|
|
|
Telecommunications
Services for the Health Care Industry
1996-2001
a market research report
|
|
Outdated, cumbersome, and costly administrative systems
plague the health care industry. While medical technology
has made significant advances, information systems in the
health care industry have remained mainframe-based and
inflexible--which provides a unique opportunity for
telecom and equipment vendors who can offer integrated,
interoperable business solutions.
Telecommunication Services for the Health Care Industry
examines the opportunities for the implementation of
telemedicine and health information networks (HINs),
revealing the key forces driving electronic health care
commerce. Installation of integrated delivery systems is
just one crucial step toward the widespread deployment of
networked health systems; however a lack of standards and
protocols may impede adoption. Formidable barriers exist,
and this report exposes them all.
Home health care via telemedicine is still in its
infancy, but Insight predicts it will account for a major
portion of telemedicine revenue by the end of the decade
and will accelerate usage of telecom networks. Now is the
time for carriers to form alliances with equipment
providers, care providers, and government agencies to
ensure that the infrastructure needed for telemedicine is
in place. A potential threat: cable networks that are
making substantial investments in interactive video.
This report provides a comprehensive overview of
telemedicine and HINs––the computer and telecom
facilities that allow doctors, payors, pharmacies, and
hospitals to share patient, financial, and clinical data.
For telecom carriers, software vendors, and system
integrators, revenue opportunities in health care are
projected in the billions. And those vendors involved
early on will be the ones to benefit.
Telecommunication Services for the Health Care
Industry projects carrier revenue through the year
2001, providing forecast models that estimate connection
costs, service demand, and annual revenue in five
segments: health information networks, teleradiology,
interactive video, prison telemedicine, home health care,
and telemedicine export (international telemedicine).
|
|
|
Report Excerpt
|
|
Background
The early 1990s brought accelerated turmoil to the US
health care industry as rising costs, an aging
population, misdirected attempts at health care reform,
increasing liability insurance costs, and the closure of
rural hospitals conspired to create a melt-down in our
national health care delivery system.
The increased pressure to cut the cost of health care
while improving the quality and access to care has led
the industry to focus on
technology as a way to achieve its goals. While the
health care industry has made advances in medical
technology, its administrative and back office
infrastructure remains outdated and cumbersome.
Insight's research focused on two
telecommunications-related technologies that have the
potential to improve the quality of and
access to health care, while helping to contain costs:
telemedicine and health information networks (HINs).
Telemedicine
Insight defines telemedicine as the delivery of health
care services to a remote location or locations via
telecommunications facilities. Currently, most of the
telemedicine systems in the US are in the trial or
evaluation stage so it is premature to say that market
forces are driving the deployment of telemedicine.
However, we have noted ten factors and market conditions
which have the potential to drive the deployment of
telemedicine systems--and on the other side of the
equation, we found a number of important issues that need
to be addressed and overcome before telemedicine can be
fully implemented.
To cite just three examples which have the potential to
drive the deployment of telemedicine: in cases where
extensive travel time for a health care provider is involved, telemedicine
technology can increase efficiency and perhaps reduce
costs by eliminating travel time and making the provider
more productive. Telemedicine can also be used as a
partial replacement for physical home health care visits;
by using two-way interactive video, it is possible for
the health care professional to be "with" the
patient every time he takes a pill or administers an
injection. Telemedicine can also become a source of
revenue to a consulting medical provider when
telemedicine consultations become a routine paying
proposition.
Before society can derive the benefits associated with
telemedicine, a number of issues need to be addressed.
For example, state regulations currently limit the
licensing of health care professionals to in-state
practitioners, while telemedicine often crosses state
lines. At the present time, the American Telemedicine
Association is lobbying the Federation of State Medical
Licensing Boards to solve the problems surrounding
licensing and telemedicine. Possible solutions to the
issue of licensing would include allowing patients under
the care of in-state physicians to benefit from
consultation with out-of-state physicians; another
possible solution would be to provide some sort of a
limited license for practicing via telemedicine.
