The telemedicine market - Italy (2023)

1.2 The global market

Telemedicine emerged as an essential component of health care during the COVID-** pandemic. Although telemedicine services were integrated into most healthcare systems even before the onset of the pandemic, the services began to be widely used only during the COVID-** crisis.

In ****, the global telemedicine market reached a value of $***.** billion. Between **** and ****, a compound annual growth rate (***) of **.** percent is expected, due to which the market value could reach $*** billion by the end of the period.

Telemedicine Market World, ****-****, in billions of dollars Mordorintelligence

The advent of the pandemic in **** has also contributed to the rapid development of telemedicine in the European context. In ****, the telemedicine market on this continent is worth $**.** billion and is expected to exceed $** billion by **** thanks to a compound annual growth rate (***) of **.**%. Thus, the European market is expected to develop faster than the rest of the world.

Telemedicine market Europe, ****-****, in billions of dollars Insights**

1.3 The Italian market

The Italian market represents one of the main segments of the larger European market. In ****, the Italian digital medicine market is worth $*.** billion and is expected to reach and exceed $** billion by **** thanks to a compound annual growth rate (***) par to **.*%.

Telemedicine market Italy, ****-****, in billions of dollars Insights**

The growth of the Italian market is supported by an increase in household spending on digital health. Between **** and ****, Italians' total spending on digital health grew by **.* percent, from €*.** billion to €*.* billion. The greatest growth was recorded tea **** and **** when within a single year total spending increased from *.* billion euros to *.** billion euros (***).

Spending on digital health Italy, ****-****, in billions of euros Source: ****

Moreover, looking ahead, telemedicine represents the third largest investment over the next three years for industry leaders. Only artificial intelligence and electronic dossier gather higher approval (***).

Main investments in Italy over the next * years Italy, ****, % Philips

1.4 The Impact of COVID-19

The COVID-** pandemic was, and is, first and foremost a massive public health failure, which then unleashed terrible economic consequences. This reality intersects directly with the fields of telemedicine and digital health specifically, and health more generally. The €*** billion Recovery Fund has secured nearly €** billion in public health investments. Future investments will certainly boost the following areas:

Solutions for family homes and hospitals

The Recovery FUnd drafts allocate several billion euros for the creation of "community homes," facilities designed to promote the integration of social and health services. They are envisioned as the evolution of "Health Homes," facilities that can bring together primary care physicians, outpatient specialists and nursing staff and provide services outside traditional hours and largely as alternatives to emergency room use at night and/or on holidays. Under discussion are approximately just under *,*** Health Homes, which will be joined by *** "community hospitals" (***).

artificial intelligence (***)

Here we sway between many established applications and many more or less enticing promises. Machine and Deep Learning are already widely used with success (***) for support in referral and symptom/signal interpretation.

Applications such as "Babylon," a TV platform that originated in the UK and has spread to some other countries, take full advantage ...

2.1 Demand in Italy

By ****, only **.*% of Italians were included in a telemedicine/e-health program.(***). The other aspects covered **.*% of cases.

Aspects for which Italians have been involved in telemedicine/e-health programs Italy, ****, % Active citizenship

During ****, more than ***,*** telemedicine services were provided in the network of more than *,*** pharmacies participating in the HTN-Federfarma project: ***,*** electrocardiograms, **,*** blood pressure holter monitoring and **,*** via cardiac holter, allowing even significant abnormalities to emerge with immediate referral of patients at risk to the emergency room or the attending physician.

Telemedicine services provided by pharmacies, breakdown by type of service Italy, ****, % Federfarma

Considering the types of consultations requested, in **** in first place are primary care and general medicine services (***). Finally, gynecological consultations accounted for **% of the total. Type of consultation requested from one's doctor Italy, ****, % Capterra Finally, analyzing the context in which the use of telemedicine was necessary, the first consultation tops the list with **% of cases. This is followed by consultations for taking a medication (***) garner just under * in * cases. Context in which telemedicine consultation was needed Italy, ****, % Capterra

2.2 The opinions of Italians

Considering the opinions expressed by those who have used telemedicine services, it is possible to highlight the advantages and disadvantages of the service. Regarding the advantages, **% of those say that reducing waiting time for an appointment with their doctor is the main strength of telemedicine. Forty percent see reducing the possibility of infection as a major advantage. Finally, ** percent find it advantageous to be able to access prescriptions and reports through their electronic devices. Main advantages of teleconsultation Italy, ****, % Capterra Then considering the disadvantages, **% of Italians consider the inability to receive physical exams to be one of the main shortcomings of telemedicine. This is followed by technical problems related to electronic devices and internet connection (***). Main drawbacks of teleconsultation Italy, ****, % Capterra Regarding citizens' opinion about the activities that need to be enhanced, telemedicine ranks fourth among Italians' priorities in **** (***).

