highly integrated workflow, and being able to access the highly specialized tools without jumping between workstations or between environments. These are examples where we work with the other vendors to provide cohesive solutions for our partners. This is an area where I see the landscape continuing to evolve. We've gotten very, very positive feedback, both from the customers and from the industry partners around wanting to do more of this. I would expect us moving forward to identify additional opportunities where can we work together to bring the market forward, to be thought leaders in terms of how we accomplish these things for our customers and make more of this happen.
All right. Now we go into the next session, the demos. When you rapidly presented the demo guys before, but I think you guys should stand up so you can be acknowledged, and found out in the coffee room where we will have this combinated session, so to speak. If you're not tech-savvy, do not worry. Lisa tried me as a guinea pig, and even I saw some benefits to this. I urge you to delve into the different solutions that the guys. What we're demoing is Johan, Cardiology. Lisa, Radiology, that we haven't spoke so much about healthcare, but that's our main business. Johan, Education, and Fredrik, Genomics. We have many more, but we try to keep the numbers down a little bit.
Following that, we will have the touching up on some of the questions we have in the queue in the first Q&A session. Fredrik will carry it on the Sectra One and the business model transition. Following that, Isaac will attend to the more focused on the U.S. section where we also will be technology provided. Hopefully, we will talk to a real- life customer, Dr. Navarro from Kaiser Permanente, which is a great value for us, I think, to listen. Okay. Mind the time, please, and enjoy the demos. Without further ado, from the cinnamon bun to Sectra One.
Thank you so much, Max. T hat was a good start of the day. Good afternoon. Great to see you all. My name is Fredrik Gustavsson. I am the CTO. I have had the pleasure of being with Sectra for some 12, almost 13 years now. I have been in the e-health business for about 25 years. I am going to talk about the transition to cloud and services today.
Torbjörn already mentioned some of that during his Q&A session, so I will try to flesh out that a bit, give some nuances, and talk about what that shift means, where we are at, and try to paint a picture on this very important step in Sectra's journey. Pleasure being here. Hope we will have 15 interesting minutes. One of the things we did four or five years ago was to really try to simplify our offering. Making something simple is very hard.
Every day we work very hard to make the lives of our users simpler, easier, more effective, and efficient. We do that with our business model, our service delivery as well. We did Sectra One, it is actually about four years, maybe 4.5 years from now. That was the shift to a single subscription model where customers had an easier way of getting access to all that innovation and to the products and modules that we have been talking about. That was a big success. It was very successful. Customers really like that. The big shift we are seeing right now is the shift to software as a service. Customers ask us for something that is really comprehensive, predictable, and scalable. We are going to talk more about the shift to cloud services.
Basically, today, when you are buying new solutions for PACS Radiology, most of our customers feel like, "Well, I am not going to install this on-prem. I want to actually get this as a service. I do not want to manage. I do not want to go out and buy hardware. I do not want to buy storage. I do not want to buy network switches. It is too complicated, too much effort. I have lack of resources.
Can I buy this in a better way? Can I get access to this technology innovation in a better way?" That is where Sectra One Cloud comes in. It is the combination of the Sectra One business model that we started with that was just for the software, and then combination with cloud and software as a service. I will expand a bit on that. I will contrast a bit what some of our competitors are doing.
Some of our competitors, if you may look at it and look at those margins, they actually take the software, sell that to the customer, and then the customers sort of have the fun task of getting that onto the cloud platform themselves. That means that that revenue recognition happens up front, which improves the profit margin short-term. From a Sectra perspective, we do not think that is the best way. Our customers ask us for a service, not just software that then they have to host on their own. They want Sectra to help them on the journey of becoming more effective, efficient by using the Sectra software. We think there is a fundamentally better way to deliver our solutions and innovation to customers. That is by providing a comprehensive software as a service.
We sometimes use the phrase one throat to choke, not sure how politically correct that is, but it sort of really illustrates what it is all about. It is us taking responsibility to deliver a kickass service to our end customers. If something goes wrong, we are going to fix that. That really comes back to that culture that Torbjörn talked about earlier this morning, customer dedication, customer focus. We can deliver much better service to our end customers. I think there is a fundamental economical perspective in terms of efficiency that we should cover as well when we talk about SaaS and cloud. This is why we think it is a much better model of delivering our innovation and technology to customers. If you think about having thousands of customers in a dispersed, spread-out environment, think about 1,000 different customers, 1,000 different environments.
