WIRELESS ELECTRONIC HEALTH RECORDS: TECHNOLOGIES AND GLOBAL MARKETS

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1 WIRELESS ELECTRONIC HEALTH RECORDS: TECHNOLOGIES AND GLOBAL MARKETS HLC147A January 2014 Varsha Bhat Project Analyst ISBN: BCC Research 49 Walnut Park, Building 2 Wellesley, MA USA (toll-free within the USA), or (+1) information@bccresearch.com

2 TABLE OF CONTENTS CHAPTER 1 INTRODUCTION 2 TECHNOLOGIES AND APPLICATION 2 STUDY BACKGROUND 2 STUDY GOALS AND OBJECTIVES 2 INTENDED AUDIENCE 3 SCOPE AND FORMAT 3 METHODOLOGY AND INFORMATION SOURCES 3 ANALYST CREDENTIALS 4 RELATED BCC RESEARCH REPORTS 4 BCC RESEARCH ONLINE SERVICES 4 DISCLAIMER 4 CHAPTER 2 SUMMARY 6 SUMMARY TABLE GLOBAL WIRELESS EHR MARKET, 6 SUMMARY FIGURE GLOBAL WIRELESS EHR MARKET, 6 CHAPTER 3 MARKET OVERVIEW 9 FIGURE 1 WIRELESS EHR MARKET: POPULATION AGE 65+ (WORLD), 2011 (%) 9 WIRELESS EHR MARKET DEFINITIONS AND OVERVIEW 10 FIGURE 2 WIRELESS EHR MARKET: PRODUCT DEFINITION, EVOLUTION AND BUSINESS IMPACT 11 VENTURE CAPITAL INVESTMENTS 12 FIGURE 3 WIRELESS EHR MARKET: U.S. VENTURE CAPITAL INVESTMENTS IN DIGITAL HEALTH, (%) FIGURE 4 WIRELESS EHR MARKET: NUMBER OF DEALS BY DIGITAL HEALTH INVESTORS, 2012 (%) FIGURE 5 WIRELESS EHR MARKET: NUMBER OF DEALS BY SERIES OF FINANCING, 2012 (%) TABLE 1 WIRELESS EHR MARKET: TOP FIVE DEALS IN DIGITAL HEALTH INVESTMENT, U.S., 2012 ($ ADOPTION OF SMARTPHONES AND TABLETS 15 FIGURE 6 WIRELESS EHR MARKET: COMMON USES OF APPS BY CLINICIANS, 2012 (%) KEY WIRELESS EHR PRODUCT CATEGORIES 17 Episodic Devices 17 Continuous Stand-Alone 17 Continuous Networked 17 EHR AND "BIG DATA" 18 STAKEHOLDERS AND TRENDS 19 SENSOR PROVIDERS 19 CHIPSET PROVIDERS 20 EHR PROVIDERS 21 HEALTHCARE PROVIDERS 22 MEDICAL DEVICE INTEGRATION SOFTWARE PROVIDERS 23 MEDICAL DEVICE MANUFACTURERS 23 IT SOLUTION PROVIDERS

3 IBM 24 Cisco 25 Cisco Medical-Grade Network (MGN) 25 Cisco Context-Aware Healthcare Solution 25 Cisco Medical Data Exchange Solution 25 EXTENSION Solution Suite 25 Oracle 25 STANDARDS, REGULATIONS AND LEGISLATION 26 FIGURE 7 WIRELESS EHR MARKET: SDO HARMONIZATION STRUCTURE, ISO/TC FIGURE 8 WIRELESS EHR MARKET: ISO TC 215 SUBCOMMITTEE/ WORKING GROUPS, 2012 CEN/TC HL7 28 DICOM (DIGITAL IMAGING AND COMMUNICATION IN MEDICINE) 29 ASTM (AMERICAN STANDARDS FOR TESTING AND MATERIALS) 29 IEEE (INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS) 30 CATEGORIES OF STANDARDS 30 Vocabulary 30 Structure and Content 30 Good Electronic Health Record (GEHR)/OpenEHR Initiative 31 CEN EN 13606/ EHRcom 31 TABLE 2 WIRELESS EHR MARKET: CONTEXTUAL BUILDING BLOCKS OF EHRCOM 32 HL7 Clinical Document Architecture 32 Messaging 32 HL7 32 Security 33 MEDICAL DEVICE INTEROPERABILITY STANDARDS 33 TABLE 3 WIRELESS EHR MARKET: IHE USE CASES TO PROFILES, Continua Health Alliance 34 Disease Management 35 Health and Fitness 35 Independent Living (Aging Independently) 35 FIGURE 9 WIRELESS EHR MARKET: CONTINUA INTERFACES AND STANDARDS, AAMI and UL 36 INSURANCE REIMBURSEMENT SCENARIO 36 REIMBURSEMENT FOR REMOTE/WIRELESS PATIENT-MONITORING DEVICES 36 Funding/Incentive Schemes for EHR Solutions 37 Australia 37 United Kingdom 37 France 37 Singapore 38 United States 38 TABLE 4 WIRELESS EHR MARKET: SUMMARY OF MEANINGFUL USE CRITERIA 38 IMPLEMENTATION 39 EMR ADOPTION MODEL 39 TABLE 5 WIRELESS EHR MARKET: EUROPE AND U.S. EMR ADOPTION MODELS,

