Strategy for growth 29 November 2018 Andy Thorburn Group CEO - - PowerPoint PPT Presentation

Strategy for growth

29 November 2018

Andy Thorburn Group CEO

Agenda

• Welcome and introductions
• Business overview

Andy Thorburn

• Healthcare market

Dr Shaun O’Hanlon

• Medicine management

Ian Taylor

• Patient update

Jason Keane

• Technology roadmap

Pete Malcolm

• Moving forward and summary Andy Thorburn
• Panel Q&A

Group Executive Team

Our track record

Our track record – market-leading systems

Community systems

#2

29.4m annual consultations recorded A&E systems

#2

14.2m patients annually Hospital pharmacy systems

#2

11m patients annually Community pharmacy systems

#1

454m items dispensed annually London & SE STP |CCG |Trusts| Major Practices GP hosted systems

#1

2.25bn clinical documents and 40m patient records Patient Access 2.0

#1

6m registered users Diabetic eye screening

#1

private provider 500,000 patients screened annually Healthcare partner network

#1

100 partners in primary care GP systems

#1

160m annual appointments GP practice check ins

#1

22% market share

Our strong, consistent financial delivery

• Recurring revenue has always been at least 75% since 2010 IPO
• Significant cash generated from operations every year
• 10%+ increases in the dividend annually since IPO
• Consistently delivered operating margins over 20%
• CAGR since IPO
• Revenue

+15%

• Adjusted operating profit

+11%

• EPS

+12%

Improving our NHS Digital relationship

• Our relationship with NHS Digital (NHSD) is changing for the better
• We are aligned with their priorities and are converging our

roadmaps

• We are not complacent – however we believe we are well positioned

for GP IT Futures

• Our service level agreement (SLA) issues are now behind us and

we are near to settlement completion - we expect this to be within

• ur provision level

Our plan

Our senior leadership team

Andy Thorburn Chief Executive Officer Barry Bonnett Group Business Development Director Jacqui Summons EMIS Group HR Director Pete Malcolm Group Chief Technology Officer Dr Shaun O’Hanlon Chief Medical Officer – EMIS Group

Ian Taylor

Chief Operating Officer Jason Keane Chief Executive Officer – Patient Platform Ltd Peter Southby Chief Financial Officer Steve Wilcock Managing Director – Egton and Primary

Our strengthened senior team

Clinical team

• Shaun
• Pippa
• Rob
• Jonathan
• Sarah
• Ian
• Ed
• Haidar
• Shanel
• Tarun
• Sima

Product team

• Guy
• Chris
• Ian
• Shanel
• Graham
• Jenny
• Tom
• Andy

NHS customer team

• Barry
• Steve
• Ed
• Bob
• Steve
• Lynette
• Karen
• Neil
• James
• Nick
• Lydia
• Helen

Technology team

• Pete
• Paul
• Jon
• Rob
• Pankaj
• Iain
• Idris
• Richard
• Andy
• Nick
• Esmat
• James

Private sector customer team

• Ian
• Jason
• Eduardo
• Stephen
• John
• Alex

Existing senior talent New senior talent

Talent Team

• Jacqui
• Carla
• Claire
• Pete
• Charlotte
• Colin

Finance and governance team

• Peter
• Dean
• Neil
• Paul
• Christine
• Ian

Our plan to re-energise the Group’s growth

• Improve service performance and efficiency in our NHS business
• Rapidly grow our private sector business
• Build sustainable sales momentum
• Update and accelerate our technology roadmap

Expected financial outcomes in the medium term

• Mid-to-high single-digit annual revenue growth for the Group
• Increase private sector revenue to 50% of Group
• Margins moving towards 30%
• Tech investment self-funded through new sales and operational

leverage

Attractive balance of NHS and private sector opportunities

An NHS business that is focussed on integrated care enabled by new technology

NHS integrated care

• Primary care
• Child health
• Mental health
• Community
• Unscheduled care
• Social care

Improving operating efficiency for the NHS and EMIS Group

An enterprise business that is focussed on new opportunities in the private sector

Private sector growth markets

• Management of medicines
• Patient facing services
• Partner ecosystem
• UK healthcare blockchain
• New markets

Providing new double-digit growth

• pportunities

Building market momentum and service performance

NHS

• Investing in our team size and

quality

• Getting closer to our customers
• Expanding our product portfolio
• Delivering NHS-wide value

propositions

• Deploying new support systems

Private sector

• Building on established capability
• Identifying new markets
• Acquiring new capabilities
• Developing new value propositions
• Hiring new leadership and talent

