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2 TABLE OF CONTENTS 1. Global Telemedicine Market Introduction 2. Global Telemedicine Market Size, Global Telemedicine Market Segmentation 3.1. By Telehome and Telehospital, The US Telemedicine Market Introduction and Size, The US Telemedicine Market Overview Role of Government in The US Telemedicine Market Role of Rural Population in Telemedicine Market Regulations in Telemedicine Market The US Telemedicine Market Size Benefits of Using Telemedicine Facility 4.1. The US Telemedicine Market Value Chain 5. The US Telemedicine Market Segmentation 5.1. By Telehome and Telehospitals, By Asynchronous and Synchronous Method of Telemedicine, By Telemedicine Applications, By Technology and Services, Price Analysis of The US Telemedicine Market 7. Competitive Landscape of Major Players in the US Telemedicine Market 8. The US Remote Patient Monitoring System Market Introduction and Size, Global mhealth Market Introduction and Size, The US mhealth Market Introduction and Size, The US mhealth Market Segmentation By End User (Patients and Doctors), By Hardware, Software and Services and Network,

3 12. The US Telemedicine Market Trends and Developments Advent of Push To Talk Devices in Telemedicine Market Ingress of In-Home Care Solutions Introduction of Telewound Technology Increasing Role of Technological Innovations in The US 13. The US Telemedicine Market Future Outlook, Cause and Effect Relationship between Macro Economic and Industry Factors and the US Telemedicine Market Prospects 14. Macroeconomic Variables for the US Telemedicine Market, The US Personal Disposable Income, The US Population, The US Healthcare Expenditure, The US Obese Population, Internet Users in the US, Appendix Market Definitions Abbreviations Research Methodology Data Collection Methods Approach Variables (Dependent and Independent) Final Conclusion Disclaimer 3

4 LIST OF FIGURES Figure 1: Global Telemedicine Market Size on the Basis of Revenue and Growth in USD Million and Percentage Respectively, Figure 2: Global Telemedicine Market Segmentation on the Basis of Revenue by Telehome and Telehospital Market in Percentage, Figure 3: The US Telemedicine Market Size on the Basis of Revenue and Growth in USD Million and Percentage Respectively, Figure 4: Tele-A&E (Accident and Emergency) Value Chain Figure 5: Tele-Consulting Segment Value Chain Figure 6: Tele-Monitoring Segment Value Chain Figure 7: Tele-Surgery Segment Value Chain Figure 8: The US Telemedicine Market Segmentation on the Basis of Revenue by Telehome and Telehospital Segment in Percentage, 2013 Figure 9: The US Telemedicine Market Segmentation on the Basis of Revenue by Real Time, Store and Forward and Hybrid Methods in Percentage, 2013 Figure 10: The US Telemedicine Market Segmentation on the Basis of Revenue by Different Applications in Percentage, 2013 Figure 11: The US Telemedicine Market Segmentation on the Basis of Revenue by Telemedicine Services and Technology in Percentage, 2013 Figure 12: The US Telemedicine Remote Patient Monitoring Market Size in USD million, Figure 13: Global mhealth Market Size on the Basis of Revenue in USD Million, Figure 14: The US Telemedicine mhealth Market Size on the Basis of Revenue in USD Million, Figure 15: The US mhealth Market Segmentation on the Basis of Revenue by End User in Percentage, 2012 Figure 16: The US mhealth Market Segmentation on the Basis of Revenue by Products in Percentage, 2012 Figure 17: Companies in the US Telemedicine Market on the Basis of Number of Employees Strength in Percentage,

5 Figure 18: The US Telemedicine Market Future Projections on the Basis of Revenue in USD Million, Figure 19: The US Personal Disposable Income in USD Million, Figure 20: The US Population in USD Million, Figure 21: The US Healthcare Expenditure in USD Million, Figure 22: Number of Federal and Non-Federal Hospitals in the US, Figure 23: The US Obese Population in Million, Figure 24: The US Internet Users in Million,