"Which of the following activities do you think should be strengthened in the context of the reorganization of territorial services?" Italy, ****, % Active citizenship

2.3 Demand trends

Considering the advantages and disadvantages listed in the previous section, those who used telemedicine services in **** intend to do so in the future. Almost all subjects (***). Only *% among those who have used this service say they do not want to use it again in the future.

Willingness to continue using telemedicine services Italy, ****, % Capterra

The trend toward a hybrid model of care, combining telemedicine and in-person treatment, has been identified as the future of telemedicine. This model makes use of a range of technological tools, such as remote monitoring, augmented reality, virtual reality, and in-person care, in order to provide decentralized care tailored to the patient's lifestyle, clinical needs, and social preferences. Hybrid care models can offer greater operational flexibility and better utilization of resources, as well as increase patient engagement and provide more personalized and precise care.(***)

2.4 Geographical distribution of demand

In order to analyze the geographical distribution of demand, a map was created with the average monthly expenditure of Italian households on their health. Thus, a higher demand for telemedicine services is assumed where the average monthly expenditure is higher.

In ****, the Northeast is the leading macro-region in terms of average monthly spending on personal health-related services (***).

3.1 The market structure

To analyze the structure of the market, services of medical practices (***) and pharmacies are considered. Specifically, the number of enterprises, number of employees and legal form of activities will be analyzed for each sector.

Medical practice services

Between **** and ****, the total number of general and specialist medical practices grew by **.* percent, reaching ***,*** in ****. The growth is particularly evident between **** and ****, when within just two years the number of medical practices grew by **.*%.

Services of general and specialist medical practices Italy, ****-****, in thousands Istat

Turning to the number of employees, again there is growth between **** and **** (***). The trend recorded for the number of employees follows precisely that of the number of medical practices. In fact, again the growth is concentrated in the two-year period ****-**** during which the number of employees grew by *.*%.

Service employees of general and specialty medical practices Italy, ****-****, in thousands Istat Sole proprietorships and the self-employed account for almost all activities in the sector, gathering **.* percent of the total. They are followed by limited liability companies with *.* percent and other forms of business with *.* percent. Legal form services of general and specialist medical practices Italy, ****, % Istat

Pharmacies

The pharmacy sector, like that related to medical practices, ...

3.2 The value chain

Theestablishment and exploitation of a technological infrastructure, is critical as it provides the basis on which all telemedicine services are delivered. This phase includes:

The development and maintenance of secure telemedicine platforms, which may include software for video calling, systems for patient management, and platforms for data collection and analysis. The creation of reliable and secure networks to transmit sensitive data, ensuring privacy and compliance with data protection regulations, such as GDPR in Europe. The integration of telemedicine systems with electronic health records (***), enabling easy accessibility of patient data by physicians and supporting continuity of care. The implementation of cybersecurity tools to protect against digital threats and ensure the integrity of patient data.

This infrastructure must be designed with scalability in mind so that it can adapt to the growing demand for telemedicine services and evolving technologies. In addition, the main challenge remains the integration and interoperability of data through the use of APIs (***), which facilitate the exchange of data between different systems.

(***)

3.3 Deployment of telemedicine

Digitization of patient records facilitates telemedicine processes; in fact, the latter is not possible without the former. Doctors and health care providers must have electronic records of their patients in order to perform any form of remote intervention or diagnosis. In Italy these are called Fascicolo Sanitario Elettronico (***).

As visible in the chart below, in **** the use of the Electronic Health Record by primary care physicians is extremely uneven along the peninsula. While in the autonomous province of Trento, Emilia Romagna, Lombardy, Sardinia, and Valle d'Aosta, *** percent of physicians use this technology, physicians in Molise, Tuscany, and Lazio do not exceed ** percent.

Share of citizens and primary care physicians using EDF Italy, ****, in % Source: ****

NB Not all regions are included in this chart due to the lack of complete information from many of them.

Physician-patient communication

Next, regarding doctor-patient communication, in **** medical videoconferencing applications are by far the most used, accounting for ** percent of cases. This is followed by phone calls with **% of cases. Finally, the use of messaging apps such as WhatsApp are used in **% of cases.

