Carasent AB (publ) ($CARA)

Earnings Call Transcript · April 14, 2026

OM SE Health Care Health Care Technology Earnings Calls 69 min

Highlights from the call

In Q1 2026, Carasent AB reported a revenue of SEK 90.4 million, reflecting a 6% increase year-over-year, driven by a robust 16% growth in Annual Recurring Revenue (ARR) to SEK 360 million. The company's EBITDAC margin improved to 10%, up from 6% a year ago, indicating effective cost management despite a significant drop in consulting revenues. Management maintained a positive outlook for ARR growth, particularly in the Nordics, while signaling challenges in the German market due to legacy product churn. Guidance for the upcoming quarters suggests a focus on scaling the new Webcur system in Germany and leveraging AI capabilities to enhance product offerings.

Main topics

  • Strong ARR Growth: Carasent achieved a 16% year-over-year growth in ARR, reaching SEK 360 million, with a net revenue retention rate of 111%. CEO Daniel Ohman emphasized, "We continue to scale our business in a good way," highlighting the strong demand for their recurring revenue model.
  • Decline in Consulting Revenues: Consulting revenues fell by 50% from SEK 8 million to SEK 4 million, impacting overall revenue growth. CFO Svein Bjornstad noted, "Consulting revenues typically vary more from quarter-to-quarter and is more lumpy in nature," indicating a strategic shift away from consulting.
  • AI Integration and Product Development: The company is focusing on integrating AI into its products, particularly with Medsum, which aims to streamline administrative tasks for healthcare providers. Ohman stated, "We believe strongly that as it gets fast and faster to develop software, customer demands will increase," indicating a commitment to enhancing user experience through AI.
  • Challenges in the German Market: Management acknowledged ongoing challenges in Germany, with a third of churn attributed to legacy products. Ohman commented, "It will probably continue more or less in that trend," suggesting a cautious outlook for immediate growth in this region.
  • Cost Management and Profitability: The EBITDAC margin improved to 10%, with management successfully converting approximately 80% of revenue growth into profits. Bjornstad remarked, "We have been able to absorb these costs and become more efficient in other areas," reflecting strong operational discipline.

Key metrics mentioned

  • Revenue: SEK 90.4 million (vs SEK 85.2 million last year, +6% YoY)
  • ARR: SEK 360 million (up 16% YoY)
  • EBITDAC Margin: 10% (up from 6% a year ago)
  • Net Revenue Retention: 111% (strong retention rate indicating customer satisfaction)
  • Consulting Revenues: SEK 4 million (down from SEK 8 million, -50% YoY)
  • Organic Growth: 7% (reported organic growth in the quarter)

Carasent's strong ARR growth and improved profitability metrics are encouraging for long-term investors. However, the decline in consulting revenues and challenges in the German market present risks. Investors should monitor the rollout of Webcur and AI integrations as potential catalysts for future growth.

Earnings Call Speaker Segments

Operator

Operator
#1

Welcome to Carson Q1 Report for 2026. [Operator Instructions] Now I will hand the conference over to CEO, Daniel Ohman; and CFO, Svein Martin Bjornstad. Please go ahead.

