Healthcare Information Technology
This Report:
Provides in-depth analysis of the developing U.S. market for selective clinical health care IT technologies
Forecasts trends and sales in the U.S. market for selective clinical health care IT technologies through 2014
Identifies the segments in the clinical health care IT technologies industry with the greatest growth potential
Discusses barriers to deployment of clinical health care IT technologies including lack of standards, lack of compatibility with existing records, technology limitations, hardware availability, lack of skilled personnel, storage requirements and lack of funding
Provides information on the selling channels, standards and purchasing criteria that will be useful to heath care IT vendors seeking a share of the market.
Chapter-1: EXECUTIVE SUMMARY
SUMMARY TABLE U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 5
SUMMARY FIGURE CLINICAL HEALTH CARE TECHNOLOIGES MARKET SHARES, 2008-2014 (%) 6
Chapter-2: CLINICAL HEALTH CARE IT: AN OVERVIEW
DEFINITIONS 7
TABLE 1 MAJOR CLASSES OF HEALTH CARE IT TECHNOLOGIES 7
CLINICAL SOFTWARE 7
HARDWARE DEDICATED TO CLINICAL IT APPLICATIONS 8
HISTORY 8
HISTORY (CONTINUED) 9
Chapter-3: TYPES OF CLINICAL IT TECHNOLOGIES
TABLE 2 MAJOR TYPES OF CLINICAL HEALTH CARE IT TECHNOLOGIES 10
ELECTRONIC HEALTH RECORDS 11
PROVIDER ORDER ENTRY SYSTEMS FOR DRUGS, LAB TESTS, AND PROCEDURES 12
ELECTRONIC PRESCRIBING SYSTEM 12
PICTURE ARCHIVING AND COMMUNICATION SYSTEMS FOR FILMLESS IMAGING 13
LABORATORY INFORMATION SYSTEMS 13
CLINICAL DECISION SUPPORT SYSTEMS 13
TELEMEDICINE 14
OTHER RELATED AND SUPPORTING TECHNOLOGIES 14
Personal Health Records 14
Radio Frequency Identification 15
VeriChip 16
Bar Coding 16
Speech Recognition 16
Medical Equipment Interfaces 17
BENEFITS OF CLINICAL HEALTH CARE IT TECHNOLOGIES 17
BENEFITS TO PATIENTS 17
Improved Quality of Care 17
Lower Costs 19
Wider Availability of Health Insurance 20
BENEFITS TO HOSPITALS, PHYSICIANS, AND OTHER CAREGIVERS 21
Clinical Efficiencies and Improved Quality 21
Verification of Insurance Eligibility and Benefits 21
Patient Satisfaction 22
Image and Public Relations 22
Reduced Malpractice Risk 22
Employee Morale 23
BENEFITS TO THE PHARMACEUTICAL INDUSTRY 23
Pharmaceutical Manufacturers 23
Improved Drug Safety Surveillance 24
Clinical Trial Recruitment 24
Support of Regulatory Approval 25
Retail Pharmacies 25
Opportunities to Increase Revenues 25
BENEFITS TO HEALTH INSURANCE PROVIDERS 26
BARRIERS TO DEPLOYMENT 27
COST 28
LACK OF METRICS 28
LACK OF STANDARDS 29
Clinical Vocabularies 30
Clinical Ontologies 30
COMPATIBILITY 31
Backwards Compatibility 31
Sideways Compatibility 31
Forwards Compatibility 32
WIDE RANGE OF SOFTWARE CHOICES 32
LACK OF PERSONNEL WITH APPROPRIATE SKILLS 32
LIMITED FINANCIAL RETURNS ON HEALTH IT INVESTMENTS 33
PRIVACY CONCERNS 34
SAFETY ISSUES 35
LEGAL LIABILITY 36
Privacy 36
Safety 37
PREVIOUS IMPLEMENTATIONS OF HEALTH CARE IT 37
U.S. 38
U.S. Department of Veterans Affairs 38
Cedars Sinai Medical Center Physician Order Entry System 39