Over here, I do everything in the cloud. I can automate. I can really create efficiencies of scale. If I install in 1,000 different customers' environments, or if I run it in a cloud, it is fundamentally different when it comes to long-term efficiency and profitability. That is why we think the model that we have selected is a far superior way to deliver the services, both from a customer experience point of view, customer satisfaction point of view, and ultimately efficiency and profitability. Customers ask us also for, and we did have a bit of a chat over the cinnamon bun and the coffee, how can we take down thresholds for customers to access new technology, to access the Sectra Education Portal, to access genomics, to access digital pathology?
We are doing that by providing customers access in our cloud solution by sort of taking down the threshold and saying, "You pay on a usage basis." Whereas historically, they had to pay upfront for the software license, right? Also, if they were to start using pathology, they might have to go about it buying a petabyte of storage as an upfront capital investment. When we were delivering a SaaS and a cloud service, we can say, "You can get started tomorrow. You pay for what you use." So we are taking down the thresholds. We let customers get much faster access to our technologies and services. The usage-based pricing is fundamentally also taking down thresholds, providing access to innovation and technology, and it is going to spur growth and scalability. All right.
We already touched on some of the reasons why customers are really moving to the cloud, and I think there was a question, what are the benefits or customers' testimonies in terms of efficiencies or benefits they have seen? These are three different areas where we see sort of really drive the adoption of cloud and basically the why. AI and scalability. As I mentioned, the ability to scale when you have organizations that acquire other organizations and the ability to quickly bolt them on and to create efficiencies within radiology groups to share information and to really leverage that organizational growth. If you have to start buying hardware, setting that up, constructing, scaling, it becomes much more complicated in an on-prem environment. So a dynamic landscape, a cloud solution is far superior when it comes to scalability.
It also provides access to AI, both in terms of Sectra Amplifier, which is our AI store that Torbjörn talked about earlier, but also new technologies such as augmentation through GPT and reporting. So the actual ability to gain access to a lot of that AI innovation right now also really connects well into that cloud story. As mentioned, genomics is actually only available on cloud. All of this really creates a fundamental, powerful platform for customers to grow on. So really gives them access to innovation, scale, and growth. Torbjörn did mention security. The average cost, and again, the healthcare customers are really prime targets. So this is data from the U.S. The average cost of a data breach in the U.S. related to PHI or patient healthcare information is about $10 million.
Through the combination of experience and know-how within Sectra on the cybersecurity side, with the fundamental knowledge about how we develop safe and secure software, in combination with also the capabilities that are exclusively available on the cloud platforms, we can create an offer that is as strong as it can be. There is never 100% guarantee, but there is really a tremendous difference between trying to manage that level of threat when you are on-prem and if you have a lack of resources. It is hard to recruit. It is hard to recruit cybersecurity professionals if you are competing with the Googles and the Amazons, the Microsofts, if you are a small hospital somewhere. That shared leverage of size and technical ability really builds a higher level of security into our offering. All right. Have we been successful? I really think so.
It is actually to the point where 85% of the order intake right now is cloud-based deals. Torbjörn presented during the nine months year-over-year comparison, 44% growth on the cloud recurring revenue. As you think about it, the 85% on the order intake is a precursor to revenue growth, right? Those are the contracts that over time will materialize into revenue. So it is a huge proof point that the shift is happening. Customers are really loving it, and we are seeing a huge adoption in the market. Now, how quickly it will go, will it take five years? Torbjörn said there were some differences in different markets, so it is very hard to predict, but the numbers are very clear.
Another number I wanted to share with you is that when we compare software-only versus our SaaS cloud deals right now, and do not take this as a rule, but now, on average, it is about 100% increase of the revenue for the total deal. Comparatively speaking, if we were to sell a solution for X, it is actually 2 x, 2x, when you add on the service fees for cloud hosting, storage, and other services related to that. So it is a top-line growth. If you think about those economies of scale that I mentioned in the beginning, in that 1,000 environments versus one cloud environment, looking in the future, the efficiencies are going to be huge. Okay. Torbjörn also mentioned some of the changes that we have seen already and that we are seeing over the coming years in the shift in terms of revenue recognition.
