Pro Medicus, Ltd. · ASX:PME
Pro Medicus — Shareholder Meeting (November 2021)
60 slides from Pro Medicus's shareholder meeting presentation, Nov 23, 2021
Slide 1: Chairman's Address AGM 2021
Chairman’s Address AGM 2021 ® VISAGE IMAGING’
Slide 2: Chairman's Report
Pro Medicus Ltd AGM 23 November 2021 CHAIRMAN’S REPORT Overview By any measure, the past financial year has been the company’s most successful to date, not only financially, but also in terms of sales and achievement of R&D and operational metrics. Each of our businesses in our principal markets (Au
Slide 3: Chairman's report continued
On 1 October 2021 we announced the signing of a 7-year, $40 million contract with Novant Health, a community based integrated delivery network, spanning three U.S states. This contract is the equal largest deal to date for the company. Each of these contracts is significant in its own right and all
Slide 4: Surplus cash and M&A
As I indicated earlier our cash and other financial instruments have continued to grow during the year. These funds are maintained to allow the company to continue to invest in the development of our product suite (including AI), to meet our dividend obligations and to take advantage of acquisition
Slide 5: CEO Address AGM 2021
CEO Address AGM 2021 ® VISAGE IMAGING’
Slide 6: Pro Medicus
PRO MEDICUS (ASX:PME) Healthcare IT company specializing in Enterprise Imaging and Radiology Information System (RIS) software. Leading edge products, growing global presence. EU HQ/R&D Berlin GmbH U.S. HQ San Diego CA GROUP HQ Melbourne AUS OVER 40+ SOFTWARE ENGINEERS 3
Slide 7: Product Suite
ASX:PME VISAGE RIS VISAGE 7 OEM PRODUCT SUITE 4
Slide 8: FY21 Highlights
FY 21 - Most Successful Year by any Measure • Record year financially despite currency headwinds • Unprecedented – sales success – 6 major wins, 5 in North America, 1 in Europe • Completed 5 major implementations – more than any other year • Signed Research collaboration agreements with NYU Langone
Slide 9: Results FY 2021
RESULTS FY 2021 $67.9M $30.85M $42.63M 63.2% Underlying Profit Underlying EBIT Revenue after tax Profit margins up 19.5% up 33.7% Before Tax up 41.0% $61.8M $0.15 Cash Company Strong Full year & debt balance dividend FF Investments free sheet Up 25% up 42.4%
Slide 10: FY 2021 Revenue Split
FY 2021 REVENUE SPLIT $80,000,000 Full year revenue split Exam/licence revenue*** Support/baseline revenue*** Capital revenue (net of hardware) Professional Services*** Archive data migration ***Recurring revenue $70,000,000 $3,413,000 $6,047,000 $60,000,000 $4,609,000 $50,000,000 $17,484,000 $6,464
Slide 11: FY2021 Highlights – Financial Results
FY2021 HIGHLIGHTS – FINANCIAL RESULTS Revenue by Geographic Segment Operating Cash ($M) $70.00 $80,000,000 Fixed Income Securities Operating Cash $60.00 $70,000,000 $60,000,000 $50.00 $50,000,000 $40.00 $40,000,000 $30.00 $30,000,000 $20.00 $20,000,000 $10.00 $10,000,000 $- $- FY2017 FY2018 FY2019 F
Slide 12: Operational (Transaction) Model
OPERATONAL (TRANSACTION) MODEL • Used in vast majority of US contracts • Delivered as SaaS model • Now used in RIS contracts in AUS • Model based on transaction minimums • Forward revenue > A$320M/5 years* • Upside as client examination volumes grow • Annuity style revenue stream – greater predictab
Slide 13: Operating Leverage
OPERATING LEVERAGE • Highly scalable offering • No capex (HW) – SW only model • Training & Installation – charged as professional services • Contained cost base • High operating leverage • Margin continues to grow as footprint increases 10
Slide 14: Margin Expansion
MARGIN EXPANSION EBIT Margins 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% FY2017 FY2018 FY2019 FY2020 FY2021 11
Slide 15: Sales Pipeline
