Not only has Orion Health cornered the public health information exchange (HIE) market in the U.S. and abroad, the healthcare integration and HIE software provider is now making inroads into the private HIE market. Since breaking into the healthcare IT space 18 years ago, the company has built many capabilities on top of its integration product to meet the ever-changing needs of today’s healthcare organizations in the throes of meaningful use.
After conquering its homeland New Zealand, Orion Health went on to break into the other commonwealth countries of Australia and England. Hoping to crack the North America market, Paul Viskovich, president, Orion Health North America, moved to the U.S. in 2002. After having a difficult time getting the attention of larger provider organizations, Orion Health approached and won over rural locales, building an initial customer base and gaining some stateside credibility with its Rhapsody integration engine product that connected disparate systems and supported a range of communication protocols and messaging formats.
“There’s an ongoing need to embrace and support the ongoing and evolving standards that are developed and commit and lead in this area to ensure that you can connect most effectively to the participants and the exchanges,” says Viskovich.
Disease Surveillance in Texas
Orion’s big American hit was when it supported messaging standards for the Centers for Disease Control (CDC) National Electronic Disease Surveillance System (NEDSS), an initiative that facilitated the development of integrated, registry-based, public health surveillance systems to identify and track emerging infectious diseases and potential bioterrorism attacks, as well as to investigate outbreaks and monitor disease trends. Rhapsody is the platform for NEDSS, which relies heavily on industry standards like LOINC, SNOMED, and HL7, and upon which modules can be built to meet state and area data needs to collect and process data.
The Texas Department of State Health Services implemented the NEDSS Base System for web-based reportable disease surveillance in May 2004, and went into statewide operation in January 2005. When the swine flu outbreak occurred in 2009, NEDSS was able to track those who were infected.
“Along came H1N1, and because we had a standards-based disease surveillance system, we could readily and rapidly customize that data capture mechanism to adjust to the peculiarities of that condition as it was emerging,” says Doug Hamaker, NEDSS coordinator, Texas Department of State Health Services. “Some of that preliminary work-up that we needed to do to capture was immediately shareable to all other states that were also users of the NEDSS system.”
The Rhapsody engine was also instrumental in helping Texas hospitals move forward with meaningful use. “We already have the infrastructure in place, so we were ahead of the curve,” says Hamaker. “We were able to be active and participatory with the hospitals and EHRs as meaningful use has been layered into the mix. It was very comfortable to be sitting where I’m sitting having the tools prior to them being called upon.”
Orion Health supports the departments of health for 48 states, including Alaska, Massachusetts, New York, and California. Internationally, seven out of 10 provinces in Canada use Orion for their HIEs, and Orion has linked up entire countries like Singapore and Australia. With all this success, Orion Health was able to tackle private HIEs like Geisinger Health System, UCLA Medical Center, St. Vincent’s HealthCare, and Catholic Healthcare Initiatives in the U.S.
Layering Services atop Standards
Orion Health’s strategy has been to layer quintessential services for providers atop its Rhapsody integration engine, says Chris Hobson, M.D., chief medical officer, Orion Health. In 1999 Orion Health took its engine to the next level by offering providers a configurable portal view for access to patient information from myriad subsystems. Two years later, a medication reconciliation and an integrated chronic disease case management module were added. The Orion Health products have continued to evolve in the past five years to engage the patient in their own care. To this end, Orion Health just signed a deal to support a patient portal for all Australians.
Hobson says the one area he’s excited about moving forward is the care of the elderly. “We see the needs for standardized care of the elderly as being one of the next big things just because the population involved coming through,” he adds. “There’s going to be a need for more systematic evidence-based care of that population.” He says that Orion Health has started a geriatrics project with Ontario to provide evidence-based assessments, based on University of Michigan data, to create a care plan if the patient has mental or mobility issues.
Chris Hobson, M.D.
Hobson says Orion Health has also helped build patient-center medical homes and accountable care organizations (ACOs), mentioning clients like the Beacon Community of the Inland Northwest, which is focusing on diabetes care and show how improved care can lead to a reduction of ED visits and inpatient admissions. Orion Health enables the capture of core clinical data at the point of care and alerts the physician if a patient has not received a certain intervention like a foot or eye check.
“What ACOs are doing today is likely to be different in three years time, so it’s important that the solutions and toolsets that we provide to ACOs are very easily extensible to meet those changing needs,” says Viskovich.
“As a software [company], we see sustainability in the ability to provide more value over and above just connecting stuff, and we see the answer in terms of providing more capabilities,” adds Hobson. “We’ve built a lot of technology that’s enabled us to build web views that otherwise would be a client’s server with more complex legacy architecture. So we’re interesting on the point of view of software capabilities, and the focus on flexibility and integration, which has enabled us to keep up with the tsunami of new requirements that keep coming at us.”