Enabling technology strategy

• EMIS Group is investing in software and systems to enable growth
• We are upgrading our EMIS Web system that serves GPs and

community customers

• We are also extending this upgrade into acute, pharmacy and other

new markets in a modular way

• When completed we will have the UK’s first integrated clinical

platform serving all care – EMIS-X

“Deployment of EMIS-X will enable the transformation of the UK healthcare system and provide secure, auditable, legal and ethical authorised access to the richest UK clinical dataset.” Pete Malcolm, EMIS Group CTO

EMIS-X – improving patient outcomes

• Builds on the clinical foundations of EMIS Web
• Aligns with NHS England and NHS Digital roadmap and GP IT

Futures

• We have a team of 450 to execute our existing and new plans having

hired an additional 150 team members in the last 12 months

“I’ve seen some of the new developments that EMIS Group has coming down the track, which are very exciting, will improve lives for GPs and patients, and crucially help to save lives.” Matt Hancock, Secretary of State for Health and Social Care

Expanding NHS market with diversified revenue streams

Addressable market Diversified local funding sources National funding sources

£335m (2018) £672m (2022)

Growth drivers Local care records/ LICREs Social and community care Mental health | urgent and unscheduled care Hospital medicines management 174 trusts in acute NHS Global Digital Exemplars - £200m+ 38 community trusts Local integrated care record exemplars - £75m+ 46 clinical services Hospital medicines management - £75m 15 hospices Health systems support framework - £300m+ 50 private hospitals IT Futures - £450m over 3 years

Private sector market with diversified revenue streams

Medicines management Online services Partner ecosystem New markets

Current addressable £145m Future addressable £325m+ Market near-term addressable £20m (pharmacy marketplace) Mid-term £100m+ Current addressable £20m Future addressable £100m+ TBC

EMIS Group uniquely positioned through EMIS-X

• Joined-up NHS
• Joined-up management of medicines
• Joined-up patient online services
• Joined-up technology

NHS market drivers Dr Shaun O’Hanlon

Quality of care

Care pathways Sharing information Data driven decisions Consistency of care Mobility

Efficiency

Carter review Workforce and service planning Medicine management GP federations

Demand

Ageing population Long term conditions Social care pressures Public expectation 24-7 service

Technology

Interoperability Analytics Modular systems Mobility Cloud services

Financial

NHS Forward View NHS funding challenges £20bn increase by 2022 Reconfiguring NHS STPs/ ICOs

Underpinned by technology

NHS IT programmes

£1bn pa additional funding Global Digital Exemplar (GDE) Local Integrated Care Records (LICREs) Patient online access NHS IT Futures

Complex and diverse market drivers

Core GP capabilities (blue)

• Capabilities for current GP

practice

• Largely equate to EMIS

Web now Non-core GP capabilities (green)

• Patient services
• Add-ons for GP practices
• Opportunity for new EMIS

Group products

Extended primary care

• Integrated care capability
• Federated working
• Analytics
• Local care records
• Care homes

Standards

• Interoperability
• Reporting
• Clinical safety
• Information governance
• Data standards
• Infrastructure
• Testing
• Training
• Data migration

Summary – well positioned in a favourable market

• EMIS Group is at the heart of the changes in the UK healthcare

ecosystem

• Our focus is on providing joined up care across all settings – fully

aligned with NHS strategy

• Our new technology strategy enables our vision of integrated care

to be a reality

• We are well positioned for IT Futures

Medicines management Ian Taylor

Unique positioning and opportunity in complex market

Excellent foundations

• #1 in primary care prescribing
• #1 in community pharmacy
• #2 in hospital pharmacy
• Leader in electronic dispensing
• Leader in online repeat medicines

via Patient Access

• Knowledge and insight across all

public and private settings

Opportunities

• To provide a unique insight of the

interaction of patient, prescribing and dispensing in all settings

• Maximise margins for wholesalers

and pharmacies

• Minimise costs for the payer – public
• r private
• Enable rapid growth of private

services via patient marketplace e.g. Patient Group Directions (PGD)

Management of medicines (MoM) – market opportunity

• MoM encompasses the end to end

process of

• Prescribing – usually at a GP surgery
• r hospital
• Sourcing/ supply wholesalers
• Dispensing – hospital or community

pharmacy

• Patient taking the medication – at

home or in hospital

• Medicines accounted for £17bn of

NHS spend in 2016/7

Why the opportunity exists – wastage and inefficiency

• NHS clinical safety needs to be improved
• 22,300 deaths per annum caused by prescribing errors
• Financial cost of £1.6bn per annum
• 20% of hospital re-admissions due to medication errors