Another major obstacle is that there are currently few
policies regarding the reimbursement of physicians for
services provided by telemedicine. The Health Care
Financing Administration (HCFA), which controls
reimbursement for Medicare and Medicaid patients, is the
bellwether or model for reimbursement, yet it has made
few rulings regarding reimbursement for telemedicine
procedures or events.
Other issues that must be resolved include the medical
equipment and telecommunications technology; there must
be agreement among the vendors and suppliers on
interoperability standards and protocols. The willingness
of physicians to participate, the effects of budget
cutting on programs, and the cost of transmission and
equipment will all need to be considered and resolved.
Health Information Networks
Health information networks are the computer and
telecommunications facilities that allow providers, payors, employers, pharmacies, laboratories, and other
health care organizations to share patient, financial,
and clinical data.
As part of the effort to reduce the administrative costs
of providing health care, HINs partake of the general
business imperative that tightly couples the policies and
procedures of an enterprise to its telecommunications
networks. In this sense HINs conflate neatly with
electronic commerce and electronic data interchange (EDI)
initiatives in many different industries. Electronic
commerce, EDI, and HINs are all part of a trend toward
automating records and transactions to increase
efficiency and reduce administrative costs.
HINs are a logical growth of the enterprise-wide networks
that connect the locations of a single health care
provider. Unlike many other industries, the health care
industry has not been focused on controlling costs and
increasing efficiency until very recently. Consequently,
information systems in the health care industry are
typically mainframe-based and inflexible. One interviewee
described health care information systems as a "70s
infrastructure in a 90s world." There are very few
open standards-based systems in hospitals today; and,
consequently, there are isolated systems for each
application. This problem with legacy systems is
one of the factors impeding the growth of health
information networks. It is difficult for many providers
to shift to an enterprise-wide client/server
architecture, never mind moving into a more advanced
health information network.
As with telemedicine, there are issues and obstacles to
the implementation of electronic ways of exchanging
information. These concerns include the failure of health
care reform, the lack of standard interfaces among
systems, and issues of confidentiality and privacy.
The Market
Insight Research constructed a model for use in
calculating the revenue to telecom service providers from
telemedicine and HINs. The sub-segments addressed in our
study include HINs, teleradiology, interactive video
consultations, telemedicine applications to prison
populations, telemedicine applications in home health
care, and telemedicine applications as an exportable
product.
The two biggest opportunities to stimulate usage of the
network appear to be .............
Download the Free Executive Summary
Back to Top
|
|
Market Segmentation
|
|
