Why Telehealth Won’t be a $20 Billion Market in 2022

Telehealth has now permeated the majority healthcare settings. Whilst once it was largely focused on remotely managing a small number of patients with complex chronic conditions, or those vulnerable to hospital readmission, its use now spans physicians’ offices, rural hospitals, specialist clinics, “hub” acute hospitals, skilled nurse facilities, educational facilities and, of course, patients’ homes.

Signify Research’s just published report “Acute, Community and Home Telehealth – World – 2018 Edition” examines the market for telehealth in these different care settings and establishes the size of the opportunity in each.

The global telehealth market for platforms, hardware and services is forecast to reach $7.3B in 2022. Whilst this projection may be lower than forecasts that have been published by other analyst firms, they’re based on a detailed country-by-country analysis of each of these main care settings where telehealth is being used.

Here’s our analysis of how each setting is helping to drive this market:

On-demand Patient Access

Key Market Trends

• Estimated market size approaching $0.5 billion in 2017
• Represents just under a fifth of the market in 2016, with the share forecast to increase over forecast period
• Projected to be approaching a $2 billion market in 2022

One of the more “traditional” areas of telehealth deployment, on-demand/direct patient access services allow patients to access a physician directly via an app, web portal or other online service typically for a video consultation.

Over recent years a plethora of solutions have been developed to address this market. Some of these are provided by companies that have developed their own platform, employ their own physicians and who offer services directly to the consumer. Examples include Teladoc, Babylon Health and MD Live. Other companies provide platforms on a white label basis, and the option to use their in-house physician support services, so that providers can offer their own branded on-demand telehealth solutions, either self-resourced or utilising the platform vendor’s physician resource. Both models are forecast to continued to see success; however, as telehealth increasingly becomes integrated into the healthcare services of providers, the in-house model is forecast to grow at a faster rate. Companies that support this include American Well and InTouch Health. Typically, the services provided in these settings are low-acuity such as general medicine, behavioural health, counselling, tobacco cessation, sexual health, etc. The US is by far the largest market for these types of telehealth services; however, the market in several other countries (e.g. Sweden, Switzerland, Australia and the UK) is ramping up.

Outpatient / Referral / Rural Health

• Estimated market size of more than $0.5 billion in 2017
• Projected to account for nearly 25% of the market in 2022

This segment includes telehealth services that are provided to patients that have either been referred to a specialist, typically after an initial consultation with a primary care physician, or where telehealth is being used to support an outpatient procedure. This can include both provider-patient telehealth consultations and provider-provider telehealth, where a local provider may be using telehealth to obtain the support of a specialist that is remote. Consultations can take place in the patient’s home (or similar) or can take place in a primary care setting that is itself connected via a telehealth solution to another setting (e.g. a physician office connected to a hospital).

A typical example would be where a patient or a local professional uses telehealth to consult with specialists on conditions that cannot be resourced locally. This can save the patient from having to travel long distances to where the specialist is located. Specialists may be part of the same health system but located elsewhere, offered via relationship with a third-party health provider, or provisioned via a specialist telehealth service provider that focuses on specific conditions.

This approach can also be applied in larger systems where the provider owns multiple acute hospitals, community hospitals, clinics and rural hospitals. The premise is similar, in that telehealth is used to provide specialist care and advice in remote or smaller facilities, that may only be physically available within larger hub locations.

Tele-ICU

• Estimated market size of less than $0.4 billion in 2017
• Although still growing, this market has been slower to develop compared to other settings in recent years, with most deployments confined to the US, and a small number of other countries (e.g. India, UAE)
• Its share of the overall market is projected to fall over the forecast period

Telehealth is used in a range of acute settings. Within the Intensive Care unit (ICU) setting it is being used to remotely monitor critical patients’ data, as well as visually monitor patients.  Within larger health systems, one approach is to roll out a tele-ICU command centre or hub. In this scenario, a command centre will be established that has the responsibility of monitoring the ICUs of several hospitals within the system. One of the largest examples of this is Mercy Health in the US. Mercy set up its tele-ICU command centre to monitor the ICUs in 15 of its hospitals. It uses a combination of Philips and Vidyo telehealth platforms and hardware to monitor close to 500 ICU beds across four states. The solution allows the command centre staff to visually monitor the whole ICU unit and to directly talk to local staff, patients and patients’ families.