4 FIGURE 10 WIRELESS EHR MARKET: EMR ADOPTION BY REGION/COUNTRY, Q FIGURE 11 WIRELESS EHR MARKET: EMR ADOPTION FOR U.S. BY STAGES, (%) FIGURE 12 WIRELESS HER MARKET: EMR ADOPTION FOR SELECT EUROPE, MIDDLE EAST AND ASIAN COUNTRIES, 2011 KEY HOSPITALS BY GEOGRAPHY 43 TABLE 6 WIRELESS HER MARKET: LIST OF STAGE 7 HOSPITALS FOR U.S., EUROPE AND ASIA, 2013 KEY PRODUCT TYPES 46 FIGURE 13 WIRELESS EHR MARKET: MODE OF CONNECTIVITY BETWEEN MEDICAL DEVICES AND EHR (U.S.), 2010 (%) CLINICAL TRIALS, INVESTMENT SCENARIO AND STRATEGIC ISSUES 47 MC10 47 ST. JUDE MEDICAL 47 BIOSENSICS 47 KORONIS BIOMEDICAL TECHNOLOGIES 47 CARDIOMEMS INC. 47 GREAT LAKES NEUROTECHNOLOGIES 48 SOTERA WIRELESS 48 HEALTHSENSE INC. 48 INTELESENS LTD CHAPTER 4 MARKET TRENDS 50 MARKET DRIVERS 50 GOVERNMENT LEGISLATON AND INCENTIVES DRIVING EHR ADOPTION WORLDWIDE U.S. 50 Medicare EHR Incentive Payments: Physicians 50 Medicare EHR Incentive Payments: Hospitals 50 Medicaid EHR Incentive Payments: Physicians 50 Medicaid EHR Incentive Payments: Hospitals 51 U.K. 51 Australia 51 CHRONIC DISEASE MANAGEMENT 52 FIGURE 14 WIRELESS EHR MARKET: ECONOMIC BURDEN OF NONCOMMUNICABLE DISEASES, (%) RISING HEALTHCARE COSTS 53 FIGURE 15 WIRELESS EHR MARKET: PROJECTED PERCENTAGE INCREASE IN PUBLIC HEALTH SPENDING, (%) IMPROVED QUALITY OF CARE 54 ACCURATE DATA DEVICE CAPTURE 55 MARKET RESTRAINTS 55 PATIENT PRIVACY ISSUES 55 TABLE 7 WIRELESS EHR MARKET: PHYSICIANS CONCERN OVER EMR POSING AS RISK TO PATIENT PRIVACY, 2012 SHORTAGE OF CLINICAL IT SPECIALISTS 56 TABLE 8 WIRELESS EHR MARKET: PROJECTED CLINICAL IT STAFF SHORTAGE BY COUNTRY LACK OF INTEROPERABILITY

5 FIGURE 16 WIRELESS EHR MARKET: POTENTIAL COST SAVINGS FROM EHR-BASED DEVICE MONITORING, 2013 (%) LACK OF ADEQUATE FINANCING 58 CHALLENGES 59 DEVELOPMENT OF ARCHITECTURE AND STANDARDS 59 HIGH CAPITAL INVESTMENTS 59 KEY CONCLUSIONS CHAPTER 5 WIRELESS EHR MARKET BY DEVICES 63 TABLE 9 GLOBAL MOBILE WIRELESS EHR MARKET BY DEVICES, THROUGH 2018 ($ BLOOD GLUCOSE METERS 63 TABLE 10 GLOBAL WIRELESS EHR-BASED BLOOD GLUCOSE MONITORS MARKET BY REGION, BP MONITORS 66 TABLE 11 GLOBAL WIRELESS EHR-BASED BLOOD PRESSURE MONITORS MARKET BY REGION, PULSE OXIMETERS 67 TABLE 12 GLOBAL WIRELESS EHR-BASED PULSE OXIMETERS MARKET BY REGION, CAPNOGRAPHY 68 TABLE 13 GLOBAL WIRELESS EHR-BASED CAPNOGRAPHY MARKET BY REGION, NEUROLOGICAL MONITORING 69 TABLE 14 GLOBAL WIRELESS EHR-BASED NEUROLOGICAL MONITORS MARKET BY REGION, STRESS MONITORING 71 TABLE 15 GLOBAL WIRELESS EHR-BASED STRESS MONITORS MARKET BY REGION, SEROTONIN BIOSENSORS 72 TABLE 16 GLOBAL WIRELESS EHR-BASED SEROTONIN BIOSENSORS MARKET BY REGION, HOLTER MONITOR 73 TABLE 17 GLOBAL WIRELESS EHR-BASED HOLTER MONITORS MARKET BY REGION, APNEA AND SLEEP MONITOR 74 TABLE 18 GLOBAL WIRELESS EHR-BASED APNEA AND SLEEP MONITORS MARKET BY REGION, MULTIPARAMETER PATIENT MONITORS 75 TABLE 19 GLOBAL WIRELESS EHR-BASED MULTIPARAMETER MONITORING MARKET BY REGION, PEDIATRIC GROWTH TRACKERS 76 TABLE 20 GLOBAL WIRELESS EHR-BASED PEDIATRIC GROWTH TRACKERS MARKET BY REGION, COAGULATION MONITORS 77 TABLE 21 GLOBAL WIRELESS EHR-BASED COAGULATION MONITORS MARKET BY REGION, PEAK FLOW METER 78 TABLE 22 GLOBAL WIRELESS EHR-BASED PEAK FLOW METERS MARKET BY REGION,

6 THERMOMETERS 79 TABLE 23 GLOBAL WIRELESS EHR-BASED THERMOMETERS MARKET BY REGION, SMART INFUSION PUMPS 80 TABLE 24 GLOBAL WIRELESS EHR-BASED SMART INFUSION PUMPS MARKET BY REGION, CHAPTER 6 WIRELESS EHR SOFTWARE MARKET 82 TABLE 25 GLOBAL WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ E-PRESCRIBING 82 TABLE 26 WIRELESS EHR MARKET: ADOPTION RATE OF E-PRESCRIBING THROUGH AN EHR IN THE U.S., 2008 AND 2012 (%) TABLE 27 GLOBAL WIRELESS EHR-BASED E-PRESCRIPTION SOFTWARE MARKET BY REGION, BILLING AUTOMATION 84 FIGURE 17 WIRELESS EHR MARKET: CODING SYSTEM PRACTICE FOLLOWED BY U.S. PHYSICIANS, 2012 (%) TABLE 28 GLOBAL WIRELESS EHR-BASED BILLING AUTOMATION SOFTWARE MARKET BY REGION, DECISION SUPPORT TOOLS 86 TABLE 29 GLOBAL WIRELESS EHR-BASED DECISION SUPPORT SOFTWARE MARKET BY REGION, DOCUMENT AND IMAGE MANAGEMENT SYSTEM (RIS/PACS) 87 TABLE 30 GLOBAL WIRELESS EHR-BASED DOCUMENT AND IMAGE MANAGEMENT SYSTEM SOFTWARE MARKET BY REGION, ADMINISTRATION (CLOUD PLATFORM) 87 TABLE 31 GLOBAL WIRELESS EHR-BASED ADMINISTRATION (CLOUD PLATFORM) SOFTWARE MARKET BY REGION, ELECTRONIC HEALTH RECORDS (COMPUTERIZED) 88 TABLE 32 GLOBAL WIRELESS EHR-BASED COMPUTERIZED HEALTH RECORDS SOFTWARE MARKET BY REGION, CHAPTER 7 WIRELESS EHR BY MOBILE TECHNOLOGIES 91 TABLE 33 GLOBAL ADOPTION LEVELS OF HEALTH-BASED TECHNOLOGIES, THROUGH 2018 (%) 3G/COMMERCIAL CELLULAR 91 WIRELESS LANS 92 TABLE 34 WIRELESS EHR MARKET: OVERVIEW OF POPULAR IEEE STANDARDS 93 SENSORS 93 BLUETOOTH 94 RADIO FREQUENCY IDENTIFICATION (RFID) 95 SATELLITES 95 ZIGBEE 96 WIMAX 96 FACILITATING DEVICES: SMARTPHONES AND TABLETS 96 FIGURE 18 WIRELESS EHR MARKET: STRATEGY ON MOBILE TECHNOLOGY POLICY IN U.S. HEALTHCARE SETTINGS, 2012 (%) FIGURE 19 WIRELESS EHR MARKET: COMMON TECHNOLOGIES PROVIDED BY ORGANIZATIONS TO THEIR CLINICIANS, 2012 (%)

