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Chapter- 1: INTRODUCTION

CHAPTER ONE: INTRODUCTION
STUDY BACKGROUND
GOALS AND OBJECTIVES
INTENDED AUDIENCE
SCOPE OF REPORT
METHODOLOGY
AUTHOR’S CREDENTIALS
RELATED BCC RESEARCH
BCC ONLINE SERVICES
DISCLAIMER

Chapter-2: EXECUTIVE SUMMARY

SUMMARY TABLE U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)
SUMMARY FIGURE CLINICAL HEALTH CARE TECHNOLOIGES MARKET SHARES, 2008-2014 (%)

Chapter-3: CLINICAL HEALTH CARE IT: AN OVERVIEW

DEFINITIONS
TABLE 1 MAJOR CLASSES OF HEALTH CARE IT TECHNOLOGIES
CLINICAL SOFTWARE
HARDWARE DEDICATED TO CLINICAL IT APPLICATIONS
HISTORY

Chapter-4: TYPES OF CLINICAL IT TECHNOLOGIES

TABLE 2 MAJOR TYPES OF CLINICAL HEALTH CARE IT TECHNOLOGIES
ELECTRONIC HEALTH RECORDS
PROVIDER ORDER ENTRY SYSTEMS FOR DRUGS, LAB TESTS, AND PROCEDURES
ELECTRONIC PRESCRIBING SYSTEM
PICTURE ARCHIVING AND COMMUNICATION SYSTEMS FOR FILMLESS IMAGING
LABORATORY INFORMATION SYSTEMS
CLINICAL DECISION SUPPORT SYSTEMS
TELEMEDICINE
OTHER RELATED AND SUPPORTING TECHNOLOGIES
Personal Health Records
Radio Frequency Identification
VeriChip
Bar Coding
Speech Recognition
Medical Equipment Interfaces
BENEFITS OF CLINICAL HEALTH CARE IT TECHNOLOGIES
BENEFITS TO PATIENTS
Improved Quality of Care
Lower Costs
Wider Availability of Health Insurance
BENEFITS TO HOSPITALS, PHYSICIANS, AND OTHER CAREGIVERS
Clinical Efficiencies and Improved Quality
Verification of Insurance Eligibility and Benefits
Patient Satisfaction
Image and Public Relations
Reduced Malpractice Risk
Employee Morale
BENEFITS TO THE PHARMACEUTICAL INDUSTRY
Pharmaceutical Manufacturers
Improved Drug Safety Surveillance
Clinical Trial Recruitment
Support of Regulatory Approval
Retail Pharmacies
Opportunities to Increase Revenues
BENEFITS TO HEALTH INSURANCE PROVIDERS
BARRIERS TO DEPLOYMENT
COST
LACK OF METRICS
LACK OF STANDARDS
Clinical Vocabularies
Clinical Ontologies
COMPATIBILITY
Backwards Compatibility
Sideways Compatibility
Forwards Compatibility
WIDE RANGE OF SOFTWARE CHOICES
LACK OF PERSONNEL WITH APPROPRIATE SKILLS
LIMITED FINANCIAL RETURNS ON HEALTH IT INVESTMENTS
PRIVACY CONCERNS
SAFETY ISSUES
LEGAL LIABILITY
Privacy
Safety
PREVIOUS IMPLEMENTATIONS OF HEALTH CARE IT
U.S.
U.S. Department of Veterans Affairs
Cedars Sinai Medical Center Physician Order Entry System
Santa Barbara County Care Data Exchange
OTHER COUNTRIES
U.K. National Health Service National Programme for IT
Alberta (Canada) Net care
MARKET SUMMARY
TABLE 3 U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES BY APPLICATION TYPE, THROUGH 2014 ($ MILLIONS)
FIGURE 1 U.S. MARKET FOR CLINICAL HEALTH CARE IT TECHNOLOGIES PRODUCT MARKET SHARES, 2008--2014 (%)

Chapter-5: MARKET ENVIRONMENT FOR CLINICAL HEALTH CARE IT TECHNOLOGIES

LEGAL AND REGULATORY ENVIRONMENT
LEGISLATION
Federal Legislation
Better Healthcare through Information Technology Act of 2005
Medicare Value Purchasing Act
Health Information Technology Promotion Act
Wired for Health Care Quality Act
American Recovery and Reinvestment Act of 2009
State Legislation
Massachusetts
Minnesota
New Mexico
Rhode Island
Vermont
EXECUTIVE ORDERS
Federal Level
Executive Order 13335
Executive Order 13410
State and Local Levels
TABLE 4 STATE EXECUTIVE ORDERS RELATING TO HEALTH IT
REGULATIONS
Federal Regulations
Potential FDA Regulation of HER
EHR and HIPAA
HHS Regulations to Facilitate Adoption of Health Information Technology
State and Local Regulations
CERTIFICATION BODIES
Certification Commission For Healthcare Information Technology
ECONOMIC ENVIRONMENT
Government Funding
Federal Government
FIGURE 2 TRENDS N PROJECTED FEDERAL HEALTH IT SPENDING, 2008--2013 ($ BILLIONS)
Other Government Entities
・ Massachusetts
・ Minnesota
・ New York State
・ New York City
・ Vermont
Nonprofit Funding
California Health Care Foundation
Colorado Health Foundation
Regenstrief Institute
Markle Foundation
Robert Wood Johnson Foundation
Private Funding
Care Providers
・ Investment and Financing Trends in the Hospital Industry
FIGURE 3 EFFECT OF ECONOMIC DOWNTURN ON HOSPITALS’ IT SPENDING (%)
・ Physician Practice Financial Trends
・ Implications for ARRA Incentive Program
Insurance Companies
・ Hawaii Medical Service Association
・ Highmark Health Insurance
Mixed Public-Private Funding
Washington Health Information Collaborative