SALES PIPELINE FY21 Full Year Continues to grow STRONGLY University of California $25M/7 years $10M/7 years $18M/5 years $40M/7 years $31M/7 years $14M/8 years New Contract New Contract New Contract New Contract New Contract New Contract SEPTEMBER 2020 OCTOBER 2020 DECEMBER 2020 JANUARY 2021 FEBRUAR
Slide 16: In Review
IN REVIEW 2020-2021 Top Hospitals 13
Slide 17: Increasing footprint in the IDN space
Increasing footprint in the IDN space • Previous large clients – Mercy, Sutter Health, Allegheny • 3 large sales to IDNs in the last year, Medstar, Intermountain Healthcare & Novant • Intermountain and Novant equal largest deals to date • All 3 sales for more than one Visage product • All 3 opportun
Slide 18: Research Collaboration Agreements
RESEARCH COLLABORATION AGREEMENTS (RCA) 15
Slide 19: FY22 – Year to Date
FY22 -Year to Date • Tracking ahead of budget • Client volumes above pre COVID levels • Step-up in transaction volumes in 1st half – Northwestern, NYU, Medstar and Intermountain • Novant deal –equal largest in company’s history • 3 contracts still to come online in FY22 – 1st stage of UC’s, Universi
Slide 20: Key Implementations Completed
Key Implementations Completed 2021 OTHER SITES May 2021 June 2021 June/July 2021 October 2021 July to Now Onsite 100% Remote Hybrid Remote & Hybrid Remote & 100% Remote Onsite Onsite 17
Slide 21: COVID-19
COVID-19 • PME/Visage transitioned to WFH in mid-March 2020 • Operating at 100% capacity • Sales and marketing efforts continued throughout • “Thinness” of the technology enabled large scale remote demonstrations • New opportunities despite COVID restrictions • Visage 7 - enables radiologists to sea
Slide 22: Visage RIS
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Slide 23: Visage RIS
VISAGE RIS • Long term (5 year) contracts with Primary Healthcare and I–MED, the 2 biggest radiology providers in AUS • HIS (Healius) rollout now complete • Upside via organic and M&A growth (I-MED) • Increased market interest – new opportunities • PME undisputed market leader
Slide 24: Visage 7.0
Visage 7.0 Continues to be #1 in Speed, Functionality and Scalability. SPEED FUNCTIONALITY SCALABILITY
Slide 25: Massive Data Explosion
MASSIVE DATA EXPLOSION • High density Multi-slice CT - 10,000+ images • HD Breast Tomosynthesis - 6 GB+ • Optoacoustic breast ultrasound - 10+ GB • Total Body PET Scan - 10+ GB • 7T MRI - much larger than 3T
Slide 26: Legacy Technology
LEGACY TECHNOLOGY “Compress and Send” MODALITIES PACS RADIOLOGIST/CLINICIAN
Slide 27: Solution: Visage Streaming Technology
SOLUTION: VISAGE 7 Streaming Technology BACKEND RENDER SERVER SERVER RADIOLOGIST/CLINICIAN MODALITIES
Slide 28: Solution: Visage Streaming Technology
SOLUTION: Visage 7 Streaming Technology
Slide 29: MedStar Health
MEDSTAR HEALTH • $18M-5-year deal • Replaces legacy PACS across 10 hospitals • Largest health system in the Maryland/(DC) region • Contract for all three Visage modules –Viewer, Open Archive and Workflow • Visage 7 platform to be fully deployed in the public cloud • Extends PME’s rapidly growing foo
Slide 30: Intermountain Healthcare
INTERMOUNTAIN HEALTHCARE • $40M – 7-year deal • Largest healthcare provider in the Intermountain West • Visage to replace legacy PACS across 24 hospitals and more than 200 clinics • Contract includes the Visage 7 Viewer and Open Archive • Visage 7 to be fully deployed in the public cloud • Extends P
Slide 31: University of California Health System
UNIVERSITY OF CALIFORNIA HEALTH SYSTEM • $31M – 7-year deal • 5 leading academic campuses - UCLA, UCSF, UCSD, UC Davis and UC Irvine • Unifying all 5 academic campuses on a single diagnostic imaging platform • Visage 7 to be deployed in the public cloud • Further extends PME’s footprint in tier 1 ac
Slide 32: University of Vermont Medical Center
UNIVERSITY OF VERMONT MEDICAL CENTER • $14M – 8-year deal • Visage to replace multiple legacy PACS systems • Visage 7 to be deployed in the public cloud • Extends PME’s US academic institution footprint • Transaction-based model with potential upside 29