I will run you through an example, just for illustrative purposes. We will look at an example where we look at a deal, comparatively speaking, on the software only, and then for that identical software component, but in a SaaS setting. Okay? So we are looking at a deal about $500,000, software and maintenance historically, and it is over six years. It just sort of rounds out the numbers in a good way. What we are seeing here is that on the left-hand side, we see the revenue recognition for that traditional on-prem sale, where, from a revenue recognition perspective, that first bump comes up, that first nice set of revenues. Then there is a lower maintenance fee throughout the contract period, and that sort of continues in perpetuity, right?
When we do this in a SaaS perspective, due to the fact that there are integrated performance obligations, the revenue recognition is spread out. When you look at these different colors, the blue one is the on-prem sales upfront component, lower per year fee and maintenance. When we do this as a SaaS service, it is the higher annual total fee that sort of goes on in perpetuity. There is a break-even point at about five, six years. I want to stress, this is not adding the hosting components. This is just looking at the software component in isolation. It may sort of explain some of the delay in the growth of revenue, comparatively speaking, to what Torbjörn showed you when the graph in terms of growth of the number of exams. Does that make sense? I see a few heads nodding, at least.
This is actually the illustration of the break-even level on that. You have the opportunity to ask questions later, so I will leave that at that here. I want to maybe just stress again that this is software only and the treatment of that software in the on-prem version versus when we deliver SaaS for a cloud delivery model. Some other financial perspectives on the shift to SaaS. As you might imagine, the balance sheet effect is not that dramatic. Customers are paying on a subscription basis. Generally speaking, they pay sometimes a bit upfront on a quarterly basis, and we have our payments to our cloud providers sort of sync up with that. There is no huge effect on the balance sheet. We do not buy hardware. We typically grow this on a public cloud basis, I should say, and scale that as our business grows.
That is very nice. We do not make upfront investments on the cloud side. Cash flow perspective, we already started the shift to subscriptions four or five years back. From a cash flow perspective, that subscription shift already happened. That revenue recognition perspective, though, shifts when we do SaaS, as I mentioned before. Profit margins, without making any promises, I just want to call out again the question about economies of scale. Managing today thousands of customer environments throughout the whole world versus managing a few cloud instances. That is, I think, a very much clear picture on where we are heading, both with existing customers and new customers.
There is also a very nice sustainability perspective to add to this, and that is when we are moving to public cloud, we are moving into the modern, most well-managed data centers that is out there, that has much less carbon footprint and environmental impact than any else data center. We see this in the European markets. Some customers are asking us for our environmental impact analysis. Moving to public cloud really helps customers to also sort of respond in a positive way to what they do to contribute. Because if you run a data center on your own with the cooling and the power and the power requirements, that is usually much more ineffective than what you can do when you run these really large data centers. Right. That was a bit of fleshing out on Torbjörn's comments.
I tried to add a bit of detail on the shift in software as a service and the revenue recognition perspectives and some of the drivers. I think with that, I am actually spot on 15 minutes, and that was that. Thank you so much. Let me also introduce Isaac. We have had a great success in the U.S., and Isaac is the captain leading that team. Isaac Zaworski, please. Thank you, sir.
All right. Thank you everyone for giving me the opportunity to speak this afternoon. I, as Fredrik indicated, get the opportunity to give you a little bit of an update on how things are progressing in the United States market. This is building off of what you heard from Marie, but also touching a little bit on the business model transition and the product side of things as well. First off, who am I? My name is Isaac Zaworski. I am the President of Sectra, Inc., which is our U.S.-based entity. I joined Sectra. I am the newbie in the group out of all of these, except for maybe Jessica. I joined Sectra just almost four years ago now, so coming up this summer on four years. Actually before that, I spent the rest of my career in the defense and intelligence industry.
Got introduced to the American-Swedish partnership world through a number of previous ventures that are joint ventures that integrated technology from Sweden with market demands and needs from specialized industries in the United States, and figuring out how to scale them and bring them to market. It has been a fun three and a half for almost 4 years both coming into Sectra and having an opportunity to get to know the organization, but also to get to know the market itself and the industry as a whole. My background is in mechanical engineering. I used to build race cars, but strangely, somehow through a various winding path, have spent all of my career in IT, high-performance computing and image processing, to include some deviations in sandy parts of the world and all sorts of strange places.
As we look at the U.S. market from the Sectra perspective, really, I have the opportunity to have a very transparently positive and bright view of where we stand right now and what is in front of us. The U.S. market is not always the first to do anything. I think we have heard multiple examples here today where Scandinavia or some of the European markets have been ahead in their adoption of certain technologies and policies and approaches to problems. The U.S. has a long track record of not always being first, but when we decide to move, we tend to move very quickly and throw a lot of resources at the problem.
