Services Description
GPSoC
Service Name
GPSoC
Service ID
Service
Overview
Orion Health Clinical Portal & EMPI Package
OHHW
Orion Health’s Cross Community Care Record (CCCR) solution, based on our highly successful
Clinical Portal, has been deployed extensively throughout the world and with over 300,000 clinical
users managing over 40 million patients; we have un-rivalled experience in clinical integration,
workflow and document management. Our solution offering will meet the business requirements,
without any bespoke development or extensive technical design, saving time, money and resources (for
the avoidance of doubt, the solution will still require configuration, but not software development).
Already live at over 65 sites throughout the UK and Ireland, Orion Health technology has been
architected to support all prevailing clinical data standards, regulations and modes of working.
Orion Health’s Cross Community Care Record (CCCR) provides a platform for care teams to support
the effective coordination of care between multiple agencies across the community.
Modern healthcare often requires many different care sectors to work together, focused on one patient,
including acute care and it's clinical specialties, primary care, community care, social care, unscheduled
care, mental health and out of hours.
The Orion Health solution supports the delivery of integrated care at three important levels:
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Shared, single view of patient data, integrating key patient and citizen information from
multiple sources, from multiple agencies, and providing secure, consent-based access
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Coordination of best-practice care workflows involving cross-agency and multi-disciplinary
teams
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Direct involvement of the patient in the care process by providing relevant information to them
via web and mobile devices
The solution does not replace existing systems – it connects them to create a shared, secure single view
of the patient.
The following diagram demonstrates the key components of the Orion Health solution. The core of the
solution is comprised of the established Orion Health Clinical Portal, Orion Health Healthcare
Pathways, Orion Health Clinical Data Repository, NextGate MatchMetrix EMPI, PDS adaptor and
Orion Health Rhapsody Integration Engine.
Presentation
Clinical Portal
Security & Privacy
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Patient Record
Authentication
Authorization
Single Sign-On
Patient Privacy & Consent
Relationships
Audit Logs
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Demographics
Laboratory
Radiology
Encounters
Allergies
Diagnosis
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Portal
Medications
Problems
Procedures
Transcribed
Documents
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Healthcare Pathways
Patient Search
Patient Lists
Patient Summary
Timeline
Flowcharts
Secure Messaging
Orion Health Applications
Third Party Applications
• Forms tools
• Rules builder
• Orion Health Tasks
Notifications
Secure
Inbox
E-Mail
Mobile
Demographics
Patients
Data
MPI
Clinical Data Repository
PDS Adaptor
Integration
Patient
Demographic
Service
Rhapsody Integration Engine
Example
Source
Systems
Principle
Systems
Subsidiary
Systems
Social Care
Mental
Health
Acute Care
Orion Health Clinical Portal
A modern, secure web based Clinical Portal is the foundation Orion Health solution, ensuring that the
right information is accessible by the appropriate users at the right time by providing a single point of
access to a unified view of patient information that resides in data silos across the wider health and
social care community.
Orion Health Healthcare Pathways
Orion Health Healthcare Pathways provides users with the tools to manage and coordinate patient care
via Healthcare Pathways. Healthcare Pathways enables users to follow best clinical practice for the
treatment of users patient’s condition. By following a proven path that includes diagnostic tests, goal
setting and monitoring, users give their patient the best chance to achieving a better health outcome.
Orion Health Clinical Data Repository
Orion Health’s Clinical Data Repository is a single database that stores discrete patient data from
source systems for the purpose of making it available for viewing within the Clinical and Patient Portal.
It is a dynamic repository capable of storing user-defined models. It includes a pluggable infrastructure
for adding custom message processing and comes with out-of-the-box support for a number of standard
HL7 interfaces.
NextGate MatchMetrix EMPI
NextGate’s MatchMetrix EMPI is an enterprise master person index software application that links and
tracks related patient data from disparate applications and facilities into an enterprise master index of
patients. It uses probabilistic and deterministic algorithms to evaluate patient records and assigns an
Enterprise Unique ID (EUID) to facilitate data quality management and interoperability. The EMPI
identifies and resolves duplicate patient records, improves the accuracy of patient identification, enables
a patient-centric view of information, and simplifies connectivity with source systems.