Slide 33: Novant Health
NOVANT HEALTH • $40M – 7-year deal • Visage to replace multiple legacy PACS systems • Visage to deploy Visage 7 Workflow and Visage 7 Viewer • Extends PME’s rapidly growing footprint in NA IDN Market • Transaction-based model with potential upside 30
Slide 34: Fast Track Implementation
FAST TRACK IMPLEMENTATION • All implementations on or ahead of schedule • Fast track methodology continues to deliver • Large scale projects completed in under 1/4 the time of industry norm • Delivers huge savings for client • Frees PME staff for other jobs • Reduces barrier to change • OSU first 10
Slide 35: Visage – Proven ROI
VISAGE – PROVEN ROI Significant IT & Unparalleled Increase in Greater Clinical Infrastructure Savings Radiologist Efficiency Accuracy Improved Physician Delivers Superior Engagement Value Proposition 32
Slide 36: Clinical Outcomes
Clinical Outcomes Moving the Needle 33
Slide 37: Visage – Clinical ROI
VISAGE – Clinical ROI Improved Physician Engaement 34
Slide 38: Breast cancer screening article
Doctors, spurred by the pandemic, try to make breast cancer screening easier and faster By Felice J. Freyer Globe Staff, July 10, 2021, 3:07 p.m. • 15 percent of patients got their mammograms read instantly – mostly white women with higher incomes. • We had unintentionally developed this system that
Slide 39: Radiogenomics of Paediatric Brain Tumors – Purpose
Radiogenomics of Paediatric Brain Tumors – Purpose • ~ 4,170 new cases in US in 2022, with median survival in primary malignant brain and other CNS tumors being 8 months for glioblastoma and up to 16.6 yrs for oligodendrogliomas • Grading and classification of brain tumors is very nuanced and World
Slide 40: Whole Tumor Measurement
Whole Tumor Measurement By Itself Is Insufficient Solid portion of the tumor 25 Volume (cm3) 20 15 10 5 0 10/4/18 27/10/18 15/5/19 1/12/19 18/6/20 4/1/21 23/7/21 Time Cystic portion of the tumor 9 8 Volume (cm3) 7 6 5 4 3 2 1 0 10/4/18 27/10/18 15/5/19 Time 1/12/19 18/6/20 4/1/21 23/7/21 37
Slide 41: Radiogenomics of Paediatric Brain Tumors – Solutions
Radiogenomics of Paediatric Brain Tumors – Solutions • Implementation of workflow efficient and standardized tools • AI based solutions to extract more information from MR images: Machine Learning (leveraging radiomics) tools that can successfully differentiate low/intermediate grade gliomas from hi
Slide 42: Yale-Visage Partnership Highlights
Yale-Visage Partnership Highlights Accelerated and comprehensive/integrated workflow from hours to minutes using: • Automatic 3D registered compare 4 MPR layout • Visage built automatic AI brain tumor segmentation algorithm that can delineate whole, core, and necrotic tumor compartments. • Segmentat
Slide 43: PACS is our clinical world
“PACS is our clinical world for Radiologists. Incorporation of AI into PACS, gives us clinical “This is what AI based value.” segmentation of gliomas in PACS looks like! Advanced image processing at your Mariam Aboian, MD, PhD Assistant Professor fingertips is our next Radiology & Biomedical Enginee
Slide 44: Future of Collaboration
Future of Collaboration • Yale Glioma Dataset (2000 pts) • Yale Lymphoma Dataset (82 pts) • Development of Oncology Toolkit that applies to primary and • Yale Pituitary Adenoma Dataset metastatic CNS malignancies, lung cancer, neuroendocrine (272 pt) • Yale Lung Cancer Imaging- cancer, liver primary
Slide 45: Growth Strategy
GROWTH STRATEGY New product offerings Transaction growth Extend to new from existing clients geographical markets Leverage R&D capability Expand footprint – to introduce next new clients generation products 42
Slide 46: North American Pipeline
NORTH AMERICAN PIPELINE Prospects Progressing through Network Effect various stages of the cycle Opportunities Further increased as a result of recent high- profile wins New inbound RFPs Pipeline Robust even during COVID In terms of quality and quantity of opportunities 43