|
- Type of Healthcare Site
- Hospital
- Clinic of Large Group
- Solo or Small Office
- Pharmacies
- Payors
- Type of Service
- HIN (Health Information Network)
- Teleradiology
- Interactive Video
- Home Healthcare
- Prison Healthcare
- Telemedicine Export
(International Telemedicine)
Back to Top
|
|
Table of Contents
|
|
|
Chapter I
EXECUTIVE SUMMARY
1.1 Background
1.2 Telemedicine
1.3 Health Information Networks
1.4 The Market
Chapter II
BACKGROUND
2.1 Introduction
2.2 Telemedicine
2.2.1 Market Forces Driving Telemedicine
2.2.1.1 The Need to Reduce Costs and Increase Efficiency
2.2.1.2 The Move Towards Capitation
2.2.1.3 The Increasing Need for Home Health Care
2.2.1.4 The Need to Train Personnel Cost-Effectively,
With Minimal Time Away From Job
2.2.1.5 The Increasing Demand for Medical Information
2.2.1.6 The Need for Additional Revenues
2.2.1.7 The Need to Provide Medical Care in Situations
Where Delivery Is Difficult
2.2.1.8 The Need to Deliver Quality Health Care to Rural
and Other Under-Served Areas
2.2.1.9 The Increasing Need for Consultations with
Specialists
2.2.1.10 The Falling Prices of Transmission Bandwidth and
Equipme
2.2.2 Issues and Obstacles to the Implementation of
Telemedicine
2.2.2.1 Licensure Issues
2.2.2.2 Lack of Reimbursement for Telemedicine
Consultations
2.2.2.3 Lack of Standards and Protocols for Telemedicine
2.2.2.4 Administrative and Organizational Factors
2.2.2.5 Physician Culture
2.2.2.6 Budget Cuts
2.2.2.7 Interoperability Problems
2.2.2.8 Cost of Transmission and Equipment
2.3 Electronic Commerce
2.3.1 Market Forces Driving Electronic Commerce for the
Health Care Industry
2.3.1.1 Integrated Delivery Systems
2.3.1.2 The Need for Increased Information to Improve
Medical Decision-Making
2.3.1.3 The Need for Increased Information to Improve Financial Decision-Making
2.3.1.4 The Need for Outcomes Data to Improve Financial
and Medical Decision-Making
2.3.1.5 The Need to Share Expensive Resources
2.3.1.6 Capitation and Managed Care
2.3.1.7 The Need to Reduce Administrative Costs
2.3.2 Issues and Obstacles to the Implementation of
Electronic Commerce
2.3.2.1 Failure of Health Care Reform
2.3.2.2 Lack of Standard Interfaces Among Systems
2.3.2.3 Confidentiality and Privacy
Chapter III
ELECTRONIC COMMERCE, ELECTRONIC DATA INTERCHANGE, AND
HEALTH INFORMATION NETWORKS
3.1 A Way to Reduce Administrative Costs
3.2 Electronic Commerce
3.2.1 Definition of Electronic Commerce
3.2.2 Benefits of Electronic Commerce
3.2.3 Telecommunications Services for Electronic Commerce
3.2.4 Electronic Commerce Issues
3.2.5 Cost Savings from Electronic Commerce
3.3 Electronic Data Interchange
3.3.1 Definition of EDI
3.3.2 Benefits of EDI
3.3.3 Telecommunications Services Used with EDI
3.3.4 EDI Issues
3.4 Health Information Networks
3.4.1 Definition of HINs
3.4.2 Benefits of Health Information Networks
3.4.3 Telecommunications Technologies Used for HINs
3.4.4 HIN Issues
Chapter IV
TELEMEDICINE
4.1 Definition and Background
4.2 Applications
4.2.1 The House Call of the Future
4.2.1.1 Home Health Care for the Elderly and Chronically
Ill
4.2.1.2 Home Health Care for Routine Visits and
Consultations
4.2.1.3 Is Home Health Care via Telemedicine Effective?
4.2.1.4 Is Home Health Care via Telemedicine
Cost-Effective?
