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#Q3 FY24 Results
Added 3 months ago

Ok, so there's some cause for optimism in these results.

You can read the ASX announcement here, but the key points are:

  • ALC has $37.4 in contracted and scheduled renewal revenue for the first 9 months of the year -- up 2% on pcp. And there's almost $3m in additional revenue to be recognised this year from new sales made during the quarter. Ok, so the revenue growth will look tame compared to previous years, but it should be positive and it should also deliver improved margins now they've reduced expenses by about $6.4m annually (hopefully not at the expense of future growth).
  • Q4 (historically the best quarter, which is a pattern ALC expects to continue) will enjoy the full benefits of cost cuts, and the business is expecting to be cf +'ve in the second half.
  • They have $6.5m in cash and said they have "adequate funds"
  • Cash receipts down a little on pcp, but up 17% on the preceding quarter and there's $12.9m due from debtors (last year it was $7.3m)
  • Basically cash flow b/e on an underlying basis, when you remove redundancy costs.
  • Continued to sign up new trusts, which as Kate says help build their "referencability"


Despite the drop in the pace of growth -- which seems more to do with the industry environment, rather than the business itself -- the company is still moving forward. Maybe they lose some marks for ramping costs up too fast (although that's always easier to know in hindsight), and maybe they'll handicap themselves with less resources going forward, but the bigger picture thesis doesn't seem broken to me. Although i'd rethink that if they couldn't get back to higher rates of growth, or they lag on a relative basis next to other players in the NHS.

Last year shares were on ~4x sales, now they're on 1.5x. So i'm happy to keep my holding for now (about a 1.7% weighting).

5abb2f21a0a1658b4f526e888792d89111f8e5.png

#Management Meeting Notes
Added 5 months ago

My notes from this arvo's chat with Kate Quirke, ALC CEO. Have rearranged the notes into logical headers as a lot of ground was covered in the call.

My Thoughts Reflecting on the Call

  • Institutions are still backing ALC - Aust Super and new Substantial Holder, Salter Brothers Emerging Companies took a 5.11% stake 2 days ago.
  • Walked away from the meeting not feeling that there has been permanent or structural change and that today’s challenges appear “transitional” (for 12-18M) rather than permanent. 


@nerdag 's bullish thinking is increasingly resonating. Salter Brothers clearly acted on this.

The only way forward is up (by how much is another question altogether), with a base revenue position of ~$120m over the next 5 years anchoring the viability of ALC. This does not feel like a $0.00 company at all, which is the max loss from here.

Might actually be a very good time to average down - buy when everyone else is fearful. It feels like we are in peak pessimism mode now on what FEELS like a transitonary problematic period.

Discl: Held IRL and in SM

-------------

Summary of Meeting

  • A mixed feeling of “defiance” and “resignation” is the feeling I walked away with
  • Defiant - ALC is clearly going through a rough patch, as is every other competitor, but Kate remained clear and had high conviction that there is a lot of growth ahead once ALC gets past the current NHS challenges - she flagged another year
  • Resignation - doing all they can within what is controllable, will need to be patient for the NHS spend to be unlocked, resigned to the negativity in the meantime, weathering it as best as it can


Overall Challenges

  • Confluence of micro and macros issues, compounding each other
  • Challenge is acknowledged and FY2024 will not be a good year
  • All competitors face the same pressures as everyone is impacted
  • Another year to run, after which ALC’s focus will move from Tier 0 hospitals to the more matured Tier 2 hospitals


Downsizing

  • Taken $6m out of the cost base
  • Comfortable with executing the downsizing now as the focus in the last 18M was on developing repeatable processes as ALC scales, which is bearing fruit with the downsizing


R&D

  • R&D has not been sacrificed with the downsizing as - resources to support the ADF contract reached end-of-delivery, creating capacity post downsizing


Cash Position & Cash Forecasting

  • $120m of contracted revenue in the next 5 years, business is now rightsized
  • Have the ability to forecast cash flow pretty well, very little bad debts
  • Expect to sign more contracts
  • Capital raise was an “insurance policy” prior to downsizing
  • Cashflow positive target will be met after incorporating the cost of downsizing redundancies


UK NHS Activity

  • Significant uptick in tender activity
  • Budget is severely constrained this year to recover from Covid spend, budget for the next year is looking to be in catch-up mode
  • As ALC’s buyers are government buyers, they are driven by/guided by what spend is permitted
  • Buying cycle is long as ALC is focused on meeting the needs of Doctor’s and Nurses to increase their efficiency as their primary objective, not the Patient’s needs (who benefit from better service from the NHS)
  • The NHS is still a key ALC revenue stream:
  • Very significant growth opportunity in a sizeable market funded by the government
  • Sale of additional modules to existing NHS customers
  • Largest employer in the UK
  • Good launch pad to other countries eg. Canada


ALC Platform Competitive Advantage

  • ALC’s platform & modular approach allows it to position against the current “moment in time EPR focus” as well as the changing NHS focus over the years - ability to mix and match modules to solve healthcare problems
  • ALC has, and will continue to detect emerging trends in healthcare challenges and build the platform response early - the Silverlink acquisition and integration into Miya precision allowed ALC to position itself to solve the current EPR challenges that the NHS is facing
  • Have already built in AI into the ALC platform for many years and will continue to incorporate elements of AI


M&A

  • A lot of increased M&A activities/opportunities, but is not ALC’s focus at the moment, still very much focused on organic growth and demonstrating the value from the ALC platform
  • ALC is at a reasonable level of scale already, presently


Competition

Nerve Centre in the UK

  • Main ALC competitor in the NHS, a small company based in the Midlands and is doing well in the UK
  • ALC is more focused in the North of the UK
  • Nerve Center is only now just building a Patient Admin module - need a proven reference case in NHS tenders
  • ALC has the advantage of a ready-to-go platform and has modules in areas where Nerve Center does not


Telstra Health in Australia

  • “Copying” ALC
  • Is trying to be all things to all people - still trying to work out its unique proposition
  • Acquired a lot of companies, has a different architecture, different technology stack


Other Opportunities Discussed

  • Management of Medications - lots of localisation and legislative requirements required, EPR players in Australia already have a module for the large hospitals, remain open to this
  • Aged Care - very poor state of IT, but profit margins in the sector are too thin to make investing worthwhile


On Hindsight

  • Would have executed downsizing earlier but they had to find the right balance against the then-reality of NHS moving at pace - classic IT company conundrum
  • Would have combined Silverlink and Miya solutions earlier
  • Better marketing of the business and value proposition and would have spent more time in marketing to counter the massive marketing teams that ALC’s competitors have (their competitors are also laying off people)


#ASX Announcements
stale
Added 8 months ago

Much-needed good news for beleaguered $ALC.

ASX Announcement

Alcidion signs $23.3M South Tees contract extension until 2033

• Alcidion extends contract with South Tees Hospital NHS Foundation Trust for an additional 8 years for Miya Precision Electronic Patient Record (EPR) o Extended contract period is 10 years (to 2033) which includes 2 years remaining on the existing contract

• The minimum contract value is $23.3M (£12.2M) over the new contract period of 10 years

• Further options to include PAS (Silverlink PCS), Emergency Department (ED) and Virtual Care modules would add $9.3M (£4.9M) to the minimum contract value • Options exist to extend for a further 5 years to 2038

• Validates value proposition for Miya Precision Electronic Patient Record (EPR) solution and acts as key reference point for the NHS EPR market 


My Analysis

South Tees was already $ALC's largest and highest-profile NHS client, and this contract is by some margin, the largest even pipping the 15-year potential of the Leidon ADF contract (if I am not mistaken).