PDS Adaptor
Orion Health’s PDS adaptor is a certified component that will allow connectivity between Rhapsody
Integration Engine and the Patient Demographic Service hosted on the Spine.
Orion Health Rhapsody Integration Engine
Orion Health's Rhapsody Integration Engine is a comprehensive and powerful back-end integration
broker for health enterprises. It delivers advanced inter-system messaging capabilities. Rhapsody is
designed for rapid, effortless installation and use, and enables quick, accurate, and efficient exchange of
electronic health data. It will take messages in any format, from any source, translate between formats
and route the messages to their correct destinations.
Orion Health Professional Services Group
The Orion Health Professional Services Group (PSG) focuses mainly on project delivery, implementing
Orion Health solutions and managing client relationships throughout the entire project lifecycle. Our
experienced team members have significant industry experience including clinical, consulting, and
technology expertise.
Orion Health PSG uses standard project management and project lifecycle approaches to ensure our
client's implementation phase—including evaluate, build, test, and launch—are successful.
Case Studies
The following case studies demonstrate Orion Health’s capability to deliver an integrated solution
across health and social care settings. Further case studies are available on our website –
www.orionhealth.com.
Health and Social Care (HSC), Northern Ireland
In 2012 Health and Social Care Northern Ireland (HSCNI) selected Orion Health to provide a clinical
portal-based Electronic Care Record (ECR) for the entire population of Northern Ireland. Covering a
population of more than 1.8 million people, the ECR enables the communication and sharing of patient
data taken from multiple, existing information systems across acute, community, primary health and
social care.
Previous to full roll out that went live in June 2013, Orion Health successfully implemented a ‘Proof of
Concept’ pilot of the EHR in Ulster Hospital Dundonald, the Belfast City Hospital and 2 general
practices in 2010. This involved 200 clinicians and more than 9000 patients and provided the business
case for the full roll out of the ECR across the HSC. It also demonstrated that the solution could reduce
the length of encounters, improve the quality and safety of patient services, and achieve cost and
efficiency savings in staff time and resources.
As part of the ECR project, the Orion Health Clinical Portal provides streamlined, secure, web-based
access, from a single browser view, of patient information to authorised HSCNI health and social care
professionals. The ECR includes critical patient information, including latest lab results, patient
medications, allergies and clinical correspondence. Audit tools and patient privacy controls have been
built into the ECR to help ensure patient confidentiality.
In addition to the Clinical Portal, HSCNI now has access to Orion Health’s Rhapsody Integration
Engine, forms technology, patient portal and case management software that will help support the
management of long-term conditions and will provide the underpinning technology framework for
sharing information across multi-disciplinary teams.
Orion Health is aligned with Northern Ireland’s vision for more integrated healthcare to help manage
patients across care settings, accessing and sharing information in a secure, role-based manner and our
technology portfolio enables this journey. The Electronic Care Record programme improves the quality
and safety of patient care as the system makes all of the relevant existing information available to
doctors, nurses and other staff at the point of care.
“I am confident that the Electronic Care Record system will assist in developing a sustainable health
care system that delivers now and will continue to deliver in the future for the good of everyone in
Northern Ireland.”
Edwin Poots, Minister of Health
Northern Ireland
The benefits document created after the proof of concept shows that many efficiencies were realised as
a result of implementing Orion Health technology. Most importantly there was very positive feedback
from the clinical community which shows that they like the solution, and they felt it contributed to
improving patient safety and outcomes. Significant results noted in the Proof of Concept Evaluation
report included:
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94% of clinical users agreed that the use of the ECR improved the quality of patient care
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83% of doctors reported a better clinical outcome as a result of use of the ECR
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89% of users “strongly agreed” or “agreed” that the ECR improved patient safety
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Reduction of time to resolution of medications reconciliation for Clinical Pharmacists from 3
hours 45 minutes to 22 minutes (ECR was 10 times faster)
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A time use audit revealed that using the ECR to look up data on 30 patients per day,
compared to existing legacy systems, could save clinicians 53 minutes per day
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Significant evidence of a reduction in the duplication of laboratory tests and diagnostic imaging
– saving both clinical time and valuable resources
NHS Greater Glasgow and Clyde Health Board
The NHS Greater Glasgow and Clyde Health Board, was formed in 2006 through the merger of NHS
Greater Glasgow and part of NHS Argyll and Clyde. Now the largest health board in the United
Kingdom, it delivers services through 35 major hospitals, 10 specialised units and 50 health centres and
clinics. General practitioners, dentists, pharmacies, physiotherapists and other health care providers
work through these facilities.
