Opportunities in Healthcare Cloud Market in the US and Europe. Evolving Regulatory Scene Likely to Boost Healthcare Cloud Adoption

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1 Opportunities in Healthcare Cloud Market in the US and Europe Evolving Regulatory Scene Likely to Boost Healthcare Cloud Adoption October 2014

2 Contents Section Slide Number Executive Summary 8 Market Overview 18 Competitive Playbook 23 Total Healthcare Cloud Market - Driver, Restraints, and Trends 28 Forecasts and Trends 39 Demand Analysis 61 Competitive Environment 64 IaaS Segment Analysis 72 PaaS Segment Analysis 77 SaaS Segment Analysis 82 United States Analysis 87 Europe Analysis 92 United Kingdom Analysis 98 4

3 Contents (continued) Section Slide Number Germany Analysis 102 France Analysis 106 Italy Analysis 110 Spain Analysis 114 Scandinavia Analysis 118 Benelux Analysis 122 Customer and End-user Analysis 126 Key Companies to Watch 137 The Last Word 141 Appendix 145 5

4 Methodology The objective of the research service is to present a comprehensive analysis of the healthcare cloud market in Europe and the United States with respect to market potential and key market dynamics. The regional scope of the analysis is focused on the United States, United Kingdom, Germany, France, Italy, Spain, Scandinavia, and Benelux. The study also covers factors driving the growth, challenges affecting the market, and opportunities within the total market, and the market segments as estimated for the forecast period. The study period covered by this service is from 2013 to 2020, with the base year as 2013, and forecast period from 2014 to

5 Methodology (continued) The 12 step Market Engineering Research Methodology Process 9. Market forecasting 12. Post production market monitoring and customer feedback 11. Confirm results and quality control 10. Develop strategic recommendation Industry feedback and constant market monitoring by the team. Quality assessment by director, draft preparation, editing, and production. Frost & Sullivan specific and generic but strategic recommendations Key trends, revenue forecast, maturity measurements, market share movements; expert opinion consensus model. 8. Research analysis Current market status size, historic growth rate, segments, technology, pricing, competitive landscape, market position in life cycle. 7. Conduct primary research Heart of the research process cross-verification of data, bottom-up approach for sizing, and measuring revenue growth rate (CAGR approach). 3. Research team designing 2. Objectives and goal definitions 4. Launch data collection phase 6. Test the survey design 5. Selection of interview strategy and design survey Pilot interviews, correction of research design, standardisation of research process; usage of same terminology, measurements, interviewing style. Questionnaire design, interview technique planning, and define sample size. Identify specific sources Frost & Sullivan data, online databases; structure research deliverable, contents, develop customer database, and competitor database. Research team formation lead and support the analyst, research director, account manager, market engineering consultants, industry advisers and customers, and research editors. Hypotheses development, identify industry issues, definition of market metrics, segmentation, tools, and sources. 1.Market problem definition Initial feasibility (primary research), title evaluation, and brainstorming sessions. Industry needs, analyst knowledge, updates 7

6 Key Findings The healthcare cloud market in the United States and Europe is in the growth phase with average market penetration rates of Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS) expected to increase by % by the end of the decade. Investments in healthcare IT applications and evolving regulatory guidelines are increasing the need for effective documentation, storage, management, and sharing of patient healthcare information, and healthcare cloud solutions can meet this objective in a cost-efficient and secure manner. Less upfront costs, access to on-demand capacity, quick deployment, and easier management of IT staff are the major advantages offered by healthcare cloud. Healthcare providers are highly focused on implementing electronic health record (EHR) for real time patient data management, and transition to personalized healthcare delivery is expected to significantly increase the adoption rates of healthcare cloud. On the other hand, persisting challenges pertaining to security, privacy, and performance, are slowing down the adoption rate for healthcare cloud. Data migration and data portability are also concerns for healthcare providers choosing to move from on-premise solutions to a cloud-based model. Hosting of clinical data applications, healthcare information exchange (HIE), and backup and recovery of EHR are major application areas of healthcare cloud currently. Adoption rates of SaaS are currently the highest among cloud adopters in both the US and European markets. However, in the next years, IaaS and PaaS segments are also expected to grow. 9

7 Key Findings (continued) The average spending on cloud technology by hospitals is increasing, accounting for % of the total healthcare IT spending. The major areas of spending are SaaS followed by IaaS and PaaS. There is a high degree of competition between cloud service providers catering to the healthcare market, and includes cloud service providers with healthcare as an industry vertical, HIPAAcompliant managed hosting cloud service providers, and healthcare-specific remote hosting organizations. The early adopters of cloud technology installed solutions from cloud service providers with healthcare as an industry vertical. Such vendors include AWS, IBM, Rackspace, Orange Business Services, Microsoft, Dell, Verizon, and Oracle, and they hold the highest market share. However, with rising importance of adherence to HIPAA and other regulations, cloud service providers offering managed hosting solutions exclusive for healthcare, such as ClearDATA, LogicWorks, and CareCloud, are emerging as strong contenders and have the potential to be the market growth leaders in the next years. An increase in competition is also expected from healthcare-specific remote hosting organizations such as Cerner, McKesson, Allscripts, NextGen, and Practice Fusion. Cloud service providers rely mainly on direct sales for go to market. However, the major distributors and value-added resellers are evolving their business models for market development. The US healthcare market offers a large number of opportunities for cloud implementations, while Europe has varying adoption rates across countries, with Scandinavia, Germany, the United Kingdom, and Benelux having strong adoption rates followed by Italy and Spain. 10