Chapter-6: ELECTRONIC HEALTH CARE RECORDS: TECHNOLOGIES AND MARKETS

SUMMARY
FIGURE 4 U.S. MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
EHR VERSUS EMR
EHR FUNCTIONALITIES
TABLE 5 TYPICAL EHR FUNCTIONALITIES
CLIENT/SERVER ARCHITECTURE VERSUS APPLICATION SERVICE PROVIDER
SUPPLIERS
TABLE 6 EHR TECHNOLOGY PROVIDERS
MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, 2008--2014
IMPACT OF THE U.S. RECESSION
IMPACT OF ARRA
TABLE 7 ARRA INCENTIVES AND THE MARKET FOR EHR
TABLE 8 POTENTIAL (UNCONSTRAINED) U.S. MARKET FOR EHR SYSTEMS, THROUGH 2015 ($ BILLIONS)
CONSTRAINTS ON IMPLEMENTATION CAPACITY
TABLE 9 REALISTIC U.S. MARKET FOR ELECTRONIC HEALTH RECORDS TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)

Chapter-7: PROVIDER ORDER ENTRY TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 5 U.S. CPOE TECHNOLOGY MARKET, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
SUPPLIERS
TABLE 10 CPOE TECHNOLOGY SUPPLIERS
MARKET FOR PROVIDER ORDER ENTRY TECHNOLOGIES, 2008--2014
TABLE 11 NUMBER OF U.S. HOSPITALS WITH CPOE SYSTEMS, 2002--2007
TABLE 12 U.S. MARKET FOR CPOE SYSTEMS, THROUGH 2014 ($ MILLIONS)

Chapter-8: ELECTRONIC PRESCRIBING: TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 6 U.S. ELECTRONIC PRESCRIPTION TECHNOLOGY MARKET, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
CURRENT PRACTICES
ELECTRONIC PRESCRIBING
E-Prescribing Software
Installed Applications
Web-Based Applications
Mobile Interface Devices
PDAs
Smart Phones
Electronic Data Interchange
SUPPLIERS
TABLE 13 E-PRESCRIPTION SOFTWARE SUPPLIERS
MARKET FOR E-PRESCRIBING SOFTWARE, 2008--2014
TABLE 14 U.S. MARKET FOR ELECTRONIC PRESCRIPTION TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)
FIGURE 7 U.S. ELECTRONIC PRESCRIPTION MARKET SEGMENTS (%)

Chapter-9: PICTURE ARCHIVING AND COMMUNICATIONS TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 8 U.S. PACS TECHNOLOGY MARKET, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
ARCHITECTURES
In-House PACS
Web-Based PACS
DICOM and Web-Based PACS
INTEGRATED PACS/RICS
PACS STORAGE AND ARCHIVING
Advanced Storage Technologies
Holographic Storage
Digital Image Compression
SUPPLIERS
TABLE 15 PACS TECHNOLOGY SUPPLIERS
MARKET FOR PICTURE ARCHIVING AND COMMUNICATION TECHNOLOGIES, 2008--2014
FIGURE 9 U.S. PACS SALES, 2008 (%)
TABLE 16 U.S. MARKET FOR PACS, THROUGH 2014 ($ MILLIONS)

Chapter-10: LABORATORY INFORMATION SYSTEMS TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 10 U.S. LABORATORY INFORMATION SYSTEM MARKET, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
INTEROPERABIILTY ISSUES
LIS-CPOE Interoperability
LIS-CDSS Interoperability
LIS-EHR Interoperability
DATA STANDARDS
SUPPLIERS
TABLE 17 LABORATORY INFORMATION SYSTEM SUPPLIERS
MARKET FOR LABORATORY INFORMATION SYSTEMS TECHNOLOGIES, 2008--2014
TABLE 18 U.S. MARKET FOR LIS, THROUGH 2014 ($ MILLIONS)