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44,000 staff
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1,000 consultants
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300 additional general practitioners
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270 dental services local
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180 optician practices
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300 pharmacies
Following the merger, the new board embarked on a series of major building projects to move services
from cramped Victorian-era buildings into modern hospitals that could better support 21st Century
medicine.
One of the first projects the health board wished to undertake was to make it easier for its tens of
thousands of providers across these dozens of facilities to access patient medical records. It wanted to
implement an electronic health record (EHR) system that incorporated a portal with an intuitive user
interface that could provide all clinicians with access to a unified patient medical record regardless of
where the patient lived or where the clinician was located.
The health board selected the Orion Health Clinical Portal as the key that would realise the NHS
Greater Glasgow and Clyde EHR vision. Using the Clinical Portal, real-time ward lists and clinic lists
are built by consolidating data from multiple Patient Administration Systems (PAS), including
Meditech and iSoft. All A&E visits, outpatient appointments and inpatient episodes can be viewed
regardless of which facility the patient attended, complete with procedure and treatment codes. Upon
opening a patient record, data is aggregated and displayed in a variety of formats including XML, XLS,
DOC, PDF, TIFF, GIF, HTML and JPEG.
The Clinical Portal provides single-click access to view Kodak PACS images and place diagnostic
orders using its Single Sign On scripting tools. Before the Clinical Portal went live, finding the
Ordering screen in Meditech involved navigating through up to nine screens, including login and
patient search. With the Clinical Portal, users can reach the Ordering screen in just one mouse click,
saving several seconds per order and minimising the chance of opening the wrong patient record in
Meditech. For users in North Glasgow, a similar single sign on interface is used to access iSoft
PASWeb.
The health board uses Rhapsody to send 2,000 clinic letters per day and 1,000 referral letters per day to
SCI Store. SCI Store also stores clinical documents, discharge summaries, ECGs and endoscopy results
generated in other point of care systems.
The system at Glasgow is integrated across multiple care settings and includes integration to social care
systems, SWIFT and CareFirst.
The system was deployed to staff at a rate of 70 per week, and now supports the viewing of over
160,000 results per week via the portal. The estimated savings attributed to reduced ordering of tests is
in the order of £75M per annum, with an additional £15M per annum in reduced transportation costs
now that letters and documentation is available online.
NHS Camden CCG
The Integrated Care record in NHS Camden aims to improve outcomes for patients; create access to
better, more integrated care outside of hospital; reduce unnecessary hospital admissions and enable
effective working of professionals across organisational boundaries.
As part of NHS Camden Integrated care vision, the Orion Health Cross Care Community Record
solution (CCCR) has been procured, to provide professionals, involved in delivery health and social
care in Camden, with a unified view of data from a variety of existing clinical and social information
systems.
The NHS Camden Commissioning Partnership model has been developed to enable clinicians, from
different provider organisations to work together in multi-disciplinary groups. Within this multidisciplinary system, the model will be supported by overarching enablers including a joint governance
model, aligned incentives, information sharing and organisational development.
The Integrated Care pilot was launched on the 2nd of April 2012 and includes hospital, general
practice, community care, social care and mental health provider organisations. Patient representation is
an important element of this pilot.
NHS Camden Commissioning Partnership Partners include:
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Camden Clinical Commissioning Group (CCCG)
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Royal Free Hospital (RFH)
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University College London Hospital (UCLH)
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Camden and Islington Mental Health Foundation Trust (C&I FT)
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Central and North West London Trust (CNWL)
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London Borough of Camden (LBC)
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Camden GP Practices
Orion Health’s overall approach to deliver the NHS Camden Integrated Care IT system is to;
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Install the Orion Health Cross Community Care Record (CCCR) with Healthcare Pathways,
NextGate to provide the EMPI and Risk Stratification services.
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Utilise an experienced project delivery team that has specific domain knowledge and
experience in integrated care projects to fast-track the implementation
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Apply the “Lessons Learned” from previous projects
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Transfer the necessary skills and knowledge to NHS Camden ensuring their Integrated Care
solution investment will be self-sustaining in the future.