4.2.1.5 Profile: H.E.L.P Innovations’ ResourceLink
and Home Health Care
4.2.2 Education for Medical Personnel/Continuing Medical Education
4.2.2.1 Definition of Continuing Medical Education
4.2.2.2 Profile: Allegheny Health Education Research Foundation, AT&T, and Fore Systems
4.2.2.3 Profile: University of Kansas Telemedicine
Project
4.2.2.4 Profile: REACH-TV
4.2.2.5 Profile: Mountaineer Doctor TeleVision
4.2.3 Patient Education
4.2.4 Health Information and Services on the Internet
4.2.4.1 Tangled in the Web
4.2.4.2 WWW Health Care Sites
4.2.4.2.1 Healthgate
4.2.4.2.2 Galter Health Sciences Library
4.2.4.2.3 Medical Matrix
4.2.4.2.4 Medscape
4.2.4.2.5 Healthwise (Go Ask Alice!)
4.2.4.2.6 OncoLink
4.2.4.2.7 Johns Hopkins Medical Institution Information
Network
4.2.4.2.8 Virtual Hospital
4.2.4.2.9 CancerNet
4.2.4.2.10 GenBank
4.2.4.2.11 PharmInfoNet
4.2.4.2.12 Physicians Online
4.2.4.2.13 National Library of Medicine (HyperDOC)
4.2.4.2.14 Physician’s GenRx
4.2.4.2.15 Additional Internet Sites of Interest
4.2.5 Remote Consultation
4.2.5.1 Definition
4.2.5.2 Store-and-Forward
4.2.5.3 Exporting Telemedicine
4.2.5.3.1 Profile: Mountaineer Doctor TeleVision
4.2.5.3.2 Profile: University of Texas Medical Branch
–Galveston
4.2.5.3.3 Profile: Texas Telemedicine Project
4.2.5.3.4 Profile: Harvard Medical School Tele-Psychiatry Project
4.2.5.3.5 Profile: The Mayo Clinic
4.2.5.3.6 Profile: Rural East Carolina Health Network
4.2.5.3.7 Profile: American Telemedicine International
4.2.5.3.8 Profile: University of Kansas Telemedicine
Project
4.2.5.4 Military Telemedicine
4.2.5.4.1 Profile: PrimeTime II
4.2.5.5 Cost Justification for Telemedicine Remote Consultations
4.2.6 Teleradiology and Telepathology
4.2.6.1 Definition of Teleradiology
4.2.6.1.1 ACR Teleradiology Guidelines
4.2.6.1.2 Teleradiology Transmissions
4.2.6.2 Teleradiology in the Military
4.2.6.3 Profile: Virginia Mason Medical Center
4.2.6.4 Profile: Teleradiology Associates
4.2.6.5 Cost Justification for Teleradiology
4.2.6.6 Definition of Telepathology
4.2.7 Remote Monitoring
4.3 Overall Cost/Benefit Analysis for Telemedicine
Chapter V
ASSOCIATIONS, ORGANIZATIONS, AND STANDARDS
5.1 The American College of Radiology
5.2 American National Standards Institute
5.3 American Telemedicine Association
5.4 Association for Electronic Health Care Transactions
5.5 Center for Health Policy Research
5.6 The Center for Healthcare Information Management
5.7 Healthcare Information and Management Systems Society
5.8 Health Care Financing Administration
5.9 Information Technology Services and Research Unit
5.10 The Koop Foundation, Inc.
5.10.1 The HII Consortium
5.10.2 Research and Development
5.10.3 Testbeds
5.10.4 Support Activities
5.11 Medical Records Institute
5.12 National Information Center on Health Services
Research Health Care Technology
5.13 Office of Rural Health Policy
5.14 Radiological Society of North America
5.15 Telemedical Interactive Consultative Services
5.16 Telemedicine Research Center
5.17 Workgroup for EDI
Chapter VI
VENDORS
6.1 Acuson
6.2 American Telemedicine International
6.3 Ameritech Health Connections – Electronic
Commerce
6.4 Andersen Consulting
6.5 Apollo Software, Inc.
6.6 AT&T
6.6.1 AT&T Health Care Network Integration Services
6.6.2 Telemedicine Offerings
6.6.3 EasyLink
6.7 BellSouth
6.8 Compression Labs, Inc.
6.9 COMSAT
6.10 Emed
6.11 GTE
6.12 Harbinger Corporation
6.13 H.E.L.P. Innovations
6.14 IMS MEDACOM, Inc.
6.15 Instream
6.16 Kodak Health Imaging
6.17 MCI
6.17.1 Information on Demand
6.18 md/tv, inc.