6 LIST OF TABLES Table 1: Telemedicine Technology Versions and Their Specifications Table 2: Telemedicine Facility Benefits and Drawbacks to the Patient, Primary Care, Secondary Care and to the System Table 3: Global Telemedicine Market Segmentation on the Basis of Revenue by Telehome and Telehospital Market in USD Million, Table 4: Average Treatment Cost per Day in the US, 2012 Table 5: The US Telemedicine Market ROI Analysis Table 6: Cost Comparison of Hospital and Telemedicine Service on the Basis of Various Treatment Procedures Table 7: Competitive Landscape of Major Players in the US Telemedicine Market Table 8: Company Details of Major Telemedicine Vendors in the US Telemedicine Market Table 9: Cause and Effect Relationship between Macro Economics and Industry Factors and the US Telemedicine Market Prospects Table 10: The US Internet Users Segmentation on the Basis of Type of Race and Ethnicity in Percentage, Table 11: Correlation Matrix of the US Telemedicine Market Table 12: Regression Coefficients Output 6

7 GLOBAL TELEMEDICINE MARKET SIZE, The global telemedicine market has witnessed prolific growth in the last few years, majorly owing to the increasing healthcare cost across various multi-specialty hospitals and nursing homes. It has been observed that an average cost of the treatment is relatively much higher as compared to the cost of diagnosis and treatment received by the patient via telemedicine channel. Additionally, the remarkable growth of telecommunication sector along with increasing internet penetration around the world has augmented the demand of telemedicine services across various hospitals and clinics. In the year 2013, the telemedicine market generated revenue of worth USD ~ million, growing at 16.7% from USD ~ million in 2012 Global Telemedicine Market Size on the Basis of Revenue and Growth in USD Million and Percentage Respectively, , , , , , , , , , % 20.0% 19.0% 18.0% 17.0% 16.0% 15.0% USD Million Growth % 7

8 GLOBAL TELEMEDICINE MARKET SEGMENTATION BY TELEHOME AND TELEHOSPITAL, The deployment of telemedicine services has significantly improved the healthcare services industry in the world, majorly owing to various technological innovations in the field of medical equipments and services. Additionally, the consistent rise in the demand for high quality healthcare services coupled with increasing prevalence of chronic diseases across various countries have also augmented the need for telemedicine services in the world. In light of the growing scope of treatments through telemedicine approach, various hospitals as well as in-home healthcare services have taken a step forward towards telemedicine market in the recent years. Therefore, the global telemedicine market can be classified into two broad categories as telehome and telehospital segments Global Telemedicine Market Segmentation on the Basis of Revenue by Telehome and Telehospital Market in Percentage, % 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Telehospital Market Telehome Market 8

9 THE US TELEMEDICINE MARKET INTRODUCTION AND SIZE, The cost of healthcare is one of the critical issues in the US. In order to overcome the overbearing number of casualties and health related incidents together with lagging number of healthcare specialists offering opportunity to the public as well as the private players to develop and implement telemedicine networks for hospitals and in-home care. The growing healthcare expenditures in the country along with the increasing lack of healthcare specialists in the country has provided strong driving force to the telemedicine market in the US. In 2013, the market for telemedicine generated annual revenue of worth USD ~million at a massive growth of 60.1% from USD ~million in 2012 The US Telemedicine Market Size on the Basis of Revenue and Percentage in USD Million and Percentage Respectively, , , , , , , % 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 9

10 THE US TELEMEDICINE MARKET VALUE CHAIN Telemedicine Service Portal IT or Telecom Service Patient Healthcare Experts Insurance Company/ Taxation Payers Source: Ken Research Note: Money Flow is represented by Medical Service/Consultation is represented by Telemedicine Procedure is represented by 10

