To counter my bear post, there is definitely a case for the upside. Generally, it seems they are likely to have a very sticky product, but that will need to be proven over the medium term.

Firstly, despite what I said about managers not valuing what clinicians want, Alcidion are clearly making headway with a number of health trusts/districts/boards. Up until the souuth Tees conversion, I was not particularly impressed as the seemed to be pretty small fry in the UK. So having converted a large health care system, there is greater reason to be hopeful for others to follow. These larger wins are a bit like getting a large enterprise customer vs a SME.

Secondly, COVID has destroyed health care systems. We havent really seen that in Australia in the same way that Europe has, but even here routine surgery has been delayed repeatedly, normal patient flows have had to be completely re-configured to allow a "COVID stream" and "no COVID stream". This has essentially meant a duplication of system with capacity for both resulting in increasing inefficiency.

Following on from the above, the system was broken already. Anybody been through a public emergency department recently? Even getting in the front door can be a challenge, ambulances are ramped for hours, patients meant to be admitted to the ward sit in ED for hours (or even days, if you live Launceston), hospital capacity is routinely in the high 90 %s or even over 100%. Trying to overcome this, even without the chaos that COVID has caused, is clearly going to require a new wave of investment and a different way of looking at things. Alcidion can be part of that solution, if they have the data to prove their systems will improve efficiency, safety and be cost effective. But it is hard to be strategic when you are rushing around putting out fires!

Sadly, there is no health budget to provide "new stuff". COVID has broken the bank in most countries. Debt to GDP ratios are at historic highs, nominal interest rates are possibly going up so the cost of servicing all that debt is going to increase (this is a whole separate conversation, I know!). Infrastructure bills are lkely to take the lion's share etc.

So who knows.

@momo

There is much in your post I agree with. Which is why I am not a holder of Alcidion. I also am a clinician, and have suffered through numerous different iterations of EMR offerings. I did a time and motion study a decade ago when working in a metropolitan NZ Emergency depratment, with a reasonably good EMR, and we used 50% of our working time on documentation and looking up results - astoundingly inefficient.

I now work in public and private (in australia). I would like to correct the preconception regarding private medicine being a good target market for Alcidion. Spending someone else's money is way easier than spending your own on upgrades: public health has waaaaay more money to spend on systems and middle management than private. Private, in my limited experience, is run on a very tight budget.

I havent used Miya precision or any of their other products. I would really like to - they sound awesome. As you are no doubt familiar with, and as Kate identified in her presentation, most health departments have mulitple IT systems, one for pathology, radiology, patient flow, ED medical records, ward records, outpatient records, mental health records, allied health records. None of which talk to the other system, and none of which talk to the GP's systems either. this is not exceptional - it was exactly the same in the UK and NZ.

When I lived in Singapore I considered working in one of the Emergency Depts over there, and went for a walk round to see how it all worked. I was astounded when every patient at reception gets their national ID card scanned and instantly there was all their medical records and results, from every medical interaction and encounter, available to the clincian!

Surely, it must be easy!

The opposite experience is when Tony Blair tried to create a unifying medical IT system for the NHS. A laudable goal, but an ultimate catastrophe costing 10 billion GBP and was abdandoned after a number of years. So, I am not convinced that any of the incumbent EMR providers can solve this in a hurry. As Kate also stated, they are "creating their own market" and dont really have any competitors. I'm not sure if creating a new market is always a good thing.

So. If Alcidion can manage to solve many of these problems at a reasonable cost, I think they can really kick some goals. But creating a new market from scratch in a slow moving, slow adoption, highly conservative industry is hard work. I think there is a risk they are going to struggle to scale up at a fast enough rate.  

Also. As you point out, health managers are not answerable to clinicians. Those days are long gone. They have a different set of values and metrics, and like you, I am not convinced that Alcidion's offering is consistent with those metrics.

There are a lot of believers in their product and model. I think it is needed, from what I understand of it, but am unconvinced of the network effects alluded to in her presentation, and think there is a long slow slog ahead of them.

I would be very happy to be proved wrong!

I think this is another quality, high margin SaaS company at an inflection point. Excellent 4c. Good management. Accelerating sales momentum in UK with large TAM. Cash flow positive now with no need for dilutive CR. (Unless acquisition which is unlikely).

buy