Daniel Ohman

Executives
#2

Good morning, and welcome to our presentation of the first quarter of 2026. We will start with me giving a company update, and then I will hand over to Svein Martin for more of a financial update. First, a quick overview of who we are. So our business is to help our customers, who are private hospitals and clinics, to help as many patients as possible. We do this through our HR systems and related products. We're growing rapidly this quarter with 16% ARR growth and with highly recurring revenues in this quarter, it's actually above 95%, and with net revenue retention of 111%. So looking a little bit more of the highlights of the first quarter. So as I mentioned, we had good ARR growth of 16%, and we continue to scale our business in a good way. In this quarter, we had almost 80% of the growth translating into profitability. And we've been working in the last couple of years, and this is how we aim to continue working. In the quarter, we have quite low consulting revenues. And consulting revenues, they vary between quarters very much depending on exactly what happens, which type of projects we have in each quarter. And what I think is also, and we have mentioned many times before, consulting revenues are not our focus. That's not what we want to build our business on. And we're trying and we're working to move consulting revenues into ARR instead. It also makes it easier to convince the customers of changing their HR system by not having a lot of upfront costs. So this is something we're working towards. But sometimes the projects are the type where you can have consulting revenues, and sometimes customer is of such type that they expect costs there and can accept costs there, and it's difficult to move them into ARR. We have a major milestone as we speak. We're moving our first paying customers into our German system, Webcur, which was formerly named Webdoc. Webcur was a name that was preferred in the German market. This is a major milestone. We are very much looking forward to it and to start scaling the sales of our new system in Germany. Also, we have some promising traction from Medsum. We have signed up more than 100 new users this month or last month, and I will come back to this. As I mentioned, ARR is now at SEK 4 million. And what I think is worth mentioning around that is that almost SEK 4 million are new. So all those are sales from this quarter. The SEK 5 million we had last quarter has already been implemented. And in total, with the 6% organic ARR growth and the lower consumer revenues, we have 7% reported organic growth in the quarter and an EBITDAC margin of 10%, up from 6% a year ago. So talking about what I think most people are talking about at the moment, AI. This quarter, I plan to talk a little bit about how we act, what we do with AI. And there are three areas which I would like to mention. The first one is that we accelerate development. We believe strongly that as it gets fast and faster to develop software, customer demands will increase. So what our plan for that is to use all efficiency gains into producing more functionality for our customers and a better user experience for our customers instead of saving money. So the aim is to really increase the pace, get more and more functionality out to our customers. And what that means is that we're widening the gap between our product and the legacy systems who do not really develop. And if you haven't really developed, AI will not help you very much starting to develop. You don't have the culture, you don't have the structures, you don't have the staff. So I think that, that will really help us. But I think it also will be an expectation of customers, and it also means that we're keeping gap to potential new threats and competitors the same or like to same, keep a big gap between us and them by continuing to always develop and increasing the speed as we go. And we see quite big gains from AI in development and in many other functions also, too. At the same time, it's very important that we continue to live up to all regulations to make sure the product is always stable and that it's secure. So it's a bit of a balance act, but I think we're taking big steps forward and getting better every week and increasing the pace. We also do a lot with AI in the product, and there's a lot of potential to do a lot with AI in the product. And that comes from health care has a lot of administrative demands and it takes a lot of time from our users. And AI is really good at administrative part. So Medsum, which is our [ medical scribe ], that means that we're listening in the discussion between the doctor and the patient and automatically proposes a general note already prefilled entry system, where the doctor can then make some smaller changes if he or she needs to do that. What's been very important there is to match the quality of the leading scribes that started a bit before us. And we now feel that we are at that point, and I know that many of our customers feel so. Most of the customers we gain from other scribes because they already know the structures, they know they like to work with those types of tools. And they feel it's much better that it's completely included within the HR system instead of a separate system. And the potential gains from this are really big. The studies out there say that you save between 15% and 33% of the documentation time, which is a lot of time for our users. I will get back to next steps, what we'll do on the next slide, what we plan to really do. But what I think we're focusing on now is to really rebuild the UI of mostly Webdoc, our largest system, to make sure that the AI experience fits the UI experience, and it creates, in total, really good experience for user and a really efficient experience. So this year, we're building quite big parts of the front-end of Webdoc to make sure that AI is a natural part of it. And what we want to do with the AI tool studies, and part of it we already do, but when you have the discussion with your doctor, will listen in on the entire discussion. But from the discussion today, we have proposed a clinical notes. The next step is to really catch everything that you agree with the patient to do, so prescriptions, referrals, follow-up bookings, sick leaves and so on. So all of these are tasks that their doctor, physical therapist or so needs to do either documentation and quite often do after documentation patients. And it's a lot of their time and there are stuff that they don't really like. So we catch it all so you don't have to remember it. You can just see it popping up in the system as you speak, the task that you have to do. And then while you're done, you just go through the task that the AI has proposed for you. And as much as possible, there are some legal hurdles on some of these tasks. But most of them, we can have completely prefilled proposals, both from the talk but also from previous medical notes and other information we have in the HR system to really make sure that we give such as good proposal as possible. And this we aim to have in place by the end of the year. The reason is takes until the end of the year is that we redo the entire UI. We are interviewing, we're sitting with a lot of users, testing different ways of building this, testing how they really want it to work. Because as I mentioned before, the most important is that we build technology that really fits how our users want to work and fits their every day. We are in no stress. We have the strong position we have. And this will not -- in Sweden and the Nordics and Germany, this will not grow exponentially. This will be a steady step that uses one to start using this type of tools. So we're doing it really properly. We're doing it fully built in as a natural part of the system rather than just hiring it out. We want to be a fast follower in Germany. So it will be a very interesting autumn, I think, releasing all this functionality. Looking a bit more at the journey ahead, we aim to continue as we do, so with strong organic growth. especially focus on ARR. We aim to continue to have a good grasp of the costs, not to reduce costs. We believe that we need to release ever more functionality to our users. There is so much we can do for them. But we have a tight cost control, and we aim not to increase our cost and that the absolute majority of all growth should translate into profit. And then this year, we're also launching Webcur, formerly Webdoc X in Germany, which is a major milestone for us. With those first, I will hand over to Svein Martin.

