Good morning, everyone, and thank you for joining us for our 2024 Q1 conference call. Before we begin, I will read our cautionary note regarding forward-looking information. Certain information to be discussed during this call contains forward-looking statements within the meaning of applicable securities laws, including among others, statements concerning the company's 2024 objectives, the company's strategy to achieve those objectives, as well as statements with respect to management's beliefs, plans, estimates, and intentions, and similar statements concerning anticipated future events, results, circumstances, performance, or expectations that are not historical facts. Such forward-looking statements reflect management's current beliefs and are based on information currently available to management and are subject to a number of significant risks and uncertainties that could cause actual results to differ materially from those anticipated. Also, our commentary today will include adjusted financial measures, which are non-GAAP measures,
These should be considered as a supplement to and not as a substitute for GAAP financial measures. Reconciliations between the two can be found in our MDNA, which is available on SEDARPlus.com and our website. With that, I will hand over the call to our CFO, Mr. Brian Goffenberg, to go over our financial highlights for the quarter. Please go ahead, Brian.
Good morning, everyone, and thank you for joining us today. The first quarter has set a strong pace for 2024, and I'm thrilled to discuss our accomplishments and the exciting trajectory we are on. We kicked off the year with remarkable growth marked by significant increases in revenue, Adjusted EBITDA, and net income, reflecting the success of our strategic initiatives and robust operational execution. Our focus on expanding and enhancing our healthcare technology solutions continues to drive increased adoption and deeper engagement with healthcare providers worldwide. We've also made strategic acquisitions that are already contributing to our top-line growth, while our operational efficiency efforts have helped improve our financial health. As we move forward, these results not only demonstrate our ability to execute our business plan but also position us well for sustained growth throughout the year. I'll now highlight our key financial performance for the quarter.
Total revenue for Q1 2024 reached CAD 15.3 million, marking a 21% increase from CAD 12.6 million in Q1 2023. This growth is driven by both organic initiatives and strategic acquisitions demonstrating our commitment to expanding our market reach. Revenue from term licenses, maintenance, and support in Q1 2024 reached CAD 12.5 million, up from CAD 10 million in Q1 2023, reflecting a 25% increase. This growth is primarily attributable to our sustained organic revenue increases within our core product offerings, bolstered further by strategic revenues accrued through our recent acquisition. Term licenses, maintenance, and support continue to be a critical pillar of our revenue strategy due to their predictable and recurring nature. They comprise 82% of total revenues in Q1 2024, maintaining a consistent share compared to 79% in Q1 2023. Revenue from perpetual licenses in Q1 2024 was CAD 121,771, down from CAD 310,398 in Q1 2023, marking a decrease of 61%.
Perpetual software licenses, which are influenced by the specific product mix sold in any given period, saw this reduction primarily due to the timing of delivery of several key Intouch products. Revenue from professional services and hardware in Q1 2024 totaled CAD 2.67 million compared to CAD 2.29 million in Q1 2023, an increase of 17%. This revenue stream can fluctuate based on the timing of hardware deliveries and the progression of customer projects. The increase in this quarter is primarily attributable to the successful deployment of new and ongoing customer projects, coupled with timely hardware deliveries, which have contributed positively to our growth in this sector. Annual recurring revenue, or ARR, of which we formerly refer to as annual contract value, reached CAD 47.8 million as of March 31, 2024, up from CAD 44.6 million at the end of December 2023, marking a sequential increase of 7.2%.
The substantial portion of this growth, CAD 1.5 million or approximately 3.4% of the total ARR, and translating to an annualized growth rate of 13.6%, was organic, underscoring our commitment to sustained growth through enhancements in our core service offering. Gross margin on total revenue for Q1 2024 was 81% compared to 80% in the same period last year. This improvement is primarily attributable to an increase in high-margin maintenance and support revenues, which represents a larger share of our overall revenue mix. Recurring revenue constituted 82% of total revenue this quarter, maintaining a consistent level with Q1 2023, highlighting our strong focus on sustained revenue streams. Operating expenses in Q1 2024 were CAD 8.8 million, reflecting a 15% increase from CAD 7.7 million in the first quarter of 2023.