I think we're in the midst of several major transitions in the healthcare industry, where some kind of longstanding alignment around what direction to take has settled in, and we're now very much in the very rapid investment and transition curves. Which is a fun place to be, particularly when you've established the foundation to work from that we have here at Sectra. Speaking of that foundation, this is not the first time you've heard this today and probably won't even be the last time that you'll hear it today. Customer success is the foundation of everything that we work with here at Sectra, and I'm extraordinarily proud of the team in the U.S. for the fact that the Best in KLAS Awards this year represent 12 consecutive years for our organization in delivering that best-in-class customer satisfaction for our customers.
It's always good to be on top, but it's always difficult to be on top in the way that you become the target for everybody else that's out there. As Marie alluded to earlier, we invest an incredible amount of time and effort engaging with not only our customers, but also engaging with organizations like KLAS to make sure that we are keeping our eye on where the ball needs to go. That has driven a lot of our strategic changes, which I'm also extremely proud to highlight, has led us to a place where not only is this the 12th consecutive year that we're Best in KLAS, but this is actually the highest scores for customer satisfaction that we have ever had as an organization.
Coming through my tenure here at Sectra, we've gone through some major organizational changes where we set expectations with our customers that through those changes, the experience with us would take some time to stabilize. We had to retool our organization to be able to scale from a people perspective, from a customer perspective, from a customer engagement perspective. We're now, as Marie indicated, on the tail end of many of those big organizational changes as far as the way we interact with our customer. We've transitioned through a dip that we knew would be coming. Even though we were still on top, it was a dip in the overall scores.
We're now on the other side where we're not only trending higher and higher than we have ever been, but for me, the fact that we got not a single score from a customer under the 70% threshold is one heck of a strong example of the level of detail that we go into with every single one of our customers. We leave no one behind. I think one of the powers of the reorganization that we have undertaken is that it really allows us to get back to that small business level of focus, where we have small groups focused on small groups of customers, so nobody gets left behind, no matter how big we get or how many new customers we add. Add to that one additional piece of data that I'll share from the data that KLAS collects.
This is a bit of information around all of the procurement decisions that they tracked, I believe between the end of 2023 and the beginning of 2025. A couple of things to note in this. Out of all of the procurement decisions that they tracked amongst the cohort of customers that are relevant for us, we are considered in half of the deals. Within those deals that we were considered, we won half of them, which is a pretty astounding statistic. You can take the half that we were not considered in as either we qualified them out because we did not feel that they were a good fit for us, or they were organizations that decided to stick with their incumbent vendor or something to that matter. That is roughly where that is.
By far, if you look at us in comparison to the rest of the industry, we are being considered more often and we are winning more often. Couple that with the little column on the right-hand side that highlights the fact that now 100% of our customers, our existing customers, view us as a part of their long-term plans and are not looking in any time in the near future to shift away from us. 100%. It is a heck of a stat. What does the market look like today? We have 122 customers in the United States that represent many more hospitals beyond that. As of right now, the bulk of them are on-prem and install-based customers. We have seven active live Sectra One Cloud customers. This has been a big area of focus for the new sales and deployment side of the world for us now.
Of those 122 customers, that represents about 62 million annual exams that we are managing through active systems. Which, depending on how you do your math, based on volume, puts us at about an 8% market share in the United States. If we look at what is under contract, this is what is signed in backlog being deployed right now in the near future. That number for installations jumps a little bit, 133 installations. You will notice that that includes some transition of some of our on-prem customers into Sectra One Cloud, as well as continuing to aggressively add new Sectra One Cloud customers. Out of the net 11 new installations that are getting added here, that represents almost a 50% increase in the overall exam volume that we are going to be hosting in those live systems, which is, needless to say, not a small jump.
That will take us over the 10% threshold and up to 12% or thereabouts in the market. This is just what is on contract right now that we are executing on. Needless to say, a lot of work is ongoing, and I will say that our organization is running very fast. I like to talk to my organization about the fact that we have spent the last several years, to one of the questions earlier, working through the how do we manage all these organizational transitions, how do we get through the early stages of getting to a first reference customer for Sectra One Cloud in the market, and then how do we start scaling our ability to deploy those so that we can keep up with demand from the market.