Santa Barbara County Care Data Exchange 40
OTHER COUNTRIES 41
U.K. National Health Service National Programme for IT 41
Alberta (Canada) Net care 42
MARKET SUMMARY 43
TABLE 3 U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES BY APPLICATION TYPE, THROUGH 2014 ($ MILLIONS) 44
FIGURE 1 U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES PRODUCT MARKET SHARES, 2008–2014 (%) 45
Chapter-4: MARKET ENVIRONMENT FOR CLINICAL HEALTH CARE IT TECHNOLOGIES
LEGAL AND REGULATORY ENVIRONMENT 46
LEGISLATION 46
Federal Legislation 46
Better Healthcare through Information Technology Act of 2005 46
Medicare Value Purchasing Act 47
Health Information Technology Promotion Act 47
Wired for Health Care Quality Act 47
American Recovery and Reinvestment Act of 2009 48
American … (Continued) 49
State Legislation 50
Massachusetts 50
Minnesota 51
New Mexico 51
Rhode Island 51
Vermont 52
EXECUTIVE ORDERS 52
Federal Level 52
Executive Order 13335 52
Executive Order 13410 53
State and Local Levels 53
TABLE 4 STATE EXECUTIVE ORDERS RELATING TO HEALTH IT 53
TABLE 4 (CONTINUED) 54
REGULATIONS 54
Federal Regulations 54
Potential FDA Regulation of HER 54
EHR and HIPAA 55
HHS Regulations to Facilitate Adoption of Health Information Technology 56
State and Local Regulations 57
CERTIFICATION BODIES 57
Certification Commission For Healthcare Information Technology 57
ECONOMIC ENVIRONMENT 58
Government Funding 58
Federal Government 58
FIGURE 2 TRENDS N PROJECTED FEDERAL HEALTH IT SPENDING, 2008–2013 ($ BILLIONS) 59
FIGURE 2 (CONTINUED) 60
Other Government Entities 60
• Massachusetts 60
• Minnesota 60
• New York State 60
• New York City 61
• Vermont 61
Nonprofit Funding 62
California Health Care Foundation 62
Colorado Health Foundation 62
Regenstrief Institute 63
Markle Foundation 63
Robert Wood Johnson Foundation 64
Private Funding 64
Care Providers 64
• Investment and Financing Trends in the Hospital Industry 64
FIGURE 3 EFFECT OF ECONOMIC DOWNTURN ON HOSPITALS’ IT SPENDING (%) 65
• Physician Practice Financial Trends 65
• Implications for ARRA Incentive Program 66
Insurance Companies 66
• Hawaii Medical Service Association 66
• Highmark Health Insurance 66
Mixed Public-Private Funding 67
Washington Health Information Collaborative 67
Chapter-5: ELECTRONIC HEALTH CARE RECORDS: TECHNOLOGIES AND MARKETS
SUMMARY 68
FIGURE 4 U.S. MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, 2008–2014 ($ MILLIONS) 68
FIGURE 4 (CONTINUED) 69
TECHNOLOGIES 69
EHR VERSUS EMR 69
EHR FUNCTIONALITIES 70
TABLE 5 TYPICAL EHR FUNCTIONALITIES 70
TABLE 5 (CONTINUED) 71
CLIENT/SERVER ARCHITECTURE VERSUS APPLICATION SERVICE PROVIDER 71
SUPPLIERS 72
TABLE 6 EHR TECHNOLOGY PROVIDERS 72
TABLE 6 (CONTINUED) 73
MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, 2008–2014 74
IMPACT OF THE U.S. RECESSION 74
IMPACT OF ARRA 75
TABLE 7 ARRA INCENTIVES AND THE MARKET FOR EHR 75
TABLE 8 POTENTIAL (UNCONSTRAINED) U.S. MARKET FOR EHR SYSTEMS, THROUGH 2015 ($ BILLIONS) 76
CONSTRAINTS ON IMPLEMENTATION CAPACITY 76
