Healthcare Electronic Data Interchange Market Analysis

Global Healthcare Electronic Data Interchange Market Overview

Healthcare Electronic Data Interchange Market Size was valued at USD 4.98 Billion in 2023. The Global Healthcare Electronic Data Interchange industry is projected to grow from USD 5.43 Billion in 2024 to USD 11.11 Billion by 2032, exhibiting a compound annual growth rate (CAGR) of 9.36% during the forecast period (2024 - 2032). 

The Healthcare Electronic Data Interchange is a software solution that helps the healthcare professionals or the managing directors of the organizations to manage the patients’ information and other business information related to the organization securely and speedily. The standardized manner and secured manner of transferring the data have enhanced the healthcare institutions' procedures and enhanced the overall quality of services.

The healthcare industry is huge and handles an enormous amount of data every day, the huge amount of data generated in the healthcare organization and handling them requires a potential software solution to avoid human errors, time consumption. The increasing number of healthcare centers in several countries, increasing geriatric population, and growing health-related emergencies have augmented the overall growth of the Healthcare Electronic Data Interchange market in recent years.

COVID 19 Analysis:

The economic shock created by the COVID widespread is reducing in recent times, however, several healthcare associations have been significantly affected by the COVID infection. The business processes, retail, logistics, and other processes have been affected by lockdown and other regulations. However, several healthcare sectors have started adopting the Electronic Data Interchange software solutions for business continuity and safer data transactions and contactless transactions during the pandemic. The World Economic Forum has encouraged contactless payment methods, Quick response codes, facial recognition, and other technologies that would eliminate having closer association and thereby spreading the infection. Such factors have augmented the overall growth of the Health care Electronic Data Interchange Industry.

In April 2024, the nationwide expansion of health information exchange (HIE) has progressed significantly. As of 2021, a total of 88% of hospitals are actively engaged in the exchange of electronic health data, as reported in a 2023 data brief by the Office of the National Coordinator for Health Information Technology (ONC). As the advancement of digital health continues, certain states are seeking to promote interoperability by implementing data exchange frameworks. The California Health and Human Services Data Exchange Framework (DxF) is designed to facilitate California's efforts to revolutionize healthcare, enhance access to treatment, and enhance the seamless sharing of information across healthcare and social service providers. Organizations have the option to utilize a qualified health information organization (QHIO) as an intermediary for exchanging data, or they can choose alternative methods that adhere to the Data Sharing Agreement (DSA). Implementing HIE can be challenging for certain firms. Based on the 2021 survey data from the American Hospital Association, small and rural hospitals exhibit lower participation rates in Health Information Exchange (HIE) networks compared to medium and large hospitals. This discrepancy can be attributed to the limited availability of economic and technological resources in small and rural hospitals. ADT messages are a widely recognized data standard that contains information about various events, including as patient admissions, registrations, updates, and discharges.

In November 2023, Medweb, a prominent pioneer in medical imaging technology, introduced MedwebX, an all-encompassing and efficient solution aimed at revolutionizing the manner in which medical facilities securely exchange data, including imaging, research, and reports. MedwebX strongly endorses the 21st Century Cures Act, a law enacted in 2016 that promotes the widespread sharing of electronic health information and prohibits any actions that impede, obstruct, or significantly discourage access to or the interchange of data. MedwebX enables the efficient and safe exchange of extensive medical data, including blood tests and imaging results. By connecting all healthcare participants involved in a patient's ongoing care, MedwebX promotes a unified system for sharing data, which is crucial for delivering high-quality patient care. Medweb, founded by a physician thirty years ago, is a leading provider of web-based, secure telemedicine, teleradiology, and RIS/PACS solutions. It has been installed in over 1,000 locations worldwide.

Healthcare Electronic Data Interchange Market Trends

Drivers:

The advantages that come with Healthcare Electronic Data Interchange solutions are considered as the primary drivers. The advantages include, faster processing, improved productivity, uninterrupted workflow, patient satisfaction, reliability towards the healthcare sector, cost-saving, and much more. 

Reduction in human intervention has significantly reduced the human errors that occur in the healthcare sector. Especially, the errors associated with billing, invoice generation, stock handling, security breaches were highly burdening the healthcare sectors. The reduction of human intervention has benefitted the overall growth of these healthcare sectors. 

Opportunities:

The rising number of EDI providers is expected to boost the growth of the Healthcare Electronic Data Interchange market. Such EDI providers are efficiently addressing the challenges risen in the industry. For instance, time-consuming tasks such as communication between trading partners and clients; troubleshooting, managing software errors are handled by the EDI providers. They take ownership of managing the EDI requirements imposed by the government authorities and ensure compliance with the ongoing rules and regulations. 

The advent of Healthcare Electronic Data Interchange solutions has eliminated the transactions made through paper documents, unprotected texts and emails, USD drives, fax, PDF files, and other paper-based transactions. On the other hand, the healthcare Electronic Data Interchange has established a common structured format for the sensitive data, such factors have presented lucrative growth opportunities for the Healthcare Electronic Data Interchange industry.

Restraints:

In the healthcare sectors with complex use cases and technologies, the implementation of EDI software is difficult. On the other hand, the EDI mapping and developing the EDI maps for the organization for every associated trading partner, developing multiple EDI maps are challenging for the Healthcare Electronic Data Interchange market growth. 