This increase is mainly due to elevated sales and marketing activities, which included additional spending on conferences and exhibitions, as well as a sustained investment in research and development to further enhance our product offerings. Notably, despite the increase in absolute figures, the operating expenses as a percentage of revenue improved significantly, decreasing to 57.5% in Q1 2024 from 60.7% in Q1 2023. This demonstrates the ongoing operational efficiencies and cost synergies being realized across the company. Net income before income taxes in Q1 2024 was CAD 2 million compared to a net income of CAD 780,428 in the equivalent prior period, representing an increase of 154% year-over-year. This substantial growth in profitability for the quarter can be largely attributable to the significant rise in revenues driven by both organic growth and strategic acquisitions, alongside continued efforts to optimize costs and enhance operational cost synergies across our business units.
Net income after tax in Q1 2024 was CAD 1.3 million, a significant improvement from the net income of CAD 162,000 in Q1 2023. This marks an increase of 713% year-over-year, highlighting our successful financial strategies and the robust growth stemming from both enhanced operational efficiencies and strategic acquisitions. EBITDA in Q1 2024 was CAD 3.1 million compared to CAD 2 million in Q1 2023, an increase of 56%. The substantial growth in EBITDA underscores our successful strategic initiatives and operational efficiencies that continue to positively impact our bottom line. Adjusted EBITDA in Q1 2024 was CAD 4 million, or 27% of revenues, compared to CAD 2.9 million, or 23% of revenues in Q1 2023, representing an increase of 38%. This improvement was largely driven by an increase in recurring revenues, which rose to CAD 12.5 million in Q1 2024 from CAD 10 million in Q1 2023.
This revenue growth, combined with our persistent efforts to streamline operations and realize cost synergies, has significantly bolstered our Adjusted EBITDA margins. Cash flow from operations before changes in working capital for Q1 2024 was CAD 2.9 million compared to CAD 1.5 million for the same period last year, representing an improvement of approximately 98%. This significant increase highlights our enhanced operational efficiency and robust revenue performance. Cash on hand at March 31, 2024, was CAD 33.3 million compared to CAD 33.5 million at the end of 2023. The slight decrease over the quarter can be attributable to strategic financial moves, including an investment of approximately CAD 5.3 million in acquisitions. Despite these expenditures, the company maintained a robust cash position due to strong operational cash flows and ongoing revenue growth. When you add our recent financing, the company now has an excess of CAD 70 million in cash.
With that, I'd like to hand the call over to Dan for an update on the business.
Thanks, Brian. Good morning, everybody. Just a brief update from me. I think we just spoke about six weeks ago with the end of the year, so not a dramatic change. Again, a good quarter for us in Q1. Again, proof of our business model being cemented in, and we continue to make acquisitions. We did get one over the finish line with BookWise in the quarter, and our organic growth continued to go at a pace of CAD 1.5 million, which is the high end of our guidance. Again, proof of our ability to make an acquisition. I think it was highlighted. Our cash position remained the same, although we still made the acquisition of BookWise for CAD 5 million in the quarter. So we're using our own cash in that particular situation to make acquisitions. So it's something that we'd like to highlight.
Again, adding the 1.5 was on the high end of our guidance in terms of ARR. A little bit on the BookWise acquisition, we're excited about that one. It's a company that our U.K. group has known for a while and has worked with and competed with in terms of room and resource booking in respect to outpatient facilities. So we have a little light module of light BookWise already in the Intouch suite of products, and it just gave us a more robust base. So we hope to get some good cross-sell base sales of that as we continue to work towards that. Again, our organic growth across all of our product lines was primarily led by the TREAT and Transforming-based solutions. We're seeing and continue to see some uplifts in that particular product set and really good activity in respect to that.
We did have some questions that came to me by email. I do want to address some people started looking at the high balance of our accounts receivable relative to the other quarter. Q1 has a lot of seasonality in respect to our accounts receivable. We have a lot of our government year-ends at the end of March, so we do have a lot of our renewals that come in at the end of March. So that has a lot to do with our ARR perspective to do it. In respect to M&A, our expectation is to be very robust in that in the next little while. Our pipeline is really strong. We have a lot of activity going on in the M&A perspective, with some of that being on the high end of the ARR side. So we're excited about that.
We're excited about getting to the next phase of growth with M&A when positioning our organization to be able to absorb some of these larger acquisitions. So we are starting to make investments more into our corporate infrastructures, our integration methodologies, so that we're ready for these in a concrete fashion. You saw the formation of Pat Mezza to COO. He's a seasoned veteran in terms of working in this particular space. We have other senior folks that are stepping up and other senior folks that we're looking to bring in to help us with these integrations. So a lot of that is starting to happen on a global basis. So we continue to make investments in sales as well in our areas that we're not into that much in terms of the Middle East and Australia primarily.
