Telemedicine has become one of the fastest growing healthcare technologies owing to its ability to overcome routine health management challenges. Telemedicine adoption is accelerated majorly during COVID-19 due to critical chronic disease management, its ability to reduce health management costs, rising mental health concerns, substantial government support from developing and developed nations, and coverage of telemedicine consultations under health insurance. Owing to these drivers telemedicine sales is expected to grow at a CAGR of 40.4% from 2022 to reach $627.5 billion in 2030.
However, poor infrastructure and technology barriers in developing and under-developed nations, the lack of data privacy, loss of critical information, and the high risk of cybercrimes due to inadequate security and potential vulnerabilities can restrain telemedicine market growth. On the other hand, the integration of telemedicine into medical tourism, and also AI-based advancements in telemedicine applications can act as huge opportunities in the telemedicine market.
1. Telemedicine Market’s Major Drivers
1.1. Accelerated Telemedicine Adoption During and Post COVID-19 Especially in Chronic Disease Management
The healthcare system is evolving and it starts the healthcare industry’s transition from in-person care to virtual delivery. Technology and adoption have clashed, and no less in the midst of a pandemic. Even though telemedicine services were generally available before the pandemic, the COVID-19 crisis was the first time that they were actually utilized.
The fact that the COVID-19 crisis witnessed fewer in-person meetings and travel limitations, prompted clinicians to modify telemedicine-based consultations even more during the pandemic. As a result, it is projected that the COVID-19 pandemic will have a substantial positive impact on the growth of the global telemedicine market. These circumstances have highlighted the several important advantages of telemedicine for both patients and doctors, as well as shown a huge opportunity in previously untapped revenue streams.
During the global COVID-19 pandemic, telemedicine offered a safe, practical, and dependable technology, especially for the long-term treatment and self-management of chronic disease with advantages including reducing the danger of patient-to-patient infection. Additionally, hospitals and clinics also recommend telemedicine to maintain social distance and reduce their chances of coming into contact with infected patients. Owing to this there had been a significant rise in the adoption of virtual care services by patients.
Further, management of chronic diseases such as cancer, diabetes, and hypertension, causes of 41 million (approximately 71%) fatalities across the globe, was a challenge during the COVID-19 pandemic period. Patients with chronic diseases such as cancer, diabetes, and hypertension require regular appointments with multiple hospital visits in order to avoid any serious complications.
Exhibit-1
Global Prevalence of Cancer, Diabetes, and Hypertension in 2021
| Chronic Disease | Global Prevalence (2021) |
|---|---|
|
Cancer |
1.8 Million People |
|
Diabetes |
523 Million People |
|
Hypertension |
1.28 Billion People |
Source- PubMed, WHO, and International Diabetes Federation
Due to this, there had been significant adoption of Telemedicine as it has simplified this process by eliminating obstacles that patients may have due to transportation, the weather, or mobility concerns. As per the report of Science Soft (2020) many telemedicine providers have already reported growth in demand for their solutions such as:
- Teladoc Health video appointments surged by 50% in 2020
- PlushCare appointments were up by 70% in 2020
- One Medical reported a 51% increase in engagement with its digital platform in 2020
According to a population-based repeated cross-sectional study by PLOS ONE (Canada 2022), the use of virtual care (such as telemedicine) increased across Chronic Obstructive Pulmonary (COPD), Congestive Heart Failure (CHF), Angina, Diabetes, Asthama, and Hypertension patient populations.
Exhibit-2
Average Weekly Visit Rates Per 1000 Patients, and Growth Rate (From Previous Period to Current Period), by Medical Condition
Source- PLOS ONE
Before COVID-19: From January 2018 to March 2020; During COVID-19: From March 2020 to January 2021; COPD: Chronic Obstructive Pulmonary Disease; CHF: Congestive Heart Failure
Thus, more patients with chronic diseases are started adopting telemedicine since the COVID-19 outbreak for treatment which is projected to propel the telemedicine market forward.
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1.2. Significant Reduction in Health Management Cost
The ability to pool resources through remote analysis services like telepathology and teleradiology and teledermatology leads to lower costs and higher-quality healthcare. According to a review article published in the National Library of Medicine (Australia 2020), telemedicine resulted in significant cost reduction for patients.