7 CHAPTER 8 WIRELESS EHR MARKET BY APPLICATIONS 100 TABLE 35 GLOBAL WIRELESS EHR MARKET BY APPLICATIONS, THROUGH 2018 ($ NURSING 100 TABLE 36 GLOBAL WIRELESS EHR MARKET APPLICATION IN NURSING BY REGION, ADMINISTRATION 101 TABLE 37 GLOBAL WIRELESS EHR MARKET APPLICATION IN ADMINISTRATION BY REGION, LAB 103 TABLE 38 GLOBAL WIRELESS EHR MARKET APPLICATION IN LABORATORIES BY GEOGRAPHY, RADIOLOGY 103 TABLE 39 GLOBAL WIRELESS EHR MARKET APPLICATION IN RADIOLOGY BY REGION, PHARMACY 104 TABLE 40 GLOBAL WIRELESS EHR MARKET APPLICATION IN PHARMACY BY REGION, CLINICIANS 105 TABLE 41 GLOBAL WIRELESS EHR MARKET APPLICATIONS IN CLINICS BY REGION, FIGURE 20 WIRELESS EHR MARKET: PERCENTAGE OF U.S. PHYSICIANS WHOSE EHRS PROVIDED SELECTED BENEFITS, CHAPTER 9 WIRELESS EHR MARKET BY END USERS 109 TABLE 42 GLOBAL WIRELESS EHR MARKET BY END USERS, THROUGH 2018 ($ PHYSICIAN OFFICES 109 FIGURE 21 EHR ADOPTION RATES FOR PRIMARY CARE PHYSICIANS BY COUNTRY, 2009 AND 2012 (%) FIGURE 22 EHRS WITH MULTIFUNCTIONAL CAPABILITIES ADOPTION RATES FOR PRIMARY CARE PHYSICIANS BY COUNTRY, 2012 (%) TABLE 43 GLOBAL WIRELESS EHR MARKET-PHYSICIANS OFFICES AND CLINICS BY REGION, LONG-TERM CARE FACILITIES 112 U.S. 112 TABLE 44 WIRELESS EHR MARKET: EHR ADOPTION IN LONG-TERM CARE SETTINGS (%) EUROPE 113 FIGURE 23 WIRELESS EHR MARKET: PUBLIC AND PRIVATE EXPENDITURES ON LONG-TERM CARE, 2008 (%) TABLE 45 GLOBAL WIRELESS EHR MARKET-LONG-TERM CARE FACILITIES BY REGION, HOSPITALS 114 U.S. 114 FIGURE 24 WIRELESS EHR MARKET: NON-FEDERAL ACUTE CARE HOSPITAL ADOPTION OF BASIC EHR SYSTEMS, TABLE 46 WIRELESS EHR MARKET: NON-FEDERAL ACUTE CARE HOSPITAL ADOPTION OF BASIC EHR SYSTEMS BY STATE, 2012 (%) EUROPE

8 FIGURE 25 WIRELESS EHR MARKET: EHR COVERAGE FOR HOSPITALS, (%) TABLE 47 GLOBAL WIRELESS EHR MARKET-HOSPITALS BY REGION, THROUGH 2018 ($ TABLE 48 GLOBAL WIRELESS EHR MARKET-HOSPITALS BY BED COUNT, THROUGH 2018 ($ CHAPTER 10 WIRELESS EHR BY SPECIALTY 120 TABLE 49 GLOBAL WIRELESS EHR MARKET BY SPECIALTY SEGMENTS, THROUGH 2018 ($ FIGURE 26 HEALTH RECORD STORAGE METHOD BY SPECIALTY (U.S.), 2010 (%) 120 CARDIOVASCULAR 121 FIGURE 27 WIRELESS EHR MARKET: PREVALENCE OF HEART DISEASE (U.S.), 2012 (MILLION AMERICANS) TABLE 50 GLOBAL WIRELESS REGION, 122 OBSTETRICS AND GYNECOLOGY 122 FIGURE 28 WIRELESS EHR MARKET: MATERNAL MORTALITY RATIOS, TABLE 51 GLOBAL WIRELESS EHR MARKET IN OBSTETRICS AND GYNECOLOGY BY REGION, ONCOLOGY 124 FIGURE 29 WIRELESS EHR MARKET: PREVALENCE AND INCIDENCE OF CANCER BY TYPE (WORLD), 2008 (MILLION PEOPLE) FIGURE 30 WIRELESS EHR MARKET: INCIDENCE OF CANCER BY REGION, 2008 (MILLION PEOPLE) TABLE 52 GLOBAL WIRELESS EHR MARKET IN ONCOLOGY BY REGION, THROUGH 2018 ($ UROLOGY 126 TABLE 53 GLOBAL WIRELESS EHR MARKET IN UROLOGY BY REGION, THROUGH 2018 ($ ORTHOPEDICS 127 FIGURE 31 WIRELESS EHR MARKET: HIP REPLACEMENT SURGERIES BY COUNTRY, 2009 (SURGERIES PER 100,000 POPULATION) FIGURE 32 WIRELESS EHR MARKET: KNEE REPLACEMENT SURGERIES BY COUNTRY, 2009 (SURGERIES PER 100,000 POPULATION) TABLE 54 GLOBAL WIRELESS EHR MARKET IN ORTHOPEDICS BY REGION, OPHTHALMOLOGY 130 TABLE 55 GLOBAL WIRELESS EHR MARKET IN OPHTHALMOLOGY BY REGION, PSYCHIATRY 131 TABLE 56 GLOBAL WIRELESS EHR MARKET IN PSYCHIATRY BY REGION, THROUGH 2018 ($ NEUROLOGY 132 TABLE 57 GLOBAL WIRELESS EHR MARKET IN NEUROLOGY BY REGION, THROUGH 2018 ($ PEDIATRICS 132 TABLE 58 GLOBAL WIRELESS EHR MARKET IN PEDIATRICS BY REGION, THROUGH 2018 ($ CHAPTER 11 COMPETITIVE LANDSCAPE 135 FIGURE 33 WIRELESS EHR MARKET: COMPANY STRATEGIES, (%) 135

