Feedback PLC’s Product Evolution: Transforming Legacy Tech into a Modern Platform

Inheriting legacy technology often feels like being handed an anchor when you need a speedboat. In a recent episode of Category Visionaries, Thomas Oakley revealed how Feedback PLC transformed decades-old medical imaging software into a modern clinical collaboration platform, turning technical debt into market advantage.

The Legacy Challenge

When Thomas joined in 2019, he inherited two merged companies with deep technical roots. “Feedback actually started out as two different companies, a company called Cambridge Computer imaging and a company called Textrad,” he explains. They specialized in “Pax company, which is a picture archiving and communication system. That’s really how hospitals store their radiology images. Think of it a bit like a digital library.”

While the technology was solid, the market was saturated. “That market particularly got overtaken by much larger companies, such as General Electric, Phillips, Siemens, and it became very difficult to compete with those.” The company faced declining revenues and no clear path forward.

Finding Hidden Value in Legacy Code

Rather than scrapping everything and starting fresh, Thomas saw potential in their medical device certification and imaging expertise. “One of the unique things about that is that in the UK and in fact, internationally, a lot of the radiology imaging is considered a medical device function,” he notes.

This certification, combined with their technical foundation, became the springboard for innovation. They began exploring how non-radiologists use medical images, leading to Bleeper – what Thomas describes as “a clinical grade version of WhatsApp, which provides you with a secure, chatty environment that is patient specific… instead of having photos and videos, you have CT scans and MRIs, blood results and ECGs.”

Balancing Innovation with Regulation

The team had to solve a fundamental tension between agile development and medical device requirements. As Thomas explains, “If you are developing software in an agile way, you rapidly create a new version of a product, see what works, see what doesn’t, and then iterate those changes back into your product. You can’t do that in a clinical environment where if you get something wrong or there’s a bug in your software that could have an impact on patients.”

Their solution was developing a unique approach to regulated innovation. “The medical device way of developing software is to risk, assess everything that you’re doing, anticipate risk and try and remove it from the product before you ever put it into the hands of clinicians.” This created a high barrier to entry while still enabling customer-driven development.

Expanding Platform Capabilities

Customer obsession drove their evolution. During COVID, they rapidly developed capabilities allowing “consultants who were treating patients in Manchester and advising on treatment plans whilst being at home with family in Delhi.” This demonstrated how their platform could “completely remove the geographic parameters of care.”

Even their veterinary work sparked innovation. Technology developed for imaging horses in fields without WiFi later enabled rural healthcare in India, providing “AI-powered TB screening diagnosis within about 30 seconds of an x-ray being taken anywhere in India where you had 3G connectivity.”

The Results

The transformation has delivered consistent 74% year-over-year growth for three years running, with an 89% increase in sales in their latest period. More importantly, they’ve demonstrated the ability to “reduce wait times in the NHS by 70% without needing any additional clinical staff at all, and in a way that actually releases cash back to that system.”

Future Vision

Looking ahead, Thomas sees their platform becoming “essentially a digital glue that pulls healthcare environments together.” Their goal is to create a system where “patients can come and go from any care setting, have that care setting add to their record, and be treated by specialists who could be anywhere in the world.”

The lesson for founders? Legacy technology isn’t always a liability. With the right vision and execution strategy, it can become the foundation for innovation that others can’t easily replicate. The key is seeing beyond current limitations to identify unique advantages hidden in your technical DNA.