Svein Bjornstad

Executives
#3

Thank you, Dani. So starting off by looking at the financial highlights of the quarter. So the headline growth figure, as Dani mentioned, looks a bit lower than we were used to, and I will get back to that in more detail on the next slide. But the underlying metrics that we follow that we believe drive value in the long term, the ARR growth, the scalability and the cash flow generation, continued to develop in the right direction and improved a lot compared to last year. We ended the quarter with SEK 360 million ARR contract there. It grew 16% year-over-year. And we had a strong net retention of 111%. Profitability also improved a lot, and EBITDA margin was 20% and EBITDAC margin was 10%. Starting with the P&L. You see that the revenues came in at SEK 90.4 million compared to SEK 85.2 million last year. And this, as you see illustrated here, is a growth of 6%, 7% adjusted for currency. And you see that there was a drop in the consulting revenues from SEK 8 million to SEK 4 million, so a 50% decline, and that is the reason why the growth is lower than the ARR growth. This is a few different reasons, but the consulting revenues typically vary more from quarter-to-quarter and is more lumpy in nature. We also had in Metodika, we had to focus a lot on cost implementation work for Volvat that didn't generate the revenues. And in general, we prioritize away consulting in new sales processes compared to the recurring revenues. Looking at the cost base, which I think is one of the key highlights of this quarter. The cost base is essentially flat year-over-year. You see personnel expense increased SEK 1 million. Other OpEx decreased around SEK 1 million. And the capitalized development increased SEK 0.5 million, so around SEK 0.5 million increase in total. And this is even though we had quite a lot of cost for AI-related features, such as Medsum, we have a big hosting cost before we get a lot of revenues. And also in our own development, we had tools. We have been able to absorb these costs and become more efficient in other areas basically. So this results in EBITDAC of SEK 8.6 million compared to SEK 4.8 million last year. So you see that the revenues grew approximately SEK 5 million and EBITDAC grew close to SEK 4 million. So we were able to convert close to 80% of the revenues into profits, even though we have very low consulting, which typically has 100% drop through rate. So this is a very important metric for us. Also worth noting that there is no adjustment in the figure and there was no adjustment last year either. Looking at the ARR bridge. It clearly shows what the growth is coming from. Now you see on the left side, we had SEK 320 million contracted ARR last year. And then the net sale this year was very strong, SEK 45 million or 15%. This is also stronger than historical figures. And this is because some of the large new units we have added is included here, such as Medtanken and Volvat, adding SEK 10 million alone. This is good net because we had some units from these customers before we signed a big contract. So it's an existing customer. Upsell in general also was very strong. in the quarter. And you see churn here, SEK 10 million, 3%. 1/3 of this is coming from the German legacy product. So in the Nordics, we can see now that the churn has normalized again, as we had communicated in that we saw that churn was down to lower levels. And if you remember March last year, we took effect a lot of the churn we had in Webdoc there took effect in March. So now this is not included in the figures anymore. On the new customer side, we had SEK 50 million in ARR added, 5% growth, and it improved quite a lot compared to last year as well when it was SEK 11 million. So in total, ARR grew 16%. And worth noting is that the Nordics is now growing at very strong levels. So excluding Germany, the ARR growth was 19% in the quarter, which is higher than we have seen actually for the last few years. So this is a very good sign that the momentum in the business is continuing. This slide, we have shown many times now, and it's a good illustration of how we think about developing the business. To explain it to those who haven't seen it, the orange line there is the revenues and then the bars is the cost base that we have. And the dark blue part of the bar is the OpEx, CapEx and personnel expense for the organic business, if we exclude the acquisition we made. And you see that it's been extremely flat over the last 10 quarters. And this means that we have also been able to take out costs given that we have wages increase in inflation, et cetera. And this is, of course, very powerful. So if you look at how the margin has developed because of this, we had the EBITDAC of minus 30% 3 years ago. It's now plus 10%. And we still have capacity to continue to scale, and that's the plan going forward, to add very little cost. We will add some roles this year in Germany to roll out Webcur commercially. But in the Nordics, we will continue to be very disciplined. Finally, on the cash flow. You see that in the quarter, we had very strong free cash flow, 47% operating cash flow and a 36% margin on the free cash flow. This is, of course, because of a very strong working capital effects during the quarter. And it's driven by three main effects. Firstly, as I talked about in Q4, we had a big customer that had a delayed payment in Q4. This came in, in January, and it was SEK 10 million added. So this would normally have been Q4. Then we had very high consulting revenues in Q4. This was paid in Q1 as well. So this, of course, boosted the working capital to convert to normalized levels. But then Q1 is typically also quite strong because we have annual invoicing of certain customers. And it's worth noting also that our working capital profile is very supportive to our cash flow in the long term because we charge upfront and we generally pay our invoices after the period and salaries. So all in all, final point there, share buyback. We did SEK 40 million in the quarter, and it took around SEK 40 million in cash. But all in all, a quarter that, the underlying metrics, the ARR growth, the conversion of revenues into profits was a step in the right direction. And we continue to deliver on the plan on these important metrics. So with that, I can open up for Q&A.

Operator

Operator
#4

[Operator Instructions] The next question comes from Elvin Rolder from DNB Carnegie.

Elvin Rolder

Analysts
#5

Daniel and Martin, I hope you can hear me. I have a couple of questions from my end covering a bit of a range of topics. Maybe we can begin on the consulting part given that it was kind of a contributor to the lower revenue here in Q1. You mentioned in the report that especially the Volvat effect are expected to subside in Q2 already. Can you kind of help us in what kind of base shall we use going into Q2 here now? Or do you think like Q2 2025 is still very unrepresentative? You mentioned the comp in Q1 was difficult. And so can you help us kind of bridge that a bit to understand that?

Svein Bjornstad

Executives
#6

Yes, sure. So I would say that the Q1 is a bit on the weaker side on consulting than like a normal level because we didn't have Metodika doing a lot of consulting work. But in general, it's not the key priority for us, as we mentioned. It's not that simple to be very specific on like guiding for the next quarter and the year. But I would say, in Q1, it's a bit lower than what we have as a run rate level when Metodika is fully free to do consulting work. I don't know if you have anything to add.

Daniel Ohman

Executives
#7

No, I would say is that what happens is that Metodika, with the big implication involved, we had some work to continue to do in the first quarter, which we do not charge them for at all. We feel it's very important to have a happy customer. And we can also see if we get a lot of questions from potential customers in the Norwegian market from successful roll out project. So I think that's worth the investment. But they will move on now to more of a normal business in the second quarter. So we should really see consulting revenue picking up. I can also mention that we, even if our focus is ARR, we want to, of course, have a good result as possible. So we're also looking over a bit how we work. So it used to be that when we sold to a new customer, we had quite not high fees, but we charge them for education, setting it up for them and so on. Now we very often, to a very large degree, give it away to the customer as part of the negotiation and not to negotiate a lower ARR or the subscription base. You don't want to lower that. But maybe we're giving it away a bit too easy. So that's something we're discussing internally. I don't have an answer for that yet. But that's something that we're looking at because ARR is our priority, but of course, if it's possible to also, without hurting the subscription revenue, to have some other revenues, that's fine. And that's something we want, of course. So we're looking over that a bit, if we're giving it away a bit too easily. But in general, the coming quarter will be better than this quarter, but not as good as the best quarters last year when it comes to consulting revenues.