And if we were looking at this in an analogy to a race at this point in time, I like to say that we've gotten off the blocks and our heads are up, but we are still very much gaining speed, and there's a whole lot of runway in front of us. Getting to the question of what's really driving the decisions in our favor in the market. You've heard much of this from some of the previous presentations, but really to put a fine point on it, consolidation is a huge driver amongst the customers that we're engaging with today. You'll hear it again from Dr. Navarro here in a few minutes from the Kaiser Permanente perspective, but this is just true across all of the major health systems that we're interacting with today. They're investing heavily in commercializing their management and their infrastructure.
When you have new leadership coming in from frequently the outside of the industry, looking at the almost 2,000 IT systems that an individual hospital is maintaining, consolidation is very high on their priority list. You add to that the fact that we're dealing with organizations that are, in many cases, distributed across an entire state or multiple states, multiple time zones, where they're looking for solutions that can actually support not only the scale of their operations from an exam volume perspective, but actually the physical scale of their operations as well, which is a non-trivial problem to deal with. Then ultimately, it comes down to cost. For them, our healthcare in the U.S. is under tremendous pressure from a cost and efficiency perspective. Every decision that is being made is being made through the lens of cost control.
Granted, the investment in us may not be directly cutting costs, but it is enabling efficiency in revenue-generating centers for the hospitals that yield a net return on investment that's quite significant. That's where the Software as a service message really starts to resonate. Because once you have leadership in these big organizations that are looking more holistically at the question of how do we generate return on investment, how do we cut costs across the entire organization, then the message around Software as a service and the fact that you can remove some of these really tight pain points, generate efficiencies, allow us as a vendor to do the thing that we're best at, while focusing your staff on where you're actually generating revenue. That message really, really hits home.
In that context, the Sectra One journey, which was referenced earlier, is a key component for us. As I mentioned, the incredible volume of new work that we are bringing on and add to that the volume of conversion work as we start to look at that install base of on-prem and recognize that we need to be able to get them over into our Sectra One Cloud infrastructure as quickly as possible in order to recognize the efficiencies that we have planned on and that we really want to see out of these investments. We have to be able to run things very efficiently in parallel with as few staff as possible.
That's a challenging aspect, but through the work that we've invested in the Sectra One journey and changing the methodology for how we do things, we're getting much more effective at being able to empower the customers to do more of the work, to take more of a standardized approach where we can do things repeatably and efficiently. Then really focusing down on how we structure the engagement with the customer all the way from contract signing, all the way up through their activation and go live. But then the continuing customer success cycle where we continue to grow with them and roll out additional modules and generate additional value in a much, much more efficient and structured way. That really truly is going to start to hit as we really build up some momentum in this transition process.
For us, I've set a very aggressive goal for my organization. I have the benefit of the fact that our market doesn't face any of the policy challenges that maybe Europe does in whether or not we can move to a public cloud software as a service. I've been very aggressive with my organization in ending sales for new on-prem customers. We did that last year. We're going to end sales for hardware refreshes for our existing customers in the very near future as a means of as rapidly as possible moving all of our customers into this new model. We've been very transparent with our customers, and the response has been quite positive from them thus far. It's going to be one of our key areas of focus, certainly over the next several years.
That I think kind of brings us to the where is our North Star? What are we orienting our organization towards? The answer really comes down to execution at this point in time. We've done an incredible amount of work internally in order to prepare the organization to execute at scale, and now we're really starting to pick up steam. As the business model and the revenue recognition side of things starts to catch up with the usage side of the world that we can see very materially, I think our organization is in a really strong place to move forward. Beyond that, as we think forward to our next presenter with Dr. Navarro coming on board, the question of where do we in the U.S. go from here? Because that's an incredible amount of business, but it is bread-and-butter business in my mind.
It's the stuff that we really know. We know well. We're taking the products that we are really, really comfortable with, even the ones that have maybe been more dedicated in the European market, and we're really bringing those and scaling them in the market. What comes next for the market is going to be huge, and this is where we're starting to see a massive recognition in the value of what we'll call either enterprise imaging or integrated diagnostics. Looking at the broader medical imaging world through the lens of modern oncology and cardiology use cases, where as technology and AI continues to develop, the ability to get towards that more precision medicine future state is going to be enabled by these platforms.