That a core client undertakes such a commitment to the $ALC product suite is great news. However, to maintain the thesis $ALC needs to follow-up over the coming months with additional material NHS contracts, including with new customers.

I cotninue to hold, for now, but am still mulling this one over as it was descended towards the bottom of my merit order.


Disc: Held in RL and SM

#Analyst Views
stale
Added 8 months ago

From Fintel & Nasdaq

Alcidion Group (ASX:ALC) Price Target Decreased by 31.25% to 0.11

The average one-year price target for Alcidion Group (ASX:ALC) has been revised to 0.11 / share. This is an decrease of 31.25% from the prior estimate of 0.16 dated October 31, 2023

The price target is an average of many targets provided by analysts. The latest targets range from a low of 0.08 to a high of 0.14 / share. The average price target represents an increase of 53.70% from the latest reported closing price of 0.07 / share

What is the Fund Sentiment?

There are 6 funds or institutions reporting positions in Alcidion Group. This is a decrease of 1 owner(s) or 14.29% in the last quarter. Average portfolio weight of all funds dedicated to ALC is 0.00%, a decrease of 30.59%. Total shares owned by institutions decreased in the last three months by 18.66% to 922K shares


DISC: Held in SM & RL

#ASX Announcements
stale
Added 8 months ago

Some comments and observations based on discussions I have had with Alcidion in relation to the recent performance and capital raise.

Following that discussion and subsequent follow ups, Alcidion, to its credit, did improve and provided a greater transparency in its AGM webinar. But then... the extension of the SPP deadline had me dumbfounded...

Capital raise

Optics wise, the capital raise looked rushed and not well thought through. I was comforted by the level of due diligence Alcidion went into to explore other funding options. At the end of the day, it all comes down to which option was the cheapest.

Company is also not budgeting in the $1M from SPP. That entitlement was included to provide equal opportunity to retail shareholders. Company does not expect to use much, if any, of the other $5M, more like an insurance policy if situation does not improve.

Company also initiated preliminary discussion with major shareholders prior to the capital raise being announced and there was support from major shareholders. It was also an opportunity to bring new institutional investors on board. It is important to note that the company has no control over what the small institutional investors might choose to do with their shares if they have a very short term focus.

Cost base

When this question (which obviously was on everyone’s mind) was asked at the webinar, I felt it was a missed opportunity to articulate what other options they have considered, including what levers they could pull.

Perception wise, it came across that the company is still stubbornly electing not cut staff numbers in the hope that things would turn around soon. I know this is not the case, but what Kate could have done is to take the question head on and inspire confidence that the company is proactively seeking out ways to conserve cash. Potential options include:

·        Encouraging under-utilised staff (if any) to use their leave entitlements (including unpaid leave)

·        Exploring other employment options (e.g. contractor arrangements to provide the company with more flexibility)

·        Undertaking a review to extract further efficiency gains and savings

As the old saying goes.... "Never let a serious crisis go to waste".

These potential options are not mutually exclusive, nor does it mean that Alcidion has to deviate from its current course.

My understanding is that the company is not envisaging to use the $5M (or $6M) raised for operational purposes. But if things do not improve, company has contingency plan on other levels to pull, including reducing underlying cost base.

At this stage, company is still expecting a stronger second half and remains confident of EBITDA and operating cashflow positive result for FY24. I suggested withdrawing this guidance given all the uncertainties, but company remains confident.

Corporate strategy

I questioned if the current high risk strategy of running a cash burning company is still sustainable, one that is largely based on hoping to win some (but considerably delayed contacts) is still suitable for current circumstances. Shouldn’t company simply bunker down, work towards sustainability asap and wait out any further delays with the procurement process without raising capital?

Company remains committed to current strategy and believes it is temporary. If uncertainties persist, company will then react accordingly and pull other levers.

Public perception and investors’ confidence

Company agreed that it wasn’t a good look to delay the quarterly webinar, release the 4C after market and announcing a capital raise on the last quarterly reporting day. Many things were happening at once and many discussions were held over different matters over a longer period. Nevertheless, company will look to improve its performance in this area.

For obvious reasons, the market reaction has highlighted both the board (led by Rebecca Wilson) and Kate’s diminishing credibility. It is imperative that steps are taken to restore market confidence.

As investors, we now need a clear line of sight of how the board and Kate intends to steer Alcidion out of this situation and emerge stronger. It is comforting to know from my discussion that the company does indeed have contingency plans if things don’t turnaround in subsequent quarters. However, this point was not made but should have been articulated at the webinar.

Greater care also needs to be taken regarding the language used in further webinars. Lines such as "It became obvious during the last few weeks" does not inspire confidence that both the board and management are keeping their fingers on the pulse of the business or even (I hope not) suggests a disconnect between CFO with the CEO/Board.

Dual role of chairperson

I expressed my concerns with Rebecca Wilson’s involvement as chairperson with both Alcidion and LBT Innovations on the basis that would this divert her time, attention etc between one another. Have received assurances that this would not occur. I will continue to hold the company and her accountable on that front.


#Industry/competitors
stale
Added 9 months ago

I wanted to have a look at how the NHS is progressing in its digitalisation stratgy.

So I teamed up with my new buddy Bing Chat Enterprise to generate this list of 40+ accouncements for EMR systems from over the last two years. These are much bigger investments that for $ALC's products. The contract sizes range from about GBP8m right up to GBP50m. (I have not personally verified the whole list, however, a sample do check out.)

I note that the 2023 list is shorter (pro rata) than 2022.

I wondered though, with so many decsions being taken on big EMR platforms, whether that may be one issue for $ALC for the following reasons:

  1. The EMR is a big financial commitment, In the run up to making it and in the aftermath, spending on other systems many be squeezed
  2. In the run up to an EMR procurement decision, it may be hard to get management to take decision on patient flow and other solutions. This could be for reasons including: attention focused on EMR bundles of functionality (which may obviate the need for $ALC investment) and questions of inter-operability
  3. Both in the run-up to and aftermath from an EMR decision, human capacity in the NHS Trust will likely be focused on the success of the EMR. $ALC may be struggling for attention, in some cases.


So, an alternative hypothesis is: "$ALC is reporting slow decsion-making on new contracts, because the systems attention is elsewhere?"

Here is the AI-facilitated list (enjoy)