Developing a solution that is monitored in-house is one approach, but as with the primary care telehealth, there are specialist third party service providers that also support this type of deployment on behalf of health systems. Advanced ICU Care is one example of a third-party service provider addressing this need. It employs a team of physicians and critical care nurses located at its remote operations centre that monitor the ICUs of its clients around the clock. This includes monitoring vital signs, medications, labs and the clinical status of its clients’ patients. Whilst substantial growth is forecast for the tele-ICU market, it is projected to be at a slower rate than other care settings. Except for a small number of relatively limited roll-outs in other countries (e.g. India, UAE, Saudi Arabia, the UK), its widespread use has been largely confined to the US and there is limited evidence that this will change significantly over the next five years.

Surgical/Medical Support

• Market to approach $1.5 billion by 2022
• Share taken of the overall telehealth market is projected to grow over the forecast period
• Tele-stroke is the leading clinical use case addressed

Another example of the use of telehealth in the acute setting is surgical/medical support. This can be provided in a range of care settings, such as the Emergency Room or during surgery. The main premise being that consultations can be made with specialists, not located at the hospital, during assessments, surgery and post-treatment via telehealth hardware and platforms.

A leading use-case to date has been in neurology. Expert neurologists can be consulted using telehealth technology during the assessment of patients admitted to hospital with a suspected stroke.  Again, a range of third party service providers have emerged that address this need. In the US service providers such as Blue Sky Telehealth, MLS Telehealth and Questcare Telehealth, provide services to hospitals supporting treatment of specific conditions. Services can also be resourced internally within the health system, utilising specialists located remotely at other facilities, other parts of the hospital or potentially at home. Several platform vendors have had success in this market including InTouch Health, Avizia and Reach Health.

Transition of Care

• The smallest of the six care settings examined in the Signify Research report
• Represents less than 10% of market in 2017, with its share projected to remain relatively stable over the next five years

This refers to the use of telehealth during the process of transferring a patient from an acute setting to a post-acute setting. It can include use of telehealth during transportation, within skilled nursing facilities (SNFs), and within long-term care facilities. It does not include remote patient monitoring at home.

An SNF telehealth program is designed to keep patients in the SNF for evaluation and treatment, to lessen the need for costly emergency transfers and to speed up the final step of returning patients back to their home. This can typically involve monitoring patients within the SNF utilising telehealth technology and services, either internally or externally provisioned, and video consultations with specialist physicians to ensure routine care is delivered in the most effective manner. Using a telehealth solution in this setting also allows SNFs to virtually meet new admissions prior to their discharge from an acute setting and familiarise themselves with their medical history and specific needs. Further, using telehealth technology during the transfer of care process can improve capacity utilisation and improve patient throughput.

Home Remote Patient Management

• Largest of the six, main telehealth care setting examined
• Represents more than a quarter of market in 2017
• However, its share is projected to fall slightly over the forecast period as other care setting markets ramp up

Home Remote Patient Monitoring refers to using telehealth hardware and platforms to monitor a patient in a home setting in order that a care provider can remotely monitor a patient’s condition. Typically, this involves the use of remote medical devices that track patients’ health data (e.g. blood pressure, blood glucose levels, etc.).

The final step for a patient who has experienced an episode of acute care is the return home. This is the setting where telehealth was historically first implemented with the intention that remote patient monitoring, patient education and video consultations with medical teams be used to ensure that a patient limits the potential for hospital re-admission, limits the likelihood that the condition severity will escalate, adheres to prescribed medication and that the patient adopts certain behaviours. There is a vast number of vendors of hardware, peripherals, platforms and services targeted at this sector and it’s the most developed application for telehealth. However, it is still an area where innovation is seen. In particular, the increasing integration of telehealth, patient engagement and population health management (PHM) workflows.

About the Report

The information presented in this insight is taken from Signify Research’s just published market report “Acute, Community and Home Telehealth—2018 Edition”. This report will present the market for telehealth platforms, hardware and services and will include projections and market sizings for more than 20 countries across each of the care settings discussed.

The report is available as a stand-alone product, but it is also a component of Signify Research’s ”Population Health Management and Telehealth Service”. This is a year-round service that provides ongoing data, insights, and analysis on the global population heath management and telehealth markets. The service includes four market reports delivered over a 12-month period, regular updates of key market metrics, competitive environment and market share analysis by product type and region and quarterly analyst briefings to each subscriber firm.

About Signify Research

Signify Research is an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Our major coverage areas are Healthcare IT, Medical Imaging and Digital Health. Our clients include technology vendors, healthcare providers and payers, management consultants and investors. Signify Research is headquartered in Cranfield, UK.
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