Chapter-11: CLINICAL DECISION SUPPPORT TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 11 U.S. CLINICAL DECISION SUPPORT SYSTEM MARKET, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
KNOWLEDGE-BASED SYSTEMS
Expert Systems
Probabilistic Systems
Bayesian Networks
Heuristic Systems
NON-KNOWLEDGE-BASED SYSTEMS
Artificial Neural Networks
Genetic Algorithms
WORKFLOW INTEGRATION
SUPPLIERS
TABLE 19 CLINICAL DECISION SUPPORT TECHNOLOGY SUPPLIERS
MARKET FOR CLINICAL DECISION SUPPORT TECHNOLOGIES, 2008--2014
TABLE 20 U.S. MARKET FOR CLINICAL DECISION SUPPORT SYSTEMS, THROUGH 2014 ($ MILLIONS)

Chapter-12: TELEMEDICINE TECHNOLOGIES AND MARKETS, 2008--2014

SUMMARY
FIGURE 12 U.S. MARKET FOR TELEMEDICINE TECHNOLOGIES, 2008--2014 ($ MILLIONS)
TECHNOLOGIES
TELECONFERENCING
Real-Time, Store-and-Forward, and Hybrid Teleconferencing
IP-Based Videoconferencing
Peripheral Devices
HOME MEDICAL TELEMETRY
Telehomecare
Mobile Phone-Based Technologies
Bluetooth
Signal Transmission via Human Skin
ZigBee
SUPPLIERS
TABLE 21 TELEMEDICINE EQUIPMENT AND TECHNOLOGY SUPPLIERS
MARKETS
TABLE 22 U.S. MARKET FOR TELEHEALTH TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)
FIGURE 13 TELEHEALTH TECHNOLOGY MARKET SEGMENTS, 2008--2014 (%)
VIDEOCONFERENCING EQUIPMENT AND PERIPERALS
TABLE 23 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING EQUIPMENT AND PERIPHERAL DEVICES, THROUGH 2014 ($ MILLIONS)
Videoconferencing Equipment
FIGURE 14 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING TECHNOLOGY AND SERVICES, 2008 (%)
TABLE 24 U.S. MARKET FOR TELEMEDICINE VIDEOCONFERENCING TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)
Peripheral Devices
TABLE 25 U.S. MARKET FOR TELEMEDICINE/TELEHEALTH VIDEOCONFERENCING PERIPHERAL DEVICES, THROUGH 2014 ($ MILLIONS)
HOME MEDICAL TELEMETRY
TABLE 26 U.S. MARKET FOR HOME TELEMETRY TECHNOLOGIES, THROUGH 2014 ($ MILLIONS)

Chapter-13: INDUSTRY STRUCTURE

NUMBER AND SIZE OF FIRMS
FIGURE 15 CLINICAL HEALTH CARE IT FIRMS SEGMENTED BY ANNUAL SALES REVENUES (%)
PRODUCT SPECIALIZATION
FIGURE 16 CLINICAL HEALTH CARE IT FIRMS SEGMENTED BY TYPE OF APPLICATION (%)
MERGER AND ACQUISITION TRENDS

Chapter-14: APPENDIX

APPENDIX A: COMPANY PROFILES
AGFA HEALTHCARE
ALLSCRIPTS, INC.
AMAZING CHARTS.COM, INC
AMD TELEMEDICINE
AMICAS, INC.
CARD GUARD AG
CARESTREAM HEALTH, INC.
CERNER CORP.
CYBERNET SYSTEMS CORP.
DATALOGIC S.P.A.
DIGICHART, INC.
DRFIRST.COM
ECLIPSYS CORPORATION
EMEGEON INC.
FUJIIFILM MEDICAL SYSTEMS USA, INC.
GE HEALTHCARE
GEMMS
GLOBALMEDIA GROUP LLC
HEALTH FRONTIER, INC.
HEALTHLAND
ISABEL HEALTHCARE INC.
LANGUAGE AND COMPUTING, INC.
LIFECOM, INC.
LOGICAL IMAGES, INC.
MASSACHUSETTS GENERAL HOSPITAL
MCKESSON CORP.
MEDRX
MEDVITAL
MERGE HEALTHCARE INC.
M*MODAL
MICROSOFT CORP.
NCD MEDICAL CORP.
NUANCE COMMUNICATIONS, INC.
ONTOLOGY WORKS, INC.
PHILIPS HEALTHCARE
POLYCOM INC.
PROBLEM-KNOWLEDGE COUPLERS
SCOTTCARE CORP.
SENSITRON INC.
SIEMENS HEALTHCARE
SURESCRIPTS LLC
T+ MEDICAL AMERICAS, INC.
TELEVITAL
THERADOC INC.
UNITED THERAPEUTICS CORP.
VERICHIP CORPORATION
ZYNX HEALTH INC.
APPENDIX B: PATENT ANALYSIS
FIGURE 17 U.S. CLINICAL HEALTH CARE IT PATENTS ISSUED SINCE 1975 (%)
FIGURE 18 U.S. CLINICAL HEALTH CARE IT PATENT APPLICATOINS PENDING AS OF APRIL 15, 2009 (%)