Global health IT firm Dedalus is bringing its ORBIS EMR, Europe’s market leading electronic medical record, to the Australian and New Zealand markets, promising a cloud-enabled, modular system that users can configure to their own requirements.

ORBIS has been in the European market for 25 years and is the leading EMR in Germany and France, with over 1000 hospitals using it throughout Europe. Dedalus also plans to sunset the Lorenzo EPR, used widely in the National Health Service, and move its UK user base over to ORBIS over time.

Dedalus APAC chief medical information officer Steven Parrish said ORBIS included all of the foundational components expected of a contemporary EMR, including computerised provider order entry, clinical documentation, and results management, refined over several iterations over the years.

It also includes emergency, and acute care capabilities along with over 40 different department-specific modules that can be implemented.

“We also have something called the Composer, which allows an organisation to develop their own workflows,” Mr Parrish said. “They can take what we have and build it out and develop it for themselves, and we have some customers that have built their own modules.

“It’s quite a significant part of our offering that provides an opportunity for customers to build out what they have and to design it for themselves should they wish to.”

Mr Parrish said the latest iteration is cloud enabled but is also designed for on-premise use.

The Dedalus healthcare platform is hosted on the Amazon public cloud and leverages Amazon Web Services (AWS) cloud computing services and AWS Managed Services (AMS), which provides a set of common shared platform services such as remote access, deployment automation, network security and monitoring.

It has also been designed for mobility, with functions such as ORBIS CPOE for mobile ordering directly at the point of care, and integrates with patient administration systems including Dedalus’ own PAS systems, which dominate the market in Australia and New Zealand.

Mr Parrish emphasised ORBIS’ capabilities in clinical workflow, including through the Composer tool, which provides a ‘low-code’ approach to rapidly create new clinical workflow and customisations.

“ORBIS has over 25 years in the European market, so we’re now going into the latest iteration that’s more about clinical user experience, it’s about workflow, as opposed to being about forms,” he said. “Many EMRs are about replacing the paper form with an electronic form but this latest iteration is about leading us into more of a workflow-based process as opposed to a forms-based process.

“Through those 25 years, we’ve learned a lot. I guess the key thing for our market is that it’s not new, it’s not something that hasn’t been utilised before. It has been built on the knowledge of those 25 years in France and Germany, and we’ve really looked at what does it mean to be an EMR in the modern world.

“We need mobility and we need to make sure it enhances the clinician workflow as opposed to taking clinicians away from patient care, which a lot of EMRs seem to be the focus, as opposed to the patient being the focus?

“It’s important to engage the clinician in the care process and the patient to the care process, and help them to work together for the betterment of the outcome for that patient. To do this you make the system easy to use, making it focused on the workflow that they do, not the system itself.”

Dedalus ANZ

Mr Parrish has been CMIO with Dedalus for the last 18 months, following a five-year stint as CIO of Taranaki District Health Board in NZ, where he was also the regional lead for the Midland region’s eSPACE program and part of the national health record group and national CIO group.

Before that he was at the Mater in Brisbane, having worked his way up from clinical business analyst to CIO over 13 years.

Now, he has the rare opportunity of helping to launch a tried and tested EMR to a whole new market. It is his belief that ORBIS being a system designed for European-style socialised medicine was a big advantage on US-developed systems that have been designed initially as billing solutions for large private hospitals.

“It’s not often in your career that you get to be part of something like this,” Mr Parrish said. “To bring something that is a leader in the market in Europe to Australia and New Zealand, acknowledging that we are a little bit different to Europe, but we are more similar to some of the US systems.

“Europe has socialised medicine, as has Australia, New Zealand and Canada for that matter. ORBIS is very much designed for what you need for socialised medicine.”

While the US systems in Oracle Cerner, Epic, Altera Health and InterSystems dominate the Australian market, Dedalus very much sees opportunities in Australia and New Zealand for ORBIS, Mr Parrish said.

“We are looking at from a two-pronged approach in Australia,” he said. “One is the private sector, so looking at the medium to large private organisations, but also the publics that don’t have anything, so definitely Tasmania and Western Australia. You’d question whether Victoria is sewn up when it comes to EMRs as well.

“We all know that most organisations look at what happens in the States, and they look at about a 15-year review of an EMR for something different. We’ve seen that in NSW (which is replacing Cerner with Epic), so who knows? There could be other possibilities in our market with people rethinking their approach. I think ORBIS, with the foundation of what we have, provides a really nice solution for even those existing EMR players at the moment.”

Orion Health dominates the New Zealand market with its Clinical Workstation, and with the massive restructure of acute care through the emergence of Te Whatu Ora is still in a state of flux, but Dedalus sees a great deal of potential there as well. Dedalus has a very strong market for its webPAS, iPM, MedChart and ePharmacy systems in New Zealand and is keen to offer its EMR capability as well.

“We see New Zealand as a key market and we believe that from a value perspective, we’ll be very competitive.”

Dedalus has also been active in bringing new products to the local market, including the Amphi Systems’ amPHI electronic pre-hospital care record (ePCR) solution, the Swiftqueue enterprise appointment and scheduling platform, and most recently the DC4H interoperability platform, powered by FHIR.

Dedalus globally now has a very diverse product range following the purchase of DXC’s healthcare assets in July 2020, so the idea is to rationalise some product suites and to phase out older technology if there is a more modern offering, such as ORBIS replacing Lorenzo in the UK.

“ORBIS is our strategic EMR for the future,” Mr Parrish said. “We don’t have an EMR in Australia and New Zealand, and while we were looking to bring Lorenzo into the country, the DXC merger has helped us to make a decision as to what’s best. And we felt that this was the best for our market.

“We’re fully integrated with webPAS but ORBIS is capable of being integrated with any PAS through HL7 and FHIR. We’re also integrating with our own ambulance system, Amphi, and we’re looking at integration with iPharmacy and ePharmacy and with MedChart should we need to as well.

“We are very much primed to be open. One of Dedalus’ core drivers is to be an open system, to not be closed to the rest of the market, to make that data available, make integration easier, and just trying to make sure that we can fit because we don’t believe that everyone should have Dedalus only, we believe Dedalus can be one of the companies that can be part of that ecosystem.”

Dedalus will formally launch ORBIS at the MedInfo conference and exhibition in Sydney in July.