9 TABLE 59 WIRELESS EHR MARKET: COMPANY STRATEGIES, PRODUCT LAUNCHES: TOP STRATEGY 136 FIGURE 34 WIRELESS EHR MARKET: LEADING COMPANIES FOR PRODUCT-RELATED STRATEGIES, (%) BUSINESS COMBINATIONS BEING ADAPTED TO HELP COMPANIES STAY AHEAD OF THE CURVE FIGURE 35 WIRELESS EHR MARKET: LEADING COMPANIES FOR M &A STRATEGIES, (%) CHAPTER 12 REGIONAL ANALYSIS 140 TABLE 60 GLOBAL WIRELESS EHR DEVICES MARKET BY REGION, THROUGH 2018 ($ TABLE 61 GLOBAL WIRELESS EHR SOFTWARE MARKET BY REGION, THROUGH 2018 ($ UNITED STATES 141 TABLE 62 U.S. WIRELESS EHR MARKET BY DEVICE, 141 TABLE 63 U.S. WIRELESS EHR SOFTWARE MARKET, 142 EUROPE 142 TABLE 64 EUROPEAN WIRELESS EHR MARKET BY DEVICE, THROUGH 2018 ($ TABLE 65 EUROPEAN WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ ASIA-PACIFIC 143 TABLE 66 ASIA-PACIFIC WIRELESS EHR MARKET BY DEVICE, THROUGH 2018 ($ TABLE 67 ASIA-PACIFIC WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ ROW 145 TABLE 68 ROW WIRELESS EHR MARKET BY DEVICE, 146 TABLE 69 ROW PACIFIC WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ CHAPTER 13 PATENT ANALYSIS 149 PATENT ANALYSIS BY REGION 149 FIGURE 36 PERCENTAGE OF PATENTS REGISTERED/APPROVED IN THE U.S. AND EUROPE, 2007 TO 2013 (%) THE U.S. PATENT ANALYSIS BY MARKET SEGMENT 150 FIGURE 37 U.S. PATENT ANALYSIS BY MARKET SEGMENTS, 2007 TO 2013 (%) 150 EUROPEAN PATENT ANALYSIS BY MARKET SEGMENT 150 FIGURE 38 EUROPEAN PATENT ANALYSIS BY MARKET SEGMENT, (%) 150 PATENT ANALYSIS BY MARKET PARTICIPANTS 151 FIGURE 39 U.S. PATENT ANALYSIS BY MARKET PARTICIPANTS, 2007 TO 2013 (%) CHAPTER 14 COMPANY PROFILES 154 ABBOTT LABORATORIES 154 TABLE 70 ABBOTT LABORATORIES PRODUCT PORTFOLIO 154 TABLE 71 ABBOTT LABORATORIES-RECENT DEVELOPMENTS, ALLSCRIPTS HEALTHCARE SOLUTIONS INC. 155 TABLE 72 ALLSCRIPTS HEALTHCARE SOLUTIONS INC. PRODUCT PORTFOLIO 155

10 TABLE 73 ALLSCRIPTS HEALTHCARE SOLUTIONS INC-RECENT DEVELOPMENTS, AMD GLOBAL TELEMEDICINE INC. (AMD) 157 TABLE 74 AMD GLOBAL TELEMEDICINE INC-PRODUCT PORTFOLIO 157 TABLE 75 AMD TELEMEDICINE-RECENT DEVELOPMENTS, AMERICAN TELECARE INC. (ATI) 158 TABLE 76 AMERICAN TELECARE INC. PRODUCT PORTFOLIO 158 TABLE 77 AMERICAN TELECARE-RECENT DEVELOPMENTS, CAPSULE TECHNOLOGIES 159 TABLE 78 CAPSULE TECHNOLOGIES-PRODUCT PORTFOLIO 160 TABLE 79 CAPSULE TECHNOLOGIES-RECENT DEVELOPMENTS, CARDIOCOM 161 TABLE 80 CARDIOCOM-PRODUCT PORTFOLIO 161 TABLE 81 CARDIOCOM-RECENT DEVELOPMENTS, CAREMATIX 162 TABLE 82 CAREMATIX-PRODUCT PORTFOLIO 162 TABLE 83 CAREMATIX-RECENT DEVELOPMENTS, CERNER CORPORATION 163 TABLE 84 CERNER CORPORATION-PRODUCT PORTFOLIO 164 TABLE 85 CERNER-RECENT DEVELOPMENTS, CYBERNET MEDICAL 166 TABLE 86 CYBERNET MEDICAL-PRODUCT PORTFOLIO 166 TABLE 87 CYBERNET MEDICAL CORPORATION-RECENT DEVELOPMENTS 167 DRAGER MEDICAL 167 TABLE 88 DRAGER-RECENT DEVELOPMENTS (2012) 167 EPIC 168 TABLE 89 EPIC-PRODUCT PORTFOLIO 168 TABLE 90 EPIC-RECENT DEVELOPMENTS (2013) 169 FITBITINC 169 TABLE 91 FITBIT-PRODUCT PORTFOLIO 169 TABLE 92 FITBIT-RECENT DEVELOPMENTS, GE HEALTHCARE 170 TABLE 93 GE HEALTHCARE-PRODUCT PORTFOLIO 170 TABLE 94 GE HEALTHCARE RECENT DEVELOPMENTS, GLOBALMEDIA GROUP 173 TABLE 95 GLOBALMEDIA GROUP-PRODUCT PORTFOLIO 174 TABLE 96 GLOBALMEDIA GROUP-RECENT DEVELOPMENTS, HONEYWELL INTERNATIONAL INC 174 TABLE 97 HONEYWELL INTERNATIONAL INC-PRODUCT PORTFOLIO 175 TABLE 98 HONEYWELL INTERNATIONAL INC-RECENT DEVELOPMENTS, IBM 175 TABLE 99 IBM-PRODUCT PORTFOLIO 176 INTEL 176 TABLE 100 INTEL-PRODUCT PORTFOLIO 176 TABLE 101 INTEL-RECENT DEVELOPMENTS, INTOUCH HEALTH 177 TABLE 102 INTOUCH HEALTH-PRODUCT PORTFOLIO 177 TABLE 103 INTOUCH HEALTH-RECENT DEVELOPMENTS,

