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1462665

2030 年病人參與技術市場預測：按產品類型、組件、治療領域、應用、最終用戶和地區進行的全球分析

Patient Engagement Technology Market Forecasts to 2030 - Global Analysis By Delivery Type, Component, Therapeutic Area, Application, End User and by Geography
出版日期: | 出版商: Stratistics Market Research Consulting | 英文 200+ Pages | 商品交期: 2-3個工作天內

價格

根據 Stratistics MRC 的數據，2023 年全球病人參與技術市場規模為 193.8 億美元，預計到 2030 年將達到 428.3 億美元，預測期內年複合成長率為 12.0%。

患者參與技術一詞描述了一組電子工具，旨在幫助人們掌控自己的醫療保健。這些工具簡化了管理程序，使患者能夠在自己的健康中發揮積極作用，並改善患者與醫療保健專業人員之間的溝通。此外，患者參與的技術可以實現協作、增加便利性，並最終改善健康結果。

根據美國醫學協會 (AMA) 的說法，病人參與技術透過使患者能夠積極參與治療決策並促進更好的健康結果，在改變醫療保健服務方面發揮關鍵作用。

對客製化醫療解決方案的需求不斷成長

現今的患者希望獲得更個人化、適合其獨特需求和偏好的醫療保健。病人參與科技透過提供各種個人化解決方案（例如穿戴式裝置、遠端醫療平台和健康監測應用程式），使患者能夠成為其護理旅程的積極參與者。這些技術使用機器學習演算法和資料分析來提供個人化的健康建議、預防保健提醒和生活方式介入。此外，這些解決方案透過滿足患者個別需求、提高患者滿意度和對治療計劃的依從性來改善健康結果。

工作流程中斷和供應商阻力

由於抵制變革、擔心文書工作增加以及工作流程中斷，醫療保健提供者可能會發現很難將患者參與的技術納入臨床工作流程。將新技術整合到當前的實踐中需要時間、培訓和支持，以確保順利整合和使用者接受。此外，一些醫療保健專業人員可能對患者參與的技術持懷疑態度或不願意接受，認為這可能會威脅到他們的獨立性、知識和工作滿意度。

改善患者和提供者之間的溝通

病人參與科技有可能改善患者和醫療保健專業人員之間的溝通，使其更加順暢和有效率。透過允許患者提出問題、請求處方箋補充以及透過互動式患者門戶網站、安全通訊平台和遠端醫療解決方案與醫療保健提供者進行溝通，提高患者的參與度和滿意度。此外，這些技術促進護理協調、護理連續性和共用決策，增強患者與提供者的互動並改善健康結果。

公平獲取數位資源和健康

加劇當前的健康差距和擴大數位落差是患者參與技術帶來的兩個主要風險。對於弱勢群體來說，患者參與工具可能很難實施和利用，例如低收入個人、老年人、農村居民以及那些獲得技術或網路機會有限的人。此外，數位健康素養和技術取得方面的差異可能會導致健康結果和取得方面的更大差異，因為邊緣化群體可能被排除在這些技術的好處之外。

COVID-19 的影響：

由於 COVID-19 大流行，病人參與技術得到了顯著成長和採用。疫情的爆發促使世界各地的醫療系統迅速轉向數位解決方案，以減緩病毒的傳播並保持護理的連續性。這場大流行加速了虛擬護理計劃、遠端醫療平台和遠端監控工具的採用。對患者參與技術的需求也有所增加，這些技術促進患者和醫療保健提供者之間的溝通、遠端諮詢和健康監測。此外，這場大流行凸顯了患者參與自我護理、預防和慢性病管理的價值。

雲端基礎的細分市場預計將在預測期內成為最大的細分市場

市場佔有率最大的類別是雲端基礎的細分市場。雲端基礎的病人參與解決方案的擴充性、彈性和可訪問性使醫療保健公司能夠遠端部署和管理這些技術，而無需大量的現場基礎設施​​。此外，雲端基礎的解決方案利用雲端運算資源和軟體應用程式，可以方便地存取患者資料、即時更新以及醫療保健提供者和患者之間在不同設備和位置之間的協作。

