How do you think they're positioning that support and implementation function? It's their strength apart from the implementation itself, which is difficult. But how do the people support these implementations? Are they differentiated compared to the rest of the market? How do you differ with them?

With Visage, there's only a handful of implementations going on at any given time, partly because each one of those happens so quickly. We were able to do one and then move on to the next one quickly. Whereas at Sectra, since it takes 18 to 24 months for them to do the implementation, largely because of the complexity of their overall solution—keep in mind that with Sectra, for them to provide all of the functionality that Visage provides in a single monolithic environment, that requires seven completely different systems, all of which have to be implemented, each with their own different database, and then all of those systems have to be integrated. It's at least seven times more complexity to do a Sectra implementation versus a Visage implementation. That means they need to have more people to do that. It takes longer; there's higher risk involved in the process. There's much greater likelihood of encountering problems, especially if you have software updates that take place at some point during that cycle.

Why do you think that Sectra has so much traction in the U.S., which has even more exams? Is it a matter of cost per exam? Because implementation seems to be much more expensive in Sectra, considering everything.

The implementation in Sectra tends to be anywhere from three to maybe seven times the cost of the implementation with Visage. Then the ongoing infrastructure costs with Sectra are about that same ratio; three to seven times the cost of the infrastructure with Visage.

All these concepts that you describe—it's $1, right?

Cloud is inherently more reliably accessible and more resilient than an on-premise environment. That's one of the reasons that led Visage to start working in the cloud so much earlier than other systems did; it guaranteed access to the data to the customer. Now take those same reference costs that are $1, $1, and some number based on how big the customer is for the storage for Visage. For Sectra, the license cost is probably 80 to 90 cents per study, the infrastructure cost is probably $3 to $7 per study, and the storage is roughly the same as it is with Visage. If you take all of those and add them up, Sectra ends up being substantially more expensive in total cost of operations than Visage—anywhere from two to four times the cost.