Executive Summary / Key Takeaways

• Strategic Pivot to High-Value iRWD: OneMedNet is undergoing a critical transformation, decommissioning its legacy BEAM platform to focus entirely on its AI-powered imaging Real-World Data (iRWD) solution. This strategic shift targets the burgeoning demand for regulatory-grade clinical imaging data in pharmaceutical, device, and AI markets.
• Significant Financial De-risking: The company has dramatically improved its balance sheet, reducing total liabilities by approximately $13.5 million (80%) to $6.2 million as of June 30, 2025, through debt conversions and discounted settlements. This de-risking is crucial for its long-term viability, although a "going concern" doubt persists.
• Technological Differentiation and Network Expansion: OneMedNet's iRWD platform leverages AI for secure de-identification and curation of over 121 million clinical exams from 31 million unique patients across 1,400+ healthcare sites. Recent partnerships with Datavant, HealthVerity, Protege, and Circle CVI are expanding its ecosystem and market reach, particularly in high-growth areas like cardiovascular and oncology RWD.
• Growth in Core iRWD Business: Despite an overall revenue decline due to the BEAM decommissioning, iRWD revenue demonstrated robust growth of 26% in Q2 2025 and 40% in H1 2025, signaling positive traction in its focused segment.
• Competitive Niche and Future Outlook: While smaller than industry giants like Siemens Healthineers (SHL) or IQVIA (IQV), OneMedNet's specialized AI-driven approach to imaging RWD provides a distinct competitive edge. Its future hinges on leveraging this technological differentiation, converting its expanded network into sustained iRWD sales, and achieving operational profitability.

The Dawn of AI-Powered Real-World Data: OneMedNet's Strategic Rebirth

OneMedNet Corporation stands at a pivotal juncture, repositioning itself as a focused leader in the rapidly expanding market for AI-powered Real-World Data (RWD), specifically within clinical imaging. Founded in 2015, the company initially developed solutions for digital medical image management and sharing. Its journey took a significant turn with a business combination in November 2023, followed by a decisive strategic pivot in early 2025. This transformation involves shedding legacy operations to concentrate on its high-potential iRWD solution, a move designed to unlock substantial value in healthcare research and development.

The broader industry landscape is characterized by an escalating demand for de-identified, regulatory-grade RWD, driven by advancements in AI, precision medicine, and the need for more efficient clinical trials. Major players like Siemens Healthineers, GE Healthcare (GEHC), Philips Healthcare (PHG), and IQVIA dominate various segments of medical technology and data analytics. OneMedNet, while smaller in scale, carves out a niche by specializing in imaging RWD, aiming for agility and deep expertise where larger, more diversified competitors may offer broader but less specialized solutions. This strategic focus is critical for OneMedNet to thrive in a competitive environment, leveraging its unique technological capabilities to address specific market needs.

OneMedNet's Technological Edge: Unlocking Imaging RWD Value

At the heart of OneMedNet's strategy is its iRWD solution, a proprietary AI-powered platform designed for securely de-identifying, searching, and curating clinical image archives. This technology is a foundational strength, offering tangible benefits over traditional, often manual, data aggregation methods. The platform's ability to locally de-identify data ensures patient privacy while enabling access to a wealth of internal and third-party research opportunities for healthcare providers. This secure, federated network approach is a key differentiator, addressing the stringent regulatory and ethical requirements for using patient data in research.

The specific benefits of OneMedNet's AI-driven iRWD are multifaceted. It provides regulatory-grade imaging and clinical data, which is crucial for pharmaceutical, medical device manufacturing, contract research organizations (CROs), and artificial intelligence markets. The platform's efficiency in data search and curation can significantly accelerate research workflows, potentially leading to faster drug and device development. While specific quantifiable metrics like "X% faster processing" are not detailed, the strategic intent is clear: to offer a more streamlined and reliable data source for life sciences. The company is actively developing an AI-driven toolset to anonymize and de-identify data across multiple industries, signaling ongoing R&D to enhance its core offering and expand its addressable market. This technological moat is intended to drive customer loyalty, potentially leading to stronger recurring revenue and improved margins by providing a superior, specialized service that larger, more generalized competitors may struggle to replicate with the same focus.