Source: NHS April 2018

• Do patients take their medicine?
• 10 days after starting a medicine, almost 1/3 non-adherent

with

• 55% not aware they are taking meds incorrectly
• 45% intentionally non-adherent
• £300 million medicines are wasted annually in

primary care

Source: NHS England Nov 2018

MoM ecosystem – EMIS Group’s strong market position

• High street/ community pharmacy
• 37% market
• Single ProScript platform in all countries
• Head office reporting enables multiples to

leverage data assets

• Hospital pharmacy
• 32% of market – market leading solution
• Electronic Prescribing and Medicines

Administration (ePMA)

• End-to-end prescribing and drug delivery

in acute and mental health hospitals

• 12% of growing market
• NHS investing £75m in ePMA in 2018/

2019 to migrate from paper drug charts

Our opportunity tomorrow

• Technology to improve the end-to-

end process

• Join up patient, primary, acute and

pharmacy

• New services to pharmacy through

Patient Group Directions (PGDs)

• Supply chain optimisation and

centralised fulfilment models

• Support patients - medicine

adherence/optimisation

• Analytics on group data assets to

drive

• NHS monitoring and utilisation analysis
• Intelligence driven prescribing and

medicines supply

• Alignment of databases
• Alignment of functionality
• Supply chain. Single portal
• Stock management
• Medicines reconciliation in hospital,

community and self-managed

• Prescription fulfilment into

community (Electronic Transfer

• f Prescriptions)
• Hospital
• Outpatients
• Community
• Home care

MoM – supply and administration

Centralised fulfilment – ‘hub and spoke’

Summary – well-positioned for evolving opportunity

• Medicines cost to NHS ever increasing
• Opportunities arise around improving

efficiency and safety

• EMIS Group is in a unique position to

deliver new solutions to medicines management market

• Private and public sector client base

Source: NHS England Nov 2018

Patient Access Jason Keane

Available healthcare services in the future: NHS, private, complementary Patient care needed today: including self care

Book appointment with doctor Manage my meds and set my alerts See my health/medical record Read clinical content Find a health professional Video call with my doctor Get my physio referral Book appointment with pharmacist

Patient Platform (Access)

Clinical content Private health services

NHS (Primary, secondary, CCMH*)

Community pharmacy Digital health partners

Patients (users)

*CCMH – Child, community and mental health

A patient-centric, connected healthcare service

Upload device data See consultant Refer to consultant Update personal health record Take meds Treatment plan EMIS Group view on patient care Re-order meds Order meds Prescribe meds Interact with clinical content Share clinical content See GP

Patient Platform: longitudinal data on patient care

Self-care

A longitudinal view of patients’ health

Social media, entertainment

4.8 Instagram 4.7 Spotify 4.3 LinkedIn 3.9 Netflix 2.9 Amazon 2.7 Facebook

Health tech

4.8 Babylon Health 4.7 Push Doctor 4.7 myGP 4.6 WebMD 4.1 Echo 3.2 Dimec

Comparative App Rating (iOS)

4,200,000 4,400,000 4,600,000 4,800,000 5,000,000 5,200,000 5,400,000

Monthly Logins by Registered Online Service Users (ROSU)

Mar-18 Jun-18 Sep-18

A platform that users love and GPs trust

User-driven, GP-guided content Traditional supply (pharmacy & HCPs) GP direct referrals Digital supply (API partners) USERS SUPPLIERS Matching supply with demand Our mission To create a connected healthcare service (‘marketplace’) that gives people control of their healthcare and access to the best information and clinical services Our business model

Patient Pro Patient API + Monetising access to and transactions within our platform

Listing fees Appointment booking revenue share Partner API

Monetising

• ur assets

NHS software licensing B2B primary care services (GP-enabling services) Content media

Safely guiding patients to the right care they need

6 34

Patient health records

6 154

Annual appointments

9 269

Annual prescriptions

Current Patient Access (demand) EMIS Group reach untapped (supply)

Number in millions

EMIS Group – Patient ready-made marketplace

Private practitioner therapies, £3.8bn Dental and GP, £4.4bn Medical goods, £10.1bn Residential & home healthcare, £10.7bn Government, £156.4bn Private self pay, £29.0bn Private medical insurance, £6.2bn

Total UK healthcare expenditure £191.6bn Total UK private self-pay expenditure £29bn

Includes UK prescription market

• f £15bn public; £0.6bn private

Sources: Office of National Statistics, Laing & Buisson

Uniquely positioned to deliver a connected care service

Patient Access roadmap

Q2 2018

Patient Access launch Booking appointments Managing repeat medications Access to patient health records Messaging practices Video consultations