  • September 2023: Bradford Teaching Hospitals NHS Foundation Trust selected Cerner as its preferred supplier for its new EMR system.
  • August 2023: Alder Hey Children’s NHS Foundation Trust awarded a contract to DXC Technology to deliver its Lorenzo EMR system.
  • July 2023: Nottingham University Hospitals NHS Trust signed a contract with System C to implement its CareFlow EMR system.
  • June 2023: University College London Hospitals NHS Foundation Trust selected Epic as its preferred supplier for its new EMR system.
  • May 2023: The Royal Marsden NHS Foundation Trust signed a contract with Civica to implement its Cito EMR system.
  • May 2023: Lancashire Teaching Hospitals NHS Foundation Trust selected Cerner as its preferred supplier for its new EMR system.
  • April 2023: Surrey and Sussex Healthcare NHS Trust selected Cerner as its preferred supplier for its new EMR system.
  • April 2023: Imperial College Healthcare NHS Trust extended its contract with Cerner to implement its Millennium EMR system across its five hospitals.
  • March 2023: Barnsley Hospital NHS Foundation Trust awarded a contract to DXC Technology to deliver its Lorenzo EMR system.
  • March 2023: Manchester University NHS Foundation Trust awarded a contract to Allscripts to deliver its Sunrise EMR system.
  • February 2023: The Hillingdon Hospitals NHS Foundation Trust signed a contract with InterSystems to implement its TrakCare EMR system.
  • February 2023: Oxford University Hospitals NHS Foundation Trust signed a contract with Epic to implement its EMR system across its four hospitals.
  • January 2023: St George’s University Hospitals NHS Foundation Trust selected Epic as its preferred supplier for its new EMR system.
  • January 2023: Liverpool University Hospitals NHS Foundation Trust selected Cerner as its preferred supplier for its new EMR system.
  • December 2022: Royal Berkshire NHS Foundation Trust awarded a contract to System C to deliver its CareFlow EMR system.
  • December 2022: Guy’s and St Thomas’ NHS Foundation Trust extended its contract with Cerner to implement its Millennium EMR system across its three hospitals.
  • November 2022: North Bristol NHS Trust signed a contract with Allscripts to implement its Sunrise EMR system.
  • November 2022: Sheffield Teaching Hospitals NHS Foundation Trust awarded a contract to InterSystems to deliver its TrakCare EMR system.
  • October 2022: Barking, Havering and Redbridge University Hospitals NHS Trust extended its contract with Cerner to implement its Millennium EMR system across its three hospitals.
  • October 2022: King’s College Hospital NHS Foundation Trust signed a contract with Epic to implement its EMR system across its four hospitals.
  • September 2022: Luton and Dunstable University Hospital NHS Foundation Trust awarded a contract to Epic to implement its EMR system across its two hospitals.
  • September 2022: Mid Yorkshire Hospitals NHS Trust selected Cerner as its preferred supplier for its new EMR system.
  • August 2022: East Sussex Healthcare NHS Trust signed a contract with Civica to implement its Cito EMR system.
  • August 2022: Great Ormond Street Hospital for Children NHS Foundation Trust awarded a contract to DXC Technology to deliver its Lorenzo EMR system.
  • July 2022: Dorset County Hospital NHS Foundation Trust selected Cerner as its preferred supplier for its new EMR system.
  • July 2022: Birmingham Women’s and Children’s NHS Foundation Trust signed a contract with System C to implement its CareFlow EMR system.
  • June 2022: Chelsea and Westminster Hospital NHS Foundation Trust awarded a contract to DXC Technology to deliver its Lorenzo EMR system.
  • June 2022: East Lancashire Hospitals NHS Trust selected Cerner as its preferred supplier for its new EMR system.
  • May 2022: Portsmouth Hospitals University NHS Trust signed a contract with InterSystems to implement their TrakCare EMR system.
  • May 2022: Royal Free London NHS Foundation Trust extended their contract with Cerner to implement their Millennium EMR system across their three hospitals.
  • April 2022: Cambridge University Hospitals NHS Foundation Trust selected Epic as their preferred supplier for their new EMR system.
  • April 2022: Leeds Teaching Hospitals NHS Trust awarded a contract to Allscripts to deliver their Sunrise EMR system.
  • March 2022: University Hospitals Bristol and Weston NHS Foundation Trust signed a contract with Epic to implement their EMR system across their two hospitals.
  • March 2022: The Newcastle Upon Tyne Hospitals NHS Foundation Trust extended their contract with Cerner to implement their Millennium EMR system.
  • February 2022: South Tees Hospitals NHS Foundation Trust awarded a contract to System C to deliver their CareFlow EMR system.
  • February 2022: Northumbria Healthcare NHS Foundation Trust selected Allscripts as their preferred supplier for their new EMR system.
  • January 2022: The Royal Wolverhampton NHS Trust signed a contract with Allscripts to implement their Sunrise EMR system.
  • January 2022: Royal Cornwall Hospitals NHS Trust awarded a contract to System C to deliver their CareFlow EMR system.
  • November 2021: University Hospitals Birmingham NHS Foundation Trust signed a contract with Cerner to implement their Millennium EMR system across their four hospitals.
  • November 2021: Norfolk and Norwich University Hospitals NHS Foundation Trust awarded a contract to DXC Technology to deliver their Lorenzo EMR system.
  • October 2021: County Durham and Darlington NHS Foundation Trust signed a contract with Civica to implement their Cito EMR system.
  • October 2021: Barts Health NHS Trust secured £12m of funding from NHS England and NHS Improvement to invest in a new EMR system and selected Cerner as its preferred supplier.


Note: I don't have an up to date number, but there of the order of 200-250 NHS Trust in the UK, so this is a minor but significant fractoin of the whole.

#Risks
stale
Added 9 months ago

There are multiple risks i see fundamentally and sentiment vise.

1. Management ability and willingness to reduce cost of business is minimum- and happy to raise capital at distress price to fund delayed contracts

2. Kate mentioned that procurement approach has changed for EMR and it went into tender process and not every NHS trust going in FY24.

3. Risks are two fold now, probability of them winning the contracts x probability of them winning in required timeframes till balancesheet allow to fund employees.

4. Management and Boards ability to navigate potential difficult macro environment.

5. There were no high hopes for Q2 and Q3 results - sentiments isn't going to turn anytime soon

I would have preferred them to reduce the cost base somehow instead of dilution. History of dilution is very poor...makes it difficult to increase any KPI per share

I just sold my shares at loss and will come back at higher prices once i have confidence that it is self funded.

#Alcidion and Olinqua partnersh
stale
Added 11 months ago

In the episode of Talking HealthTech, Kate and Martin ( Founder of Olinqua) discuss how their partnership can reduce hospital wait times and overall make things more efficient and Why this is the right time for this partnership.

https://www.youtube.com/watch?v=SDjGrXj5KYU

#FY23 Report
stale
Added 11 months ago

Alcidion reported its FY23 report

Revenue:

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Receipt from Customers

8a4a5c2a75cf70e933676ac2a6c106a05b6b68.png

Expense

51c1a829edbd3817ff500da84f202bc54ce293.png

Operating Cash

5687dc8f9a396821fd6d8c34822cf87e6dd420.png

No. of Shares

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My view:

In the absence of an NHS contract, Alcidion currently looks like a slow growth company. However, I get a sense that Alcidion has significantly hired in anticipation of NHS contracts and because of those contract delays, expense has grown fast compared to revenue.

In one of the calls, Kate mentioned that it would be very shortsighted of her if she started cutting costs and suddenly had NHS contracts and struggled to find the resources to fulfill them.

Although Alcidion hasn't performed that poorly in the absence of NHS contacts - However, I anticipate there will be significant pressure on Alcidion's share price for some time because one of the co-founders ( Ray Blight) seems to be selling his portion after his resignation. He resigned on 30 June 2021 and also Alcidion's previous CFO Collin MacKinnon who retired last year is selling down his portion. ( Highlighted yellow in the screenshot below).

So If Alcidion wins large NHS contact sometime in the next 6 months, that will provide significant liquidity for them to get out ( if they completely want to) and then there will be more buyers than sellers hopefully.

fe5cb0e6680a4ade980b9c3293a3de9db3fef7.png



#News - NZ Health
stale
Added 11 months ago

Interesting article about the NZ health system, potentially may help ALC if they are one of the cloud/platform providers utilised...

https://www.pulseit.news/new-zealand-digital-health/fewer-better-platforms-and-national-scale-at-the-heart-of-nzs-data-and-digital-plans/?utm_source=Pulse%2BIT+-+eNewsletters&utm_campaign=4029a82790-PulseIT_eNews_23_08_2023&utm_medium=email&utm_term=0_-4029a82790-%5BLIST_EMAIL_ID%5D&goal=0_b39f06f53f-4029a82790-413265617&mc_cid=4029a82790&mc_eid=eeee4aadd4

Fewer, better platforms and national scale at the heart of NZ’s data and digital plans

23 August 2023

By Kate McDonald

Te Whatu Ora's director of strategy and investment for data and digital, Darren Douglass.