Exhibit-3
Australia: Telemedicine Modality Used in Clinics and Associated Cost Reduction Findings in 2020
| Sr. No. | Telehealth Modality and Clinical Focus | Findings |
|---|---|---|
|
1 |
Remote monitoring for high-risk pregnancy |
Cost reduction for remote monitoring of $233,958 per year |
|
2 |
Costs of $108 per consultation for telehealth versus $155 for an in-person consultation |
Cost reduction for remote monitoring of $233,958 per year |
|
3 |
Dermatology screening, diagnosis, and triage |
Teledermatology practice had an hourly operating cost of $361 versus $456 for conventional care |
|
4 |
Pediatric videoconference service for consultation |
$598,203 saved over 5 years |
|
5 |
Remote monitoring for patients with chronic obstructive pulmonary disorder |
$8566 total service cost savings compared with traditional in-home care program over 6 months |
|
6 |
Videoconference consultations service (mainly orthopedics and dermatology) |
The cost per consultation for telemedicine is $327 versus $333 for conventional care. |
|
7 |
Triage of specialist cases via email and/or videoconference |
Telemedicine is less expensive with a saving of $10,874 over 8 months of the service. |
Source- National Library of Medicine
Through telemedicine, smaller facilities with minimum healthcare staff can provide 24/7 service at a lesser cost. When patients would have previously been watched as inpatients, remote monitoring technologies allow for ambulatory surveillance of those individuals. Due to this, there is no need to purchase/ rent physical space to provide treatment for more patients. Telemedicine lowers the overall cost per patient visit if no additional facility expenses would be incurred.
Thus, significant reduction in healthcare facilities and per visit costs is expected to boost the adoption of telemedicine by hospitals and clinics.
1.3. Rising Mental Health Concerns Fuel Telemedicine Demand
Globally, the COVID-19 epidemic brought the abrupt isolation and loss of social interactions which created a negative impact on people’s mental health. In 2020, the COVID-19 pandemic caused a 25% global increase in the prevalence of anxiety and depression which also propelled the number of psychiatric consultations. For instance, as per the PLOS medicine article (2022), virtual psychiatric visits in Canada significantly increase during the pandemic.
Source- PLOS Medicine
More, as per the survey findings by the American Psychiatric Association (2020-2021) on the use of telepsychiatry, as of January 2021, 81% of respondents indicated that they continue to see between 75 – 100% of patients via Telepsychiatry.
Exhibit-5
Telepsychiatry Use in the US, UK, Spain, Israel, and Brazil for Improvement of Mental Health Problems in 2021
| Source and Country | Intervention Type | Mental Health Problem |
|---|---|---|
|
National Library of Medicine 2021 (Israel) |
Online guided group sessions |
Depression, Anxiety, Stress |
|
National Library of Medicine 2021 (UK) |
An app that provides behavioral change support |
Anxiety, Depression |
|
National Library of Medicine 2021 (Spain) |
Occupational intervention via telehealth and telephone |
Mental Illness, Depression |
|
National Library of Medicine 2021 (USA) |
An automated text messaging platform |
Anxiety, Depression |
|
National Library of Medicine 2021 (Brazil) |
Psychiatric and health consultation via telephone contacts |
Emotional Distress |
Source- Wiley Online Library
Further, methods like virtual counseling and telepsychiatry are gaining popularity among people with mental health issues, the importance of telemedicine has significantly increased among young people because they are accessible and provide more privacy.
Source- American Psychiatric Association, nForming Analysis
More, according to World Health Organization (WHO), 70% of countries across the globe have adopted telemedicine or teletherapy to address disruptions to in-person services. For instance, more than 80% of high-income countries and less than 50% of low-income countries have reported accepting telemedicine and teletherapy to bridge gaps in mental health. Thus increase in mental health concerns and significant adoption of telemedicine by psychiatrists will result in driving telemedicine market demand.
1.4 Substantial Government Support to Telemedicine
Government agencies are embracing telemedicine by putting new rules and reimbursement standards in place. Following are some government initiatives by US, Germany, India, and Dubai in order to support telemedicine.
1.4.1 US
To assist doctors in implementing telehealth services, The Physicians Foundation, American Medical Association, Florida Medical Association, Massachusetts Medical Society, and Texas Medical Association established The Telehealth Initiative in 2020. That assisted the 24 participating practices’ 168 participating doctors in redesigning their practices so they could successfully offer telehealth services to their patients throughout COVID-19 and beyond in the USA.
1.4.2 Germany
The German Society for Telemedicine (founded in 2005) (DGTelemed) DGTelemed is a platform for telemedicine advocacy in Germany and around Europe. It is a national organization dedicated to promoting, disseminating, marketing, and publishing cutting-edge, creative telemedicine advancements, solutions, and products.