Elvin Rolder

Analysts
#8

Okay. Very clear. Continuing on Germany. You attributed 1/3 of the overall churn in the group to kind of the legacy products in Germany. And we saw a decline in revenue overall for the German operations here in Q1. Should we expect revenues from Germany to kind of decrease for the full year 2026? Or do you think that you will be able to compensate the loss from Data-AL in what you gain on Webcur? Or is that perhaps too early?

Daniel Ohman

Executives
#9

Yes, I think that's a bit too early. So this year, it will probably continue more or less in that trend, I would say. And the major thing to look at this year is to really get Webcur up and running, happy customers, the first ones who can be references for future customers that we get sales and marketing going and so on, but for them during next year and the year after that to really see growth coming and that we're growing much faster than we're losing customers. But it will take a bit of time.

Elvin Rolder

Analysts
#10

Yes. Very clear. And then moving on to Medsum here. I believe a couple of quarters ago, you mentioned that you have an ASP of, I think it was 750 per user per month. Please correct me if that's wrong. But is that still kind of a valid level to assume? And has that had an effect on sales yet? You mentioned the 100 users live or signs since last month already. And a bit tied to those users, is there anything exceptional about kind of these users that we should be aware of? Have this been involved in like kind of pilot programs and have been involved since the start in this? I guess the essence of the question is, should we expect the next 100 customers to come fast, basically?

Daniel Ohman

Executives
#11

That's a good question. It's hard to answer, actually. But I'll try to give as much information as I can. So now those were not pilot customers. We had roughly around 50 customers through their pilot phases the last maybe 6 months, a little bit on and off. But roughly 50 customers. They are still there, the users, I mean, and they are converting to paying customers. And then since we then relaunched, we have gained another 100. And every Monday will go through sales. And if you look at up sales to customers, and some is now quite a large part of all discussions and all the meetings with customers and also in signed. So I think that's going really well. I think it's a bit hard to predict. The ones we win usually now move from other such solutions. So those are early adopters. They have used these type of solutions before. They like it. The rest who does not start using these type of tools, how quickly will they start using this is kind of a question. In general, this business is slow. I mean health care workers are trained not to take risks and they are a bit conservative. Our group of users are a bit more offensive. They are on the private side. But still, I mean, they have the legacy of being educated and working the public system for the entire education and far beyond. So in general, they are slow. This technology, on the other hand, has really potential to save a lot of time for them. And it does not force them, at least not to a large extent, to work in new ways, which is typically the barrier. So I have hopes that this kind of thing only will go faster than other technologies and it will also be more enduring, I mean, at this day. And I think many of us were in the time where video meeting started, and there was [indiscernible], and it kind of didn't grow very much. And now it's declining. But this, I think, is different. I think this really saves time. I think it's easy to start using and, for many of our users, fits really well. But if you also keep in mind the other good solutions for it. We have in our systems phrase libraries. So many of our users have very similar patients over time. They have already prefilled what takes to be there. and then there may be a change from right to left eye or something like this. So it's not for everyone, but I believe it will be for many of our users in the majority over time. And as we add more functionality during the year, I think we'll see more and more users that see, okay, now it really saves a lot of time for me, too. But it's a bit hard to predict how quickly users will pick it up. As mentioned on the video is that one challenge we have, but we also overcome in these numbers, as you can see, is that the digital territories, they are actually declining a bit in Sweden and who also can use our systems. So it's a bit hard to predict where technology is going. But I think this one will pick up quite rapidly compared to other technologies for health care. That was a long answer, sorry for that.

Elvin Rolder

Analysts
#12

That's great, Daniel. A couple of more from my end. Sorry about that. But perhaps can you give a bit of an update on the surgery model. What have you seen here? When should we expect this to kind of move the needle in terms of contributing to the ARR? Or how much has that impacted ARR? If you can give some kind of general observations.

Daniel Ohman

Executives
#13

Yes. So we are in a lot of those sales processes. So that's the positive side. And all of these customers, they are 100-plus users in its place. We don't charge the views, we charge by visit, but I mean it's still a good indication on the size. And 100 for us is big. Our average customers, I assume, is like 8 to 10 users in Webdoc. So those are quite big and then you're like a small hospital. But it's also then extremely slow. I was sitting in such a meeting with a potential customer not long ago. And yes, we will move into Webdoc. We believe that this will happen maybe in 2 years' time somewhere. And it's very frustrating to sit there and have those discussions. But it does take time. They want to go through, they want to make sure they have all the staff aligned, that they plan time for it. They want to make sure they do the risk evaluation. There's the legal requirement for them to do. They want to go through every single part of the system, ensure that they have all the process in order and that it will support all the processes they have. They want to make sure that they then change if there's something that we need to change in the process. And we want them to change the process so that they really are efficient. Because quite often, they work with systems that don't really support the process today, and they have had to build process that are not optimal but the system has forced them to do it. So it really takes time. I know it's not what you want to hear. It's not what I want to hear. But I really believe that it will support strong growth for many years. But it's not coming as quickly as I thought and hoped. But the discussions are really stable. And we have an increasing number of users in there, I would say, also all the time. But to move the needle, it takes a bit more time than I expected.