The implementation of Healthcare EDIs is primarily for saving time, however, communication with trading partners is generally a time-consuming task. Other tasks such as Troubleshooting the EDI errors, EDI testing are also quite time-consuming. Such factors are hindering the overall growth of the Healthcare Electronic Data Interchange market growth.

Challenges:

The change of business processes to the electronic data interchange is considered the primary challenge for several healthcare sectors. The paper handling methods of the healthcare sectors require several procedures to adopt the electronic data interchange. For instance, some healthcare organizations might have to process bulk goods and processing invoices that require to be sent by mail within a short period. In the case of EDI, the processing of invoices is carried out during the shipment and might be a tedious process while the goods are not received yet.

A precise integration level that matches the business requirement is considered the primary challenge in the Healthcare Electronic Data Interchange Industry. Moreover, the preliminary costs involved in the procedures such as implementation, customization, and training are generally higher for some healthcare organizations.

Cumulative Growth Analysis:

The US government has introduced the HIPAA which has listed out certain regulations that should be complied with by the healthcare organizations. The rules and regulations have prohibited healthcare professionals from sharing the personal medical information of patients with others. The regulations have protected the individuals from security and compliance issues. HIPAA has covered the welfare of the healthcare workers also, which helps to create a reliable work environment in the healthcare sector. The Healthcare Electronic Data Interchange solutions have helped the health care sectors to maintain the higher standards, enables them to save costs in processing the healthcare documents, handing warehouse related documents, invoices, and others. A recent study states that the health care sectors are generating over $1 per claim for every health plans requisition and $1.49 for the physicians and over $0.83 for other estimates.

Value Chain Analysis:

The healthcare Electronic Data Interchange services are majorly set via Web-based services and cloud-based services. The Web-based segment includes conducting the Electronic Data Interchange procedures via an internet browser. The paper-based forms will be given in the internet browser, where the vendor or the trading partners have to enter the relevant information. Such information is automatically sent in the form of an EDI message via secured internet protocols. FTPS, HTTPS is majorly used in such cases. The web-based solutions are highly beneficial for organizations having trading partners from various (different) countries.

The mobile-based solutions are highly preferred due to the higher flexibility that it offers. The supply chain control that the mobile-based system offers is considered as the primary advantage of implementing the software solution. For instance, Incidences such as, creating an invoice with a simple scanning of barcode and sending it across to the customer are driving the overall Healthcare electronic data Interchange market growth.

On the other hand, the cloud-based solutions offer robust data movement and transformation, rapid onboarding and are found to be highly beneficial for the B2B data processing businesses. The accuracy in maintaining the records, and reliable processing of insurance claims, payment information, and other IT-related Data. Before the introduction of HIPAA, over 400 medical forms were handled by the healthcare sector, managing them manually consumer time and energy. Such factors are the primary driving pointers for the Healthcare Electronic Data Interchange market growth.

Healthcare Electronic Data Interchange Market Segmentation

Healthcare Electronic Data Interchange Transaction Outlook

• Claims and encounters


• Payment and Remittance Advance


• Eligibility Inquiry and Response


• Claim Attachments


• Enrollments


• Referral Certification and authorization

Healthcare Electronic Data Interchange Component Outlook

• Solutions


• Services

Healthcare Electronic Data Interchange delivery mode Outlook

• EDI Value Added Network (VAN)


• Direct (Point-to-Point) EDI


• Mobile EDI


• Web and Cloud-based EDI

Healthcare Electronic Data Interchange End User Outlook

• Payer


• Provider


• Others

Regional analysis

The Americas is currently expanding the Healthcare Electronic Data Interchange Market size owing to the increasing number of medical emergencies in the region. The economic condition in the region and increasing urbanization have influenced the overall growth of the Healthcare Electronic Data Interchange industry. On the other hand, the growing healthcare expenditure in the region and emerging market players are fueling the Healthcare Electronic Data Interchange market growth. The Plexis health care system has announced its expansion in the year 2016which has formally operated as Ignite EDI which utilizes the primary four technologies as Atlas Engine, EDI gateway, Portal technologies, EDI exploration services. Since then, the growth in the region has been extremely promising.

On the other hand, Europe is witnessing stable Healthcare Electronic Data Interchange Market growth in recent years due to the increasing governmental support for the growth of the market. The advent of the General Data Protection Regulation imposed by the European government has increased the power of their citizens over protecting their personal information, the scheme has laid a list of rules to comply with during the processing of health-related information. Additionally, the HER recommendation sets have been developed by the countries which enable the citizens of the country to securely exchange their personal information.

Competitive landscape

• Allscripts Healthcare Solutions Inc. 


• Cognizant


• Experian Information Solutions Inc.


• Optum Inc.


• Schreiner Group


• Siemens Healthineers


• GE Healthcare


• McKesson Corporation


• The SSI Group LLC


• ZirMed Inc.

Recent developments

2020:Mulesoft LLC has introduced module X12 which efficiently connects with the trading partners. The module helps support the essential operations such as validating, writing, and reading messages sent between trading partners. 

2019:A leading market player, DiCentral Corporation has partnered with Nippon Information and communication corporation which has augmented the overall performance and interchange capabilities and B2B supply chain automation 

Report overview:

This report has covered:

• Market overview


• COVID 19 Analysis


• Market dynamics


• Cumulative growth analysis


• Value chain analysis


• Segment overview


• Regional analysis


• Competitive landscape


• Recent developments