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Health
Care and Telecommunications
2000-2005
a market research report
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We have little doubt that telemedicine can help to wring costs out of the ailing US health care delivery system. Telemedicine can reduce costs in home health care (HHC); using the appropriate technology it’s possible to deliver a service yet eliminate the need for a nurse or other health care professional to make an actual physical visit to a client. Two-way interactive video allows a health care professional to view a patient and assess his condition and be “with” him when he takes a pill or administers an injection. Since Medicare clients represent 40 percent of the home health care patients, the cost savings would go directly to the government.
Yet despite its advantages in some obvious areas like HHC, telemedicine is still in the introductory stage of a product life cycle. Before it can enter a phase of sustained growth, a number of significant issues must be resolved.
As for telecom carriers, traditional telemedicine applications such as teleradiology and teleconsultations may never become major revenue
streams. However, what we are calling the new telemedicine applications––broadband services for doctors’ offices, hospitals, and home health care applications––are very large
opportunities indeed. For carriers anxious to create customer loyalty and bind the major actors in a health care delivery organization to that carrier, developing and deploying traditional telemedicine applications may be the way to set the hook.
Health Care and Telecommunications forecasts the market for both traditional and new telemedicine services through 2005 and discusses the issues that must be resolved within the medical community so telemedicine can enter a phase of sustained growth.
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Report Excerpt
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Introduction
A lead article in a recent issue of the New York Times
reports that health insurance premiums are increasing by
10 to 30 percent across the country, in part because of
the escalating drug costs. The rising cost of health care
is once again a major national issue and a focus in this
year's presidential campaign.
Can telecommunications play a role in fixing our
health delivery system? Our 1996 report,
Telecom Services
for the Health Care Industry: Telemedicine and Health
Information Networks 1996-2001 forecasted
substantial carrier revenue growth in home health care,
teleradiology and in the health information networks used
by hospitals and health care professionals to share
information. But a variety of factors retarded
telemedicine's growth including legal/regulatory
difficulties, reimbursement policies of Medicare and
Medicaid, and the medical community acceptance of new
technologies. Insight is examining the telemedicine
marketplace once again in this study, but our prognosis
for traditional telemedicine as a major growth
opportunity for carriers is a bit less sanguine.
We have little doubt that telemedicine can help to
wring costs out of the US health care delivery system.
Our report shows how telemedicine can reduce costs in
home health care (HHC); with the appropriate technology
it is possible to deliver a level of service yet
eliminate the need for a nurse or other health care
professional to make an actual physical visit to a
client. Two-way interactive video allows a health care
professional to view a patient and assess his condition
and be "with" him when he takes a pill or
administers an injection. Since Medicare clients
represent 40 percent of the home health care patients,
the cost savings would go directly to the government.
Yet despite its advantages in some obvious areas like
HHC, telemedicine is still in the introductory stage of a
product life cycle. Before it can enter a phase of
sustained growth, a number of significant issues must be
resolved. The biggest problem with telemedicine is that
it has not been developed as a business. There are few
market studies that deal with patient and physician views
on the industry, or studies on the appropriate use of
technologies. Telemedicine today is still primarily a
research and development activity. It is often a
technology looking for a problem to solve; and as such
there is the question of whether too much technology is
being brought to bear where simple solutions may exist.
As for telecom carriers, traditional telemedicine
applications such as teleradiology and teleconsultations
may never become major revenue streams. However, what we
are calling the new telemedicine applications such as
physicians' office broadband, home health care's use of
advanced Internet applications, or hospitals use of
broadband are much more substantial. For carriers anxious
to create customer loyalty and bind the major actors in a
health care delivery organization to that carrier,
developing and deploying traditional telemedicine
applications may be the way to set the hook.
Defining Telemedicine
We define telemedicine as the remote communication of
information to facilitate clinical care. The exchange of
information can be accomplished using voice, image, or
data. Telehealth deals with general health care services
in contrast to telemedicine which refers to health care
services for individuals. Insight distinguishes the
actual practice of telemedicine from health data networks
themselves.
In order to operate, telemedicine requires two types
of products: networking services and specialized
telemedicine equipment. Networking services are usually
provided by a telecommunications service provider and
include voice, data, and video services.
Our telemedicine report segments the market into the
following categories:
• Teleconsultations — which are being
used to get expert advice and care without the
patient and doctor actually meeting. This category,
which excludes teleradiology and home health care,
has been divided into three subsections: prison,
non-prison, VHA.