11 ISIRONA 178 TABLE 104 ISIRONA-PRODUCT PORTFOLIO 178 TABLE 105 ISIRONA-RECENT DEVELOPMENTS, JOHNSON & JOHNSON INC 179 TABLE 106 JOHNSON & JOHNSON INC-PRODUCT PORTFOLIO 179 TABLE 107 JOHNSON & JOHNSON INC-RECENT DEVELOPMENTS, LIFEWATCH TECHNOLOGIES 180 TABLE 108 LIFEWATCH TECHNOLOGIES-PRODUCT PORTFOLIO 180 TABLE 109 LIFEWATCHTECHNOLOGIES-RECENT DEVELOPMENT, MEDAPPS 181 TABLE 110 MEDAPPS-PRODUCT PORTFOLIO 182 TABLE 111 MEDAPPS-RECENT DEVELOPMENTS, MEDTRONIC 183 TABLE 112 MEDTRONIC-PRODUCT PORTFOLIO 183 TABLE 113 MEDTRONIC-RECENT DEVELOPMENTS, ORACLE 184 TABLE 114 ORACLE-PRODUCT PORTFOLIO 185 TABLE 115 ORACLE-RECENT DEVELOPMENTS, PHILIPS MEDICAL SYSTEMS 186 TABLE 116 PHILIPS-PRODUCT PORTFOLIO 187 TABLE 117 PHILIPS-RECENT DEVELOPMENTS, QUALCOMM 192 TABLE 118 QUALCOMM-PRODUCT PORTFOLIO 193 TABLE 119 QUALCOMM-RECENT DEVELOPMENTS, ROCHE DIAGNOSTICS LIMITED 193 TABLE 120 ROCHE DIAGNOSTICS LIMITED-PRODUCT PORTFOLIO 194 TABLE 121 ROCHE DIAGNOSTICS LIMITED-RECENT DEVELOPMENTS, ST. JUDE MEDICAL 195 TABLE 122 ST. JUDE MEDICAL-PRODUCT PORTFOLIO 195 TABLE 123 ST. JUDE MEDICAL-PRODUCT PORTFOLIO, SCHILLER AG 196 TABLE 124 SCHILLER AG-PRODUCT PORTFOLIO 197 TABLE 125 SCHILLER AG-RECENT DEVELOPMENTS, SECOND OPINION TELEMEDICINE SOLUTIONS INC. 198 TABLE 126 SECOND OPINION TELEMEDICINE SOLUTIONS INC.-PRODUCT PORTFOLIO SIEMENS HEALTHCARE 199 TABLE 127 SIEMENS HEALTHCARE-PRODUCT PORTFOLIO 200 TABLE 128 SIEMENS HEALTHCARE-RECENT DEVELOPMENTS, WELCH ALLYN 203 TABLE 129 WELCH ALLYN-PRODUCT PORTFOLIO 203 TABLE 130 WELCH ALLYN-RECENT DEVELOPMENTS, CHAPTER 15 APPENDIX 206 LIST OF PATENTS-U.S. 206 TABLE 131 LIST OF PATENTS-U.S. 206 LIST OF PATENTS-EUROPE 209 TABLE 132 LIST OF PATENTS-EUROPE 209

12 PUBLISHED STANDARDS, ISO TC TABLE 133 PUBLISHED STANDARDS, ISO TC PUBLISHED STANDARDS, CEN/TC TABLE 134 PUBLISHED STANDARDS, CEN/TC

