Healthcare Electronic Data Interchange Global Market Report 2024

Healthcare Electronic Data Interchange (EDI) is a secure means of exchanging information among healthcare institutions, insurers, and patients, employing standardized message formats and protocols.

The market for Healthcare EDI involves the provision of electronic data interchange services by various entities, including manufacturers, sole traders, and partnerships. These services aim to facilitate the secure transfer of healthcare data, ultimately reducing administrative costs, minimizing errors in claims processing, and enhancing overall productivity. The process involves the secure exchange of data between healthcare institutions, insurers, and patients, utilizing standardized message formats and industry standards.

The healthcare electronic data interchange market research report is one of a series of new reports that provides healthcare electronic data interchange market statistics, including healthcare electronic data interchange industry global market size, regional shares, competitors with a healthcare electronic data interchange market share, detailed healthcare electronic data interchange market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare electronic data interchange industry. This healthcare electronic data interchange market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future state of the industry.

The healthcare electronic data interchange market size has grown rapidly in recent years. It will grow from $4.8 billion in 2023 to $5.36 billion in 2024 at a compound annual growth rate (CAGR) of 11.6%. The growth observed during the historical period can be attributed to several factors, including regulatory compliance, enhancements in administrative efficiency, initiatives aimed at cost reduction, reduction of errors, and improvements in claims processing.

The healthcare electronic data interchange market size is expected to see rapid growth in the next few years. It will grow to $8.38 billion in 2028 at a compound annual growth rate (CAGR) of 11.8%. The anticipated growth in the forecast period can be linked to various factors, including the adoption of value-based care models, the standardization of data, increased focus on data privacy and security, enhanced inter-organizational data sharing, and heightened preparedness for pandemics. Noteworthy trends expected during this period encompass real-time claims processing, the automation of prior authorization, the implementation of blockchain for secure data exchange, the integration of data analytics and predictive modeling, and the utilization of artificial intelligence for advanced claim scrutiny.

The increasing prevalence of chronic diseases is expected to propel the growth of the healthcare electronic data interchange market in the coming years. Chronic illnesses are long-term problems that cannot be avoided with immunizations, treated with medicine, or simply disappear. They endure over an extended period, usually three months or more. Healthcare EDI plays a critical role in the entire treatment of chronic illnesses by speeding up data sharing, enhancing administrative procedures, and facilitating effective communication. It assists healthcare practitioners and patients in coordinating treatment, monitoring conditions, and improving the general standard of care for those with chronic health issues. For instance, in March 2022, according to the Australian Bureau of Statistics, an Australia-based self-governing statutory institution responsible for data collection and analysis as well as factual recommendations, in Australia, over half of the entire population (46.6%, or 11.6 million people) had at least one chronic illness. Therefore, the increasing prevalence of chronic diseases is driving the healthcare electronic data interchange market.

The proliferation of telehealth services is expected to propel the growth of the healthcare electronic data interchange market in the coming years. Telehealth, often known as telemedicine, is the use of technology for communication and information to deliver distant medical and healthcare services. Telehealth enables healthcare providers to examine, evaluate, manage, and monitor patients from a distance while also exchanging medical information using digital technologies and telecommunications. EDI improves the telehealth encounter for both healthcare practitioners and patients by increasing administrative process efficiency, lowering the chance of mistakes, and ensuring safe data interchange. It is critical to increase the reach and efficacy of telehealth services. For instance, in August 2022, according to the Australian Digital Health Agency, an Australia-based federal agency in control of My Health Record, digital prescriptions, and medical referral systems, between March 2020 and July 2022, 118.2 million telehealth treatment services were provided to 18 million individuals, and over 95,000 practitioners presently use telehealth services. Therefore, the proliferation of telehealth services is driving the healthcare electronic data interchange market.

The incorporation of advanced technologies into EDI systems is expected to be a key trend in the healthcare electronic data interchange market. Major companies are integrating EDI solutions with new technologies such as APIs, AI, and Blockchain. Advanced technologies increase the agility and connectivity of EDI solutions, which further saves cost and time. For instance, in May 2022, NextGen Healthcare Inc., a US-based software firm that creates and sells electronic medical record software and practice administration solutions to the healthcare industry, launched NextGen Health Data Hub Insights. NextGen Health Data Hub Insights is a revolutionary information center and personalized analytics platform. The software is designed to make obtaining data, performing analytics, and report generation simpler for health information exchanges (HIEs) and medical professionals throughout the country, allowing them to give a more comprehensive picture of community and patient health. Based on the NextGen Health Data Hub, which allows clients to exchange community-wide data, this modern technology enables clients to further unlock the value of their information assets by offering tailored, near-immediate visualization capabilities as well as information at the point of care.