We're starting to see a little results of that, and we're starting to see the pipeline grows in both those areas. We expect that to happen at the end of the year. So on a go-forward basis, as we make some of these acquisitions, our financials could get a little bit blurred with these acquisitions in terms of as we work to right-size them and bring them into our fold. We expect that to start happening over the next little while as we get into the latter part of this year. I'll take any questions that anybody has.
Thanks, Dan. Thanks, Brian. Should you have a question, please use the Zoom raise hand function at the bottom of your screen. First question comes from Gavin Fairweather of Cormark. Gavin, your line is open.
Hey, good morning and congrats on the strong results. Given that you're a consultant, we often focus on what products you're buying. In the prepared remarks, Brian referenced some of the organic R&D work that's kind of going on behind the scenes just to expand your TAMs and expand products and drive organic growth. Maybe you can speak to a couple of current initiatives that you're excited about and you're working away on in terms of organic R&D.
Yeah, I think a couple of examples of that, and there's more of it. We've set up a business intelligence-based group that's centered out of that acquisition we made last year called Alamac in the UK and is being beefed up by a group in our Colombo-based office, which does business intelligence where we can start adding BI and decision support modules to all of our products. And that seems to be happening as an add-on module. It makes our products a lot more stickier. It gives a lot more value. Primarily, we've been doing a lot of that work on the Transforming product set. So not only is it read-only data coming in, but they can start doing business intelligence reporting and predictive analysis on the back end of it.
A lot of our EHR products, they would like to start seeing, for no better words, a portal or patient input into the EHR. So we've added a portal-based solution on our TREAT-based solution and other solutions on the EHR side so that outside patients or clients can get access into systems and start communicating with that. So again, add-on modules that will continue to do that. The S12 product, we've added more additional modules that we can upsell on a forms perspective. The BookWise acquisition is another module that could be upsold on Intouch. Those are, we're working with the Australian group on moving some of the TREAT and Coyote-based functionality down to the Australian market, which gives some new features and functionality. So we're always looking at new initiatives like that. And those are some of the examples, Gavin.
Yeah, appreciate that. And then just secondly, on M&A, I think you referenced maybe I'm reading between the lines that maybe there's some larger acquisitions coming. You certainly have the capacity for larger acquisitions given the cash that you have. So should we be expecting, generally, deal size just to start to trend higher over time? Do you have a preference for those? Would you still consider tuck-ins? How would you frame that?
I wouldn't use the word trending to get bigger, but we do have bigger scenarios that are in play internationally, which are all, I guess, an excess of CAD 8 million-CAD 10 million of ARR that are in play. So some of them are of significant size. So again, those are, you never know how these things turn out. But all I can say, it's more than it's more than we've ever had in that protective perspective in terms of staring that in the face.
What kind of competition are you seeing in that segment these days?
There's always competition. I think for a large percentage of them, we're in good position there. You never know how these things work. We stick by our business model, and we stick on what we do. Time will tell.
That's fair. And then a couple of financial questions. Services revenue is quite strong this quarter. Is that mostly TREAT-related? And maybe you can just touch on kind of the services backlog throughout the rest of the year in terms of whether the current run rate that we saw in Q1 could be maintained, which is quite a bit stronger than we saw last year.
TREAT is a nice chunk of that, although we are seeing some coming from the Transforming base with those deals coming through as well. But TREAT is the biggest bulk of that. There's a tremendous backlog of services work in that area that continues to grow, and it sometimes gets a little overwhelming for our groups. But it's a good problem to have. As part of the implementation process, people are looking for new things and a little more complexity in terms of some of those implementations. We're still heavy into the SolGen work, and we expect that to continue. Nova Scotia continues to add additional modules and services work that continue to come into play as well as other initiatives.
So we have the ability to execute that with our Colombo base, and we do expect that to continue at least through—we have visibility at least through 2024 into pretty robust services work at least through the next couple of quarters, per se. But yeah, we'll see how that entails in the long run here in terms of what happens.
Great. And then just lastly for me, term license and support. I've noticed at times it tends to run a little bit higher than your ARR would imply. And this quarter, it was a bit more notably ahead of what your ARR would imply. So can you speak to what's driving that outperformance? Is there kind of some one-time support or things like that which are flowing through that line?
