Worldwide, telemedicine markets are poised to achieve significant growth as globally coutries are faced with citizen demands for comprehensive, quality health care at affordable prices. Telemedicine is more cost efficient than nursing home or hospital care, every patient would rather stay at home if possible.  As new telemedicine equipment and services proliferate in the U.S. and worldwide, more and more vital signs based healthcare delivery is being implemented. Healthcare delivery systems are moving towards a quantum shift in care delivery.  Technology provides a way to sense and monitor heart disease, inflammation, infection, cancer, diabetic condition, and chronic condition status using technology.  This represents a quantum shift in care diagnosis.  The old methods of verbal description that the physician rarely listens to and in person visual inspection are becoming less important.  The monitoring technologies and blood work are being used in combination with imaging and telemetrics to provide a real time, continuous evaluation of patient condition.

Table of Contents
TELEMEDICINE EXECUTIVE SUMMARY   
TELEMEDICINE SOFTWARE, EQUIPMENT, AND SERVICES   
EXECUTIVE SUMMARY ES-1   
Telemedicine Systems Market Driving Forces ES-1   
Telemedicine Market Shares ES-3   
Telemedicine Market Forecasts ES-4
Xtend / BioHarp UNI US. ES-6
WinterGreen Research Healthcare Reform Vision and Strategy ES-7

1. TELEMEDICINE MARKET DESCRIPTION AND MARKET DYNAMICS
1.1 Telemedicine Definition 1-1
1.1.1 Telemedicine Benefits 1-3
1.1.2 50 Different Medical Subspecialties Have Successfully Used Telemedicine 1-6
1.1.3 Telemedicine Reimbursement Fee Structure 1-8
1.2 Healthcare IT Support for Telemedicine in Asia 1-9
1.2.1 Healthcare IT in Australia 1-10
1.2.2 Telemedicine for the Internet 1-11
1.3 Technologies To Support Telemedicine Approaches 1-11
1.3.1 Wintergreen Research Healthcare Reform Vision and Strategy 1-12
1.4 Home Health Care 1-16
1.4.1 Home Health Quality Care 1-19
1.4.2 Medicare 1-26
1.4.3 Medicaid 1-26
1.5 Home Care Services Payors 1-30
1.5.1 Self-pay 1-31
1.5.2 Public Third-party Payors: Medicare 1-31
1.5.3 Public Third-party Payors: Medicaid 1-32
1.5.4 Public Third-party Payors: Older Americans Act (OAA) 1-33
1.5.5 Veterans Administration 1-34
1.5.6 Social Services Block Grant Programs 1-34
1.5.7 Community Organizations 1-34
1.5.8 Private Third-party Payors 1-35
1.6 Types of Home Care Agencies 1-35
1.6.1 Nursing care 1-36
1.6.2 Physical therapy 1-37
1.6.3 Occupational therapy 1-37
1.6.4 Speech therapy 1-37
1.6.5 Social workers 1-37
1.6.6 Home Health Aides/Home Care Aides 1-38
1.6.7 Homemaker/Attendant Care 1-38
1.6.8 Volunteers 1-38
1.6.9 Others 1-38
1.7 Telemedicine Information System Software Market Shifts 1-39
1.7.1 Characteristics Particular To The Telemedicine Information System Market 1-42
1.7.2 Implementation Depends On Documentation Of Each Discipline Needs 1-43
1.7.3 Home Care Services Billing Issues 1-43
1.7.4 Prospective Payment System (PPS) 1-45
1.7.5 Managed Care Requirements 1-45
1.7.6 Oasis Home Health Agencies 1-48
1.8 Need For Automation Of Home Care Companies 1-48
1.9 Telemedicine Information Technology Industry 1-50
1.9.1 History Of Low Investment In Healthcare Information Technology 1-52
1.9.2 Market Driving Forces For Worldwide Telemedicine Information Systems 1-53
1.9.3 Treatment Trends 1-53
1.9.4 Home Healthcare Delivery Industry 1-55
1.9.5 Competition Forms Basis Of U.S. Medical Care Services Delivery 1-55
1.9.6 Science And Medical Technology 1-56
1.10 Benefits Of Home Care 1-57
1.10.1 Home Health Saves Medicare Billions 1-59
1.11 Demographic Trends Driving Home Care 1-61
1.11.1 Mainstreaming Of People With Disabilities 1-61
1.11.2 Recovery And Active Lifestyles Of Disabled Portion of the Population 1-62
1.12 Healthcare Equipment Industry 1-63
1.12.1 Reimbursement Drives Healthcare Equipment Industry 1-64
1.12.2 Home Medical Equipment Industry Segments 1-65
1.13 Marketing Globally 1-67
1.13.1 U.S. Healthcare Delivery Industry 1-69
1.13.2 Competition Forms Basis Of U.S. Medical Care Services Delivery 1-70
1.13.3 European Telemedicine Market Trends 1-71
1.14 Hospital and Home Care Services Billing Issues 1-72
1.14.1 Managed Care Requirements 1-74
1.15 Market Drivers For Healthcare Cost Containment 1-77
1.15.1 Managed Care Organization Impact 1-78
1.15.2 Reasons Home Health Care Has Gained Wide-Spread Acceptance 1-78
1.15.3 Managed Care Change In The Healthcare Industry 1-79
1.15.4 Telemedicine For People With Long Term Disabilities 1-79
1.15.5 Health Care Cost Containment Trends 1-80
1.15.6 Medicare Reimbursement Guide for Power Wheelchair Drive Control Systems 1-80
1.15.7 Managed Care Organization Impact 1-81
1.16 Reasons Home Health Care Has Gained Wide-Spread Acceptance 1-81
1.16.1 Managed Care Change In The Healthcare Industry 1-82
1.16.2 Telemedicine For People With Long Term Disabilities 1-82
1.17 Worldwide Telemedicine Information Systems Market Distribution 1-83
1.17.1 Delivery Of Non-Acute Health Care 1-83
1.17.2 Leveraging Distribution Channels 1-84
1.17.3 Worldwide Telemedicine Information Systems Market Positioning 1-84
1.18 Increased Need For Information Technology 1-86
1.18.1 Medical Error 1-87
1.19 Shortcomings Of Traditional Healthcare Information Systems 1-88
1.19.1 Telemedicine Information Systems Market Strategy 1-89
1.19.2 Integrated Healthcare Information Technology Solutions 1-90
1.19.3 Flexible Product-Delivery Options 1-90
1.19.4 Leveraging Existing Customer Base 1-91
1.20 Telemedicine Information Systems Market Trends 1-92
1.20.1 Clinician Support For Spending Less Time At The Desktop And More Time Taking Care Of Patients 1-94

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