Elvin Rolder

Analysts
#14

Okay. Very clear. Let's see here. Maybe perhaps on ARR, giving on that avenue. You have a very strong growth in the Nordics. I think it was 19%. and you have quite a good kind of new customer inflow. Could you expand perhaps a bit on what is driving this? You've mentioned a couple of over the past year or 2 now that you've been trying to kind of be more active within your sales process of hiring sales people and have been more kind of outbound in your activities here. Have these kind of resulted in -- are we kind of seeing the fruits of that labor now? Or is there any other kind of factors driving those figures we're seeing?

Svein Bjornstad

Executives
#15

Sure. Yes, I think we are seeing the effect of more effective sales force in the Swedish market. So we, on the sales side, last year was actually quite a strong year. But then we had the churn levels that took down the growth a bit. So it was netted out a bit. But compared to like what we sold in terms of ARR and not the reported revenue, but the sales was up quite a lot. And it's a different effect that we have talked about a lot last year, but we restructured the entire sales organization, which is showing good effect, where sellers can focus more on chasing new customers and we have customer success representatives working on the existing. So this has an effect. We have also had very good traction in Norway, where we have taken a lot of market share from competitors basically through, yes, having invested over time more than them in the product and also in terms of like marketing and working proactively towards new customers and new segments. So it's a mix of factors, but I would say that's the main reasons.

Daniel Ohman

Executives
#16

And I think we found quite a good balance between kind of understanding the customer and being part of the health care system, but still having a sales approach and being a bit pushy. And that's a balance act. And I think in general, that's where we're quite good, I would say.

Svein Bjornstad

Executives
#17

Yes. And like Daniel mentioned as well, on the backlog, it looks like it's quite a bit down, right, from SEK 12 million to SEK 4 million. But on the other hand, that SEK 12 million, it was big customers that we sold that was in the backlog for years that took time to implement this backlog. This quarter is basically all that we had going into the ARR is spent, and then we have added for SEK 4 million additional, which is actually quite a strong quarter for us in terms of sales.

Elvin Rolder

Analysts
#18

Yes. That's also very clear. I would ask one last question, if I may, then we can move to some people's questions, perhaps. But on the CEO, Daniel, I think you're once again kind of enthusiastic about 2026. You're looking forward to kind of an upbeat tone, I would say. How should we kind of bridge that enthusiasm in terms of kind of the ARR development, expectations for Germany, expectations perhaps in Vastra Gotalands considering what was happened there perhaps for Medsum? I mean it sounds like with all of these effects that ARR should kind of accelerate from this kind of high level. Is that completely unreasonable? Or what are your kind of thoughts? And yes, how should we kind of bridge the thinking? Question. I understand that.

Daniel Ohman

Executives
#19

No, but I can try to put some color on to that. I would put it this way. So I'm very upbeat actually about what we're doing. I see that we every day get much better at shipping out to international customers, both for ARR, but also through us getting better as an organization. I also see that the AI tools within our systems, I mean, for our customers, will add a lot of value to them. So I'm very optimistic about those possibilities and also with the rebuilding of the entire UI. So it really fits, and we create a seamless good experience, I believe very strong in that. And I also believe in Webcur. But many of the things that I believe strongly that as we work hard on at the moment will not translate financial performance this year. So the most of the things I'm mostly upbeat about is maybe more long term because this completely new way with built-in AI, that's by the end of the year. and our customers are adopting the new things. So I believe it will take time. On the other hand, I also see that, as I mentioned earlier, that customer representative especially, they're really good at talking about Medsum with the customers, they're signing up new customers. We have a webinar tomorrow. I think there are 175 roughly people who is going to interact, sign up for it. And it's only about Medsum. So I think of the bridge that, if you need to bridge that, is that I think this year, we'll see the Nordics growing well. Germany, as I mentioned before, will not really grow that much this year. And then Germany, during this 3-year period that we have targets, will accelerate through that at the end of that period. We really see Webcur being a big growth factor for the Europe, but it's Nordics that will carry this year. But I think that some of the upbeat and potential I see is a bit more long term than 2026. So I think that's maybe, if you see that a difference there, if you see a bridge that needs be -- a gap that needs to be bridged. DI'd that kind of answer it, Elvin?

Elvin Rolder

Analysts
#20

Yes. Yes, of course, that's very clear.

Operator

Operator
#21

[Operator Instructions] The next question comes from Fredrik Nilsson from Redeye.

Fredrik Nilsson

Analysts
#22

Daniel and Svein Martin, I want to start with OpEx. While OpEx, as you mentioned, is rather stable year-over-year, it increased by over SEK 5 million relative to last quarter. You mentioned AI hosting costs, but could you elaborate a bit on the increase further?

Svein Bjornstad

Executives
#23

Sure. So Q1 is a bit higher than Q4 because we have holiday effects in December. That's a part of it. Then we also said in Q4, right, that we have this [indiscernible] grant that had a SEK 2 million effect, a positive effect on the cash cost in Q4 that we talked about in the quarterly call. So that was part of it. And then it was AI cost that we had. It was around SEK 1 million, I would say. So that's the total. But as you also saw, that it's quite flat year-over-year.