A Phoenix Rising: Strategic Restructuring and Financial Rebalancing

OneMedNet's recent history is marked by a significant financial restructuring, a necessary step to address recurring operating losses and an accumulated deficit of $100.5 million as of June 30, 2025. The company's cash and Bitcoin balance of $0.1 million and $1.6 million, respectively, at that date was deemed insufficient to fund operations for the next twelve months, raising substantial doubt about its ability to continue as a going concern. This stark reality necessitated aggressive action.

The company executed a remarkable financial de-risking in the first half of 2025, reducing total liabilities from $19.7 million at December 31, 2024, to $6.2 million by June 30, 2025—an 80% reduction of approximately $13.5 million. This was achieved through a series of strategic maneuvers: the conversion of $1.7 million in PIPE Notes, $2.6 million in loan extensions, and $2.3 million in shareholder loans into common stock. Additionally, OneMedNet settled deferred underwriter fees for a one-time cash payment of $0.5 million, resulting in a $2.7 million gain on troubled debt restructuring, and restructured trade payables with vendors, generating an additional $0.9 million gain. These non-cash gains significantly contributed to the reported net income of $2.98 million for Q2 2025 and $1.08 million for H1 2025. While these gains are non-recurring, the substantial reduction in debt and liabilities provides a much-needed foundation for future operations. Management plans to raise additional working capital through equity or debt offerings and aims to achieve profitable operations within the next 12 months, a critical objective given its current liquidity position.

Operational Performance: A Glimpse of the Future Amidst Transition

The financial results for the three and six months ended June 30, 2025, reflect OneMedNet's strategic pivot. Total revenue decreased by 32% to $155 thousand in Q2 2025 and by 39% to $292 thousand in H1 2025 compared to the prior year periods. This decline was primarily driven by the planned decommissioning of the BEAM platform on May 31, 2025, as the company ceased customer renewals to focus on iRWD. This resulted in a $0.1 million and $0.2 million decrease in subscription revenue for Q2 and H1 2025, respectively.

However, the focused iRWD segment demonstrated promising growth, with web imaging revenue increasing by 26% to $108 thousand in Q2 2025 and by 40% to $187 thousand in H1 2025. This growth underscores the positive traction from the company's enhanced focus on iRWD sales and increased customer deliveries. The cost of revenue as a percentage of revenue increased significantly (110% in Q2, 117% in H1), primarily due to the BEAM transition, which resulted in lower subscription revenue without immediate corresponding cost savings, alongside higher iRWD data and personnel costs to support anticipated sales growth. Operating expenses saw a mixed trend: general and administrative expenses decreased due to a one-time commitment fee in the prior year, while sales and marketing expenses increased by 12% in H1 2025, driven by increased headcount to support iRWD sales. Research and development expenses decreased by 10% in H1 2025, reflecting a reallocation of resources towards iRWD sales growth. The company's strategic investment in Bitcoin, initiated in Q3 2024, resulted in an $837 thousand unrealized loss and an $844 thousand realized gain in H1 2025, highlighting the volatility and potential impact of this treasury strategy.

Forging Alliances: Expanding the iRWD Ecosystem

OneMedNet's strategic partnerships are instrumental in expanding its iRWD ecosystem and market presence. The company has actively integrated its regulatory-grade iRWD solution into major health data platforms. Collaborations with Datavant Connect and Amazon Web Service (AWS) (AMZN) Clean Rooms enhance data discovery and analytics capabilities, providing secure, scalable, and fit-for-purpose data solutions for healthcare and life sciences. Its iRWD is now discoverable and available in HealthVerity Marketplace™, facilitating seamless integration of imaging data with broader real-world data assets to enhance evidence generation in life sciences research.