Q4 2018

Remote patient health record (PHR) monitoring

Q1 2019 Q3 2018

Triage

Q2 2019

Pharmacy marketplace

A connected healthcare marketplace with more to come

Technology roadmap Pete Malcolm

Technology focus – improves outcomes and efficiency

• Assisting clinical diagnosis and medication decisions
• Reducing operational burden for clinicians
• Eliminating unnecessary costs and inefficiency
• Improving patient experience and empowerment
• Enabling proactive vs reactive care

Current situation – ready for change led by EMIS Group

• Multiple vendors with disparate systems
• Lack of federated working
• Interoperability limited to data exchange
• Multiple records per individual citizen
• Limited access to patient records causes clinical risk
• High barrier to new market entrants
• Inefficiency, duplication, manual processes
• Patient and clinical professional inconvenience
• Systemic risk due to lack of joined up services

EMIS-X concept – fit for the future

• Cloud based clinical platform
• Hosted exclusively in UK data centres
• Extends managed services model with clinical modules
• Multi-tenant with controlled data sharing
• Foundation modules provide common services via API
• Application modules provide user apps via UX/UI
• Applications can be internal or external
• Supports third party applications and full interoperability
• Leverages blockchain technology
• Over time will become the platform for all EMIS Group solutions

EMIS-X concept

Federated working – patient records

Person/patient record relationship Patient record and permissions

Federated working – appointments

Hybrid operating model

• Allows federated ecosystem partner

participation without application re-writes

• Accessed via APIs
• Selectively replicate only required

information, e.g.

• Medications
• Available appointments
• Bi-directional via call-backs
• Real-time
• Preserves third party commercial

interests

Selective medical record replication

EMIS Web upgrade

• Data is replicated in the hybrid

model

• Embedded browser in EMIS Web

client provides user access

• Progressively adds new and

replacement functionality to EMIS Web

• Ultimately replaces EMIS Web

when functionality is equivalent

• Avoids “big bang” switch over

Upgrade model

Open platform and Amazon Web Services

Open platform

• Available to approved UK healthcare
• rganisations and vendors
• Foundation modules provide managed

administrative and clinical services

• Access from cloud hosted applications
• r from any device
• Fully configurable
• Significantly reduces development time
• Lowers barrier to entry for new

partners

• Provides sandbox test environment

Amazon Web Services (AWS)

• World’s largest and most experienced

cloud computing provider

• Most comprehensive, mature and reliable

range of compute and storage services

• Operating since 2002
• Annual revenues of $17.6bn (2017)
• More than 1m active customers:
• 2,000 government agencies
• 5,000 educational institutions
• 17,500 non-profit organisations
• 99.999999999% data durability (equivalent to
• ne lost file every 659,000 years)

Document dashboard

Synthesized data

EMIS-X major benefits

EMIS solutions

• Provides rapid deployment of upgrades/

fixes

• Reduces development times
• Reduces operating costs
• Improves security, reliability and data

resilience

• Demonstrates a progressive migration

path from EMIS Web

• Facilitates integration between EMIS

Group applications

• Provides practically infinite scalability

and future-proofing

Ecosystem

• Facilitates fully “joined-up” UK healthcare
• Multi-vendor and organisation participation
• Provides federated access to data
• Retains tenant data ownership and control
• Preserves third party commercial interests
• Significantly reduces barrier to market

entry for partner technologies

• Improves patient outcomes, control and

convenience

• Dramatically increases NHS and

medicines management efficiency and reduces cost

Ecosystem

Summary Andy Thorburn

Expected financial outcomes

• We plan to deliver mid-to-high single-digit organic revenue growth; with double-

digit organic growth in our private sector business over the medium term

• We expect bolt-on acquisitions to accelerate our speed to market and to meet
• ur target of increasing private sector business to 50% of our revenues over

time

• We will increase investment in our technology over the next 2-3 years. This

should be self-funding through productivity gains and customer funding

• Through sustained investment and the deployment of EMIS-X, we expect

increased operational leverage with margins heading towards 30% over the medium term

• We remain well capitalised and this level of technology investment will not

impact our progressive dividend policy or require significant leverage

EMIS Group summary investment case

• Strong positions in specialist markets
• Opportunity to strengthen position in private sector markets over

time both organically and by selective bolt-on acquisition

• Excellent financial strength and track record
• High levels of earnings visibility and cash generation
• New technology driving future growth and efficiency

Group Executive Team Q&A

End