Te Whatu Ora – Health New Zealand plans to consolidate its health technology assets on fewer, better cloud-delivered platforms, look to scale existing technologies on a national rather than district level and even slow down or cease planned procurements as part of its data and digital strategy in the coming years.

A refresh to the national interoperability roadmap is also underway as part of Te Whatu Ora’s data and digital thinking in response to the Pae Ora (Healthy Futures) Bill that came into force last year.

The legislation saw the district health boards replaced with Health NZ and the establishment of Te Aka Whai Ora (Māori Health Authority) and a new public health agency, but it also set a vision for the New Zealand health system that achieves Pae Ora Healthy Futures for all New Zealanders.

This includes five system shifts, including reinforcing Treaty of Waitangi principles and obligations; ensuring that people have access to a comprehensive range of support in their local communities, which has led to the establishment of localities; equitable access to high quality emergency and specialist care; and empowering the workforce.

It also emphasised the need for digital services to be at the core of achieving system reform. According to Te Whatu Ora’s director of strategy and investment for data and digital, that has provided the organisation with the ability to set policy, to commission digital services and to contract commercially at scale in ways that couldn't be done under the devolved structure.

“Our strategy … is very much intending to use those levers,” Mr Douglass told the MedInfo conference in Sydney last month. “We haven't published a digital strategy yet, but we're pretty well advanced in our thinking of what the key components of a digital strategy are.

“New Zealanders I think are really good at innovating but we are pretty rubbish at scaling that innovation. So how do we make sure that we enable innovation, we ensure that innovation is aligned to our mission and the priorities we have? I talked about levers. We have commissioning, commercial and funding levers that we can and will use to ensure conformance to standards and minimum data and digital requirements. And that will accelerate the delivery of safe and effective services.

“And where we need to will apply policy and regulatory levers as well. As we start our journey, we will simply be using commissioning, funding and other incentives, but in time, if we need to move to a regulatory environment, then we were prepared to do that.”

DIGITAL AND DATA PILLARS

New Zealand published a national interoperability framework led by chief standards adviser Alastair Kenworthy and the Health Information Standards Organisation (HISO), in September 2020, which is now being refreshed.

Mr Douglass said the roadmap was built on the principle that we should not unreasonably block or hinder access to data. “Rght now in New Zealand, within our sector organisations and within our industry, we have lots of example of blocking and hindering access to data. New Zealanders need to have access to their own data. That's the journey we're on and we're improving.

“The idea that interoperability is a feature that we might choose to add needs to go away. It needs to be at the core of everything we do. We've been moving down this track and have delivered some some really useful capability in terms of FHIR infrastructure, in terms of terminology, services, in terms of driving standards adoption, but we will we will be accelerating this.”

Te Whatu Ora has also recently announced that Accenture will build the National Data Platform (NDP) to unify information previously held by numerous organisations such as district health boards.

Te Whatu Ora has also recently announced that Accenture will build the National Data Platform (NDP) to unify information previously held by numerous organisations such as district health boards. This platform is targeted at data for planning, insights and analytics rather than data for direct patient care but is one of the data and digital team’s big priorities for the next 12 to 18 months.

Mr Douglass said the platform would make data more accessible within Te Whatu Ora and out to the wider sector. “It also mitigates a lot of our technology debt, because today, a lot of our data is locked up in pretty ageing technology that you can't get access to,” he said. “This is a major modernisation drive as well.”

NZ also has a data and information strategy for health, developed by the manager for data governance Simon Ross.

“The data and information strategy for health really strongly focuses on effective data governance, focuses on Maori data sovereignty. It is about that security, privacy, trust, social licence aspect of information. Technology is great in that we can make information and data accessible and usable in ways that five years ago we couldn't, but our governance and our maturity are really lagging behind the technology. And that's a risk.”

AGILE PLATFORMS

Te Whatu Ora is also developing a strategy around platform and agile, targeting the numerous cloud platforms that are in use but which Mr Douglass said are not used consistently.

“Our strategy is to consolidate to fewer, better cloud delivered platforms that enable reuse and innovation in scaling, alongside continuing to invest in our cybersecurity capability and maturity,” he said.

“We will be making choices and decisions around the platforms we leverage and use and then driving those out. That allows us to pool our investment, enable collaboration, and also to start small and then innovate on top of that platform capability.

“That will also simplify the environment that we have. We're going to reduce complexity and standardise our systems and processes. We’ll leverage what we've got and will accelerate delivery of these digital services nationwide. That reduces cost of risk and accelerates release of value.

“Our discussions currently are that we are going to look to restrict technologies to no more than two technical solutions in any one domain in the short term, and in the longer term, we would be looking to move to nationwide strategic platforms where feasible.”

Mr Douglass said the digital and data team met weekly with chief data officer Leigh Donoghue to look at investment proposals. A number of plans that were proposing to go to market to look for solutions that already exist in other parts of the system have been put aside.

“We've stopped activity in order to focus on how do we scale up and leverage the tools that are there,” he said “Or if we go to market, how do we go to market at national scale, not a district or even regional scale.”

Corporate systems are also being looked at as part of the organisational change that has come with Pae Ora. Bringing 29 different organisations into one means it needs corporate systems and capabilities to support the change.

“Today we have 20 payroll systems. If you were to ask anyone how many people Te Whatu Ora employs, I can almost guarantee that we wouldn't know the answer to that, because that data is spread across multiple systems. There's a balance, we can consolidate our corporate systems and deliver absolutely nothing to get us closer to Pae Ora, but if we don't address that, then you have an organisation that just finds it really difficult to do the basics.”

KEY INITIATIVES

Driving conformance to a minimum set of data and digital requirements and standards is a key initiative, which will be supported by a move towards certification of applications and solutions, Mr Douglass said.

That means a balance between setting standards but also looking at the cost of complying. “We can't fund it all from the centre, but nor can we simply set the standard and expect the sector to get there without assistance.”

Other key initiatives are the national data platform and consolidating the fewer, better platforms. “We're looking at platform capability that can be leveraged by our organisations now into the sector. We are reducing complexity and variation and we're already stopping procurements.

“We're already looking at reuse of what we've got, and scaling it up. A good example is our national maternity platform and the roll-out that's been optional for district health boards. It's no longer optional.

“We will be strongly pushing the roll-out of that national maternity platform. One of the things that gives us as a national maternity spine, so a maternity record that will be accessible everywhere in the country.”

The Hira program to provide summary record data to consumers and their whanau and available to their care team is also a key initiative, as is the technology to support population health screening programs.

“Our national immunisation register is currently being deployed and there's a lot to build on from the COVID technology platforms around population health. So bowel screening, cervical, breast screening, a lot of investment going into those areas. And then there's about 300 other things that aren't on that list.”

#Financials
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Added 12 months ago

It seems Alcidion has been quietly going about its job and slowly accumulating sales. The highlight seems their ability to continue to make sales and increasing cross sell opportunities even with the NHS digitalisation process taking place at a slower than expected pace. As a holder I am feeling a lot more reassured today that the CEO Kate has the ship moving in the right direction.

https://www.alcidion.com/wp-content/uploads/2023/07/ALC_Q4_FY23_Quarterly_Activities_Report_and_Appendix_4C.pdf



#Financials
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Added one year ago

Alcidion announced today that it had signed two Silverlink PCS contract renewals.