• Teleradiology — which transmits
radiological images electronically from one location
to another for interpretation and/or consultation.
• Physicians — who are using the
Internet for a range of applications, including
online medical information and education, data
delivery, and administrative services such as
referrals and insurance.
• Home health care (HHC) — which uses
telemedicine to replace physical visits by medical
personnel.
• Hospitals' integrated delivery systems
— hospitals and health care providers who have
common databases that are used by member networks.
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Market Segmentation
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- Teleconsultation Market
- # of Consultants
- Patient Cost for
Teleconsultations
- Telemed Telecom Expenditures
- Carrier Revenues
- Teleradiology Market
- # of Reads
- Carrier Revenue
- Telemedicine Physicians Market
- # of US Physicians
- % of Doctors Using Internet
Extensively
- # of Doctors Using Internet
- Carrier Revenue
- Home Health Care Telemedicine Market
- HCC Clients
- HCC Homes with Enhanced Internet
Health Services
- Carrier Revenues from HCC
Households
- Total Carrier Revenues from Telemedicine
and Health Data Networks
- Traditional Markets
- Teleconsultations
- Teleradiology
- New Markets
- Phys. Office Broadband
- Home Health Care
- Hospitals IDS-Broadband
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Table of Contents
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Chapter I
EXECUTIVE SUMMARY
1.1 Introduction
1.2 Defining Telemedicine
1.3 Carrier Revenues
Chapter II
OVERVIEW
2.1 Overall Definition of
Telemedicine
2.1.1 Parties Involved in Telemedicine
2.1.2 Types of Telemedicine
2.2 Products Offered by Providers
2.2.1 Networking Services
2.2.2 Network Services Definitions
2.2.3 Communications Services Providers
2.2.4 Specialized Telemedicine Equipment
2.3 Telemedicine Services
2.3.1 Videoconferencing Consultations
2.3.2 Store-and-Forward Consultations
2.3.3 Remote Monitoring
2.3.4 Medical Online Information
2.3.5 Personal, Private Medical Web Sites
2.3.6 Administrative
2.4 Market Drivers
2.4.1 Physician
2.4.2 IDS Applications
2.4.3 End User
2.5 Telemedicine as a Business
2.5.1 Use of Appropriate Technology
2.5.2 Market and Profitability Analysis
2.5.3 Need for Additional Market Studies
2.6 Market Hindrances
Chapter III
FACTORS IMPACTING THE MARKET
3.1 External Factors Impacting Telemedicine
3.1.1 Economic Factors
3.1.2 Legal/Regulatory Factors
3.1.3 Technological Factors
3.1.4 Social Factors
3.1.4.1 The Need To Serve Rural and Underserved Areas
3.2 The Current Status of Telemedicine
3.2.1 Telemedicine Programs
3.2.1.1 U S West Health Care Services Study
3.2.1.2 AT&T Mount Everest Expedition
3.2.1.3 University of Minnesota Study
3.2.1.4 Texas Telemedicine Program
3.2.1.5 Ohio State Prison System
3.2.2 Home Health Care
3.2.2.1 Balanced Budget Act
3.2.3 Teleradiology
3.2.3.1 Cost Savings
3.3 Internet Applications
3.3.1 DiabetesWell
3.3.2 Next Generation Internet Telemedicine Applications
3.3.2.1 Radiology Consultation Workstation
3.3.2.2 High-Resolution Imaging Telemedicine
3.3.2.3 Real-Time Telemedicine
3.3.2.4 Distributed Positron Emission Tomography Imaging
3.3.2.5 Remote Control Telemedicine
Chapter IV
HEALTH DATA NETWORKS AND CASE STUDIES
4.1 Health Data Networks
4.2 E-Commerce/E-Business
4.2.1 E-Commerce/E-Business Overview
4.2.2 E-Commerce and the Health Care Industry
4.3 The Current Use of the Internet in Health Care
4.3.1 Kaiser Permanente Internet Applications
4.3.2 IBM's Health Data Network
4.3.2.1 Improvements in Providing Clinical Information
4.3.2.2 Improvements in Patient Tracking
4.3.2.3 Additional Features
4.3.3 BJC Health System