There's one-time support, and sometimes there's catch-up transactions where we know they're going to come in, but they're not committed yet to coming in. It just delays, and then you get a catch-up in the quarter on that. So it gets a little bit on the other side of it because we're catching it up.
Okay. Makes sense. Just wanted to check in on that. Thanks so much, Gavin.
It's just a conservative revenue recognition perspective that we have there.
Okay. Thanks so much. I'll pass the line.
Thanks, Gavin. Next question is from Gabriel Leung of Beacon Securities. Gabriel, your line is open.
Good morning, and thanks for taking my questions, and congrats on all the progress. Got two questions for you, Dan. So first off, has there been any sort of change in the M&A environment, whether from a valuation standpoint or number of bidders you're dealing with, or even timelines around executing on your M&A pipeline that would have prompted you or the board's decision, I guess, to augment what was already a pretty strong balance sheet to begin with? I'm just curious on your thoughts on that.
Yeah. We think M&A in general, especially on the bigger side, we've been seeing companies that have the markets open to raising cash. It isn't like it used to be, right? So we're seeing some of these companies that are sitting there. There's a little bit of growth and big ARR numbers, and we think they can do better. But I think it's just that they've finally just come to the conclusion it's time to exercise their ability to sell, and they've put things up for sale. So we are seeing more of that going on, and we are seeing less competition from what I'll call unknowledgeable buyers, right? So I think anybody that I don't think anyone's going to take a flyer on a healthcare-based company unless they really know it.
I think the people that are looking at these type of acquisitions are people that understand the space as opposed to not smart money, as I would determine it. So less competition in that realm, we think, on these deals. And I think that's putting us in a better position to get them.
Gotcha. No, that's helpful. And then secondly, I mean, you guys obviously provided a pretty thorough operational update. So maybe I'll ask a bigger picture question. If you sort of look out three to five years from now, what does VitalHub look like? Is there enough opportunity within the existing product portfolio that you think you could sustain sort of that, let's call it, 50%-plus organic growth profile in ARR? Or is there an underdeveloped opportunity that you see out there that you don't address right now but would like to aspire to?
Listen, as we start making more acquisitions, we had the board meeting yesterday, and I said the canvas we need to keep building the canvas so that we can build beautiful art. And that art, to me, is both organic growth and the bottom line. And I was saying it all the way through. Our ability to sustain those high-teens organic growth isn't really what's going to happen here, right? I do think it's we will make acquisitions that we don't expect to grow and that we can get really good bottom-line access to. And that's part of our strategy. When we look at some of the deals, we look at it from both sides of the angle. We'll pay less for those acquisitions, but we'll get a pretty good return on it.
But it is going to, it will impact the top-line growth because not all of our products are meant to get top-line growth. But we do expect to continue core products and core sets to get top-line growth. And those will be offset by some of our product sets, which we expect not to grow as much. But we're always looking for cross-selling opportunities and trying to train our groups. But it's going to be an amalgamation of those. So our belief is we want to be a compounder. We want to generate the bottom line first and then the top line second. But it doesn't mean that we ignore totally the top line at all.
We want the top line, but we're not going to be that organization that's willing to take one of our assets and wait three years for it to get huge organic growth because of a TAM trying to create a unicorn within here, right? That's really not what we're trying to do here. Some of those scenarios, for sure, are getting good growth, and we'll continue to look for those growth opportunities. But the bottom line is really what we're trying to focus on.
Gotcha. No, thanks for the update, and congrats on the progress.
Thanks, Gabriel. Next question comes from Christian Sgro of Eight Capital. Christian, your line is open.
Hi. Good morning. One follow-on question on the M&A path. You kind of outlined the criteria for M&A, which seems consistent with the longer-term mission and historical recurring and profitability mixes that you're looking for. I guess as you look at the current pipeline, would you tilt towards something that's more creative financially or technically? Would you say it being accretive to EBITDA or the margin profile is a priority for you, or you want to see first and foremost fit within the portfolio? How would you tilt that way?
Well, they're both important to us, Christian, although one's a non-starter and one is a starter. If it doesn't have the financial metrics and it's synergistic, it doesn't matter. So it's got to hit the financial metrics first and then synergistic second. And if it's not synergistic and meets those financial metrics, we might do something like that as we break into a new area or a new vertical or a new country or something that makes sense. But we would think really hard before we did that, right? So ideally, we want both, right? We want something that meets into our narrative and meets our financial metrics. And I can say that everything we got in play at this stage is in both of those in both of those areas. So that's how we look at it.