預計心理健康領域在預測期內將經歷最高的年複合成長率。

病人參與技術市場年複合成長率最高的是心理健康領域。由於意識和去污名化舉措的提高，對專門為心理健康管理和支持而設計的病人參與技術的需求也隨之增加，隨著心理健康的增加，人們越來越認知到心理健康是整體福祉的一個重要方面。這些技術涵蓋了廣泛的解決方案，包括數位認知行為治療 (CBT) 程序、遠距治療平台、心理健康應用程式和情緒追蹤工具。此外，目標是改善獲得心理健康服務的機會，實現早期療育，並為人們提供更好地管理心理健康所需的工具。

佔比最大的地區：

由於先進的醫療基礎設施、數位醫療解決方案的高採用率、強大的法規環境以及醫療 IT 投資的不斷增加，北美成為病人參與技術市場佔有率最大的地區。由於該地區擁有完善的醫療生態系統，強調以患者為中心的護理並採用基於價值的報銷模式，因此各種醫療機構對病人參與技術的需求很高。此外，透過政府機構、醫療保健組織和技術供應商的策略性舉措，互通性的增強、遠端醫療的擴展和病人參與正在進一步加速北美市場的成長。

年複合成長率最高的地區：

亞太地區在病人參與技術市場的年複合成長率最高。這是由於醫療保健成本上升、醫療費用增加、數位醫療解決方案的更多採用以及醫療保健服務的普及等因素造成的。我深受啟發，該地區人口的成長、醫療保健意識的提高以及對優質醫療保健的需求不斷成長，推動了對病人參與技術的投資，以改善醫療保健的可及性、降低成本並改善結果。此外，與技術提供者的合作、監管改革以及支持數位醫療的政府舉措正在加速亞太市場的成長。

免費客製化服務

訂閱此報告的客戶可以存取以下免費自訂選項之一：

  • 公司簡介
    • 其他市場參與者的綜合分析（最多 3 家公司）
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  • 區域分割
    • 根據客戶興趣對主要國家的市場估計、預測和年複合成長率（註：基於可行性檢查）
  • 競爭基準化分析
    • 根據產品系列、地理分佈和策略聯盟對主要企業基準化分析

目錄

第1章執行摘要

第2章 前言

  • 概述
  • 相關利益者
  • 調查範圍
  • 調查方法
    • 資料探勘
    • 資料分析
    • 資料檢驗
    • 研究途徑
  • 調查來源
    • 主要調查來源
    • 二次研究資料
    • 先決條件

第3章市場趨勢分析

  • 促進因素
  • 抑制因素
  • 機會
  • 威脅
  • 應用分析
  • 最終用戶分析
  • 新興市場
  • COVID-19 疾病的影響

第4章波特五力分析

  • 供應商的議價能力
  • 買方議價能力
  • 替代品的威脅
  • 新進入者的威脅
  • 競爭公司之間的敵對關係

第5章全球病人參與技術市場：依產品類型

  • 基於網路的
  • 雲端基礎
  • 本地
  • 其他運輸方式

第6章全球病人參與技術市場：按組成部分

  • 軟體
  • 服務
  • 硬體
  • 其他組件

第7章全球病人參與技術市場：按治療領域

  • 慢性病
  • 健身
  • 女性健康
  • 精神健康
  • 其他治療領域

第8章全球病人參與技術市場：依應用分類

  • 社會管理
  • 家庭醫療保健管理
  • 財務健康管理
  • 其他用途

第9章全球病人參與技術市場：依最終用戶分類

  • 付款人
  • 提供者
  • 病人
  • 個人用戶
  • 其他最終用戶

第10章全球病人參與技術市場：按地區

  • 北美洲
    • 美國
    • 加拿大
    • 墨西哥
  • 歐洲
    • 德國
    • 英國
    • 義大利
    • 法國
    • 西班牙
    • 其他歐洲國家
  • 亞太地區
    • 日本
    • 中國
    • 印度
    • 澳洲
    • 紐西蘭
    • 韓國
    • 其他亞太地區
  • 南美洲
    • 阿根廷
    • 巴西
    • 智利
    • 南美洲其他地區
  • 中東/非洲
    • 沙烏地阿拉伯
    • 阿拉伯聯合大公國
    • 卡達
    • 南非
    • 其他中東和非洲