1.4.3 India
In 2020, the Government of India launched National Telemedicine Service by the name e-Sanjeevani (2020) which provides digital health services to the citizens through more than 250 online OPDs set up on e-Sanjeevani OPD
1.4.4 Dubai
In December 2019, The Dubai Health Authority (DHA) introduced the “Doctor for Every Citizen” smart service. One can use this service to access free consultations via phone and video chats at any time. Initial consultations and follow-up visits with DHA-certified doctors are included in the service. The doctor can issue electronic prescriptions and request laboratory and radiological tests.
The substantial government support is anticipated to enhance telemedicine market growth
1.5 Health Insurance Coverage for Telemedicine Consultations
COVID-19 encouraged more patients to choose online medical consultations over routine hospital checkups. Along with this many health insurance policies have also begun to cover teleconsultations owing to its increasing popularity and demand increase. Following are some country-wise developments to Medicare coverage for telemedicine.
Exhibit-7
Country and Their Medicare Coverage for Telemedicine
| Country | Telemedicine and Medicare Coverage |
|---|---|
|
Content |
U.S. states, including Hawaii, Arkansas, Delaware, and Delaware, have passed laws requiring health insurance plans to reimburse patients for remotely delivered care at the same rate as they would for in-person medical visits. |
|
France |
Telemedicine use has been reimbursed in the same way as that of in-person consultations SINCE 2018, i.e., up to 70% of the standard social security rate, with the remaining 30% typically being covered by the insured person’s private complementary health insurance. |
|
Germany |
The statutory health insurance program in Germany provides coverage to 90% of the population (SHI). Numerous telehealth services that are reimbursable are offered by the SHI. Currently, among other things, online video appointments, conciliar case discussions of X-rays, CT scans, and MRIs, and remote monitoring for patients with cardiac resynchronization treatment (CRT) implants or implanted cardioverter defibrillators (ICD) are reimbursed. |
|
India |
The Insurance Regulatory and Development Authority of India (IRDAI) has urged the insurer to permit telemedicine payment claims in 2020. |
Source- DLA Piper Intelligence
Health insurance coverage for telemedicine consultations will propel the telemedicine market forward.
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2. Major Opportunities in Telemedicine Market
2.1 The Integration of Telemedicine into Medical Tourism
Positive growth in medical tourism activity has been observed in 2021. Due to quarantine and immigration limitations brought on by COVID, people were unable to migrate between countries, which resulted in a massive pent-up demand for health tourism.
For instance, the six million Britons on the National Health Service (NHS) watch list travel to high-quality, less expensive nations where they can get hip replacements the day after arrival (Dubai, Malaysia, Thailand, Costa Rica). More, Turkish parents who have children with spinal muscular atrophy (SMA) go to Dubai to obtain Novartis’ gene therapy, which is not offered in their nation. Also, Americans visit a wide range of foreign nations to avoid both expensive healthcare and lengthy wait times for routine treatments. An increasing number of these scenarios involve patients communicating with their hospital representatives and doctors before and after care via telemedicine systems.
Telemedicine has also made its way into the mainstream of pre-, mid-, and post-treatment episodes of medical tourists due to the growing backlogs of surgical and medical patients in both developed and developing countries. Telemedicine enables the doctor to thoroughly examine the data and develop a diagnostic and treatment strategy that is then electronically transmitted back to the patient. Further, it also supports patients financially by reducing the required number of travel turns for physical visits. Such, telemedicine services are already being made available to patients in Uzbekistan, Dubai, and Myanmar by Indian medical tourism companies.
Thus the integration of telemedicine into medical tourism can be a huge opportunity for telemedicine market expansion.
2.2 AI-Based Advancements in Telemedicine Applications
AI-based technologies are expected to significantly alter how healthcare organizations operate, optimize, and connect with patients. In order to improve the quality of care and operational effectiveness, hospitals and care providers all over the world, particularly in developed economies, are aggressively implementing digital technologies like artificial intelligence (AI), machine learning, smart sensors, big data analytics, and the Internet of Things (IoT).
Following are a few examples of AI advancement in the healthcare sector:
- The voice-activated intelligent device “Aria” from South Korean telecom company SK Telecom. When the carrier cannot use other devices due to accidents, physical limitations, or special circumstances, Aria can place emergency calls.
- The most popular AI application in the healthcare sector is IBM’s “Watson for Oncology,” which supports clinicians by making suitable treatment recommendations.