Fredrik Nilsson

Analysts
#24

Great. And regarding Medsum and it's typical users, you mentioned, I think it was a few quarters ago perhaps, that a lot of customers are testing different solutions do you see that they are more settling down now for Medsum, hopefully? Or what do you see currently among the customers using Medsum or competitive solutions?

Daniel Ohman

Executives
#25

Yes. So I believe most of them will settle down for our solution as it's completely built into the system and has access to more information than the external ones. So I think it's just a better user experience. And that's why it will settle down for them, the key being at least on the same quality as the competitors when it comes to what we actually proposed. So that's the challenge. So we need to make sure to always improve there. But I believe that we are there and as strong as we are there. They should choose the built-in solution for most cases. But there are use cases which we do not aim to meet ourselves, where we happily work with partners. So for example, there are some users who want to walk around and kind of record as they go. So maybe their physical therapist is working a lot in the gym with the patient. We do not, at the moment, at least aim to build an app for Medsum and try to be really good in that experience, too. So there, we're happy that you choose something else then. But we'll see. I mean, it's still early days. And since most of our users joined last month, it's difficult to answer if they would settle down. But I believe that we have a good edge because of our position and the information we have and since it's the system that's already being used. But it's up to us to make sure that they do stay there, I would say.

Fredrik Nilsson

Analysts
#26

Okay. I see. And just a follow-up on that. You mentioned that a lot of your Medsum customers are coming from other solutions. But I assume then you don't see any significant movement in the other direction, Medsum customers moving to your competitive solutions, to the competitors, I should say.

Daniel Ohman

Executives
#27

No, not yet. We did see it early on so when we did lack the quality before we started selling. Because when we test it ourselves, if you just do like a simple meetings and so on, also in those test cases we had with early pilots, it looks to us that we could match the quality even when we use smaller LLMs. So we thought so. But then when it entered the real world and people started talking about call through the meetings, and there was a bit scrappy sound and things happened, our quality was a bit behind. And that's enough for them to choose another solution because then you have to do some extra work with the keyboard, and they really don't want to do that. And you should also keep in mind that what they do in general. What they want to do is kind of not to take note during meeting anymore at all. So you have to be able -- you have to make sure that you catch everything that they want to have in their notes. Because otherwise, any way, they have to take notes themselves to remember what they want to write afterwards. So it's really sensitive on the quality. But then we paused the sales, and then we have some customers leaving and choosing other solutions. But since the restart of the sales when we're using large LLM, we have not seen that. But it's early days.

Fredrik Nilsson

Analysts
#28

I see. And lastly, some years ago, you used to say that your customers have a very long list of new feature they want, but you have to focus on the most value-creating ones. I mean, has that changed given the advancements in AI? I mean, could you make those easier now? I suppose you can. But at the same time, there's also a lot of new features related to AI and the UX that you want to invest in. So I mean, is that something that you will focus on more? Or is there other things that's more interesting?

Daniel Ohman

Executives
#29

Yes. So we still have a very long list of what we want to do for our customers. There are extremely a lot we want to do, and that could really add value for them. And we keep project competing each other. And then you have, as you mentioned, the new AI functionality that's also in there competing. At the same time, we're increasing pace. So what we say internally, which I think is a good point to do also here, is that even if we get 500% more efficient as a total, I mean, in some things, we will be much more than that, but in total -- that's not a prediction, but that's just -- we still have things to do because the systems we are supporting, they are huge, our systems. And we're supporting a small hospital and a clinic, in some cases, and quite large hospitals with everything they do, all parts of it. So HR systems compared to other types of products that you use are not as polished. They are not as good in all respects. And I think that AI will start demanding that of products like ours, too. So there's really a lot we can do and need to do and which will add a lot of value for our customers. So I'm really looking forward to that. And I believe that even if you get 500% more efficient, we will have jobs for that works for us, as many jobs. But it's only a condition on that you are prepared to change, that you're prepared to really embrace the new technology, embrace that your role will change quite a lot. And then you have a place. So that's what we say internally, and I think that's the truth, is that expectations will go much higher. So if you take the old list of everything, we felt that we want to do for our customers that will add value, we have a lot of new demand, too. So I think that's where we're heading. But it's also difficult to know. Things are moving quite rapidly. They might not come to the level I expect them to or they might go beyond it. Who knows? We're trying to really make sure that we are the winner in all those scenarios. That's our aim.

Operator

Operator
#30

There are no more questions at this time. So I hand the conference back to the speakers for any written questions and closing comments.

Svein Bjornstad

Executives
#31

Okay. We have gotten quite a few questions here in the chat as well. First one, how much has the hiring of new salespeople affected the revenue?

Daniel Ohman

Executives
#32

So I think it's a bit early days. Most process are quite long. When we go through the list of potential customers that they are working on, I feel that we have good progress, good discussions. But there are not many as we are invoicing yet. But some of those signed that we leave the quarter with comes from new salespeople.

Svein Bjornstad

Executives
#33

Next one. With profitability and positive operating cash flow now established over several quarters, how are you approaching capital allocation priorities in particular? How do you assess the attractiveness of reinstating a share buyback program at current levels?

Daniel Ohman

Executives
#34

So that's really a Board decision and an AGM decision. But we believe in buybacks in general as a way of -- instead of dividends, as returning cash to our shareholders. That's what we want to do. But as also mentioned, we are looking at a few acquisitions, not in general. We're never in any structural processes, but we have a few acquisitions that we think are interesting that will strengthen our position in Sweden, so key acquisitions. They are always difficult to know when they will happen as it's us knocking on the door saying that we're interested, not the other way around. But in general, we see share buybacks as a good way, and we see that we'll have an increasing cash flow from operations, and it will continue to improve. So we will use that for share buybacks and those targeted acquisitions.