6.19 Motorola
6.20 National Electronic Information Corporation
6.21 Nortel
6.22 Pacific Bell
6.23 RADMAN, Inc.
6.24 Sprint
6.25 Sudbury Systems, Inc.
6.26 Telemedicine and Telehealth Networks
6.27 UNISYS: Health Information Management
6.28 Wise Communications, Inc.
Chapter VII
FORECASTS AND ANALYSIS
7.1 Introduction
7.2 Health Information Network Forecast
7.2.1 HIN Model
7.2.2 HIN Connection Costs
7.2.3 Annual Revenue from HINs
7.3 Teleradiology Forecast
7.3.1 Teleradiology Model
7.3.2 Teleradiology Connection Costs
7.3.3 Annual Revenues from Teleradiology
7.4 Remote Consultations via Interactive Video
7.4.1 Interactive Video Model
7.4.2 Interactive Video Connection Costs
7.4.3 Annual Revenue from Interactive Video
7.5 Prison Telemedicine Networks
7.5.1 Prison Telemedicine Model
7.5.2 Prison Telemedicine Connection Costs
7.5.3 Annual Revenue from Prison Telemedicine
7.6 Home Health Care
7.6.1 Home Health Care Model
7.6.2 Home Health Care Connection Costs
7.7 Export of Telemedicine
7.7.1 Export of Telemedicine Model
7.7.2 Export of Telemedicine Connection Costs
7.7.3 Annual Revenue from Export of Telemedicine
7.8 Total Carrier Revenues from Telemedicine and Health Information Networks
7.9 Analysis
Appendix A
WEB SITE QUESTIONNAIRE
Appendix B
ACRONYMS
Table of Figures
Chapter I
I-1 Total Carrier Revenue from Telemedicine and Health Information Networks, 1995-2001 ($Millions)
Chapter III
III-1 Comparison of Administrative Costs; Traditional Administration Versus Electronic Commerce
III-2 Portion of Medical Office Administration Functions
Using ED
III-3 Survey Results of HINs' Self Appraisal of
Evolutionary Path
Chapter IV
IV-1 Primary Telemedicine Applications Used by Health
Care Professionals
IV-2 Network Diagram of Texas Telemedicine Project
Chapter VII
VII-1 Percentage of 2001 Telecom Provider Revenues from Prototypical HIN by Type of Site
VII-2 Forecast of Telecom Service Revenues from HINs,
1995-2001 ($Thousands)
VII-3 Forecast of the Number of Radiology Practices Using Teleradiology, 1995-2001
VII-4 Fixed ISDN Line Charges for Teleradiology,
1995-2001 ($Thousands)
VII-5 ISDN Usage Charges for Teleradiology, 1995-2001 ($Thousands)
VII-6 Total ISDN Charges for Teleradiology, 1995-2001 ($Thousands)
VII-7 Telecom Carriers Revenue from Interactive Video Consultations, 1995-2001 ($Thousands)
VII-8 Telemedicine Consultations from Prison Inmates,
1995-2001
VII-9 Telecom Carrier Revenues Related to Prison
Telemedicine Consultations, 1995-2001
VII-10 Forecasted Number of Home Health Care Visits,
1995-2001 (Thousands)
VII-11 Forecasted Number of Home Health Care Visits via Telemedicine, 1997-2001 (Thousands)
VII-12 Estimated Homes Receiving Home Health Care via Telemedicine, 1997-2001
VII-13 ISDN Lines from Home Health Care Providers,
1997-2001
VII-14 Total ISDN Lines for Home Health Care, 1997-2001
VII-15 Fixed ISDN Charges for Home Health Care, 1997-2001 ($Thousands)
VII-16 ISDN Usage Charges for Home Health Care, 1997-2001 ($Thousands)
VII-17 Total ISDN Charges for Home Health Care, 1997-2001 ($Thousands)
VII-18 Telecom Carrier Revenue from Export of Medical
Expertise via Telemedicine, 1995-2001
VII-19 Total Carrier Revenue from Telemedicine and Health Information Networks, 1995-2001 ($Millions)
Table of Tables
Chapter III
III-1 Levels of Computerization of Patient Information
Systems
Chapter VII
VII-1 2001 HIN Prototype
VII-2 Estimated Annual Charges per Network Connection
VII-3 Estimated 2001 Telecom Provider Revenues from
Prototypical HIN
VII-4 Total Carrier Revenue from Telemedicine and Health Information Networks, 1995-2001 ($Thousands)
Back to Top
|
|
Pricing Information
|
|
|
Hard Copy Price
$ 799
Electronic Copy Price
(PDF
License Descriptions)
$ 939 Single-User Printable PDF
$ 1399 6-Seat Printable PDF
$ 2000 Unlimited Corporate-Wide Distribution
Back to Top
|
|
Telecom
Market
Research,