13 LIST OF TABLES TABLE HEADING SUMMARY TABLE GLOBAL WIRELESS EHR MARKET, 6 TABLE 1 WIRELESS EHR MARKET: TOP FIVE DEALS IN DIGITAL HEALTH INVESTMENT, U.S., 2012 ($ TABLE 2 WIRELESS EHR MARKET: CONTEXTUAL BUILDING BLOCKS OF EHRCOM 32 TABLE 3 WIRELESS EHR MARKET: IHE USE CASES TO PROFILES, TABLE 4 WIRELESS EHR MARKET: SUMMARY OF MEANINGFUL USE CRITERIA 38 TABLE 5 WIRELESS EHR MARKET: EUROPE AND U.S. EMR ADOPTION MODELS, TABLE 6 WIRELESS HER MARKET: LIST OF STAGE 7 HOSPITALS FOR U.S., EUROPE AND ASIA, 2013 TABLE 7 WIRELESS EHR MARKET: PHYSICIANS CONCERN OVER EMR POSING AS RISK TO PATIENT PRIVACY, 2012 TABLE 8 WIRELESS EHR MARKET: PROJECTED CLINICAL IT STAFF SHORTAGE BY COUNTRY TABLE 9 GLOBAL MOBILE WIRELESS EHR MARKET BY DEVICES, THROUGH 2018 ($ TABLE 10 GLOBAL WIRELESS EHR-BASED BLOOD GLUCOSE MONITORS MARKET BY REGION, TABLE 11 GLOBAL WIRELESS EHR-BASED BLOOD PRESSURE MONITORS MARKET BY REGION, TABLE 12 GLOBAL WIRELESS EHR-BASED PULSE OXIMETERS MARKET BY REGION, TABLE 13 GLOBAL WIRELESS EHR-BASED CAPNOGRAPHY MARKET BY REGION, TABLE 14 GLOBAL WIRELESS EHR-BASED NEUROLOGICAL MONITORS MARKET BY REGION, TABLE 15 GLOBAL WIRELESS EHR-BASED STRESS MONITORS MARKET BY REGION, TABLE 16 GLOBAL WIRELESS EHR-BASED SEROTONIN BIOSENSORS MARKET BY REGION, TABLE 17 GLOBAL WIRELESS EHR-BASED HOLTER MONITORS MARKET BY REGION, TABLE 18 GLOBAL WIRELESS EHR-BASED APNEA AND SLEEP MONITORS MARKET BY REGION, TABLE 19 GLOBAL WIRELESS EHR-BASED MULTIPARAMETER MONITORING MARKET BY REGION, TABLE 20 GLOBAL WIRELESS EHR-BASED PEDIATRIC GROWTH TRACKERS MARKET BY REGION, TABLE 21 GLOBAL WIRELESS EHR-BASED COAGULATION MONITORS MARKET BY REGION, TABLE 22 GLOBAL WIRELESS EHR-BASED PEAK FLOW METERS MARKET BY REGION, TABLE 23 GLOBAL WIRELESS EHR-BASED THERMOMETERS MARKET BY REGION, TABLE 24 GLOBAL WIRELESS EHR-BASED SMART INFUSION PUMPS MARKET BY REGION, TABLE 25 GLOBAL WIRELESS EHR SOFTWARE MARKET, 82 TABLE 26 WIRELESS EHR MARKET: ADOPTION RATE OF E-PRESCRIBING THROUGH AN EHR IN THE U.S., 2008 AND 2012 (%) TABLE 27 GLOBAL WIRELESS EHR-BASED E-PRESCRIPTION SOFTWARE MARKET BY REGION,

14 TABLE HEADING TABLE 28 GLOBAL WIRELESS EHR-BASED BILLING AUTOMATION SOFTWARE MARKET BY REGION, TABLE 29 GLOBAL WIRELESS EHR-BASED DECISION SUPPORT SOFTWARE MARKET BY REGION, TABLE 30 GLOBAL WIRELESS EHR-BASED DOCUMENT AND IMAGE MANAGEMENT SYSTEM SOFTWARE MARKET BY REGION, TABLE 31 GLOBAL WIRELESS EHR-BASED ADMINISTRATION (CLOUD PLATFORM) SOFTWARE MARKET BY REGION, TABLE 32 GLOBAL WIRELESS EHR-BASED COMPUTERIZED HEALTH RECORDS SOFTWARE MARKET BY REGION, TABLE 33 GLOBAL ADOPTION LEVELS OF HEALTH-BASED TECHNOLOGIES, THROUGH 2018 (%) TABLE 34 WIRELESS EHR MARKET: OVERVIEW OF POPULAR IEEE STANDARDS 93 TABLE 35 GLOBAL WIRELESS EHR MARKET BY APPLICATIONS, THROUGH 2018 ($ TABLE 36 GLOBAL WIRELESS EHR MARKET APPLICATION IN NURSING BY REGION, TABLE 37 GLOBAL WIRELESS EHR MARKET APPLICATION IN ADMINISTRATION BY REGION, TABLE 38 GLOBAL WIRELESS EHR MARKET APPLICATION IN LABORATORIES BY GEOGRAPHY, TABLE 39 GLOBAL WIRELESS EHR MARKET APPLICATION IN RADIOLOGY BY REGION, TABLE 40 GLOBAL WIRELESS EHR MARKET APPLICATION IN PHARMACY BY REGION, TABLE 41 GLOBAL WIRELESS EHR MARKET APPLICATIONS IN CLINICS BY REGION, TABLE 42 GLOBAL WIRELESS EHR MARKET BY END USERS, THROUGH 2018 ($ TABLE 43 GLOBAL WIRELESS EHR MARKET-PHYSICIANS OFFICES AND CLINICS BY REGION, TABLE 44 WIRELESS EHR MARKET: EHR ADOPTION IN LONG-TERM CARE SETTINGS (%) TABLE 45 GLOBAL WIRELESS EHR MARKET-LONG-TERM CARE FACILITIES BY REGION, TABLE 46 WIRELESS EHR MARKET: NON-FEDERAL ACUTE CARE HOSPITAL ADOPTION OF BASIC EHR SYSTEMS BY STATE, 2012 (%) TABLE 47 GLOBAL WIRELESS EHR MARKET-HOSPITALS BY REGION, THROUGH 2018 ($ TABLE 48 GLOBAL WIRELESS EHR MARKET-HOSPITALS BY BED COUNT, THROUGH 2018 ($ TABLE 49 GLOBAL WIRELESS EHR MARKET BY SPECIALTY SEGMENTS, THROUGH 2018 ($ TABLE 50 GLOBAL WIRELESS REGION, 122 TABLE 51 GLOBAL WIRELESS EHR MARKET IN OBSTETRICS AND GYNECOLOGY BY REGION, TABLE 52 GLOBAL WIRELESS EHR MARKET IN ONCOLOGY BY REGION, THROUGH 2018 ($ TABLE 53 GLOBAL WIRELESS EHR MARKET IN UROLOGY BY REGION, THROUGH 2018 ($ TABLE 54 GLOBAL WIRELESS EHR MARKET IN ORTHOPEDICS BY REGION, THROUGH 2018 ($