Channel used of digital health service and telemedicine, by type Italy, ****, in % Source: ****

4.1 Various offers and support

Telemedicine offerings can be divided into four distinct macroareas, which are characterized by mode and purpose:

Remote visits

In this case, the physician has the opportunity to visit his patient using video communication systems or applications, from Skype, Zoom, Teams, and other customized solutions developed ad hoc according to the needs of the clinical experience. These are video call solutions that meet data management and image quality criteria, as well as solutions developed within a telemedicine platform, through which telesales and prescriptions can be made.

teleconsultation

Collaborative tools also come into play here. Physicians discuss the diagnosis, prescriptions, and treatment of a given patient, sharing all available information about the patient's condition and the clinical tests he or she has undergone. Telemedicine involves the electronic exchange of health information, including the collection, transmission, and interpretation of patient data (***), the extraction of health data from wearable devices, and the rapid exchange of digital information via dedicated portals, tablets, and cell phones.

Remote collaboration.

These are cases in which one physician or health care team offers remote support to another physician or health care team in cases of emergency or when it was not possible to go directly to the site. In this ...

4.2 The prices

As for the prices of medical services, between **** and **** the consumer price index increased by * points. This means that over the period under consideration, prices for consumers increased by * percent. Compared to ****, the price increase is close to *%.

Consumer price index for medical services Italy, ****-****, base ****=*** Istat

The cost of a telemedicine medical visit in Italy can vary depending on the service, specialist and healthcare facility. The following are examples of prices for certain types of visits:

TYPE OF VISIT PRICE San Donato Group cardiology videovisit (***) €***.** - €***.** San Donato Group cardiology videovisit (***) €***.** Videovisit ophthalmology San Raffaele Hospital (***) €***.** Videovisit ophthalmology San Raffaele Hospital (***) €***.** Videovisit nuclear medicine (***) €***.** Videovisit nuclear medicine (***) €***.** Neurology video consultation €**.** Videoconsultation geriatrics €**.** Videoconsulting orthopedics €**.** Videoconsultation allergology from €**.** Videoconsulting endocrinology from €**.** Nutrition videovisit (***) €**.** Pedriatic videovisita from €**.** Dietary videovisit (***) €**.**

4.3 New supply trends: artificial intelligence in the service of healthcare

Artificial intelligence (***) is playing an increasingly significant role in telemedicine, offering significant benefits to both healthcare providers and patients. AI is revolutionizing patient care by making it more efficient, personalized and accessible. Listed below are as some of the key applications and considerations of AI in this field: Mhealth and Telehealth : Mobile health (***) and telemedicine are rapidly gaining momentum. These technologies leverage artificial intelligence to provide patients with remote access to health services, transforming the way health care is delivered. EHS (***): EHS is another area where artificial intelligence is making strides. AI-based EHS solutions are improving workplace safety and environmental compliance, providing a healthier and safer work environment. EHR (***): electronic health records are being revolutionized through artificial intelligence. AI to healthcare providers to access comprehensive patient data in real time, improving patient care and safety. Advances in medical technology: the synergy between artificial intelligence and medical technology is leading to breakthroughs. From robotic surgeries to smart prosthetics, artificial intelligence is improving the accuracy and outcomes of medical procedures. Investment in artificial intelligence in healthcare: investors are recognizing the potential of artificial intelligence in healthcare, fueling the development of innovative solutions. Funding is pouring into artificial intelligence startups, promising revolutionary advances in ...

5.1 Regulations

There are several regulations regarding telemedicine or related processes, and these are at the national level but also at the regional level. The following is a non-exhaustive list showing some of the most relevant regulations.

Law No. *** of December *, **** defines what telemedicine is and its parameters Article *a of Legislative Decree ***/**** as amended and supplemented provides that "The regions ensure the essential and uniform levels of care, making use of the facilities directly managed by local health units, hospital companies, university companies and institutes of hospitalization and care of a scientific nature The Agreement signed on February **, ****(***) at the Permanent Conference for Relations between the State, Regions, Autonomous Provinces on the document entitled "Telemedicine - National Guidelines," examines aspects related to the strategic framework of interventions, the definition and classification of telemedicine services, possible organizational models, and the integration of telemedicine in the health service, identifying the reference elements necessary for a consistent design and use of telemedicine systems within the NHS The Agreement between the State and the Regions and Autonomous Provinces of Trento and Bolzano of January **, **** provides for teleconsultation to strengthen regional networks of rare diseases. Ministerial Decree April **, **** establishes the new guidelines contained in the "Digital Model ...

6.1 Segmentation

Telemedicine platforms

Private healthcare facilities with telemedicine service

• Health Telematic Network s.r.l
• Ospedale San Raffaele
• Gruppo San Donato
• Althea
• Humanitas Mirasole S.p.A.