第11章 主要進展

  • 合約、夥伴關係、協作和合資企業
  • 收購和合併
  • 新產品發布
  • 業務擴展
  • 其他關鍵策略

第12章 公司概況

  • Orion Health Ltd.
  • Medecision Inc.
  • Patientpoint, LLC
  • CipherHealth Inc
  • Oracle
  • Allscripts Healthcare, LLC
  • Phytel Inc.
  • Lincor Solutions Ltd.
  • Oneview Ltd.
  • YourCareUniverse Inc.
  • GetWellNetwork, Inc.
  • SONIFI Health Incorporated.
  • Mckesson Corporation
Product Code: SMRC25716

According to Stratistics MRC, the Global Patient Engagement Technology Market is accounted for $19.38 billion in 2023 and is expected to reach $42.83 billion by 2030 growing at a CAGR of 12.0% during the forecast period. The term patient engagement technology describes a group of electronic tools intended to help people take charge of their own healthcare. These tools simplify administrative procedures, enable patients to actively participate in their own health, and improve communication between patients and healthcare professionals. Moreover, patient engagement technology enables collaboration, improves convenience, and eventually results in better health outcomes.

According to the American Medical Association (AMA), patient engagement technology plays a pivotal role in transforming healthcare delivery by empowering patients to actively participate in their care decisions and promoting better health outcomes.

Market Dynamics:

Driver:

Growing need for customized medical solutions

Modern patients demand healthcare that is more individualized and tailored to their unique requirements and preferences. Patient engagement technologies enable patients to actively participate in their care journey by providing a range of personalized solutions like wearables, telehealth platforms, and health monitoring apps. These technologies use machine learning algorithms and data analytics to provide personalized health recommendations, reminders for preventive care, and lifestyle interventions. Additionally, these solutions improve health outcomes by meeting individual patient needs and improving patient satisfaction and treatment plan adherence.

Restraint:

Workflow disruptions and provider resistance

Healthcare providers may encounter difficulties incorporating patient engagement technologies into their clinical workflows because of resistance to change, concerns about increased paperwork, and workflow disruptions. In order to guarantee smooth integration and user acceptance, integrating new technologies into current practice routines takes time, training, and support. Furthermore, some medical professionals might be skeptical of or reluctant to accept these innovations because they believe that patient engagement technologies pose a threat to their independence, knowledge, or job satisfaction.

Opportunity:

Improvements in patient-provider communication

Technologies for patient engagement present chances to improve the smoothness and efficiency of communication between patients and healthcare professionals. Engagement and satisfaction are increased when patients can ask questions, request prescription refills, and communicate with their providers through interactive patient portals, secure messaging platforms, and telemedicine solutions. Additionally, these technologies facilitate care coordination, continuity of care, and shared decision-making, which enhances patient-provider interactions and improves health outcomes.

Threat:

Equitable access to digital resources and health

Exacerbating current health disparities and expanding the digital divide are two of the main risks posed by patient engagement technologies. Patient engagement tools may be difficult for vulnerable populations to adopt and use, such as low-income people, elderly patients, residents of rural areas, and people with limited access to technology or the internet. Moreover, due to the potential exclusion of marginalized groups from the benefits of these technologies, there may be even greater disparities in healthcare outcomes and access as a result of this discrepancy in digital health literacy and access to technology.

Covid-19 Impact:

Patient engagement technology has seen significant growth and adoption due to the COVID-19 pandemic, which has caused healthcare systems all over the world to quickly shift to digital solutions in an effort to slow the virus's spread and preserve continuity of care. The pandemic has accelerated the adoption of virtual care programs, telehealth platforms, and remote monitoring tools. It has also raised demand for patient engagement technologies, which facilitate communication between patients and providers as well as remote consultations and health monitoring. Additionally, the pandemic has highlighted the value of patient involvement in self-care, prevention, and the management of chronic conditions.

The Cloud Based segment is expected to be the largest during the forecast period

The category with the largest market share is the cloud-based segment. Healthcare companies can deploy and manage these technologies remotely without requiring a large amount of on-site infrastructure, thanks to the scalability, flexibility, and accessibility of cloud-based patient engagement solutions. Moreover, cloud-based solutions facilitate easy access to patient data, real-time updates, and collaboration between healthcare providers and patients across various devices and locations by utilizing cloud computing resources and software applications.