TABLE 9 REALISTIC U.S. MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 77
Chapter-6: PROVIDER ORDER ENTRY TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 78
FIGURE 5 U.S. CPOE TECHNOLOGY MARKET, 2008–2014 ($ MILLIONS) 78
TECHNOLOGIES 79
SUPPLIERS 80
TABLE 10 CPOE TECHNOLOGY SUPPLIERS 80
MARKET FOR PROVIDER ORDER ENTRY TECHNOLOGIES, 2008–2014 80
TABLE 11 NUMBER OF U.S. HOSPITALS WITH CPOE SYSTEMS, 2002–2007 81
TABLE 12 U.S. MARKET FOR CPOE SYSTEMS, THROUGH 2014 ($ MILLIONS) 81
Chapter-7: ELECTRONIC PRESCRIBING: TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 82
FIGURE 6 U.S. ELECTRONIC PRESCRIPTION TECHNOLOGY MARKET, 2008–2014 ($ MILLIONS) 82
TECHNOLOGIES 83
CURRENT PRACTICES 83
ELECTRONIC PRESCRIBING 84
E-Prescribing Software 84
E-Prescribing … (Continued) 85
Installed Applications 86
Web-Based Applications 87
Mobile Interface Devices 87
PDAs 87
Smart Phones 88
Electronic Data Interchange 89
SUPPLIERS 89
TABLE 13 E-PRESCRIPTION SOFTWARE SUPPLIERS 89
TABLE 13 (CONTINUED) 90
MARKET FOR E-PRESCRIBING SOFTWARE, 2008–2014 90
TABLE 14 U.S. MARKET FOR ELECTRONIC PRESCRIPTION TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 90
FIGURE 7 U.S. ELECTRONIC PRESCRIPTION MARKET SEGMENTS (%) 91
FIGURE 7 (CONTINUED) 92
Chapter-8: PICTURE ARCHIVING AND COMMUNICATIONS TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 93
FIGURE 8 U.S. PACS TECHNOLOGY MARKET, 2008–2014 ($ MILLIONS) 94
TECHNOLOGIES 94
ARCHITECTURES 95
In-House PACS 95
Web-Based PACS 95
DICOM and Web-Based PACS 96
INTEGRATED PACS/RICS 97
PACS STORAGE AND ARCHIVING 98
Advanced Storage Technologies 98
Holographic Storage 99
Digital Image Compression 99
SUPPLIERS 99
TABLE 15 PACS TECHNOLOGY SUPPLIERS 100
MARKET FOR PICTURE ARCHIVING AND COMMUNICATION TECHNOLOGIES, 2008–2014 100
FIGURE 9 U.S. PACS SALES, 2008 (%) 101
FIGURE 9 (CONTINUED) 102
TABLE 16 U.S. MARKET FOR PACS, THROUGH 2014 ($ MILLIONS) 102
Chapter-9: LABORATORY INFORMATION SYSTEMS TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 103
FIGURE 10 U.S. LABORATORY INFORMATION SYSTEM MARKET, 2008–2014 ($ MILLIONS) 103
TECHNOLOGIES 104
INTEROPERABIILTY ISSUES 104
LIS-CPOE Interoperability 104
LIS-CDSS Interoperability 105
LIS-EHR Interoperability 105
DATA STANDARDS 106
SUPPLIERS 107
TABLE 17 LABORATORY INFORMATION SYSTEM SUPPLIERS 107
MARKET FOR LABORATORY INFORMATION SYSTEMS TECHNOLOGIES, 2008–2014 108
TABLE 18 U.S. MARKET FOR LIS, THROUGH 2014 ($ MILLIONS) 108
Chapter-10: CLINICAL DECISION SUPPPORT TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 109
FIGURE 11 U.S. CLINICAL DECISION SUPPORT SYSTEM MARKET, 2008–2014 ($ MILLIONS) 109
TECHNOLOGIES 110
KNOWLEDGE-BASED SYSTEMS 110
Expert Systems 110
Probabilistic Systems 111
Bayesian Networks 112
Heuristic Systems 112
NON-KNOWLEDGE-BASED SYSTEMS 113
Artificial Neural Networks 113
Genetic Algorithms 114
WORKFLOW INTEGRATION 115
SUPPLIERS 115
TABLE 19 CLINICAL DECISION SUPPORT TECHNOLOGY SUPPLIERS 116
MARKET FOR CLINICAL DECISION SUPPORT TECHNOLOGIES, 2008–2014 116
TABLE 20 U.S. MARKET FOR CLINICAL DECISION SUPPORT SYSTEMS, THROUGH 2014 ($ MILLIONS) 116