Svein Bjornstad

Executives
#35

Yes. And you see now that in the quarter, we had a cash balance of SEK 130 million. We don't plan to have that large of a cash balance like in the long term. And so we will deploy it either through buybacks or these strategic acquisitions that we have mentioned. Next one. What are the opportunities in the pipeline to continue growing over the midterm? Signed implemented ARR currently stands at SEK 4 million, which is low compared to previous periods. Yes. So I think we addressed the backlog there a bit earlier, that over the last few years, we had a big backlog, but it was also customers that was in the backlog for quite some time because it took time to implement. And this is basically a new backlog, which is a very strong quarter for us, I would say, signing SEK 4 million new ARR. And in midterm, we see great potential to continue to grow. We still have a low market share in the Nordics, much market left to grow in, to take market share and also in Germany as we get more traction there. And you see that momentum in ARR this quarter already with the 19% growth in Nordics, which is very strong, I would say, for us. Next one. How will you attract new customers in Germany, through salespeople on the ground or companies partners?

Daniel Ohman

Executives
#36

Yes. So that's why the acquisition was important to have something to build on. So we have a sales force in Germany, small, it will have to grow, working. And we're also selling through partners already, the existing products in Germany. So I think we'll continue with both. What we really want to develop in our Germanization is much more trading lease for marketing. We still work very conservatively into Germany with a lot of cold visits, and that's quite an expensive and inefficient way of selling. We have to be mindful that Germany is not like Sweden. We tried to do cold visits in Sweden. That really doesn't work and no one wants to meet. So it is a bit different between the markets, and we have to appreciate that. But we are strengthening the Germanization with local experts on how to sell and market in a modern way in Germany. So that's something we're under progress of strengthening the organization. But I think we have good base building with good sales people that we can then become even more efficient.

Svein Bjornstad

Executives
#37

Okay. Great. Next one. Could you please update us on your progress in Stockholm also in regards to further hiring of further sales reps?

Daniel Ohman

Executives
#38

So Stockholm is moving to Cambio from TakeCare in 2029, 2030. We see that as a great opportunity. I think you can all read in the papers how those regions that moved to Cambio especially those, there are a few that actually moved from TakeCare. And as a user, you feel that TakeCare is a much more modern system than Cambio, and it's also much more suitable for small private clinics than Cambio is. So when that change happen, it will really help us grow a lot is our expectation. It is still so far in the future that it doesn't help us very much in Stockholm because, I mean, we can say you're going to change systems anyway. But I mean, typically this process get delayed also. So it's 5, 6 years in the future. So that doesn't really count, that in the end, we have to do it in 5, 6 years' time. So it doesn't really help us from that perspective yet. But still, Stockholm is market. We can win customers from TakeCare. We can continue work. But over time, that change, we believe, will really strongly help us. But it's not yet. But still, we're growing in Stockholm. Most new customers are in Stockholm. We will not tie new sales reps at this point in time. I feel that the ones we hired are still catching up and coming up to speed, and it's the same with the customer representatives kind of success. They are still kind of learning their roles, but doing it at a really good pace.

Svein Bjornstad

Executives
#39

Next one. Could you comment on how the UI should look like in your perspective in an AI world? How will that incorporate workflows in conjunction with AI?

Daniel Ohman

Executives
#40

Yes. That's something we're really testing out and trying out. So we have a lot of folks that we are testing with real customers. not with real data yet because they are limiting what we can do then. So we do a lot of videos in the testing the system while we're interviewing them. So I don't think it will look in the first version, this year, will look extremely different than from before with rebuilding the UI. And at the same time, we're addressing all things we want. We know it anyway want to improve, but then everywhere we're building in AI support so that if we have the knowledge from the meeting, from recording or from anywhere else in the system, we prepropose things. There are limits to what we can pre propose. So we are currently not allowed to propose things that help them make a decision. So it's more of the administrative side. I think that's quite okay because that's where our users have a lot of work to do. It's not the actual decisions they make. They're typically what is in the private health care setting and not what takes the time. And also the administrative part, they really don't like. But there are a lot of legalese when it comes to prescriptions, there are a lot of requirements. And we have to follow the exact same look as [indiscernible] has already approved in our system. So there are certain limitations within the sector. But in general, we think it will not look that different, not at least yet. But you will feel and you see the AI support in all different views in the system, and it will also take you to the right views and the right places when you need it to. But we don't have it all in place yet. We have attempted how we think it will look by the end of this year, still being worked on with the details. But then it will continue to evolve, I'm sure.

Svein Bjornstad

Executives
#41

Next one. Could you help us understand how difficult it is to switch a system currently and which part makes it hard or easy?

