Big data has become a hot topic of late for Orion Health, as the technology has matured to a point where it can be successfully used in real applications to enable effective population health management.

While the concept of 'population health management' isn't often used in Canada, it's an idea whose time has come and can bring about healthcare advantages if embraced by CIOs, healthcare decision makers and governing jurisdictions. Provincial and territorial health systems continue to implement and grow successful EHRs that tear down barriers to seamless communication amongst providers through the secure, yet fluid, transfer of complete clinical records and eReferrals. The data acquired during these processes provides valuable insight for clinicians and improves the quality of care we deliver. This has come about because the EHR allows healthcare providers access to more complete information on patients at the point of care. Additionally, that information, when handled correctly, can provide a much better understanding of health patterns across a population or region, allowing for new ways to take action in our quest to improve healthcare.

So how do we go about collecting useful patient data, pulling insights and making them actionable? Orion Health has developed a six step process that outlines, at a very high level, the project plan for achieving this. It includes the Acquisition of data; Aggregation of data; Access to data, Analytics, Action and Adoption of systems. These six As explain how care providers and healthcare organizations can achieve population level healthcare through the better understanding of their patients and by leveraging the proper IT infrastructure. Over the next few months, Orion Health will profile each of these steps and explain how they apply to the Canadian context. So allow us to introduce the first step.


Patient data resides in a wide range of clinical sources – from EMRs to EHRs. These processes and systems carry with them a wealth of information that provincial and territorial healthcare providers can use. As the capabilities of the healthcare system expand to include both internal and external IT systems, the complexity of patient data acquisition is amplified. It's not enough to consider the data that is collected when a patient is admitted or a referral is received. Key patient data in community practices and specialist clinics' must be collected and made securely accessible as well. This is where an integration engine comes into play. Without the ability to securely connect data from every source, that information remains within its own silo.

We can't gain valuable insights into cancer care if we're simply gathering data from a certain few specialists. Data from across the entire care continuum must be captured in order to have a complete picture of the patient and to recommend the most relevant actionable insights. Installing and connecting a fully interoperable integration engine is the logical first step and ensures that the right information is easily acquired.

Consider the province of Quebec – with almost a quarter of Canada's population residing in the country's second largest province, Quebec required robust scalable technology that could support the weight of the population while still reaching all geographical corners. Adding to the challenge was the fact that Quebec is a French province, with 80% of the population identifying as Francophone. Quebec needed a healthcare system that was equally intuitive in both of Canada's official languages, while still flexible enough to service a large population.

Quebec leveraged Orion Health's Rhapsody Integration Engine and a Clinical Portal to create the 'Dossier Santé Québec (DSQ)” EHR system, enabling proper care coordination across the entire province. The solution collects and makes available essential health information for frontline services, including prescribed medications, lab results as well as imaging results. Eventually, the DSQ will evolve to include administered vaccinations, hospital discharge notes and patient allergies or intolerances. The collection of essential data from various sources helps Quebec seamlessly connect and consolidate patient data province-wide. Rhapsody's highly flexible integration engine ensures that a huge volume of patient data is collected regardless of language or location while remaining secure. As of 2013, the DSQ is now in place everywhere in Quebec with full support for the French language. The province can use the solution to gain insights into their population's health and enhance procedures across the entire spectrum of care for almost eight million Canadians. Quebec demonstrates that no matter what unique circumstances are in play, population health management is still obtainable through standardization and the right IT infrastructure.

There's no question that acquisition of data is the first integral step in improving population health management, but there's still five more steps to come. Keep your eyes out for our next post where we will discuss successful data aggregation.