Along with this signing, these two contracts also trigger the earnout payment of A$2.8m agreed upon during the acquisition.

An interesting new update is that their current cash on hand is $15.6m Which is $4.5m more than the last disclosed figure as of 31 March 2023 in their 3Q 4C.

So two months of 4th Q have passed and their general expense of Q is ~11.5m so I think it indicates to me that 4th Q receipt will be in the vicinity of ~$15m.

8b776d79a1ffa7f289217b91c152a655ff4758.png

So if we exclude this $2.8m payout, their FY23 operating cash outflow will be roughly 2m or thereabout.

Essentially, if it manages to sign a few big NHS contracts by the end of FY24, the Probability of them being cash flow positive in FY24 is very high.

sentiment currently for this business is very low.

Seems like the perfect setup for better performance compared to the index in my opinion for the next 2 years.

#4C Report Q2 FY23
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Last edited one year ago

Just me trying to provide a balanced view to facilitate a more robust discussion, not ramping nor down ramping Alcidion.


The Q2FY23 was a combination of hits and misses to me for the following reasons:


MISSES

1) I felt Alcidion was trying to divert attention from the disappointing numbers using using the $5.2M figure to explain the lower cash receipt. As the CFO has clarified in the webinar, only around $2.6M can be attributed to the delayed payments. The remaining $2.6M is correctly attributed to Q2FY23 and has no bearing on the lower than expected cash receipts in Q1FY23.


How it has been worded has had the unintended/intended consequence of making some shareholders think that Alcidion would have been cashflow positive in Q2FY23 if the whole $5.2M was entirely attributed to Q1FY23.

6ad6f2f1e501a6dad8cba14bc424d9cbeb1cb3.png

2) Rightly or wrongly, I was personally expecting a better 4C for Q2FY23 going by previous comments made by the CEO. Because we had a modest negative operating cashflow 4C in Q1FY23 and a positive operating cashflow of $1.5M in Q2FY22, I was therefore not expecting an underlying -$1.8M operating cashflow in Q2FY23 (after accounting for the $2.6M in delayed payments). To be fair, I might also have misinterpreted some of the context underpinning the comments.

468e0d574554f268fdbc935e412cfc023c0a30.png

3) Having watching the webinar a second time, I also picked up that Kate has added a disclaimer to her usual guidance that the company remains on track to achieve a positive underlying EBITDA and cashflow in FY23. It now assumes 'continued momentum in the UK', bearing in mind that the political uncertainty in Alcidion's biggest market has had an adverse impact in CY22.


4) Alcidion has also stop reporting the recurring and non-recurring split in its entirely, only disclosing this split for new sales. Looks the same to most people but mean differently in practice.


For example, this spilt was previously disclosed as

310f54eae22ed68a45db42bd01ee2f37c50abb.png

Now we only get this from Q1FY23:

8517d2a027a77841e867ddc84b50b05d827955.png

5) The lumpiness in Alcidion's cash receipts profile is inherently lumpy, as evidenced from the chart below. Q1 and Q2 will continue to underperform relative to the second half of the financial year. Nevertheless, the overall trend is still positive.

104ceadb246086b3dedefa9471ccbcf1065406.png


HITS

1) New sales and recognisable revenue continue to track upwards

de607de5969b33c4eba3d66df0555bc3b3cbcb.png

48f6c614d989c005af7a00dbb4f9888475cc2b.png

2) Cash expense has stabilised and maybe (just maybe) the benefits of operating leverage would soon start to kick in. Management has indicated that the cost base has achieve stabilisation and is unlikely to fluctuate substantially moving forward..

...the opening of the revenue-cost jaw.

7c85b332fd1624fc842c5257125b1db0119557.png





#4C Report
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Added one year ago

@composerI don't see your straw as unduly negative or down-ramping at all.

I've been too busy this week (with commitments outside of investment management) to post my own straw, but I watched the recording of the results and presentation and came away with very mixed feelings. For me the biggest concern was that I sensed that Kate herself was ill at ease in discussing the results, which weren't great from a cashflow perspective. I attach my standard analysis below. The numbers support your general tone.

For now, I am going to continue to hold my small RL position in $ALC. But (just as with $3DP and $EVS discussed in other straws over the last week), $ALC is not making the progress necessary for me to increase my allocation, which clearly in the success case I am aiming to do.

Disc: Held in RL and SM


8d509c7d34736834957abec86d96c916bf2f4e.png




#Investor webcast
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Added 2 years ago

Some of my notes:

One thing I noted from the 4C was they said -4.5 mil operating cashflow due to receipts not coming through at the right time. When someone asked a question in the update - they said they expected half of the 5m outstanding in receipts was expected to go through - so they still would've been negative. Weird to write that on the presentation and either way it would've been negative operating cashflow.

Another thing mentioned on the call, not particularly new info was the importance of Silverlink in them winning the contrast for the exemplar University hospital South Hampton, and the number of modules chosen at this location. Having a presence at one of the digital exemplars is a big deal due to this being a proving ground of success and the potential of it being used as a template for the rest of the roll out in the UK. There was also a bit of expansion in existing customers and extension of contracts.

A number of tenders are up and not entirely just for EPR, but many of the other offerings that Alcidion has, another thing to watch with Alcidion over the year.

Lastly, Kate mentioned that the NHS digitisation strategy had some delays due to various political issues in the UK - but the deadlines are still the same - so it will be interesting to see how this plays out.

#ASX Announcements
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Added 2 years ago

Below is the summary of all the major agreement/contracts Alcidion has announced on the asx since reverse listing on the asx. As of January 2023 Alcidion has at least one product in 40 NHS trusts in the UK.

·      December 2022 $2.8m University Hospital Southampton NHS Foundation Trust – procures Miya Precision for EPR. https://www.asx.com.au/asxpdf/20221201/pdf/45j9wbd8gtq57n.pdf

·      April 2022 - $5.0m NT Health – to upgrade from earlier version of Miya to current Miya Precision platform, continuing a 13 year partnership with Alcidion. https://www.asx.com.au/asxpdf/20220419/pdf/45835lwbn1vkfd.pdf

·      April 2022 - $1.43m East Lancashire Hospitals NHS Trust – to implement Miya Flow. East Lancashire are a current user of ExtraMed’s Inpatient Flow manager, with new agreement representing the first upgrade from ExtraMed’s flow solution to Miya Flow. https://www.asx.com.au/asxpdf/20220406/pdf/457qzp7j0j4js0.pdf

·      April 2022 - $2.8m Moorfields Eye Hospital and Liverpool Heart and Chest Hospital for use of Silverlink Patient Care System (PCS) solution. https://www.asx.com.au/asxpdf/20220404/pdf/457nbk0tf2svxm.pdf

·      April 2022 - $3m Dartford and Gravesham NHS Trust expanded agreement with Dartford and Gravesham NHS trust to include a new module of Miya Precision, Miya Emergency, along with reselling new partner Provation’s anaesthetics module. First to implement Miya Emergency in NHS. https://www.asx.com.au/asxpdf/20220401/pdf/457l3dzvwnp60p.pdf

·      March 2022 - $1.35m Herefordshire and Worcestershire Health and Care NHS Trust – to implement Miya flow. First NHS community trust to procure Alcidion’s flow technology. https://www.asx.com.au/asxpdf/20220322/pdf/4577hn71x3g3jr.pdf

