Orion plans to take on the big guys in health data revolution

Orion Health has outlined its plans to overtake the global health IT giants and do to healthcare what Facebook has done to social media by developing “thinking” software that can harness new data sources, use machine learning and ultimately provide more precise healthcare delivery.

Orion Health CEO Ian McCrae told a customer conference in Sydney this week that the company plans to double its product development capabilities by the start of 2016 and to invest in large-scale R&D programs to “have a crack” at revolutionising healthcare much like Facebook has done to social lives.

Orion Health has also restructured internally and dropped some of its musically themed brand names such as Concerto and Soprano, splitting into three solution groups called Intelligent Integration, Healthier Populations and Smarter Hospitals to better reflect the different market segments they service.

Within the latter, Orion has developed three different solutions – Enterprise, Consult and Medicines – that together can provide an end-to-end solution that can run a whole hospital but can also to reach into community healthcare.

While Orion Health is best known in New Zealand and Australia for its Concerto clinical portal and Rhapsody integration engine, the company's main market is in the US, where it is one of the leading health information exchange (HIE) vendors. Mr McCrae said the company's current position had been improved by the buy-outs of most of its competitors – Medicity, Axolotl, CareFX and dbMotion – but he wants to expand beyond HIE and overtake the really big guys: Cerner, McKesson, Epic and Allscripts.

While Orion's revenues of $160 million are minuscule in comparison to the giants, Mr McCrae believes that a revolution in health data over the next decade will fundamentally change the face of health IT.

“We are going to go from 500 petabytes of data (in 2012) to 25,000 petabytes pretty quickly (2020),” he said. “The clinical data repositories out there today can't store that amount of data. Over the next decade, lots of things are going to happen in genomics, wearable sensors, ingestibles, tissue-embedded sensors, mobile health and social health.

“Over the next decade things are going to change a lot. We would like to become one of the leading software vendors pretty much like Facebook did to our social lives. There is an opportunity for someone to do that in the health area. We'd like to have a crack at it.”

He said Orion Health had strength in that its current technology was pretty recent while others are still working with relatively old tech, and it only used two code bases – the Java web-browser code set it started with and the Microsoft code set it inherited with its purchase of Microsoft's Amalga health information system in 2012 – which the company was current combining. “Many of our competitors are M&A companies with 30, 40, 50, 100 different code bases and they have a problem trying to merge those things together,” he said.

Orion now plans to heavily invest in R&D to be in the position to harness what Mr McCrae calls the health data revolution.

“[Currently] all we do is take existing data, format it up and present it back to the users,” he said. “It's pretty dumb software. We should have thinking software – we should be reasoning, making suggestions all the time. At the end of the day it is the doctors and nurses who make the final determination, but we can help a lot.

“The first thing to do with thinking software is to get all of the data from the traditional data sources and put it into a bucket, then format it nicely and serve it back up to doctors and nurses. We can do that today and do it pretty well. Then the next thing you want to do is serve it up to the patient and their circle of care.

“Then we need to add new data sources – devices, genomics, business data, payer data, all into the same repository. Then we need to add a machine-learning, reasoning logic to the data, because ultimately what we want to do is have precise health.

“So to get from here to there, we are talking about some very large R&D programs. All of the products that we have today will probably be obsolete a couple of times over, so R&D is very important. We are going to grow our product development shop quite significantly, across several locations.

“What we are about to see is this fundamental, once in a generation change in healthcare, which is pretty exciting. What we are about is creating modern, web 2.0, thinking software.”

Smarter hospitals

Wayne Oxenham, Orion Health's executive vice president for Smarter Hospitals, told the conference that in addition to segmenting the business into three solution groups, the hospital product portfolio had also been split into three different solutions - Enterprise, Consult and Medicines - with the latter's full-line solution to be launched in nine to 12 months.

The Enterprise solution encompasses the full product offering that can run a hospital end to end, including electronic medical records, patient administration systems, clinical systems and health information exchange. Much of the core of the solution has been developed from Microsoft's Amalga HIS, which Orion purchased in 2012. The Consult solution, which is based on Concerto, and the Medicines solution, which is still in development, can be provided separately but are also part of the full Enterprise solution.

While Enterprise isn't being actively sold in Australia at the moment, there are plans to do so, he said.

“It is is functionally rich and can run a whole hospital end to end,” Mr Oxenham said. “We think is has some really nice UI. We've got integration strength and this solution also pulls in open technologies, so we can take information into our system and export it out of our system or publish it from our system so other people can use it.

“A lot of people are frustrated with things like patient administration systems where you can't put data in unless you key it in. You can't get data out in a useful form unless you get someone to write a lot of expensive code. We are passionate about creating open systems with good integration points that other people can leverage.

“We are pretty close to finishing off a solution that is multi-tenant – we can install one instance of our Enterprise solution, and it can run many hospitals. It is very scalable, and the technology that underlies it can grow rapidly with the demands on it.”

The Consult solution encompasses what most users would know as Orion's Concerto suite in addition to some added extras. This includes a clinical review – what Concerto can do now in terms of web-based, single sign-on access to a range of clinical systems – along with diagnostics, whiteboards and problem lists, and the new Medicines solution. He said this solution would be suitable for Commonwealth countries like New Zealand and Australia, where hospitals and health services have limited funding and need to continue to use clinical software bought over time.

“You might have bought a patient administration system, a lab system, a radiology system but you don't have them all together and accessible in one place to make sense to its users,” he said. “Consult is really about sitting on top of those best-of-breed solutions and providing views that are relevant to the user into that existing system.

“Then we have 'doing on top of the viewing', which is about orders, referrals, clinical documentation, whiteboards, problem lists etc. Our Consult sits on top of other people's solutions.”

The Medicines solution will have full medication ordering, pharmacy, medicines administration, medicines reconciliation and clinical decision support. While the medicines reconciliation function is available now, the full end-to-end solution is still in development and will be available sometime in the next year.

Orion Health is about to go live in the next few weeks in a brand new hospital in Turkey that uses the full end-to-end solution, the Koc University Hospital in Istanbul, he said.

Closer to home, the South Island's new Patient Information Care System (SI PICS) that is due to be rolled out to all hospitals in the South Island from next year is being built on the Consult platform.

Posted in New Zealand eHealth

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