8 Scope and Segmentation Geographic coverage Scope Europe and US Study period Base year 2013 Forecast period Monetary unit US Dollars Conversion rate 1 = $ The scope of the research study revolves around healthcare cloud defined as a pool of compute, memory, and input-output resources, and applications or operating environment with seemingly infinite scalability, delivered as a service over a network, be it private or public. Healthcare cloud can be broadly segmented into Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS). The scope of the analysis pertains mainly to the United States and Western Europe including the United Kingdom, Germany, France, Italy, Spain, Scandinavia, and Benelux. The study includes rest of Europe in forecasting to get a complete perspective of Europe. However, it does not analyze the regional market dynamics of rest of Europe on the grounds that it is difficult to generalize across the region. 11

9 Key Questions this Study will Answer Is the healthcare cloud market in the United States and Europe growing, how long will it continue to grow, and at what rate? What is the future potential of the market? What are the key drivers and restraints impacting the growth opportunities in the healthcare cloud market in the United States and Europe? What is the market potential of various segments in the healthcare cloud market and what are the major market forces affecting these segments? What is the regional landscape for the healthcare cloud market in the United States and Europe? How does government spending, healthcare regulations, and so on affect the market in the two regions? Which are the major market participants in the healthcare cloud market in the United States and Europe, and what are their major service/product offerings? What are the prices and key components of price of healthcare cloud offered by the vendors to the end users? 12

10 Market Engineering Measurements Healthcare Cloud Market: Market Engineering Measurements, US, 2013 Market Overview Market Stage Market Revenue Market Size for Last Year of Study Period Compound Annual Growth Rate Growth $ M $ M % (2013) (2020) (CAGR, ) Customer Price Sensitivity Degree of Technical Change Market Concentration Market Penetration Rate (scale:1 [low] to 10 [high]) (scale:1 [low] to 10 [high]) % (market share held by tier 1 companies) SaaS: % IaaS: % PaaS: % (2013) Decreasing Stable Increasing For a tabular version, click here Note: All figures are rounded. The base year is

11 Market Engineering Measurements (continued) Healthcare Cloud Market: Market Engineering Measurements, Europe, 2013 Market Overview Market Stage Market Revenue Market Size for Last Year of Study Period Compound Annual Growth Rate Growth $ M $ M % (2013) (2020) (CAGR, ) Customer Price Sensitivity Degree of Technical Change Market Concentration Market Penetration Rate (scale:1 [low] to 10 [high]) (scale:1 [low] to 10 [high]) % (market share held by tier 1 companies) SaaS: % IaaS: % PaaS: % (2013) Decreasing Stable Increasing For a tabular version, click here Note: All figures are rounded. The base year is

12 CEO s Perspective 1 Healthcare providers will increasingly adopt cloud to meet the infrastructure requirements mandated by regulations and to cope with rising costs. 2 Data security and compliance with regulations such as HIPAA and HITECH are the top factors influencing the choice of a cloud service vendor by a healthcare provider. 3 Cloud service vendors offering HIPAA-compliant managed hosting services exclusive to healthcare customers will emerge as market growth leaders. 4 Telecommunication companies and HIE vendors with existing infrastructure and competencies are expected to extend into cloud computing, thereby increasing the competition. 15

13 Key Companies to Watch ClearDATA LogicWorks Orange Business Services ClearDATA provides highly secure and HIPAA-compliant cloud computing and managed services exclusively for healthcare customers. The company is an industry leader in the United States in the areas of highly scalable solutions for EHR and image backup, disaster recovery, storage, and vendor neutral archive (VNA). The company also has market presence in PaaS and HIPAA compliance risk and security analysis. LogicWorks is a strong market contender in healthcare IaaS services for mission-critical applications that require high availability, compliance, and service support. With a HIPAA-compliant managed hosting services portfolio exclusive for healthcare customers, the company addresses the ongoing complexity of connecting disparate systems across the healthcare delivery ecosystem. Orange has ventured into healthcare recognising the potential of M2M technology in revolutionising healthcare delivery. The company s strong experience in the telecommunications market and global reach have enabled it to serve healthcare customers. With its Business Together as a Service portfolio, Orange offers customers dedicated cloud computing infrastructure that delivers high performance and guarantees high security. Note: For additional information on companies, click here. 16

14 Executive Summary 3 Big Predictions 1 Adoption of HIPAA-compliant cloud solutions for data storage, archiving, and hosting of healthcare IT applications will significantly increase in the next years. 2 Evolving regulatory landscape and drive for operational efficiency will give impetus to investments in cloud by healthcare providers. 3 Niche healthcare cloud service providers will emerge as top contenders in the market, followed by cloud computing vendors with healthcare as one of the industry verticals. 17

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