15 TABLE HEADING TABLE 55 GLOBAL WIRELESS EHR MARKET IN OPHTHALMOLOGY BY REGION, TABLE 56 GLOBAL WIRELESS EHR MARKET IN PSYCHIATRY BY REGION, THROUGH 2018 ($ TABLE 57 GLOBAL WIRELESS EHR MARKET IN NEUROLOGY BY REGION, THROUGH 2018 ($ TABLE 58 GLOBAL WIRELESS EHR MARKET IN PEDIATRICS BY REGION, THROUGH 2018 ($ TABLE 59 WIRELESS EHR MARKET: COMPANY STRATEGIES, TABLE 60 GLOBAL WIRELESS EHR DEVICES MARKET BY REGION, THROUGH 2018 ($ TABLE 61 GLOBAL WIRELESS EHR SOFTWARE MARKET BY REGION, THROUGH 2018 ($ TABLE 62 U.S. WIRELESS EHR MARKET BY DEVICE, 141 TABLE 63 U.S. WIRELESS EHR SOFTWARE MARKET, 142 TABLE 64 EUROPEAN WIRELESS EHR MARKET BY DEVICE, THROUGH 2018 ($ TABLE 65 EUROPEAN WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ TABLE 66 ASIA-PACIFIC WIRELESS EHR MARKET BY DEVICE, THROUGH 2018 ($ TABLE 67 ASIA-PACIFIC WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ TABLE 68 ROW WIRELESS EHR MARKET BY DEVICE, 146 TABLE 69 ROW PACIFIC WIRELESS EHR SOFTWARE MARKET, THROUGH 2018 ($ TABLE 70 ABBOTT LABORATORIES PRODUCT PORTFOLIO 154 TABLE 71 ABBOTT LABORATORIES-RECENT DEVELOPMENTS, TABLE 72 ALLSCRIPTS HEALTHCARE SOLUTIONS INC. PRODUCT PORTFOLIO 155 TABLE 73 ALLSCRIPTS HEALTHCARE SOLUTIONS INC-RECENT DEVELOPMENTS, TABLE 74 AMD GLOBAL TELEMEDICINE INC-PRODUCT PORTFOLIO 157 TABLE 75 AMD TELEMEDICINE-RECENT DEVELOPMENTS, TABLE 76 AMERICAN TELECARE INC. PRODUCT PORTFOLIO 158 TABLE 77 AMERICAN TELECARE-RECENT DEVELOPMENTS, TABLE 78 CAPSULE TECHNOLOGIES-PRODUCT PORTFOLIO 160 TABLE 79 CAPSULE TECHNOLOGIES-RECENT DEVELOPMENTS, TABLE 80 CARDIOCOM-PRODUCT PORTFOLIO 161 TABLE 81 CARDIOCOM-RECENT DEVELOPMENTS, TABLE 82 CAREMATIX-PRODUCT PORTFOLIO 162 TABLE 83 CAREMATIX-RECENT DEVELOPMENTS, TABLE 84 CERNER CORPORATION-PRODUCT PORTFOLIO 164 TABLE 85 CERNER-RECENT DEVELOPMENTS, TABLE 86 CYBERNET MEDICAL-PRODUCT PORTFOLIO 166 TABLE 87 CYBERNET MEDICAL CORPORATION-RECENT DEVELOPMENTS 167 TABLE 88 DRAGER-RECENT DEVELOPMENTS (2012) 167 TABLE 89 EPIC-PRODUCT PORTFOLIO 168 TABLE 90 EPIC-RECENT DEVELOPMENTS (2013) 169 TABLE 91 FITBIT-PRODUCT PORTFOLIO 169 TABLE 92 FITBIT-RECENT DEVELOPMENTS,

16 TABLE HEADING TABLE 93 GE HEALTHCARE-PRODUCT PORTFOLIO 170 TABLE 94 GE HEALTHCARE RECENT DEVELOPMENTS, TABLE 95 GLOBALMEDIA GROUP-PRODUCT PORTFOLIO 174 TABLE 96 GLOBALMEDIA GROUP-RECENT DEVELOPMENTS, TABLE 97 HONEYWELL INTERNATIONAL INC-PRODUCT PORTFOLIO 175 TABLE 98 HONEYWELL INTERNATIONAL INC-RECENT DEVELOPMENTS, TABLE 99 IBM-PRODUCT PORTFOLIO 176 TABLE 100 INTEL-PRODUCT PORTFOLIO 176 TABLE 101 INTEL-RECENT DEVELOPMENTS, TABLE 102 INTOUCH HEALTH-PRODUCT PORTFOLIO 177 TABLE 103 INTOUCH HEALTH-RECENT DEVELOPMENTS, TABLE 104 ISIRONA-PRODUCT PORTFOLIO 178 TABLE 105 ISIRONA-RECENT DEVELOPMENTS, TABLE 106 JOHNSON & JOHNSON INC-PRODUCT PORTFOLIO 179 TABLE 107 JOHNSON & JOHNSON INC-RECENT DEVELOPMENTS, TABLE 108 LIFEWATCH TECHNOLOGIES-PRODUCT PORTFOLIO 180 TABLE 109 LIFEWATCHTECHNOLOGIES-RECENT DEVELOPMENT, TABLE 110 MEDAPPS-PRODUCT PORTFOLIO 182 TABLE 111 MEDAPPS-RECENT DEVELOPMENTS, TABLE 112 MEDTRONIC-PRODUCT PORTFOLIO 183 TABLE 113 MEDTRONIC-RECENT DEVELOPMENTS, TABLE 114 ORACLE-PRODUCT PORTFOLIO 185 TABLE 115 ORACLE-RECENT DEVELOPMENTS, TABLE 116 PHILIPS-PRODUCT PORTFOLIO 187 TABLE 117 PHILIPS-RECENT DEVELOPMENTS, TABLE 118 QUALCOMM-PRODUCT PORTFOLIO 193 TABLE 119 QUALCOMM-RECENT DEVELOPMENTS, TABLE 120 ROCHE DIAGNOSTICS LIMITED-PRODUCT PORTFOLIO 194 TABLE 121 ROCHE DIAGNOSTICS LIMITED-RECENT DEVELOPMENTS, TABLE 122 ST. JUDE MEDICAL-PRODUCT PORTFOLIO 195 TABLE 123 ST. JUDE MEDICAL-PRODUCT PORTFOLIO, TABLE 124 SCHILLER AG-PRODUCT PORTFOLIO 197 TABLE 125 SCHILLER AG-RECENT DEVELOPMENTS, TABLE 126 SECOND OPINION TELEMEDICINE SOLUTIONS INC.-PRODUCT PORTFOLIO 198 TABLE 127 SIEMENS HEALTHCARE-PRODUCT PORTFOLIO 200 TABLE 128 SIEMENS HEALTHCARE-RECENT DEVELOPMENTS, TABLE 129 WELCH ALLYN-PRODUCT PORTFOLIO 203 TABLE 130 WELCH ALLYN-RECENT DEVELOPMENTS, TABLE 131 LIST OF PATENTS-U.S. 206 TABLE 132 LIST OF PATENTS-EUROPE 209 TABLE 133 PUBLISHED STANDARDS, ISO TC TABLE 134 PUBLISHED STANDARDS, CEN/TC