11 THE US TELEMEDICINE MARKET SEGMENTATION BY TELEHOME AND TELEHOSPITALS, 2013 The telehome service has been increasing in the last few years, on account of rising development in mobile technology and increasing internet penetration in the US. If the patients are left to their own judgments, some patients are could attempt fatal decisions related to their personal health, due to ignorance of the disease symptoms, genetic inheritance and lifestyle habits. The telehome facility enables the healthcare specialists to accurately accessing patient condition via a combination of advanced testing and telemonitoring. The telehome service segment contributed ~% to the total revenue of telemedicine market in the US BY ASYNCHRONOUS AND SYNCHRONOUS METHOD OF TELEMEDICINE, 2013 Synchronous is a live, interactive videoconference telemedicine method, in which a healthcare specialist and the patient are present at the same time at different geographic locations. The medical specialists are able to diagnosis the patients condition while sitting in his clinic or hospital. This mode of communication is facilitated, largely by using secure digital videoconferencing software, in which doctor s image is captured by a video camera, digitized and transmitted over broadband speed telecommunications lines. The transmitted imagery is then received by the patient s machine and it appears on a video screen. Simultaneously, the patient s image is captured by the similar process and transmitted to the other side, which could be viewed by the medical specialist. In the country such as the US, the transmission speed of broadband network is sufficiently fast due to which the doctor and the patient can conduct an online conversation without any hindrance. Such mode of telecommunication between healthcare veterans and the patients are also called as Real Time Telemedicine, as this interactive telemedicine services provide real-time interactions between patient and provider. The real time videoconferencing has been remarkably replacing the position of phone conversations between doctors and patients, online communication as well as the in-home visits. Apart from the real time remote patient monitoring, this mode of telemedicine also facilitate few more activities such as history review, remote physical examination, psychiatric evaluations and ophthalmology assessments, among others. In 2013, the overall telemedicine market was dominated by real time telemedicine, which accounted for a share of ~% in the overall revenue of telemedicine market in the US 11

12 BY TELEMEDICINE APPLICATIONS, 2013 The telemedicine has numerous applications in the field medical information technology industry. Rising cost of healthcare systems and home care health services and enabled the telemedicine market to flourish in the US geography. Lack of required number of Medicare consultants, especially for chronic diseases has created a huge need for such services, wherein, a healthcare consultant could be accessed from a distant place for the diagnosis and therapy of the patient. In terms of the major medical applications, the market is largely dominated by gynaecology, with a share of ~% in The ease and comfortability of being at home for a woman, coupled with the fact that a number of women are apprehensive to gynaecology clinic, has largely contributed in making this segment as the largest segment in the country. Moreover, in the field of pregnancy and prenatal care, telemedicine has offered some of the greatest opportunities in the field of women s health care. Various applications such as remote and distant monitoring of blood glucose in diabetic pregnancies and others are the major applications of tele-gynaecology in the country BY TECHNOLOGY AND SERVICES, 2013 In 2013, the service segments, which also include the revenue from software, contributed a share of ~% in the overall revenue of telemedicine market in the US. Rising cost of healthcare, lack of required number of healthcare experts in the country and increasing cutting edge technological advancements in the field of telecommunications, internet and smartphone has enable the tech companies to cater to a large number of under-served patients. It has been observed that nearly ~% of physicians are located in metropolitan areas, while the remaining ~% are located in rural areas. As the telemedicine services penetration is increasing, the patients in rural communities are hugely benefited and they are able to receive the diagnosis of therapy of various conditions from afar without having to commute to a distant place 12

13 PRICE ANALYSIS OF THE US TELEMEDICINE MARKET Average Treatment Cost per Day in the US, 2012 Average Treatment Cost Per Day In USD In Hospital Nursing Home Telemedicine The US Telemedicine Market ROI Analysis Particulars In USD Million Total Estimated Cost U.S Acute Care Visits (Addressable by Remote Consultations) Average Cost per Visit in a Hospital Total Cost of Treatments via Hospital (Avoidable) Total Cost of the same Number of Treatments via Telemedicine Cost Savings to the Healthcare System Cost Comparison of Hospital and Telemedicine Service on the Basis of Various Treatment Procedures Particulars Treatment Cost from a Hospital in USD Treatment Cost from a Telemedicine in USD Total Cost Savings ER Visit Urgent Care Specialist Visit PCP Visit 13