Further solidifying its position, OneMedNet partnered with Protege to provide real-time, multimodal patient data for AI developers and researchers, expanding access to high-quality datasets for next-generation AI solutions. A significant project with Inka Health focuses on leveraging OneMedNet's regulatory-grade patient data for AI-driven oncology projects, specifically for developing external control arms (ECAs)—a potentially faster and more cost-effective alternative to traditional clinical trials. The company also announced a long-term strategic partnership with Circle Cardiovascular Imaging Inc. (Circle CVI), initiating a new subscription revenue model and adding 85 cardiovascular centers and 2.7 million annual cardiovascular studies to its network. This expansion positions OneMedNet as one of the largest providers for Cardiovascular Real-World data, demonstrating its ability to onboard major data marketplaces and surpass 121 million clinical exams from 31 million unique patients. These alliances are crucial for extending its reach, validating its technology, and driving future revenue streams.

The Competitive Arena: ONMD's Position Against Giants

OneMedNet operates in a competitive landscape dominated by large, diversified healthcare technology and data analytics firms. Direct competitors like Siemens Healthineers, GE Healthcare, Philips Healthcare, and IQVIA possess significantly greater scale, broader product portfolios, and more extensive financial resources. These giants offer comprehensive solutions spanning hardware, software, and data services, often with established global distribution networks and deep customer relationships. For instance, Siemens and GE excel in diagnostic imaging hardware and integrated AI, while IQVIA leads in broader healthcare data analytics and clinical research services.

OneMedNet's competitive standing is defined by its specialized focus and technological differentiation. Its proprietary AI-powered iRWD platform offers a distinct edge in the niche of regulatory-grade imaging data curation. This specialization allows for greater agility and potentially superior performance in specific research applications, such as de-identification and secure data sharing, compared to the more generalized offerings of its larger rivals. For example, OneMedNet's AI benefits could counter Siemens Healthineers' hardware focus by providing notably faster data processing for research, potentially allowing ONMD to exploit Siemens' cost inefficiencies in specialized data handling. Similarly, its secure, AI-native solutions for medical imaging could differentiate it against IQVIA's broader analytics tools by offering notably faster processing for imaging data curation.

However, OneMedNet's smaller scale presents vulnerabilities. It faces materially higher operating costs relative to revenue, impacting profitability and cash flow, and potentially limiting its ability to compete on price or invest as heavily in R&D as its larger counterparts. Its financial health, as evidenced by negative gross and operating profit margins (TTM Gross Profit Margin: -125.00%; TTM Operating Profit Margin: -2030.43%), lags significantly behind competitors like Siemens (Gross Profit Margin: 0.12%; Operating Profit Margin: 0.05%) and IQVIA (Gross Profit Margin: 0.35%; Operating Profit Margin: 0.14%), which have demonstrated consistent revenue growth and strong profitability. While barriers to entry such as regulatory approvals and high R&D requirements protect the industry, they also favor larger, more established players. OneMedNet's strategic response involves leveraging its technological advantages and expanding its network through partnerships to capture market share in high-growth, specialized segments, rather than competing head-on across the entire spectrum of healthcare technology.

Conclusion

OneMedNet Corporation is in the midst of a profound strategic transformation, pivoting from a diversified digital imaging company to a specialized, AI-powered imaging Real-World Data provider. The company's aggressive debt reduction and financial restructuring efforts have significantly de-risked its balance sheet, providing a crucial foundation for its renewed focus. While the "going concern" warning remains a serious consideration, the substantial reduction in liabilities and recent capital injections offer a lifeline.

The core investment thesis hinges on OneMedNet's ability to capitalize on the burgeoning demand for regulatory-grade imaging RWD through its differentiated AI technology and expanding network of partnerships. The robust growth in iRWD revenue, despite overall declines from the BEAM decommissioning, signals positive momentum in its chosen market. As OneMedNet continues to integrate its platform with key industry players and expand its data sources, its technological leadership in secure, de-identified imaging data could carve out a defensible niche against larger, more generalized competitors. Investors should closely monitor the company's progress in converting its strategic alliances into sustained iRWD sales, improving its operational profitability, and ultimately achieving financial self-sufficiency, as these factors will dictate its long-term success in the dynamic RWD landscape.