Daniel Ohman

Executives
#42

Yes. I think that the hardest part is that health care, if you run a clinic, you have all these fixed costs. And I know I talk about this often, but you have always fixed cost and then you have a variable income. So the entire mentality among our customers is that every day, we need to fill it. We have to make sure that we don't have a single empty slot because then we're not making any profits. So that mentality means that you're really working the same way. You don't really take a step back and think about how should we work with our process, how can we improve. I mean, that's a major shortfall of European healthcare, in most Europe markets, at least, where you don't really think through your process and think, okay, if we do this work now, then we'll every day get a bit more efficient. And the same thing with changing systems. They see the short-term pain that comes from that. You need to reeducate your staff, you need to do these assessments of risk of changing systems that you have to, there's a legal obligation they have and we support them with it. And then you also have to work through, okay, how do we work now. In general, we try to support all workers they have today. But quite often, they come from them adapting to a not great system and they should really rethink a bit how they work. But it's difficult for them to take the time to do it because they have such a short-term focus when it comes to planning and everything. So I think that's quite a big hurdle. Then it's also a bit hard -- will make it a bit more extra difficult, I would say, is that when the regions change systems and you read everything about it in the newspaper, it makes everyone more afraid of changing systems, even though when the regions do it, they do it in a completely different way than us. So it is not that difficult. But I think many have the few that it is very difficult when it is not very different when we help them. We ask all customers a month after they change to Webdoc, how happy are you with the change? And it's a scale from 1 to 5. And about 4.5. So already a month after, they're very happy with the change. So we try to mark that. We try to tell that story. But it's a sector that's afraid of change.

Svein Bjornstad

Executives
#43

I think we can follow up here on the AI discussion. It says, does this mean agents could be deployed? Are you planning to connect MCPs? And how does this work with regards to restrictions on sensitive patient data?

Daniel Ohman

Executives
#44

Yes. So those are tricky questions. In general, we are not allowed to train on sensitive data, but we can give them access to sensitive data for MCP, for example. That's fine, a bit depending on what we do. It cannot be a decision supporting them with the new certifications, which we might do. We haven't decided yet. One reason why our AI cost gets quite high is that we also have to make sure that it's always processed within Europe. And that's from some of the large LLM models that doesn't cost extra. But when we do quality checks and we do blind tests with different LMs, we can change in a day, Open AI is the one that scores highest in blind tests from Google, Anthropic and Open AI. And the Open AI charge quite a lot for guaranteeing that it's within Europe and also guaranteeing that it's zero retention. Zero retention is not a legal requirement, but it's something that's really appreciated with our customers, that the data is never stored in an American-owned cloud and it's within Europe.

Svein Bjornstad

Executives
#45

But it's worth noting that they charge a lot. It's like a minimum fee. So it's not like the gross margin will be very weak. It's more or that we need the big volumes to defend the...

Daniel Ohman

Executives
#46

Yes. Because the token is better and it's lowest with Open AI with all of them actually. And Open AI uses less tokens than the other models for the same query when it comes to these questions. So over time, that will make us more cost efficient. Within in general development, it's mostly Claude we use. But in the customer-facing products, it's Open AI at the moment. But that's easy to change. So let's see, did I answer the full question? Yes, so the sensitivity. Yes, so it's difficult. But as long as it stays within Europe, we do not train on data, then it's fine. We do use the feedback. So when users change something in the medical notes we have proposed, our structure learns from those changes, but we do not train the LLM model. But we set up the structure so for all changes, it learns from it. And it gets more and more personalized because it's used just once, he replies and the medical notes in a bit different way. So it learns from that. But we're not training on the sensitive data. We are training on other data.

Svein Bjornstad

Executives
#47

Next one. How does Medsum differentiate itself from competitors like Tandem Health?

Daniel Ohman

Executives
#48

So we're not really trying to differentiate ourselves. We're trying to be on the same quality level. Differentiation factor we have is that it's completely built into the system and have access to all the data in the system. And it's one user experience. I think that's how the difference we want to make. Then I think Tandem is good for certain cases that we do not aim to meet because they cost too much for us at the moment at least to develop compared to the amount of our users that need it. So they're going a bit different direction, I would say, than what we're doing. And I think that's fine and that's good. We have the collaboration with them. But for the typical Webdoc and use of our systems, I think that Medsum, we solve their needs in a good way.

Svein Bjornstad

Executives
#49

Next one. Is Medsum a transaction-based revenue or subscription from a segment reporting standpoint? So it's a subscription revenue that we charge per user.

Daniel Ohman

Executives
#50

But that having been said, we want to move from charge per user over time, but that's just because everyone we're competing with are charging per user. But we want to charge for usage in the future, like we do with Webdoc charging per visit. I think that makes more sense. And as they use more and more, we'll have more revenues, like we do with Webdoc.

Svein Bjornstad

Executives
#51

Yes. Then the final one, I think you addressed it, Daniel. But can you comment on recent sales development in Stockholm and VGR?

Daniel Ohman

Executives
#52

Sorry?

Svein Bjornstad

Executives
#53

Can you comment on the recent sales development in Stockholm and VGR?

Daniel Ohman

Executives
#54

Yes. So most of our new sales are in Stockholm. That's where we do most of our progress. I think it's also extremely important from a long-term perspective that we get more and more known in Stockholm. So when they change the systems, we are well known and everyone thinks about Webdoc. We have to make sure that that's the case. But as now is the biggest market that's where everyone is, and that's where we focus our sales efforts. VGR, we are continuing sales also. But it's a smaller market, and we have a stronger position already, where we do have a lot of discussions within primary care. And we're getting a larger and larger part of the private primary care market in VGR.

Svein Bjornstad

Executives
#55

Okay. That was the final one.

Daniel Ohman

Executives
#56

Excellent. Thank you all for listening in. And if you have any questions, yes, let us know. Thank you.

Svein Bjornstad

Executives
#57

Thank you.

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