Agreed. And then for my second question, non-Transforming in the UK, is there anything to be said about reaching a level of saturation under your current buying or your current penetration? Or do you think very positively on the TAM there, the visibility into growing that expanding across the NHS this year?
You're talking about just the NHS in itself?
Yes, for transforming or more broadly if it's elsewhere.
Listen, it's a pretty sizable TAM, and we still think we got work to do there and more things to go on. And penetration levels are still there, but it is a limited TAM like anywhere else. And we need to move those products outside of those markets, and we are. And we need to make acquisitions that are continuing to grow to do that. So both of those are all in the works. But yeah, our expectation is to continue to make sales of those things, at least in the next little while, for sure. And other things will take its place, and new modules will take its place. And the bigger we get with acquisitions, we still think we're going to be able to sustain some pretty good organic growth numbers across the entire organization. It's a combination of a bunch of things.
It's not just one product set. Right now, those product sets are in a pretty good run.
That's all helpful. Thanks for taking my questions, and I'll pass the line.
Thanks, Christian. Next question comes from Doug Taylor of Canaccord. Doug, your line is open.
Yeah. Thank you. Good morning. Another couple of questions about the M&A strategy and roadmap here. I mean, obviously, your cost of capital here is reduced. Have you changed your aperture in terms of the amount that you'd be willing to pay for some of these growth year and more sizable acquisition targets?
I think it's just a question of how we model it at the time, Doug. If we have to pay more and the model still works, that we can make good money on it, we'll pay more, right? But if it doesn't, it doesn't. So it's all how we model each scenario and how we look at it strategically and how it all fits. And everyone has it. Every acquisition has its pros and cons and trends and understanding the markets to be able to assess it. So sure, we would pay more. We always would for something that makes sense to go do. But it has to make sense.
Maybe said another way, you haven't changed the goalposts with respect to valuations as a result of having a lower cost of capital now?
Yeah. I don't think the lower cost of capital is really driving our methodology at all. It's always going to remain the same.
Okay. You spoke, I think, on the last call or at least recently about some M&A opportunities that happened over the last short couple of quarters that you'd passed on or you were outbid that might be coming back around. I mean, do you want to update us on whether some of those opportunities still exist? Is that what you're referencing with some of these CAD 8 million-CAD 10 million ARR acquisition targets?
Yeah. I don't know if they were ever outbid or not. Some of them are. Most of them aren't. Most of them are companies we've been talking to. Yeah. There's companies that I've known for 20 years in that bucket, right? So they're groups that we continuously talk to, and we continuously have conversations. And CEOs to CEOs speak and say, "Hey, this plus this makes a lot of sense. And I think it's good for your guys, and I think it's good for us. And this is what we can do with it together. And let's see what we can do to make these things happen." So that's really what the scenarios are.
Okay. And the last one for me. At the end of your prepared remarks, Dan, you made the comment that we might expect or could see the financials get, I think, to use your terminology, blurred or blurry, the financials of VitalHub as a whole. Maybe I just want to maybe press you on exactly what you mean by that statement. Are you referring to the relative size of what you're acquiring versus the existing business, or?
Yeah. We're going to start making some of these bigger acquisitions that they're not going to have our growth profile or our earnings profile out of the get-go, right? And it's going to take us time to move these things around and to shift they're bigger, right? So we got to be prepared for that. That's why we cashed up. That's what we think we need to do as a company, is get more size and scale and get things going. But there will be potentially, if we get these things over the finish line, some transitionary timeframes to make that all happen. And it will take some quarters till we come back and maybe see the same profile here. So it's something just if it happens, it hasn't happened, but that could happen.
Just try to manage the expectations of everybody that this is a long run that we're looking at.
Understood. Thanks for the extra clarification.
Yep.
Thanks, Doug. If there are no further questions, Dan, back to you for your closing remarks.
Yeah. Just like to thank everyone for coming. Again, it's Q1. We won't see everyone till, I guess, August here. But we're available for any questions. We're really excited where we are as a company. We're sitting with, we're generating cash. The organic growth machine keeps going. And we're ready to get to the next level of moving to getting this company over the CAD 100 million mark. So that's what we're focused on right now. We're inching forward every quarter, and we'll just keep running the business model, per se. And thanks, everyone, for their support. And if you need any questions answered, give us a call.
Thanks, Dan. Thanks, Brian. Thanks, everyone. This concludes our call today. You may go ahead and disconnect. Thank you.