ONMD’s rapid RWD network expansion boosts strategic asset, but financing and execution risks remain dominant

What happened

OneMedNet announced that in the three months since August 2025 it has expanded its iRWD network by roughly 22% to more than 2,130 provider sites, with de-identified patient records growing 38% to over 47 million and clinical exams/images rising 37% to more than 186 million. This materially enlarges what was already a sizeable imaging-centric real-world data asset base (previously >1,400 sites and >31 million records), reinforcing the company’s claim to be one of the largest regulatory-grade, continuously refreshed RWD networks. Management is framing the build-out as a way to underpin subscription-style offerings, a notable nuance versus prior disclosures that emphasized fixed-fee iRWD contracts after decommissioning the legacy BEAM subscription platform in May 2025. While this scale should enhance ONMD’s attractiveness to imaging AI, medtech, and pharma customers and could support more recurring, multi-year data-access arrangements, the press release provides no visibility into associated revenue growth, contract wins, or margin impact. Against the backdrop of sub-scale revenues, going-concern language, and heavy reliance on external financing highlighted in prior filings, the announcement is strategically encouraging but not yet thesis-changing.

Implication

For investors, the sharp increase in provider sites, patient records, and clinical exams meaningfully improves the potential utility and differentiation of ONMD’s dataset, which is a prerequisite for larger and more repeatable contracts with AI, medtech, and pharma customers. If management can convert this capacity into visible subscription or multi-year iRWD agreements, it could accelerate topline growth and begin to address concerns around revenue scale and volatility flagged in the DeepValue report. However, the company has not yet demonstrated that this expanded footprint translates into materially higher revenue, better gross margins, or reduced cash burn, and it still faces going-concern and Nasdaq compliance overhangs. As such, the risk/reward remains skewed toward dilution and execution risk, and the stock is still more appropriate for speculative capital than for core holdings. Key watchpoints now include disclosure of subscription/iRWD contract signings tied to the expanded network, trajectory of quarterly iRWD revenue, any moves to bolster liquidity on non-distressed terms, and progress toward restoring Nasdaq compliance.

Thesis delta

The news strengthens the strategic side of the ONMD story by demonstrating rapid network scale-up and reinforcing the company’s potential to be a differentiated provider of regulatory-grade, imaging-centric RWD, which modestly increases the long-term optionality embedded in the equity. That said, the update does not address the core concerns in the prior SELL thesis—namely sub-scale and lumpy revenue, a very thin liquidity cushion, dependence on potentially dilutive external financing, and Nasdaq listing risk—so the overall stance remains SELL. In effect, we see a somewhat better asset but unchanged near-term financial risk, and will need to see this network expansion convert into sustained revenue and funding improvements before revisiting the rating.