The Mental Health segment is expected to have the highest CAGR during the forecast period

The patient engagement technology market's highest CAGR is seen in the mental health segment. Demand for patient engagement technologies specifically designed for mental health management and support has increased as a result of growing awareness and destigmatization initiatives, as well as the growing recognition of mental health as a crucial aspect of overall well-being. These technologies cover a broad range of solutions, such as digital cognitive behavioural therapy (CBT) programs, teletherapy platforms, mental wellness apps, and mood tracking tools. Furthermore, their goals are to improve access to mental health services, enable early intervention, and give people the tools they need to manage their mental health more successfully.

Region with largest share:

Due to its sophisticated healthcare infrastructure, high rate of adoption of digital health solutions, strong regulatory environment, and rising investments in healthcare IT, North America is the region with the largest market share for patient engagement technology. Patient engagement technologies are in high demand across a range of healthcare settings due to the region's developed healthcare ecosystem, strong emphasis on patient-centered care, and value-based reimbursement models. Additionally, the promotion of interoperability, the expansion of telehealth, and patient engagement through strategic initiatives by government agencies, healthcare organizations, and technology vendors has further expedited the growth of the market in North America.

Region with highest CAGR:

In the patient engagement technology market, Asia-Pacific has the highest CAGR. This is due to factors like rising healthcare costs, growing healthcare expenditures, the growing adoption of digital health solutions, and expanding access to healthcare services. Investments in patient engagement technologies aimed at enhancing healthcare access, affordability, and outcomes have been stimulated by the region's growing population, growing healthcare awareness, and growing demand for high-quality healthcare. Furthermore, partnerships with technology providers, regulatory reforms, and government initiatives to support digital health have accelerated the growth of the Asia-Pacific market.

Key players in the market

Some of the key players in Patient Engagement Technology market include Orion Health Ltd., Medecision Inc., Patientpoint, LLC, CipherHealth Inc, Oracle, Allscripts Healthcare, LLC, Phytel Inc., Lincor Solutions Ltd., Oneview Ltd., YourCareUniverse Inc., GetWellNetwork, Inc., SONIFI Health Incorporated. and Mckesson Corporation.

Key Developments:

In January 2024, Finland's Orion Corp has entered into a licensing agreement with digital therapeutics (DTx) specialist Newel Health, handing over rights to an app designed to support patients with chronic pain. Newel gains exclusive worldwide rights to develop, manufacture, and commercialise the app, called Rohkea or ODD-403, which uses virtual reality to deliver a gamified treatment programme for chronic pain that specifically aims to address patients' fear of movement and re-injury.

In November 2023, Oracle signed a Memorandum of Understanding (MOU) with the Ministry of Higher Education, Scientific Research and Innovation, and the Ministry of Digital Transition and Administrative Reform. The MoU brings together the classroom to career learning resources and curriculum of Oracle Academy to all higher education institutions in Morocco, alongside Oracle University providing complementary professional digital learning journeys and certifications accessible from a dedicated Learning Portal.

In January 2023, CipherHealth has announced a partnership with Google Cloud partner SADA to enable social determinant of health (SDOH) data integration in an effort to improve patient care. SADA, together with Google Cloud, has enabled us to provide our customers with new insights into their patient populations, giving them the power to make appropriate care delivery changes that directly impact patient care, Nate Perry-Thistle, chief technology officer at CipherHealth, said in a press release.

Delivery Types Covered:

  • Web Based
  • Cloud Based
  • On Premise
  • Other Delivery Types

Components Covered:

  • Software
  • Service
  • Hardware
  • Other Components

Therapeutic Areas Covered:

  • Chronic Diseases
  • Fitness
  • Women Health
  • Mental Health
  • Other Therapeutic Areas

Applications Covered:

  • Social Management
  • Home Healthcare Management
  • Financial Health Management
  • Other Applications

End Users Covered:

  • Payers
  • Providers
  • Patients
  • Individual Users
  • Other End Users

Regions Covered:

  • North America
    • US
    • Canada
    • Mexico
  • Europe
    • Germany
    • UK
    • Italy
    • France
    • Spain
    • Rest of Europe
  • Asia Pacific
    • Japan
    • China
    • India
    • Australia
    • New Zealand
    • South Korea
    • Rest of Asia Pacific
  • South America
    • Argentina
    • Brazil
    • Chile
    • Rest of South America
  • Middle East & Africa
    • Saudi Arabia
    • UAE
    • Qatar
    • South Africa
    • Rest of Middle East & Africa