·      March 2022 - $1.9m NHS Tayside – to implement the Miya Observations and assessments modules of Miya Precision. https://www.asx.com.au/asxpdf/20220316/pdf/4571y33tcdr8gk.pdf

·      December 2021 - $23.3m Leidos Australia – Alcidion as part of a consortium led by Leidos Australia has been awarded a contract to deliver key capability for a Healthcare IT project for the Commonwealth of Australia. ALC will provide the Longitudinal Health Record via its Miya Precision product. https://www.asx.com.au/asxpdf/20211203/pdf/453rlj46fcdcn2.pdf

·      October 2021 - $1.8m Sydney Local Health District expands use of Miya Precision. Announced on July 2020 ALC signed an initial 12 month contract with Sydney LHD to deploy Miya Precision. This announcement delivers an additional $1.8m in revenue over the next three years.https://www.asx.com.au/asxpdf/20211018/pdf/451r9j1h95f92d.pdf

·      October 2021 - $630K Queen’s Hospital Burton is part of University Hospital of Derby and Burton NHS foundation Trust, one of the largest NHS trusts in the UK. For its patient flow management software, ExtraMed’s Inpatient Flow Manager (IPFM). https://www.asx.com.au/asxpdf/20211012/pdf/451k0yqq836flz.pdf

·      March 2021 – $2.2m East Lancashire Hospitals NHS Trust for Patientrack and Smartpage. https://www.asx.com.au/asxpdf/20210324/pdf/44ty4761h40c26.pdf

·       March 2021 - $0.6m Te Manawa Taki District Health Boards (total of five DHBs) in New Zealand for a pilot implementation of Better’s OPENeP Electronic Medication Management solution. https://www.asx.com.au/asxpdf/20210302/pdf/44t8g11p4wy26k.pdf

·      December 2020 - $2m South Tees Hospitals NHS Foundational Trust extension of  contract announced November 2020 (one below) extended to cover Smartpage, cloud hosting managed service for cloud hosting, and business change management services.  The total contract value (TCV) for the extension is $2m, which now increases the TCV of the entire South Tees contract to $11.3m https://www.asx.com.au/asxpdf/20201214/pdf/44qxb5n31z71m0.pdf

·      November 2020 - $9.5m South Tees Hospitals NHS Foundational Trust – for Alcidion’s Miya Precision solution and the Better OPENeP electronic prescribing and medicines administration (ePMA) system. https://www.asx.com.au/asxpdf/20201109/pdf/44pnf7fx7xwzvk.pdf

·      July 2020 - $1.52m NHS Lanarkshire to deploy Patientrack to all three Lanarkshire hospitals and into the community setting, covering approximately 1,250 beds. https://www.asx.com.au/asxpdf/20200724/pdf/44kstb7d7rr0wv.pdf

·      July 2020 - $1.3m ACT Health announce it has renewed its ongoing support service contract with ACT Health for two further years. This is an extension to a long standing service contract with ACT Health, the last extension to which was signed in 2018. https://www.asx.com.au/asxpdf/20200717/pdf/44klytgmgjdybt.pdf

·      July 2020 - $686 Murrumbidee Local Health District has signed two contracts with Murrumbidgee LHD to continue use of Alcidion’s Miya Precision platform, including the MEMRe mobile application and for related professional services. Wagga Wagga Base Hospital. https://www.asx.com.au/asxpdf/20200714/pdf/44khlx1lhgqnf3.pdf

·      July 2020 - $560K Sydney Local Health District has signed an initial 12 month contract for the implementation of the Miya Precision base platform to support the delivery of virtual care. LHS oversees five hospitals including the Royal Prince Alfred and Concord Hospitals and a range of in-hospital and community based support services. https://www.asx.com.au/asxpdf/20200701/pdf/44k41bpvvyv7px.pdf

·      April 2020 - $1.47m NHS Nife has signed an extension and renewal agreement for an additional 5 year term, extending the board’s use of the electronic bedside monitoring system across the whole estate (minimum 10 Hospitals). https://www.asx.com.au/asxpdf/20200401/pdf/44glhzhjpk93qc.pdf

·      December 2019 - $1.9m Dartford and Gravesham NHS Trust – to implement the OPENeP Electronic Prescribing and Medication Administration (ePMA) system produced by Better. https://www.asx.com.au/asxpdf/20191227/pdf/44cxgt0pc8y3g6.pdf

·      December 2019 - $500K Taunton and Somerset NHS Foundation Trust in the UK. To deliver Patientrack. Taunton and Somerset NHS foundation Trust is one of 17 acute (hospital) trusts in the NHS England’s Global Digital Exemplar (GDE) program, a knowledge-sharing program designed to improve patient care through the adoption of world-class technologies, and to create blueprints for other trusts to adopt. https://www.asx.com.au/asxpdf/20191219/pdf/44cqhr8zkkn3vn.pdf

·      September 2019 - $895k Partnership with Healthscope for data and analytics. Using data from Healthscope’s 43 hospitals, Alcidion will develop dashboard to support predictive analtics and long-range planning for Healthscope services. https://www.asx.com.au/asxpdf/20190917/pdf/448l76mh2hx5n0.pdf

·      June 2019 - $970K Western Sussex Hospitals NHS Trust renews Patientrack. Western Sussex Hospitals NHS trust first implemented Patientrack in 2012, making it one of the longest serving users of the software. This is the second time it has renewed its contract. System is live in 68 wards across the trusts three hospitals. https://www.asx.com.au/asxpdf/20190626/pdf/4463z9vhtdqn67.pdf

·      May 2019 - ~$700k NSW Health to build and integrate components of a Child Digital Health Record (CDHR). Engaged to build and integrate two key components for a proposed national child Health Record (CDHR) which will be trailed in two NSW Health Districts. https://www.asx.com.au/asxpdf/20190520/pdf/4456npbxkkjnlx.pdf

·      March 2019 - ~$1m Brighton and Sussex University Hospitals NHS trust in the UK – will implement Alicidion’s Patientrack software solution to improve patient care and safety. https://www.asx.com.au/asxpdf/20190321/pdf/443nq78hyykqmh.pdf

·      March 2019 - ~$2m Dartford and Gravesham NHS Trust- adopt Alicidion’s total product suite (Miya, Patientrack and Smartpage) and will implement the suite across the entire Trust. https://www.asx.com.au/asxpdf/20190318/pdf/443kmb4p39vp09.pdf

·       Feb 2019 - $711K ACT Health – new contact with ACT Health to further extend the use of Patientrack across the ACT https://www.asx.com.au/asxpdf/20190225/pdf/442xxmq08ghdr9.pdf

·      December 2018 - $1.27m ACT Health subsidiary MKM Health has renewed its ongoing support contract for a period of two years with ACT Health. https://www.asx.com.au/asxpdf/20181219/pdf/441cddgj8ryc45.pdf

·      November 2018 - ~$12 million contracted revenue pool over five years, Queensland Health for Nextgate Provider Registry – establish a Queensland wide referral service directory, using a local SaaS deployment managed by its software partner NextGate Solutions. https://www.asx.com.au/asxpdf/20181126/pdf/440mnhkmfy8tc5.pdf

