Health in your hands: Welcome to the era of 'Precision Medicine'

Some call the smartphone the remote control of modern life. And Orion Health is combining that pervasive technology with its own expertise to pioneer the future of health.

The future of health looks a lot like your smartphone: personal, accessible, real time and connected. And it’s coming to a small screen near you, especially if Kiwi technology company Orion Health has its way. 

In modern contemporary offices on Auckland’s Khyber Pass a team of developers, UX designers and health professionals are beavering away at the next generation of health management tools. They want it to connect someone to, say, their doctor, specialist, physio, pharmacist and health funder all in one intuitive, friendly mobile app.

“We are building tools that will help you and I manage our own health – as opposed to being managed by someone else,” says Richard Fraser, VP, Engage Solutions, a line of business within Orion Health's R&D Group. “We want health to be as easy and enjoyable as using your favourite mobile apps – simple to use, super helpful, fast and connected.”

It’s a big ambition. For one thing, the opportunity is global now that devices such as smartphones are becoming such ubiquitous and all-powerful tools. 

But it’s also a challenge because health systems are notoriously complex: they’re fragmented, highly politicised and full of security and privacy concerns. 

“It’s probably one of the most complex environments to work in. We are solving whole-of-system issues as we develop. But if anyone can crack it, Orion Health can,” he says.

Credible player, big opportunity

Orion Health, an NZX-listed company, has a long track-record of success. Since its launch in 1993 it has had an export focus, developing enterprise systems for healthcare providers around the world. Today, it employs 1250 staff serving thousands of clinicians in over 17 countries. Altogether Orion Health software manages 90 million patient health records globally. Improving the management of patient data has become one of the key drivers for hospitals and primary care organisations worldwide. The pressure on these organisations is immense:

As the population ages, the number of patients is becoming overwhelming.

Lifestyle diseases such as diabetes and heart disease are massively driving up demand for treatments.

In the USA, one in ten people have a rare disease; the complexity of treatments constantly increases.

The discovery of new treatments, while exciting, also drives demand and cost.

At the same time, governments are facing the real prospect of dwindling tax revenue as the number of tax-payers falls compared to the number of elderly citizens.

Such pressure on the health system requires efficiency like never before. In the USA alone $910 billion (representing 34% of total US healthcare spend) is wastage, according to research published in the Journal of the American Medical Association. And this is where Orion Health can help.

Screenshots of Clinical Companion, a native mobile app developed in partnership with Canterbury District Health Board

A solution

By empowering the consumer with their own health data, and along with the change in incentives in the global health sector away from a fee-for-service economic model to value-based outcomes, Orion Health is shifting the emphasis from treatment to prevention.

“It’s about managing well-being in the community rather than sickness in the hospital,” says Fraser.

So how does this work? In collaboration with the Canterbury District Health Board, one of Orion Health’s innovation partners, the company has created mobile applications that will serve as the platform for clinicians and patients to access and contribute to their electronic health record data, which includes medical records, contact with care teams, and the ability to submit self observations, answer questionnaires and set personal well-being goals. 

In some ways these apps are an extension of Orion Health’s ‘patient and clinical portals’, already used by patients, hospitals and physicians globally. But it’s also a new platform entirely, requiring a massive investment in technology and usability design. And the complexity of the project derives from the scale of the challenge. 

“We're not just talking about lifestyle data from devices like the Apple Watch," says Fraser. "These apps need to understand all consumers, from the ‘well’ to the ‘will’ – -that is, people who are at risk due to poor lifestyle – and hopefully keep them from becoming the ‘ill’.”

The future of health being shaped by the team at Orion Health's Auckland office

Lifestyle management

A good example of how the app could save money and improve outcomes are the consumers who suffer chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD), asthma and hypertension. These so-called lifestyle diseases are growing in numbers and if left too late can present as expensive episodes in hospital. 

One 2012 study from the American Diabetes Association said the total estimated cost of diagnosed diabetes was US$245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity. If Orion Health can encourage consumers to become more involved in managing their lifestyle around healthy goals and tasks, allowing users to access their care plan from home and manage it with real-time data in liaison with their carers, there’s every chance they can avoid presenting to hospital. This is broadly known as patient engagement in the health industry.

“We are building tools that will help you and I manage our own health – as opposed to being managed by someone else. We want health to be as easy and enjoyable as using your favourite mobile apps – simple to use, super helpful, fast and connected.” – Richard Fraser – VP, Engage solutions

Precise engagement

What is interesting about patient engagement is that to be successful the industry needs to adopt consumer marketing techniques. Patients are consumers, with consumer expectations of the service experience. Therefore a deeper understanding of the unique profile of the consumer is required to understand their health needs and concerns, in order to more accurately address their specific health issues. 

To build a truly deep understanding of the patient (or consumer) Orion Health is building the capability to capture, store and deliver a wide set of information such as genetic, environmental, socio-demographic, and consumer-submitted observations, as well as the traditional medical and insurance data.

The collection, organisation and analysis of this data enables Orion Health to provide the real-time information that health professionals need to be able to offer highly personalised care plans, which consumers and patients can then access via their apps.

Orion Health CEO Ian McCrae

This is called Precision Medicine. When there is concern or a patient’s health deteriorates the app serves as a communication device between the patient and their clinician.  The person’s mobile device becomes the medium through which to exchange relevant data and present specific goals, actions and care plans to the patient based on their individual profile. Patient privacy is of paramount importance, which is why Orion Health technology features an advanced privacy service that provides granular access to data elements based on user roles and the sensitivity of the data.

The goal is for patients to choose to correspond with their doctor  via the mobile application rather than making an appointment. From the doctor’s perspective, they can alert a patient and discuss treatment before the patient’s condition deteriorates and hospitalisation is required.

“The opportunity for innovation in the health sector is almost limitless given the size of the problem," says Fraser. "This requires the sort of creative thinking New Zealanders are famous for. 

“With the tradition of creative thinking and innovation, as well as the visionary leadership from our founder and CEO Ian McCrae, there is no doubt Orion Health is well-placed to create the solutions needed in the global health sector for clinicians and consumers. It’s a great time to be part of a New Zealand company doing business with the world.”

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About Orion Health:

  • Established in 1993
  • 27 offices in 15 countries
  • Over 90 million patient records
  • Over 1,250 employees worldwide
  • Over 750 customers in 25 countries
  • $164m FY2015 operating revenue $102m HFY2016 operating revenue
Main Image: Richard Fraser, VP, Engage Solutions, a line of business within Orion Health's R&D Group