What our report offers:

  • Market share assessments for the regional and country-level segments
  • Strategic recommendations for the new entrants
  • Covers Market data for the years 2021, 2022, 2023, 2026, and 2030
  • Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations)
  • Strategic recommendations in key business segments based on the market estimations
  • Competitive landscaping mapping the key common trends
  • Company profiling with detailed strategies, financials, and recent developments
  • Supply chain trends mapping the latest technological advancements

Free Customization Offerings:

All the customers of this report will be entitled to receive one of the following free customization options:

  • Company Profiling
    • Comprehensive profiling of additional market players (up to 3)
    • SWOT Analysis of key players (up to 3)
  • Regional Segmentation
    • Market estimations, Forecasts and CAGR of any prominent country as per the client's interest (Note: Depends on feasibility check)
  • Competitive Benchmarking
    • Benchmarking of key players based on product portfolio, geographical presence, and strategic alliances

Table of Contents

1 Executive Summary

2 Preface

  • 2.1 Abstract
  • 2.2 Stake Holders
  • 2.3 Research Scope
  • 2.4 Research Methodology
    • 2.4.1 Data Mining
    • 2.4.2 Data Analysis
    • 2.4.3 Data Validation
    • 2.4.4 Research Approach
  • 2.5 Research Sources
    • 2.5.1 Primary Research Sources
    • 2.5.2 Secondary Research Sources
    • 2.5.3 Assumptions

3 Market Trend Analysis

  • 3.1 Introduction
  • 3.2 Drivers
  • 3.3 Restraints
  • 3.4 Opportunities
  • 3.5 Threats
  • 3.6 Application Analysis
  • 3.7 End User Analysis
  • 3.8 Emerging Markets
  • 3.9 Impact of Covid-19

4 Porters Five Force Analysis

  • 4.1 Bargaining power of suppliers
  • 4.2 Bargaining power of buyers
  • 4.3 Threat of substitutes
  • 4.4 Threat of new entrants
  • 4.5 Competitive rivalry

5 Global Patient Engagement Technology Market, By Delivery Type

  • 5.1 Introduction
  • 5.2 Web Based
  • 5.3 Cloud Based
  • 5.4 On Premise
  • 5.5 Other Delivery Types

6 Global Patient Engagement Technology Market, By Component

  • 6.1 Introduction
  • 6.2 Software
  • 6.3 Service
  • 6.4 Hardware
  • 6.5 Other Components

7 Global Patient Engagement Technology Market, By Therapeutic Area

  • 7.1 Introduction
  • 7.2 Chronic Diseases
  • 7.3 Fitness
  • 7.4 Women Health
  • 7.5 Mental Health
  • 7.6 Other Therapeutic Areas

8 Global Patient Engagement Technology Market, By Application

  • 8.1 Introduction
  • 8.2 Social Management
  • 8.3 Home Healthcare Management
  • 8.4 Financial Health Management
  • 8.5 Other Applications

9 Global Patient Engagement Technology Market, By End User

  • 9.1 Introduction
  • 9.2 Payers
  • 9.3 Providers
  • 9.4 Patients
  • 9.5 Individual Users
  • 9.6 Other End Users

10 Global Patient Engagement Technology Market, By Geography

  • 10.1 Introduction
  • 10.2 North America
    • 10.2.1 US
    • 10.2.2 Canada
    • 10.2.3 Mexico
  • 10.3 Europe
    • 10.3.1 Germany
    • 10.3.2 UK
    • 10.3.3 Italy
    • 10.3.4 France
    • 10.3.5 Spain
    • 10.3.6 Rest of Europe
  • 10.4 Asia Pacific
    • 10.4.1 Japan
    • 10.4.2 China
    • 10.4.3 India
    • 10.4.4 Australia
    • 10.4.5 New Zealand
    • 10.4.6 South Korea
    • 10.4.7 Rest of Asia Pacific
  • 10.5 South America
    • 10.5.1 Argentina
    • 10.5.2 Brazil
    • 10.5.3 Chile
    • 10.5.4 Rest of South America
  • 10.6 Middle East & Africa
    • 10.6.1 Saudi Arabia
    • 10.6.2 UAE
    • 10.6.3 Qatar
    • 10.6.4 South Africa
    • 10.6.5 Rest of Middle East & Africa

