Healthcare Electronic Data Interchange (EDI) Market Research Report – Global Forecast till 2030

Healthcare Electronic Data Interchange (EDI) Market Research Report Information by Component (Software and Services), by Delivery Mode (Web and Cloud-based, EDI VAN), by Transaction (Claims & Encounters), end user - Global Forecast Till 2030

ID: MRFR/HC/5869-HCR | 90 Pages | Author: Kinjoll Dey | December 2023         

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Healthcare Electronic Data Interchange Market Overview:

Healthcare electronic data interchange market was valued USD 2674 million in 2017 and is projected to grow at a CAGR of 8.60% by 2030. 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.

Healthcare Electronic Data Interchange Market Dynamics:


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. 


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.


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.


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 Segment Overview:

Based on Transaction:

  • Claims and encounters

  • Payment and Remittance Advance

  • Eligibility Inquiry and Response

  • Claim Attachments

  • Enrollments

  • Referral Certification and authorization

Based on Component:

  • Solutions

  • Services

Based on delivery mode:

  • EDI Value Added Network (VAN)

  • Direct (Point-to-Point) EDI

  • Mobile EDI

  • Web and Cloud-based EDI

Based on End User:

  • Payer

  • Provider

  • Others

Healthcare Electronic Data Interchange Market 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.

Healthcare Electronic Data Interchange Market Competitive landscape:

  • Allscripts Healthcare Solutions Inc. Cognizant

  • Experian Information Solutions Inc.

  • GE Healthcare

  • McKesson Corporation

  • Optum Inc.

  • Schreiner Group

  • Siemens Healthineers

  • The SSI Group LLC

  • ZirMed Inc.

Healthcare Electronic Data Interchange Market Recent developments:

In the year 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. 

In the year 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

Report Scope:

Report Attribute/Metric Details
  Market Size   2030: Significant Value
  CAGR   8.60% (2020-2030)
  Base Year   2019
  Forecast Period   2020-2030
  Historical Data   2018
  Forecast Units   Value (USD Million)
  Report Coverage   Revenue Forecast, Competitive Landscape, Growth Factors, and Trends
  Segments Covered   Component, Delivery Mode, Transaction and end user
  Geographies Covered   North America, Europe, Asia-Pacific, and Rest of the World (RoW)
  Key Vendors   GE Healthcare, McKesson Corporation, Cognizant, Allscripts Healthcare Solutions Inc., Siemens Healthineers, Optum, Inc., The SSI Group, LLC, Schreiner Group, ZirMed Inc., Experian Information Solutions, Inc., Emdeon Inc., Passport Health Communications, HealthFusion
  Key Market Opportunities   Rising awareness about the benefits associated with EDI software
  Key Market Drivers   Rising adoption of EDI for operational intelligence and performance management

Frequently Asked Questions (FAQ) :

Global healthcare electronic data interchange market was valued at more than USD 2.6 billion in 2017.

Global Healthcare Electronic Data Interchange (EDI) Market is expected to exhibit a solid 8.60% CAGR over the forecast period from 2020 to 2030.

The major driver for the healthcare electronic data interchange market is the increasing demand for higher operational intelligence and performance management in the healthcare sector, which has driven the demand for digital healthcare solutions.

The high costs of electronic data interchange systems and the threat of data theft are the key restraints on the global healthcare electronic data interchange market.

Leading players in the global healthcare electronic data interchange market include GE Healthcare, McKesson Corporation, Cognizant, Siemens, Optum Inc., ZirMed Inc., and Emdeon, among others.

Key Questions Answered

  • Global Market Outlook
  • In-depth analysis of global and regional trends
  • Analyze and identify the major players in the market, their market share, key developments, etc.
  • To understand the capability of the major players based on products offered, financials, and strategies.
  • Identify disrupting products, companies, and trends.
  • To identify opportunities in the market.
  • Analyze the key challenges in the market.
  • Analyze the regional penetration of players, products, and services in the market.
  • Comparison of major players’ financial performance.
  • Evaluate strategies adopted by major players.
  • Recommendations
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