That's where going from what used to be radiology into radiology and cardiology and pathology and then genomics, and being able to pull them together in a way that clinicians like Dr. Navarro can actually look at the holistic picture of a patient is really the future of where we're going. With that, I think I'm handing it back to Torbjörn, who's going to introduce the next presenter.
We will now proceed with the last presentation, and then you're free to have coffee or go, whatever you like. All right. Thank you. Where are we going? Some final remarks. What we hear from customers, not the least in the U.S., but all over the world. We lack medical staff, and our workload is increasing. The burnout risk is real, and there's been surveys done in U.S. medical doctors where more than 50% say, "I'm just on the brink of burning out." That is not the case in Europe. It's not as bad here. They make a lot of money compared to European salaries, but there is a limit, and people need to see their kids, even if you're a medical doctor. If 50% burn out, the workload on the rest will be absolutely impossible. This is a real concern in hospitals.
We can't get new ones because it's too chew-run. Our workload is increasing. People are getting older and older, and more and more images is done. We risk burning out the ones we have. Very important driver in healthcare, and not the least in the U.S. Work through efficiency becomes paramount. A lot of the customers who are up for, or replace their systems, is because it's not fast enough, and we are super fast. They need to be fast. You cannot walk up and go. That's why the integration with Siemens CT is so important for them, because Siemens has come out with a new photon counter CT, the best product in the world. But you need a special software to view that efficiently. You can view it in a normal workstation, but then it's just a normal CT.
You would buy something cheaper than a Siemens token counting device. The doctors say, "I cannot rise up and go to another place, log in, find the patient, view the images, take down the results on a thicket, go back to my normal workstation workday." It takes too much time. Even if it's better medical care, they won't do it. That collaboration between us and Siemens, Lisa showed up here, and Fredrik has been paramount in. We have a lot of Fredriks, by the way. Fredrik Häll. It's super important for customers, and that is really nice. We are good at working with other companies. Most companies see everyone else as competitor. We are primarily taking everyone else is primarily cooperator, a partner in delivering what our healthcare needs to get in order to survive. We want healthcare when we get old as well.
I'm already almost old, but not there yet. Another thing they say, we have too many IT systems. Untenable. I can't hire the people, I cannot support it. It's huge cybersecurity risks because no chain is stronger than its weakest link. If you have 1,000 IT systems in a hospital, there's 1,000 potential attack vectors, and you can't be sure all these are safe. Stanford University Hospital, which is one of our customers had 1,085 IT systems. You know the cost of a software engineering, Silicon Valley, Palo Alto, is not cheap. It's dangerous and difficult to maintain. Lately, we also integrate diagnostics. To take a diagnostic decision on a patient is not the job of a single radiologist or single pathologist. It takes a team to do that. Then you want all information available that you need to take the decision.
We can provide all that information to, for instance, a tumor board, where there's pathology, there's genomics, there's radiology, there's patient history. That is super important, and if any time saver is important, those tumor boards, when there are 25 doctors in there, super stressed, sitting in one meeting, losing two minutes there is disaster. AI will need data. So far, AI has gotten data for only one modality. You get AI in pathology, AI in radiology. No human would do that. You don't take decision without even reading the patient history. It's now being realized in the AI industry that an AI needs auxiliary information as well from the EMR, from other modalities, and then AI can become really strong. Very few AI today do that.
As I said, tumor boards and these meetings, 25 doctors sitting there with a very high cost per minute. If they don't get the information presented effectively, that's a disaster. They don't have that time. We have radiology, cardiology, pathology, genomics, ophthalmology, dermatology, orthopedics, and we have taken these four or five different major diseases for the aging person, which will be a critical problem going forward in society. We are addressing all of them one by one. Ophthalmology addresses, of course, the eye diseases. We work with Kaiser during pandemic, a very interesting development. Our teams sat in Linköping. No one can travel anywhere except we can go to Norrköping, perhaps, and to the shop. California, they were locked in, really.
We developed it during the pandemic, and with general teams meetings, and we show them the prototypes during the entire development, that this works. It's fantastic. We can work directly with customers in the U.S. within years in Sweden to develop a very good product. We are the only vendor with all of this in one single system. That creates opportunities also for true integrated diagnostics, where you can have all this data available when you take the decisions, which is crucially important. Cuts cost and time to treatment, and it decreases cybersecurity risk. We see ourselves as Microsoft Office in imaging. In the old days, you can buy a PowerPoint solution. I think it was called Elvis Presentation in the old days. You can buy the word processor and you can buy a spreadsheet from different vendors.