- A medical AI diagnosis system that can accurately prescribe therapies for more than 50 eye illnesses has been developed by doctors at the Moorfields Eye Hospital in London.
- The Mayo Clinic, a leading US healthcare institution known for its advancements in patient care and health technology, used AI for cervical cancer screening to spot precancerous alterations in a woman’s cervix.
- In order to “detect possible at-risk patients under ICU care” using predictive and advanced analytics, The Cleveland Clinic, a nonprofit multispecialty academic medical facility in Cleveland, Ohio, started employing Microsoft’s AI digital assistant Cortana in 2016.
Further, AI has the potential to significantly improve clinical care pathways (diagnoses and prognoses), patient-facing solutions like providing personalized medical advice and information, and far-reaching efficiency in fields like health-systems administration, drug research, and clinical trial design. By 2030, it is predicted that there will be a severe shortage of 18 million healthcare professionals and AI is the only solution to address this problem. Thus AI-based diagnostic and preventive advances can be a huge opportunity in the telemedicine market.
3. Major Threats and Challenges in Telemedicine Market
3.1 Poor Infrastructure and Technology Barrier in Developing and Under Developed Nations
Information technology (IT) and telecommunication infrastructure are the latest telecommunications equipment, high-speed internet, with high bandwidth and storage capacity is a must for the integration and transmission of medical data. However, in many developing and developed nations, such infrastructure is either in the developing stage or yet to begin. As per the report of the Tony Blair Institute for Global Change (2021), a total of 3.7 billion people across the world have no internet access.
Source- Tony Blair Institute for Global Change
Further, telemedicine programs require a minimum of 1.5 Mbps (187.5 Kbit/s) for both upload and download speeds to successfully display audio and video data this is still not achieved in developing and underdeveloped countries, thus telemedicine application is still a major challenge.
Source- International Telecommunication Union (ITU)
Hence, the adoption of telemedicine services is likely to be hampered by technological and infrastructure barriers in developing and under developing nations.
3.2 The Lack of Data Privacy, and Loss of Critical Information
Telemedicine apps are largely designed to make life more convenient for patients, from virtual consultation to tracking sleep. However, with increased reliance on these digital applications, concerns about patient data privacy are also increased.
According to American Medical Association (AMA), July 2022 survey, patients are comfortable with their doctors having access to their medical records. However, they are equally concerned about safeguarding the privacy of their health information.
The American Medical Association a patient-owned organization that seeks to link patients with health innovators commissioned a poll of 1,000 patients. The study looked at patient perceptions of data privacy and suggested ways for the medical community and the government to build confidence while safeguarding patient records.
Among the AMA survey findings:
- 92% of people believe privacy is a right and their health data should not be available for purchase by corporations or others
- 75% of people are concerned about protecting the privacy of their health data
- 93% of patients and consumers are demanding transparency in product use and sharing personal health data
- 88% of patients believe doctors and hospitals should have the ability to review and verify the security of health apps before sharing patient data
The majority of health app regulations are either non-existent or weak. Due to this patient confidence in data privacy is impacted as technology companies and data brokers obtain irreversible health data and share it with third parties, without obtaining patient consent.
For instance, as per the report of Techcrunch published in 2021, Bicycle Health, Boulder Care, Confidant Health Workit Health, DynamiCare Health, Kaden Health, Loosid, Pear Reset-O, PursueCare, and Sober Grid were the ten opioid therapy applications accessed unique identifiers about the user’s device and, in some cases, shared that data with third parties.
Thus, the lack of privacy and confidentiality of patient’s health information can restrain the telemedicine market.
3.2 Cybercrimes Due to Inadequate Security and Potential Vulnerabilities
Telemedicine can be a big opportunity for cybercriminals to steal a patient’s private information, including their Social Security number and other identifying details, hackers may attempt to infiltrate telemedicine networks. They might be able to find out about payments from these data. Hackers may occasionally even take insurance information in order to use it fraudulently or for their own medical needs. To sell to businesses or use as extortion against public figures like politicians or celebrities, other criminals may try to obtain patients’ confidential medical information.
According to the report of Fierce Healthcare (2022), cybersecurity breaches in the US reached an all-time high in 2021 and exposed a record amount of patients’ protected health information (PHI).
Source- Fierce Healthcare
Thus, inadequate security and potential vulnerabilities such as data breaches and healthcare cyber-attacks can decrease the adoption of telemedicine applications thereby restraining telemedicine market growth.
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