Analysis of the Latin American Electronic Medical Record Market Current and Proposed Regulations will Boost the Market in Argentina, Colombia, and

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1 Analysis of the Latin American Electronic Medical Record Market Current and Proposed Regulations will Boost the Market in Argentina, Colombia, and Mexico March 2013

2 Contents Section Slide Numbers Executive Summary 4 Market Overview 9 Total EMR Market External Challenges: Drivers and Restraints 19 Forecast and Trends 30 Demand Analysis 46 Competitive Analysis 48 Argentina Breakdown 51 Colombia Breakdown 70 Mexican Breakdown 88 The Last Word 111 Appendix 114 3

3 Executive Summary This study analyzes the Latin American electronic medical record (EMR) market. For the purpose of this study, Latin America includes Argentina, Colombia, and Mexico. The analysis is with regard to revenue, installed base, market share, and the competitive scenario. In 2012, Mexico presented the highest adoption rate in the region with implemented EMR systems percent of the total healthcare institutions. In Colombia, the average adoption rate is percent, which represents institutions with EMR systems installed. Finally, in Argentina, the total installed base is with an adoption rate of percent of total healthcare institutions. The most representative and mature market for this solution is Colombia, representing percent of the 2012 total market revenue, with 488 EMRs implemented. Argentina represents the percent of the 2012 total market revenue, with implemented EMRs. Mexico, highly influenced by 2012 presidential elections, represents percent of the total market revenue with 26 EMR units shipped. In 2012, the total market presented a revenue of $ million and will reach $ million by 2017, with a compound annual growth rate (CAGR) from 2012 to 2017 of percent. 5

4 Executive Summary Market Engineering Measurements Market Overview Market Stage Market Revenues Total EMR Market: Latin America, 2012 Unit Shipments Weighted Average Selling Price Revenue at End of Forecast Period Growth $ M $ M $ M (2012) (2010) (2012) (2012) (2018) Base Year Revenue Growth Rate Compound Annual Growth Rate Customer Price Sensitivity Degree of Technical Change % % ( ) (scale:1 [Low] to 10 [High]) (2011; scale:1 [Low] to 10 [High]) Decreasing Stable Increasing For a tabular version, click here. Note: All figures are rounded. The base year is

5 Executive Summary Market Engineering Measurements (continued) Competitor Overview Number of Competitors Over (active market competitors in base year) Average Price Values per Unit of Solution High EMR Middle EMR Low EMR $ M $ M $ M (2012) (2012) (2012) Decreasing Stable Increasing For a tabular version, click here. Note: All figures are rounded. The base year is

6 Executive Summary CEO s Perspective 1 There are different definitions of EMR across Latin America Colombian regulations demand the mandatory implementation of EMR by the end of Low adoption turns the region into a hot spot for EMR vendors and system integrators. EMR distribution channels include local and multinational EMR vendors and system integrators. Healthcare IT is one of the fastest growing segments in Latin America healthcare. 8

7 Market Overview Definitions The Latin American electronic medical report market (EMR) is focused on Argentina, Colombia, and Mexico: The three more important countries in the region. The Brazilian EMR market market engineering research service (NC02-48) analyze in detail the trends and actual situation of this market in Brazil. The base year for the study is 2012 and the end of the study period is In Latin America different terminology is used to refer to EMR. In Mexico, EMR is referred to as expediente clinico electronico; in Argentina, it is called historia clinica electronica, and in Colombia it is called registro clinico electronico. EMR and EHR are not clearly differentiated as in other regions of the world. The market is segmented by the size and type of healthcare institution as well as the complexity of the EMR system. High EMR systems are used for tertiary healthcare institutes and include higher capabilities; Middle EMR systems are implemented in secondary healthcare institutes, and Low EMR systems are used in primary healthcare institutions (also called ambulatory) with few features. 10

8 Market Overview Definitions (continued) Healthcare institutions can chose between implementing the EMR system from a EMR vendor/integrator or developing their own EMR Homegrown system. For the purpose of this research service, analysis considers EMR systems sold by EMR vendors or integrators. Prices are defined as the price paid by the healthcare institutions for the software and implementation. Hardware is not considered. The installed base has been defined as the number of installations made for a particular technology by a vendor in the last financial year. Units are defined as the sale or lease of a product or service during the year in question. A total of healthcare IT vendors and integrators were targeted for the analysis in this research service. Top vendors in this region have presence throughout Latin America. A total of key opinion leaders (KOL) were interviewed. KOLs participated in important implementations in the region, or they are pushing towards specific EMR regulations. 11

9 Market Overview Key International Standards and Protocols The World Health Organization (WHO) provides input towards minimum requirements for an EMR/ EHR system. However, it does not participate in developing standard definitions. Health Level Seven International (HL7): This is a non-profit, ANSI-accredited standards developing organization that provides frameworks and standards for the integration and exchange of electronic health data to facilitate management, evaluations, and delivery of healthcare services. The organization comprises almost corporate members who represent percent of the IT vendors in the healthcare space. International Standards Organization (ISO): Founded in 1947, the ISO is the largest developer of voluntary standards in the world. Some of the ISO standards relevant to healthcare IT include ISO/HL :2009, ISO/TR 21730:2007, and ISO :2004. The ISO/ HL :2009 Electronic Health Record Systems Functional Model (EHR-S FM) Release 1.1 was published in Nov It highlights the key functions and features an EHR must contain. Release 2.0 is expected towards the end of International Health Terminology Standards Development Organization (IHTSDO): A Denmarkbased non-profit organization that owns and administers the rights to SNOMED-CT (Systemized Nomenclature of Medicine-Clinical Terms) and related terminology. Digital Imaging and Communications in Medicine (DICOM): DICOM includes standards for storing, transmitting, handling, and reproducing medical images and similar data along with file format definitions and network communication protocols. It is also referred to as ISO 12052:

10 Market Overview Core Benefits of an EMR Benefits of an EMR/ EHR Solution, Latin America, 2012 Information for Public Health and Policies Analysis Improved Clinical Workflow Efficient Transfer of Health Information Improved Patient Management Cost Reduction for Both Patients and Providers EMR Benefits Improved Decision Support More Efficient and Effective Healthcare Delivery 13

11 Market Overview Key Questions This Study Will Answer Is there any regulation that encourages the adoption of EMR systems? Are the governments investing in EMR for public healthcare institutions? What is the size of the EMR market in Latin America? Is the market growing, how long will it continue to grow, and at what rate? Which are the key business segments in the market? What is the contribution from each segment? What will be the impact of external trends on each business segment? Who are the key participants in the EMR markets, and what kind of market dynamics exist? What are the key challenges faced by participants in this market? What are the key market drivers and restraints? How is the market impacted by emerging trends in the external environment? How will the structure of the market change with time? Is there any scope for innovation in business models? 14

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