The anticipated rise in the prevalence of chronic diseases is set to drive the expansion of the healthcare electronic data interchange (EDI) market in the foreseeable future. Chronic illnesses, characterized by their long-term nature and inability to be prevented through immunizations or resolved with medication, persist for extended periods, typically exceeding three months. Healthcare EDI plays a pivotal role in managing chronic conditions by expediting data sharing, streamlining administrative processes, and facilitating efficient communication. This technology aids healthcare professionals and patients in coordinating treatment, monitoring conditions, and enhancing overall care standards for individuals grappling with chronic health issues. Notably, in March 2022, the Australian Bureau of Statistics reported that 46.6% of the Australian population, equivalent to 11.6 million people, were afflicted by at least one chronic illness, underscoring the driving force behind the growth of the healthcare electronic data interchange market.

The surge in telehealth services is poised to propel the healthcare electronic data interchange market's growth in the coming years. Telehealth, synonymous with telemedicine, leverages technology for communication and information exchange to provide remote medical and healthcare services. This approach allows healthcare providers to assess, manage, and monitor patients from a distance, utilizing digital technologies and telecommunications for medical information exchange. Healthcare EDI enhances the telehealth experience for both practitioners and patients by increasing administrative efficiency, reducing the risk of errors, and ensuring secure data interchange. Highlighting the significance of this trend, the Australian Digital Health Agency reported that between March 2020 and July 2022, over 118.2 million telehealth treatment services were delivered to 18 million individuals, with more than 95,000 practitioners actively utilizing telehealth services. Consequently, the proliferation of telehealth services serves as a driving force for the healthcare electronic data interchange market.

The integration of advanced technologies into EDI systems emerges as a key trend in the healthcare electronic data interchange market. Major companies are incorporating EDI solutions with cutting-edge technologies like APIs, AI, and Blockchain. This integration enhances the agility and connectivity of EDI solutions, resulting in cost and time savings. For example, in May 2022, NextGen Healthcare Inc., a US-based software firm specializing in electronic medical record software, introduced NextGen Health Data Hub Insights. This innovative data center and personalized analytics platform simplify data access, analytics, and report generation for health information exchanges (HIEs) and healthcare professionals nationwide. Building upon the NextGen Health Data Hub, this modern technology empowers clients to unlock the value of their data assets by providing tailored, near-real-time visualization capabilities and information at the point of care. This adoption of advanced technologies shapes the landscape of the healthcare electronic data interchange market.

In July 2022, ImagineSoftware, a US-based medical billing software provider, successfully acquired Exchange EDI LLC for an undisclosed sum. This strategic move by ImagineSoftware involves the expansion of its service offerings through the integration of Exchange EDI, aimed at enhancing patient billing and collection processes. Leveraging their combined technology and expertise, both companies are well-positioned to improve communication between physicians and their patients. Exchange EDI LLC, a US-based entity specializing in electronic data interchange, is now a part of the ImagineSoftware portfolio.

In April 2022, Change Healthcare, a US-based healthcare technology company specializing in EDI networks, entered into a merger with Optum. The amalgamation of Optum and Change Healthcare is designed to streamline and connect critical clinical, administrative, and financial processes essential for healthcare providers and payers in delivering patient treatment. Optum, a US-based pharmacy benefit manager and healthcare provider, plays a key role in this strategic merger aimed at optimizing healthcare procedures and services.

Major companies operating in the healthcare electronic data interchange market include McKesson Corporation, Optum Inc., Allscripts Healthcare Solutions Inc., Athenahealth Inc., NextGen Healthcare Inc., Experian plc, Cognizant Technology Solutions, Cerner Corporation, Synnex Corporation, The SSI Group LLC, Waystar Health, Comarch SA., Axway Software, PLEXIS Healthcare Systems Inc., Archer Software, TrueCommerce B2BGateway, DiCentral Corporation, 123 EDI, Quadax Inc., Dell Technologies Inc., GE Healthcare, Quality Systems Inc., Epic Systems Corporation, eClinicalWorks, Practice Fusion, MEDITECH Inc., Care360 Pty Ltd., Vitera Ltd., IBM Corporation, Siemens Healthcare GmbH, Oracle Corporation, Infor Global Solutions

North America was the largest region in the healthcare electronic data interchange market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare electronic data interchange market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, the Middle East, and Africa.

The countries covered in the healthcare electronic data interchange market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

The healthcare electronic data interchange market revenues earned by entities by providing web-based EDI, point-to-point EDI, mobile EDI, and EDI via AS2 services. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.


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