11 Key Developments

  • 11.1 Agreements, Partnerships, Collaborations and Joint Ventures
  • 11.2 Acquisitions & Mergers
  • 11.3 New Product Launch
  • 11.4 Expansions
  • 11.5 Other Key Strategies

12 Company Profiling

  • 12.1 Orion Health Ltd.
  • 12.2 Medecision Inc.
  • 12.3 Patientpoint, LLC
  • 12.4 CipherHealth Inc
  • 12.5 Oracle
  • 12.6 Allscripts Healthcare, LLC
  • 12.7 Phytel Inc.
  • 12.8 Lincor Solutions Ltd.
  • 12.9 Oneview Ltd.
  • 12.10 YourCareUniverse Inc.
  • 12.11 GetWellNetwork, Inc.
  • 12.12 SONIFI Health Incorporated.
  • 12.13 Mckesson Corporation

List of Tables

  • Table 1 Global Patient Engagement Technology Market Outlook, By Region (2021-2030) ($MN)
  • Table 2 Global Patient Engagement Technology Market Outlook, By Delivery Type (2021-2030) ($MN)
  • Table 3 Global Patient Engagement Technology Market Outlook, By Web Based (2021-2030) ($MN)
  • Table 4 Global Patient Engagement Technology Market Outlook, By Cloud Based (2021-2030) ($MN)
  • Table 5 Global Patient Engagement Technology Market Outlook, By On Premise (2021-2030) ($MN)
  • Table 6 Global Patient Engagement Technology Market Outlook, By Other Delivery Types (2021-2030) ($MN)
  • Table 7 Global Patient Engagement Technology Market Outlook, By Component (2021-2030) ($MN)
  • Table 8 Global Patient Engagement Technology Market Outlook, By Software (2021-2030) ($MN)
  • Table 9 Global Patient Engagement Technology Market Outlook, By Service (2021-2030) ($MN)
  • Table 10 Global Patient Engagement Technology Market Outlook, By Hardware (2021-2030) ($MN)
  • Table 11 Global Patient Engagement Technology Market Outlook, By Other Components (2021-2030) ($MN)
  • Table 12 Global Patient Engagement Technology Market Outlook, By Therapeutic Area (2021-2030) ($MN)
  • Table 13 Global Patient Engagement Technology Market Outlook, By Chronic Diseases (2021-2030) ($MN)
  • Table 14 Global Patient Engagement Technology Market Outlook, By Fitness (2021-2030) ($MN)
  • Table 15 Global Patient Engagement Technology Market Outlook, By Women Health (2021-2030) ($MN)
  • Table 16 Global Patient Engagement Technology Market Outlook, By Mental Health (2021-2030) ($MN)
  • Table 17 Global Patient Engagement Technology Market Outlook, By Other Therapeutic Areas (2021-2030) ($MN)
  • Table 18 Global Patient Engagement Technology Market Outlook, By Application (2021-2030) ($MN)
  • Table 19 Global Patient Engagement Technology Market Outlook, By Social Management (2021-2030) ($MN)
  • Table 20 Global Patient Engagement Technology Market Outlook, By Home Healthcare Management (2021-2030) ($MN)
  • Table 21 Global Patient Engagement Technology Market Outlook, By Financial Health Management (2021-2030) ($MN)
  • Table 22 Global Patient Engagement Technology Market Outlook, By Other Applications (2021-2030) ($MN)
  • Table 23 Global Patient Engagement Technology Market Outlook, By End User (2021-2030) ($MN)
  • Table 24 Global Patient Engagement Technology Market Outlook, By Payers (2021-2030) ($MN)
  • Table 25 Global Patient Engagement Technology Market Outlook, By Providers (2021-2030) ($MN)
  • Table 26 Global Patient Engagement Technology Market Outlook, By Patients (2021-2030) ($MN)
  • Table 27 Global Patient Engagement Technology Market Outlook, By Individual Users (2021-2030) ($MN)
  • Table 28 Global Patient Engagement Technology Market Outlook, By Other End Users (2021-2030) ($MN)

Note: Tables for North America, Europe, APAC, South America, and Middle East & Africa Regions are also represented in the same manner as above.