I asked Klaus about this around 3 months ago. Klaus made it clear that 1ST don’t see neither HE or HD as competitors at all, in fact many practices will use a combination of both softwares to get the most out of the platforms. He said that of the small amount of practices that leave the 1ST platform , it is rarely ever due to leaving for HD or HE, and is usually because of the bankruptcy of the practice itself.
As Lordearl mentions above, 1ST and HD are focussing on two opposite segments of the healthcare market, be it GP's and Allied Healthcare sectors. I believe that there is a large enough TAM for few competitors to co-exist and specialise independently of each other once the market matures.
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