·      July 2018 - $2.6m ($888k per annum) NT Health Department – 3 year contract extension with two options for 1 year extensions. For the provision of the Miya platform including Miya ED and Patient Flow modules across six hospital sites in the NT. Royal Darwin Hospital, Katherine Hospital, Gove District Hospital, Tennant Creek Hospital, Alice Springs Hospital, Palmerston Regional Hospital. https://www.asx.com.au/asxpdf/20180719/pdf/43wmq862jxw1jv.pdf

·      July 2018 - $4.75m ACT Health – 5 year contract to deploy an electronic Patient Journey Board solution, that fully integrate with Miya Flow, Patientrack and Smartpage software components. https://www.asx.com.au/asxpdf/20180705/pdf/43wb76j8lf9r28.pdf

·      June 2018 – Up to $3.8m – eHealth NSW – 3 year integration service contract to supply development and support of integration services on the Enterprise Service Bus (ESB) and Enterprise Patient Repository (EPR) platforms https://www.asx.com.au/asxpdf/20180612/pdf/43vpy9r85m1ylx.pdf

·      May 2018 – AU$890,000 – Manchester University Hospitals NHS Foundation Trust, Bolton NHS Foundation Trust, George Eliot Hospital NHS trust, NHS Fife – Extended their Patientrack licence and support contracts, for periods of one to three years. https://www.asx.com.au/asxpdf/20180516/pdf/43v282wq2jvd55.pdf

·      January 2018 – North Shore and Waitakere public Hospital in Auckland – Smartpage goes live. https://www.asx.com.au/asxpdf/20180110/pdf/43qqrlq78rpf7p.pdf

·      October 2017 - $389K Monash Health – Monash Medical Centre, Monash Children Hospital, Dandenong Hospital, Casey Hospital – 3 year deal Miya Smartpage solution will provide Monash Health with out of hours clinical task management. https://www.asx.com.au/asxpdf/20171004/pdf/43mym1q8xy7mdb.pdf

·      May 2017 – $NZD1.6m MidCentral CHB – deploy Miya Platform throughout Midcentral District Health Board in New Zealand. https://www.asx.com.au/asxpdf/20170525/pdf/43jhmc9npgk8wb.pdf

·      April 2017 – Katherine Hospital – Miya platform, patient flow solution to be deployed across three wards at Katherine Hospital. https://www.asx.com.au/asxpdf/20170418/pdf/43hkll2ml7cqgp.pdf

·      March 2017 – Sunshine Coast University Hospital - conjunction with Fujifilm medical Systems launches Intelligent Cardiovascular Information System (iCVIS) built upon the Miya platform. https://www.asx.com.au/asxpdf/20170331/pdf/43h5kb9fg6dp7b.pdf

·      December 2016 – Coffs Harbour Health Campus – conjunction with Fujifilm medical Systems launches Intelligent Cardiovascular Information System (iCVIS) built upon the Miya platform. https://www.asx.com.au/asxpdf/20161213/pdf/43dnsc797dxg75.pdf

·      September 2016 - $525k NT Health Department – Royal Darwin and Alice Springs Hospitals Miya Platform https://www.asx.com.au/asxpdf/20160922/pdf/43bch19xz6ydpp.pdf

·      August 2016 - $2.35m MoU with Western Health. Footscray, Williamstown & Sunshine Hospitals. Initial Term of three years, with an option to extend for an additional two years. Miya Platform https://www.asx.com.au/asxpdf/20160801/pdf/43904s06y814b1.pdf

Disclosure Long Term Holder HODL of ALC share IRL and Strawman.

#ASX Announcements
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Added 2 years ago

ALC has has signed an initial 3 year agreement with University Hospital Southampton NHS Foundation Trust (UHS) to implement its Miya Precision platform. As part of the agreement, Alcidion will partner with UHS to deliver a modern, modular EPR, using a combination of Miya modules and UHS incumbent products. 

In addition, Alcidion will become a supplier of some of UHS’s intellectual property, including the Hospital Integrated Clinical Support System (HICSS), which manages the scheduling and reporting of endoscopy procedures.

The initial contract value is $2.8M over 3 years covering the implementation of Miya Precision, together with Miya Access, Miya Command, Miya Emergency and Miya Flow modules.

The contract includes options to take up additional Alcidion modules, including the Patient Administration System (PAS), as UHS builds a Modern Modular EPR which will result in significant growth of the overall contract value. If all options were taken up the total contract value could reach $13.8M over a four-year period. 

The addition of UHS increases Alcidion’s UK NHS market presence to 40 Trusts or approximately 28% of the acute market with at least one Alcidion product implemented. Furthermore, UHS sits within the Hampshire and Isle of Wight ICS which will be the first time Alcidion has implemented their solution in this ICS. 

UHS is one of the largest acute teaching trusts in England, with over 1000 beds and employing approximately 13,000 staff. Well-known and highly regarded for its innovative electronic patient record (EPR) strategy and in-house development of IT systems, UHS will use the Miya Precision platform to introduce real-time care management tools that complement its long-standing approach to digital innovation. It will also gain access to a modern integration platform, with support for coding and open messaging standards, that can be used to deploy Alcidion’s modules and further drive innovation.  

Lynette Ousby, UK Managing Director for Alcidion, said:

“UHS Trust is well-known as a health tech leader, so we are delighted it has chosen the Miya Precision platform and our smart clinical tools to take its digital maturity to the next level.”

Group Managing Director and CEO Kate Quirke added:

“Our relationship with UHS is focussed on a long-term partnership and reciprocal agreement. With a strong reputation as a digital exemplar, I look forward to seeing the impact of this latest stage of the trust’s program, and to further developments in the near future.”

“As the NHS continues to deploy technology at pace, it is important to continue to listen to what IT, clinical and operational teams need. Doing that effectively requires flexibility from technology providers and a willingness to work together. It is rewarding to see the benefits of a modern, modular approach to digitisation working so well in practice.” 


#Oct31 Investor pres
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Added 2 years ago

Takeaways from the Investor presentation

  • Current turmoil in UK doesn’t necessarily put the digitisation programme at risk or that spending to the NHS has been impacted.
  • They have seen it impact the speed at which negotiations are progressing.
  • Seeing the Silverlink acquisition paying off with opening up pipeline for sales and making them competitive in areas they wouldn’t have been able to be. It’ll still take time to demonstrate the value.
  • Consolidated NZ Health is now 4 main regions, and they are positioned well with relationships for this.
  • No indication of a pullback in digitisation programme with NHS, If anything they are seeing less inclination to spend on the large electronic medical record providers.
  • On there being a possibility of Miya being used outside Healthcare Kate did mention that she wouldn’t discount adjacent areas (such as with the ADF, and with aged care).
  • Larger contract sizes are generally taking longer to sign
  • Coming out of an accelerated growth phase that required expenditure to build the business, now they’re looking at levelling out that expenditure.
  • FY23 and beyond, As they increase revenue you’ll see a larger portion of that revenue demonstrated as bottom line profit.


#UK Competitors
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Last edited 2 years ago

I have been trying to get a rough look at the competitive landscape for Alcidion, primarily in the UK.

It seems like Alcidion’s competition are companies that do a single piece of the many pieces Alcidion offer.

A good place to start felt like ALC’s most recent acquisition (Silverlink), they’ve obviously identified a need to focus on an area (EPR) - so it made sense to look at what the landscape in that area looks like.