Slide 47: New Products
NEW PRODUCTS • Single viewer for ALL images in the medical record (EMR) • Radiology/Cardiology (DICOM format) • Non-radiology– reflected light – hi-res photos & videos • Visage 7 technology ideally suited • Increases Visage value proposition • Growth opportunities within existing contracts
Slide 48: Visage Open Archive
VISAGE 7 OPEN ARCHIVE • Same highly scalable Visage 7 platform • Interoperable – works in complex environments • Enables choice of modular or single vendor solutions • Three recent sales - Viewer and Visage 7 Open Archive • Pipeline includes Visage 7 Open Archive opportunities • Key component of Vis
Slide 49: Visage Workflow
VISAGE 7 WORKFLOW • Adds to Visage 7 Viewer and Open Archive modules • Based on over 30 years experience in Worklist SW • Allows PME to offer single vendor solution • Integral part of Visage in the Cloud SaaS solution • Ability to interface with broad range of AI algorithms • Transaction based model
Slide 50: Visage in the Cloud
Visage in the Cloud • Visage 7 – fully Cloud native • Same ultrafast performance as on-premise • Full Visage 7 functionality • Security and scale of the cloud • Complete PACS deployment or as backup/disaster recovery • Suitable for all size implementations • Opens new market opportunities • Signific
Slide 51: AI in Radiology
AI in Radiology • Imbedded in SW or imaging equipment • Prioritisation of cases – eg head trauma • Screening – eg early-stage lung nodule detection • Aid to diagnosis – 2nd opinion, incidental findings • Automated diagnosis 49
Slide 52: Visage AI Accelerator
Visage AI Accelerator • Unique end to end solution • Research and production environments on a single platform • Based on market leading Visage 7 technology • Enables Visage clients to fast-track AI as part of their imaging strategy 50
Slide 53: Visage AI Accelerator
Visage AI Accelerator • Streamlines AI algorithm development • Optimised for AI data curation and validation • Open API enables native integration • AI Ecosystem - 3rd party and Visage developed algorithms • Joint development/commercialisation opportunities - 3rd parties and academic clients. 51
Slide 54: Breast Density - AI
BREAST DENSITY - AI • First diagnostic AI algorithm produced by Visage • Developed in collaboration with breast imaging team at Yale • Provides “on-the-fly” AI assessment of breast density • Previewed at RSNA 2019 as WIP • FDA clearance – February 2021 • A model for future AI development 52
Slide 55: AI Research Leadership
AI Research Leadership Malte Westerhoff, PhD Global Chief Technology Officer Detlev Stalling, PhD Head of Development Ming De Lin, PhD Clinical Research Manager North America Raj Moily, MBBS, PhD Director, AI Business Development North America 53
Slide 56: NYU Langone – RCA Update
NYU LANGONE – RCA Update • Multi Year research collaboration agreement • Work on establishing NYC R&D Hub commenced • Joint R&D to develop next generation imaging products • Visage to have onsite access to NYU Langone radiologists and imaging scientists. • Leverage R&D and commercialization opportun
Slide 57: Conference booth update
• In person in 2021 – large Visage presence • Stand to be manned by our US and European teams • Excellent number of advance bookings 55
Slide 58: Summary
SUMMARY • Most successful period in company's history • North American footprint continues to grow strongly • Expanded product portfolio – single vendor or modular • Proven remote implementation & support capability • Cloud – huge strategic advantage over competitors • Unparalleled value proposition
Slide 59: Radiologist Comment at Go Live
Radiologist Comment at Go Live “We went from a Flintstone’s car to a Tesla.” 57
Slide 60: Thank You
A’\A Gy 4 VV . Wy THANK YOU pro+medicus