Today, you buy Microsoft Office and you solve kind of all of it. It takes a very, very good spreadsheet to compete with Excel when you already have it. That's what we do. We provide a Microsoft Office to our customers, and we have Excel, and we have PowerPoint, and we have Word included in that package, which is a good thing for both, in our opinion. Then we charge per hour or charge per exam. So it's quite similar to how Microsoft Office delivers their software today. Summing up, our PACS will gradually morph into Pixel EMR, Dr. Navarro's statement here which he invented, which is enterprise imaging which Marie was very much driving from the beginning. Which will then become enterprise integrated diagnostics. Genomics is not images. That's something else.
But we're adding the information that's needed for other specialties to do a diagnosis fast, because the faster you do diagnosis, the better the treatment and the less cost for both patients and hospitals. This is absolutely required for precision medicine, especially in oncology. You need that tool. You cannot take a decision on pathology or radiology only. You need all of it. AI will be used more and more, more than only for image detection. We have so far spoken mainly of AI as an interpreter of images. But AI, you have all used ChatGPT. At least that is my assumption. These LLMs, large language models, they tried it on the final exams to become a doctor, board exams in Harvard Medical School, and the LLM standard, just out of the box, performed as the top 10% of the medical students. This will revolutionize medicine.
My personal say, it will save medicine because this burnout risk, it won't work. Someone has to be sued as well and cause stuff. This will save. It will change medicine in its foundations. I don't know if you know who Semmelweis and Fleming were, but they were important people in the history of medical. Semmelweis discovered that actually you need to wash your hands before going between the morgue and the delivery department of babies in India, and so sterilization. Fleming invented penicillin or antibiotics. These changed medicine in its foundations, so will AI. But it's different between the AI for detection, and we are working a lot with LLMs as well, but LLMs need all those information as well. This does not mean that we will abandon our core customers in radiology and pathology. We will be with them as before.
We want to be the best. We have separate groups knowing everything about these specialties. We will be the best for each one of them, but we also can deliver something together and widen the scope for hospitals, which is what Kaiser Permanente recognized. We will also concentrate not on the output, because the output of diagnostics is the value for the hospital and the patients. So we will do more work in the output and creating of output for the hospitals. That's all. With fewer IT systems, improving diagnostic efficiency, quality of diagnosis, and cybersecurity. These are what we have today. We started with radiology, it's the patient and the organ level of diagnosis. You see organs, you see the patient as a whole. Pathology goes down into the cell, which is very important.
Now, the next level we need for complete diagnosis, looking at everything, is down to the gene. We developed this picture we have used for many years. Many of you have seen it before. This is our vision. We need to get all this data, and we need population health and probability data for the EMR. We can pick it up. That together makes we can build a toolbox for integrated diagnostics. That is what we are doing. We are coming from imaging. We are becoming diagnostics in more general terms because that will be crucial for the future. A little about the culture. I present this in a rookie course for the people and say, "What is it worth to work at Sectra?" It is me there on the right, and it is a new rookie at Sectra to the left there.
At Sectra, there are only two things that you need to remember. We do important things for important people. We had a glitch here in mammography. You might have read about that. That was where we did not think all the way for the risks. It was not really a bug, but it increased risk. That meant a few women with cancer was not detected. We have to be careful doing these things. It will happen again.
We have so many lives on toe. If we do mistakes, people might die, and people might live because of us. Like the pendant, keep all promises. That is the thing. People ask me in the interviews, "Who do you think is most important in Sectra for employee?" I have one single answer, honesty. Because if you are not honest internally and with customers, society does not work. We are a team that works together.
If you see a problem at Sectra, you own it. It is a little about the culture. When I go to a customer and they complain about the wrong working or something, I need to take care of that. Everyone seeing everything in one Sectra have to listen to customers, and if they get a complaint, overspend the customer complaints, we will fix it. I like this picture. Some of you have seen it before. We are there to build integrated diagnostics. People did not think it was possible to build pathology, but we did it, and we are doing very well. That concludes our day. Our feedback is very important. Note that you also have a QR code. You can give feedback on that. These meetings are not for us, they are for you. As we listen to customers, you are today our customers.
Give us feedback, and we can make these days better, so we can become even better next month. Then I open for some final questions before we close. All right. Thank you very much for coming, and I hope you had good use of the day. Thank you very much.