17 LIST OF FIGURES FIGURE TITLE SUMMARY FIGURE GLOBAL WIRELESS EHR MARKET, 6 FIGURE 1 WIRELESS EHR MARKET: POPULATION AGE 65+ (WORLD), 2011 (%) 9 FIGURE 2 WIRELESS EHR MARKET: PRODUCT DEFINITION, FIGURE 3 WIRELESS EHR MARKET: U.S. VENTURE CAPITAL INVESTMENTS IN DIGITAL HEALTH, (%) FIGURE 4 WIRELESS EHR MARKET: NUMBER OF DEALS BY DIGITAL HEALTH INVESTORS, 2012 (%) FIGURE 5 WIRELESS EHR MARKET: NUMBER OF DEALS BY SERIES OF FINANCING, 2012 (%) FIGURE 6 WIRELESS EHR MARKET: COMMON USES OF APPS BY CLINICIANS, 2012 (%) 16 FIGURE 7 WIRELESS EHR MARKET: SDO HARMONIZATION STRUCTURE, FIGURE 8 WIRELESS EHR MARKET: ISO TC 215 SUBCOMMITTEE/ WORKING GROUPS, 2012 FIGURE 9 WIRELESS EHR MARKET: CONTINUA INTERFACES AND STANDARDS, FIGURE 10 WIRELESS EHR MARKET: EMR ADOPTION BY REGION/COUNTRY, Q FIGURE 11 WIRELESS EHR MARKET: EMR ADOPTION FOR U.S. BY STAGES, (%) FIGURE 12 WIRELESS HER MARKET: EMR ADOPTION FOR SELECT EUROPE, MIDDLE EAST AND ASIAN COUNTRIES, 2011 FIGURE 13 WIRELESS EHR MARKET: MODE OF CONNECTIVITY BETWEEN MEDICAL DEVICES AND EHR (U.S.), 2010 (%) FIGURE 14 WIRELESS EHR MARKET: ECONOMIC BURDEN OF NONCOMMUNICABLE DISEASES, (%) FIGURE 15 WIRELESS EHR MARKET: PROJECTED PERCENTAGE INCREASE IN PUBLIC HEALTH SPENDING, (%) FIGURE 16 WIRELESS EHR MARKET: POTENTIAL COST SAVINGS FROM EHR-BASED DEVICE MONITORING, 2013 (%) FIGURE 17 WIRELESS EHR MARKET: CODING SYSTEM PRACTICE FOLLOWED BY U.S. PHYSICIANS, 2012 (%) FIGURE 18 WIRELESS EHR MARKET: STRATEGY ON MOBILE TECHNOLOGY POLICY IN U.S. HEALTHCARE SETTINGS, 2012 (%) FIGURE 19 WIRELESS EHR MARKET: COMMON TECHNOLOGIES PROVIDED BY ORGANIZATIONS TO THEIR CLINICIANS, 2012 (%) FIGURE 20 WIRELESS EHR MARKET: PERCENTAGE OF U.S. PHYSICIANS WHOSE EHRS PROVIDED SELECTED BENEFITS, 2011 FIGURE 21 EHR ADOPTION RATES FOR PRIMARY CARE PHYSICIANS BY COUNTRY, 2009 AND 2012 (%) FIGURE 22 EHRS WITH MULTIFUNCTIONAL CAPABILITIES ADOPTION RATES FOR PRIMARY CARE PHYSICIANS BY COUNTRY, 2012 (%) FIGURE 23 WIRELESS EHR MARKET: PUBLIC AND PRIVATE EXPENDITURES ON LONG-TERM CARE, 2008 (%) FIGURE 24 WIRELESS EHR MARKET: NON-FEDERAL ACUTE CARE HOSPITAL ADOPTION OF BASIC EHR SYSTEMS, FIGURE 25 WIRELESS EHR MARKET: EHR COVERAGE FOR HOSPITALS, (%) 117 FIGURE 26 HEALTH RECORD STORAGE METHOD BY SPECIALTY (U.S.), 2010 (%) 120 FIGURE 27 WIRELESS EHR MARKET: PREVALENCE OF HEART DISEASE (U.S.), 2012 (MILLION AMERICANS) FIGURE 28 WIRELESS EHR MARKET: MATERNAL MORTALITY RATIOS, FIGURE 29 WIRELESS EHR MARKET: PREVALENCE AND INCIDENCE OF CANCER BY TYPE (WORLD), 2008 (MILLION PEOPLE)

18 FIGURE TITLE FIGURE 30 WIRELESS EHR MARKET: INCIDENCE OF CANCER BY REGION, 2008 (MILLION PEOPLE) FIGURE 31 WIRELESS EHR MARKET: HIP REPLACEMENT SURGERIES BY COUNTRY, 2009 (SURGERIES PER 100,000 POPULATION) FIGURE 32 WIRELESS EHR MARKET: KNEE REPLACEMENT SURGERIES BY COUNTRY, 2009 (SURGERIES PER 100,000 POPULATION) FIGURE 33 WIRELESS EHR MARKET: COMPANY STRATEGIES, (%) 135 FIGURE 34 WIRELESS EHR MARKET: LEADING COMPANIES FOR PRODUCT-RELATED STRATEGIES, (%) FIGURE 35 WIRELESS EHR MARKET: LEADING COMPANIES FOR M &A STRATEGIES, (%) FIGURE 36 PERCENTAGE OF PATENTS REGISTERED/APPROVED IN THE U.S. AND EUROPE, 2007 TO 2013 (%) FIGURE 37 U.S. PATENT ANALYSIS BY MARKET SEGMENTS, 2007 TO 2013 (%) 150 FIGURE 38 EUROPEAN PATENT ANALYSIS BY MARKET SEGMENT, (%) 150 FIGURE 39 U.S. PATENT ANALYSIS BY MARKET PARTICIPANTS, 2007 TO 2013 (%)

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