I found a list of accredited EPR providers here (it’s not the most recent, it’s from 2019 - I noted that Silverlink isn’t present on this list).

https://www.england.nhs.uk/2019/08/nhs-launches-accredited-suppliers-for-electronic-patient-records/

I need to do a deeper dive into each of these when I get the time - so this is only a surface level look and there are probably some of these you could rule out. Some other thoughts I had while quickly checking these companies were whether or not contracts signed with NHS trusts with some of these were necessarily mutually exclusive for Alcidion. Competitors with full service products obviously would, but if these competitors only offered a single piece - would that necessarily rule out Alcidion signing a contract? I’m not sure. Mainly I just wanted to have a brief idea of who the companies were and how many NHS trusts they had signed - since that appears to be the main place of opportunity for Alcidion in the UK.

The list was:

Allscripts, Cerner, DXC, IMS Maxims, Nervecentre, Meditech, TPP, System C


Oracle Cerner - The big dinosaur, Oracle products are usually slow moving beasts, and probably the one all the other Healthcare tech are disrupting. Tangent: if you ever want to see why Xero is so loved, google Oracle Netsuite.

I couldn’t quickly find information on how many NHS trusts use Cerner, however, there’s no shortage of signs of a product with quality problems. 

https://spectrum.ieee.org/uk-coroner-fingers-nhs-computer-system-in-toddlers-death

http://pediatrics.aappublications.org/content/116/6/1506

https://www.healthcareittoday.com/2014/03/12/cerner-agrees-to-pay-106m-over-allegedly-defective-software/


DXC (NYSE:DXC) - 19 NHS trusts - a spinoff of Hewlett Packard Enterprise - Lorenzo patient record systems.

https://investors.dxc.com/investor-relations/default.aspx


Meditech (Private, US Based) - 5 NHS trusts

https://ehr.meditech.com/


IMS Maxims (Private) - 3 NHS Trusts

https://www.imsmaxims.com/about-us


Allscripts (NASDAQ: MDRX)- 3 NHS trusts

https://www.healthcareitnews.com/news/black-book-ranks-top-ehr-vendors-regions-across-globe


Nervecentre software (Private, UK based) - around 3 NHS trusts

https://www.esht.nhs.uk/2021/03/17/emergency-departments-go-paper-free-with-introduction-of-new-digital-patient-system/


TPP - (Private) - around 9 NHS trusts

https://tpp-uk.com/


System C - (Private) - 2 NHS trusts

https://www.systemc.com/about-us/


I’m curious if anyone else has looked into competitors / found a good list of who Alcidion is up against and where?

*edit*: dxc sold off Lorenzo to the Dedalus group. Ill be looking more into them next as they seem like a pretty credible threat to Alcidion

#What if they didn't
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Added 2 years ago

@rh8178 I think it’s more a matter of what it would cost them if they didn’t acquire EPR capability, given the aggressive push toward digitisation in the NHS - not having a key capability that is battle tested could leave the opportunity open to global competitors and this stuff in healthcare appears to move pretty slowly - if someone else gets there first and cements their position it's going to be bloody hard for Alcidion to make up that ground, so to stretch the metaphor a bit further - you wouldn’t want to have a tailwind and no sail to push you forward.  

On the surface, it could look like Alcidion were in it to get 12 NHS trusts, and I do think that’s still a small factor at play here, but not key to the strategy. I think the fact that Silverlink had been tried and proven for EPR in multiple NHS trusts is the part that they likely wanted. It’s one thing to have EPR capability, I think the social proof is important for future contract wins.

I think Silverlink is probably too small to make a meaningful impact on its own (there are 12 personnel on LinkedIn and 1-2 specialists in integrating with NHS systems), but if Alcidion manage to integrate them well, it’ll be pretty key to their growth over the next 3 years in the UK.

So to answer your question, purely on numbers it looks expensive - but having proven and tested solutions that tick all the boxes is going to be really important moving forward and I’m not exactly sure what price that is worth.

#Tailwind
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Last edited 2 years ago

UK Government initiative to add £2 billion of funding to support electronic patient records to be in all NHS trusts (https://www.gov.uk/government/publications/a-plan-for-digital-health-and-social-care/a-plan-for-digital-health-and-social-care)

From the site:

  • Digitising health and social care records – all integrated care systems (ICSs) and their NHS trusts are aiming to have core digital capabilities, including electronic health records, in place by March 2025. In social care, the aim is for 80% of Care Quality Commission (CQC) registered providers to have digital social care records by March 2024. This won’t be the end point for digital maturity, but a marker of progress. The reality is that digital maturity will need to continue to evolve so we fully realise the benefits of digital technology. Success will allow frontline health and social care staff to spend less time on administrative tasks and more time delivering personalised care
  • a life-long, joined up health and social care record – by March 2025, all clinical teams in an ICS will have appropriate access to a complete view of a person’s health and social care record that they can contribute to. Non-clinical staff in social care settings will also be able to access appropriate information and input data into digital records in real time
  • digitally-supported diagnoses – new diagnostics capacity is being developed to enable image-sharing and clinical decision support based on artificial intelligence (AI). These technologies support testing at or close to home, streamlining of pathways, triaging of waiting lists, faster diagnoses and levelling up under-served areas


This all lines up pretty bloody well with Alcidion’s offering.

So currently we’re looking at a total of 217 NHS trusts in the UK, and based on the last 2 Annual reports of Alcidion since their acquisition of ExtraMed they had a foothold in 27 NHS trusts, and since then have signed contracts with roughly 18 new NHS trusts - putting them at about 20% of the NHS trusts so far.

Digitising healthcare in the UK seems to have loads of charitable organisations behind it such as the KingsFund and the Health Foundation - I’ve leafed through some of their recommendations and a lot of key themes are repeated around interoperability of systems (something Alcidion claims to do well), and integrated systems (pretty much the Miya offering).

There also appears to be a bit of pressure behind getting the NHS’s digitisation strategy to cut the mustard quickly enough

https://committees.parliament.uk/committee/81/health-and-social-care-committee/news/170781/new-inquiry-to-examine-government-progress-on-digital-transformation-of-nhs/

#ASA meeting
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Added 2 years ago

Just had a chat with Kate from Alcidion who is at the ASA conference in Melbourne.

A couple things of interest:

She reiterated that their customers are hyper defensive. In fact, any funding squeeze tends to be good as they force hospitals to increase efficiency.

Cash flow positive and very comfortable with the balance sheet.

She's quite excited about recent wins and how they should be able to increase penetration with these clients.

Good momentum with sales.

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#Revisiting thesis
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Added 3 years ago

Well well well, how the turntables...

Alicidion has changed it's stripes. They were hit with a brick wall on revenue growth and had to acquire Silverlink to be more competitive on future tenders. They did not time it well, to the contrary $55M acquisition for ~ $8M revenues the payback period would be greater than 3 years. They should have waited and bought the company at a discount. For Silverlink it was a win-win they were bought out at premium valuation.

The counter argument would be that management bought Silverlink for the 10 new NHS trust. $55M/10 = $5M per trust. If Miya precision and Patientrak solutions are upsold then they can make back the acquisition cost.

Despite clearly overpaying from a financial sense, management have proven to execute by winning large tenders like the $23M Leidos defense contract. There is serious expertise behind the business building and that is what makes me excited about the business.

The market has squashed growth stocks and now is the time to buy this company back. I still maintain my valuation despite the new contract win & acquisition.

As the stock experts call it -> "Buy the dip" :D

#Silverlink acquisition
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Added 3 years ago

Silverlink Software is one of the most widely used patient administration systems (PAS) in the NHS. Alcidion state that this acquisition will take its market share within the NHS to around 26 per cent.

Silverlink management team have many years of experience and have built relationships with many of the NHS trusts. Overall Alcidion is executing on their current plan of growing and reaching significant market share of the NHS.