14 THE US REMOTE PATIENT MONITORING SYSTEM MARKET INTRODUCTION AND SIZE, Remote Patient Monitoring Systems are set of medical equipments and software which are used in conducting a comprehensive study on the patient s disease from a distant place. The RPM also includes the advanced systems with remote and wireless capabilities which are used for patient monitoring across various hospitals and clinics. These equipments or set of equipments are largely comprises of technologically advanced patient monitors, monitors with patient data processing applications and monitors which are facilitated with data transfer functionality to an EMR system, including equipment. The EMR systems also linked with other peripherals which coordinate the flow of data to hospital electronic medical record systems. The peripheral devices include real-time audio and video for "face-to-face" interaction between clinicians and patients. The above mentioned data flow provides the monitoring information about the patient to the distant place and provide data for an EMR system The US Telemedicine Remote Patient Monitoring Market Size in USD Million, , , , , , ,

15 THE US MHEALTH MARKET INTRODUCTION AND SIZE, The US mhealth market generated revenue of worth USD million in 2011, which grew at a CAGR of ~% to USD ~million in The growth was led by the increasing adaptability of smartphones among US citizens, which provides access to monitoring and diagnostic services. Mhealth market has been growing majorly due to increasing integration of wireless technology with portable healthcare devices. Few other factors propelling the growth of mhealth market are increasing incidences of lifestyle diseases, cost and convenience factors, government initiatives and increasing affordability of smart phones among the US population. From the telecom providers perspective, the market is at nascent stage and it is expected that in the upcoming years, the market will flourish at a remarkable growth rate The US Telemedicine mhealth Market Size on the Basis of Revenue in USD Million,

16 THE US MHEALTH MARKET SEGMENTATION BY HARDWARE, SOFTWARE AND SERVICES AND NETWORK, 2012 Mhealth market is largely dominated by the revenue from software and services. In 2012, the software and services segment contributed a share of ~% in the overall revenue of mhealth market in the US. The software and services segment comprises of revenue from the sales of mhealth applications and their monthly or yearly subscriptions. Patients as well as the medical professionals have been purchasing the health and wellness apps for the purpose of communicating with each other. Additionally, the medical professionals also communicate with another medical specialist via these mhealth apps. Health apps are segmented into exercise, women's health, medication reminder, weight loss, sleep and meditation and others, whereas the medical apps market is bifurcated into medical reference, and other applications such as apps for mental health, dermatological treatment and emergency response THE US TELEMEDICINE MARKET FUTURE OUTLOOK, In the last few years, telemedicine equipments and software and services have witnessed remarkable growth in the global landscape, in which the US market contributed a significant part in the telemedicine revenue. The growing obesity amongst the US population together with increasing occurrence of lifestyle diseases in the country has provided a strong impetus to the growth of emergency casualties during the last decade. Moreover, the increasing rate of heart diseases, increasing obesity, diabetes and other fatal diseases have provided an upward thrust to the solution of providing instant healthcare services to the patients, which could be fulfilled by telemedicine equipments and software platforms. Currently, remote patient monitoring, telediagnosis, telesurgery, teleradiology and teleconsultations are the prevalent application performed by various telemedicine equipped hospitals and clinics, however, in the upcoming future, these hospitals and clinics will start providing telemedicine services in more number of applications such telewound and others. The telemedicine market in the US is projected to register revenues of ~USD 38 billion by 2018, growing at significant CAGR of ~% from

17 The US Telemedicine Market Future Projections on the Basis of Revenue in USD Million, , , , , , , , , ,

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