Chapter-11: TELEMEDICINE TECHNOLOGIES AND MARKETS, 2008–2014
SUMMARY 117
FIGURE 12 U.S. MARKET FOR TELEMEDICINE TECHNOLOGIES, 2008–2014 ($ MILLIONS) 117
TECHNOLOGIES 117
TELECONFERENCING 118
Real-Time, Store-and-Forward, and Hybrid Teleconferencing 118
IP-Based Videoconferencing 119
Peripheral Devices 119
HOME MEDICAL TELEMETRY 120
Telehomecare 120
Mobile Phone-Based Technologies 120
Bluetooth 121
Signal Transmission via Human Skin 122
ZigBee 122
SUPPLIERS 123
TABLE 21 TELEMEDICINE EQUIPMENT AND TECHNOLOGY SUPPLIERS 123
MARKETS 124
TABLE 22 U.S. MARKET FOR TELEHEALTH TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 124
FIGURE 13 TELEHEALTH TECHNOLOGY MARKET SEGMENTS, 2008–2014 (%) 125
VIDEOCONFERENCING EQUIPMENT AND PERIPERALS 125
TABLE 23 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING EQUIPMENT AND PERIPHERAL DEVICES, THROUGH 2014 ($ MILLIONS) 126
Videoconferencing Equipment 126
FIGURE 14 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING TECHNOLOGY AND SERVICES, 2008 (%) 126
TABLE 24 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 127
Peripheral Devices 127
TABLE 25 U.S. MARKET FOR TELEMEDICINE/TELEHEALTH VIDEOCONFERENCING PERIPHERAL DEVICES, THROUGH 2014 ($ MILLIONS) 127
HOME MEDICAL TELEMETRY 127
TABLE 26 U.S. MARKET FOR HOME TELEMETRY TECHNOLOGIES, THROUGH 2014 ($ MILLIONS) 128
Chapter-12: INDUSTRY STRUCTURE
NUMBER AND SIZE OF FIRMS 129
FIGURE 15 CLINICAL HEALTH CARE IT FIRMS SEGMENTED BY ANNUAL SALES REVENUES (%) 129
PRODUCT SPECIALIZATION 130
FIGURE 16 CLINICAL HEALTH CARE IT FIRMS SEGMENTED BY TYPE OF APPLICATION (%) 130
MERGER AND ACQUISITION TRENDS 131
MERGER AND ACQUISITION TRENDS (CONTINUED) 132
Chapter-13: APPENDIX
APPENDIX A: COMPANY PROFILES 133
AGFA HEALTHCARE 133
ALLSCRIPTS, INC. 133
AMAZING CHARTS.COM, INC 133
AMD TELEMEDICINE 134
AMICAS, INC. 134
CARD GUARD AG 134
CARESTREAM HEALTH, INC. 135
CERNER CORP. 135
CYBERNET SYSTEMS CORP. 136
DATALOGIC S.P.A. 136
DIGICHART, INC. 136
DRFIRST.COM 136
ECLIPSYS CORPORATION 137
EMEGEON INC. 138
FUJIIFILM MEDICAL SYSTEMS USA, INC. 138
GE HEALTHCARE 139
GEMMS 139
GLOBALMEDIA GROUP LLC 139
HEALTH FRONTIER, INC. 140
HEALTHLAND 140
ISABEL HEALTHCARE INC. 140
LANGUAGE AND COMPUTING, INC. 141
LIFECOM, INC. 141
LOGICAL IMAGES, INC. 141
MASSACHUSETTS GENERAL HOSPITAL 142
MCKESSON CORP. 142
MEDRX 143
MEDVITAL 143
MERGE HEALTHCARE INC. 143
MERGE HEALTHCARE INC. (CONTINUED) 144
M*MODAL 145
MICROSOFT CORP. 145
NCD MEDICAL CORP. 145
NUANCE COMMUNICATIONS, INC. 146
ONTOLOGY WORKS, INC. 146
PHILIPS HEALTHCARE 146
POLYCOM INC. 147
PROBLEM-KNOWLEDGE COUPLERS 147
SCOTTCARE CORP. 147
SENSITRON INC. 147
SIEMENS HEALTHCARE 148
SURESCRIPTS LLC 148
T+ MEDICAL AMERICAS, INC. 149
TELEVITAL 149
THERADOC INC. 149
UNITED THERAPEUTICS CORP. 150
VERICHIP CORPORATION 150
ZYNX HEALTH INC. 151
APPENDIX B: PATENT ANALYSIS 152
FIGURE 17 U.S. CLINICAL HEALTH CARE IT PATENTS ISSUED SINCE 1975 (%) 152
FIGURE 18 U.S. CLINICAL HEALTH CARE IT PATENT APPLICATOINS PENDING AS OF APRIL 15, 2009 (%) 153