4.3.3.1 Integrating Diverse Systems
4.3.3.2 Networking
4.3.4 WebMD Corporation
4.3.5 Medicare Compare
Chapter V
ASSOCIATIONS AND PUBLICATIONS
5.1 Associations
5.1.1 Association of Telemedicine Service Providers
5.1.2 American Telemedicine Association
5.1.3 The National Association for Home Care
5.1.4 Healthcare Information and Management System
Society
5.1.5 Workgroup for Electronic Data Interchange
5.2 Information Resources
5.2.1 Telemedicine Research Center
5.2.2 National Library of Medicine
5.2.3 Health Data Management Magazine
5.3 Government Agencies
5.3.1 Health Care Financing Administration
5.3.1.1 Medicare
5.3.1.2 Medicaid
5.3.2 Office for the Advancement of Telehealth
Chapter VI
TELEMEDICINE VENDORS AND SUPPLIERS
6.1 What to Expect From Outside
Partners
6.2 Equipment Suppliers
6.2.1 American Medical Development
6.2.2 American TeleCare
6.2.3 Lucent Technologies
6.2.4 PictureTel Corporation
6.2.5 VTEL
6.3 Internet-Based Health Care Providers
6.3.1 LifeMasters Supported SelfCare, Inc.
6.3.2 McKessonHBOC, Inc.
6.4 Telecom Service Providers
6.4.1 Bell Atlantic (Verizon)
6.4.2 GTE Communications Corporation (Verizon)
6.4.3 Southwestern Bell Corp. Telemedicine Program
6.4.4 Ameritech
6.5 Teleradiology
6.5.1 INPHACT
Chapter VII
FORECASTS AND ANALYSIS
7.1 Telemedicine Definitions
7.2 Teleconsultations
7.2.1 Baseline Data
7.2.2 Insight Teleconsultation Forecasts
7.3 Teleradiology
7.4 Physicians' Use
7.5 Home Health Care
7.6 Hospitals/IDS
7.7 Carrier Revenues from Telemedicine
Table of Figures
Chapter I
I-1 Carrier Revenue for the New and
Tradiitonal Markets in Telemedicine
Chapter III
III-1 Health Care Spending as a
Percentage of the GDP, 1998 and 2008
III-2 Inmate Medical Care Cost Breakdown, Traditional
Consultation versus Teleconsultation
III-3 Estimated Growth of Home Health Care Expenditures,
1999-2004
Chapter IV
IV-1 E-Commerce from the Buyer's
Point of View
IV-2 E-Commerce from the Supplier's Point of View
Chapter VII
VII-1 Number of Teleconsultations,
1993-1998
VII-2 Communication Service and Transmission Speed Used
in Teleconsultations, 1997
Table of Tables
Chapter II
II-1 Service Provider Definitions
II-2 Major Telemedicine Systems by Specialty
II-3 Percentage of Male and Female Users in US Seeking
Specific Topics on the Internet, 1998
II-4 E-Health and All Online Users in US, 2000-2005
(Millions)
II-5 Percentage of Users Interested in Checking Specific
Benefit Topics Online, 1998
Chapter III
III-1 US Health Expenditures,
1996-1998 ($Billions)
III-2 Costs Savings of Using Telemedicine Over
Traditional Medical Care, 1997-1998
III-3 Cost/Benefit Analysis of Various Parties With and
Without Telemedicine, 1997-1998
III-4 Comparison of Average Inmate Traditional and
Telemedicine Medical Care Costs
III-5 Average Annual Percentage Growth of Home Health
Care Expenditures, 1999-2004
III-6 Average Caseload Variation, In-Person versus
Video-Based Consultations
III-7 Traditional Film-Based and Digital-Based Radiology
Exams Comparative Cost Analysis, 1997-2002
III-8 An Internet-Based Patient Treatment Program
Chapter IV
IV-1 WebMD's Portfolio of Partners
Chapter V
Table V-1 Recent Initiatives and
Partnerships for OAT, 1998
Chapter VII
VII-1 Communication Services
Funding Sources and Number of Sites
VII-2 Teleconsultation Market, 1997-2005 ($Thousands)
VII-3 Carrier Revenues from Teleconsultations, 1998-2005
($Thousands)
VII-4 Teleradiology Market, 1998-2005
VII-5 Telemedicine Physicians Market, 1998-2005
VII-6 Home Health Care Telemedicine Market, 1998-2005
VII-7 Market for Hospitals Included in an Integrated
Delivery System
VII-8 Total Carrier Revenues from Telemedicine and Health
Data Networks, 1998-2005 ($Millions)
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