CareGroup's Kiwi Cure

When Boston's Beth Israel and Deaconess hospitals merged to form CareGroup last October they spent six months and less than $US50,000 creating CareWeb, a World Wide Web-based common medical record source. They did so with the help of an ActiveX messaging system called Symphonia from New Zealand-based Orion Systems.

When Boston’s Beth Israel and Deaconess hospitals merged to form CareGroup last October they spent six months and less than $US50,000 creating CareWeb, a World Wide Web-based common medical record source.

However, to merge the two hospitals’ records took several porting steps and a piece of luck. The underlying communications standards which hospitals rely on to share data is called HL7 (Health Level 7) EDI (electronic data interchange) for Healthcare.

Dr John Halamka, a postdoctoral fellow at Beth Israel, knew that it would take him months to create a component which could disassemble HL7 messages from the two hospital environments.

Instead he found an HL7-specific ActiveX messaging system called Symphonia from a New Zealand-based outfit called Orion Systems ( which could do it for him.

Orion Systems, which is based in an old fire station in Auckland has grown slowly but steadily from four people four years ago to 17 people today — 13 of whom are developers.

“We have a high ratio of developers to sales and other people,” says director Ian McCrae.

McCrae says Orion Systems’ product Symphonia is basically about communication. “We write software so different computer systems can talk to each other.”

Symphonia is finding a ready market both in New Zealand and overseas for health organisations wanting a system which enables them to read documents created in diverse languages and applications.

“We’ve sold it to Toronto hospital, the New York health department, several veterans hospital sites, Harvard University, Siemens in Germany and Hewlett-Packard — though we’re not quite sure what HP is using it for — probably to get a closer look at our technology. But that doesn’t worry me; we’re a lot quicker on our feet than HP,” says McCrae.

Orion has also had orders from Japan, Korea and lately Brazil, “but I think we’ll get the payment first from Brazil before we ship the product to them,” says McCrae.

Orion has also made some sales in Europe but McCrae says the best business opportunities are in America.

“America is far easier than anywhere else and they will spend $US20-80,000 just like that. In Asia there are language barriers and automation is not as advanced. But the scale of the American market is so large that there are towns I’ve never heard of which are bigger than New Zealand. Lab vendor site numbers are also much bigger — in the States they’ll have 500 to 2000 each whereas here, 40 would be a reasonable size. Some companies have a $US1 to $US2 billon revenue, so the opportunities are very large.”

The reason for so many overseas sales (McCrae estimates overseas sales make up a third to a half of all Orion’s sales) is Orion’s aggressive marketing.

“We set up an Internet site 18 months ago and hoped the orders would come in — they didn’t. So we pushed the software — we sent out 2000 faxes via an American Internet site where you can send faxes for US15 cents per minute and distribute from there at a local rate. We targeted businesses with health software interests. We also sent email shots to mailing groups — which occasionally backfired on us.”

McCrae found there was an initial flurry of activity from early adopters then sales went quiet until the early adopters got going with live sites and word of mouth spread that Orion had a good product.

Now Orion does a lot of its sales through follow-up calls after people download software samples from its Internet site.

“We capture the phone number as a mandatory field when they download. Most are extremely happy when they get a follow-up call. There are some who don’t like to put their phone numbers or who put wrong numbers and we do have a proportion of that, but those who are seriously interested in the product will give their correct number.”

This sales technique means Orion staff often end up working US hours.

“It’s a real problem not being represented in the US and it’s hard being taken seriously as a company from New Zealand — many large hospitals just don’t want to deal with us. But we’ve got a totally unique product so people eventually come to us. We’re starting to develop new protocols using CORBA so that we will be even further ahead than other companies.”

Because of New Zealand’s recent health reforms, McCrae believes this country is far ahead of Australia in terms of dealing with medical information and developing information systems.

“We’re quite a lot further ahead of Australia in this particular area of electronic communications. This is for two main reasons — the health reforms and because one of the past directors of information services at the Ministry of Health decided four years ago to establish HL 7 as the new protocol to transfer information between labs, referrals by GPs etc. It was one of many protocols about at the time but it happens that HL7 is the way the world is going, so that some of the health software products developed here are now ahead of products overseas.”

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