The approach is to (1) extract data from source systems; GP data from EMIS & Vision via the MiG,
Community from RiO, Acute from Royal Free (Cerner) and UCLH (Carecast), Mental Health from RiO
(2) aggregate, transform, normalise, and unify the data into a patient-centric view and (3) make this
available as an Electronic Care Record to health and care providers at the point of care via our Clinical
Portal, accessed from a desktop, laptop, tablet or iPad over N3.
Future phases will include integration into Hospice, OOH and the Ambulance Service.
Connecting Care, Avon
In December 2013, the Connecting Care Project went live. Underpinned by the Orion Health CCCR to
integrate health and social care information, to provide an integrated record across Bristol, North
Somerset and South Gloucestershire.
Connecting Care is addressing the silos of care related information that currently exist within Bristol,
North Somerset and South Gloucestershire in order to improve and streamline care pathways across
health and social care and to address some of the issues that face patients/clients, staff and
commissioners today.
The first phase of the Connecting Care project is taking data from; Primary Care, Acute Trusts,
Community Health Providers, Social Services and Out of Hours providers.
Connecting Care’s business case for funding for a full roll out contained a number of measured
benefits, but at this time Connecting Care are unable to make those and their Business Case public.
Orion Health provided significant support in developing the benefits realisation for the Connecting Care
project and have shared those to help inform future projects.
In the context of social care, some of the key benefits realised from an integrated health and social care
record include:
1. Enhanced support for referral management
2. Time saved on triage and assessment
3. Informed assessments and care planning
4. Reduced installation and equipment costs
5. Enhanced support for risk management & safeguarding
Support
Because Orion Health is an international company with clients in a number of time zones, we provide
24-hour support, 365 days a year. The Orion Health Customer Services and Support Team manages,
tracks and resolves technical questions, and manages bug fixes and enhancements where necessary.
Our Customer Services and Support team is backed by a dedicated organisation of over 1,100
employees worldwide.
The standard Orion Health support model includes:
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Third line and break fix support
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Standard break fix
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Product support
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Knowledge base
Out-of-hours cover
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Out-of-hours and weekend cover for High Priority Issues
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Assistance from global 24 x 7 structure
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On-call roster
Request fulfilment
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Facilitating change requests
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Liaison for engaging Professional Services Group resources
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License and Software requests
Major incident support
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Support for P1s and P2s
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Major incident reports
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Root cause analysis
The tables below detail our standard service level agreements and associated definitions for issue
prioritisation for on-going support, these would be finalised during negotiation with individual
customers.
Issue Response and Resolution Times
Each Fault Priority Level has specific response times. The following table describes each level’s
response times.
Fault Priority Level
Initial Response Time
Progress Report
Target Resolution
Time
Level 1 – Production
Failure (Critical)
30 minutes
1 hour
4 hours
Level 2 – Production
Degradation (Urgent)
1 hour
4 hours
8 hours
Level 3 – Functional
Impact (Major)
Next working day
1 week
2 weeks for a work
around; next release for
code changes
Level 4 – No
Production Impact
(Planed)
Next working day
By arrangement
By arrangement
Issue Prioritisation
Support Tracker has several levels of prioritising issues, referred to as the Fault Priority Level. Queries
are assigned a Fault Priority Level depending on how critical the problem is. The following table
defines the Fault Priority Levels.
Fault
Priority
Level
Definition
Level 1
Critical business impact – Problems which, if not fixed, prevent the business from
continuing. No workaround is possible.
Examples: A critical application is unavailable or all users lose access.
Level 2
Problems which do not currently stop the business but whose consequences could
interrupt or stop the business within 24 hours; these may go unnoticed by other
groups, but can be very serious for the people needing the service that has stopped.
Examples: Some users lose access; severely degraded performance; the system is
still functioning, but slow performance is impacting the efficiency of the unit.
Level 3
Problems causing minor operational impact or people have lost functionality, but
there is a workaround.
Example: Cannot action a request on an application at one terminal, but can at
another.
Level 4
Dependencies
No impact on production and implementation can wait for a future release.
Service dependencies may include (To be ratified at time of call off):
1. Customer project team in place
a. Project manager
b. Clinical leads
c. Technical lead
d. Infrastructure lead
e. Testers
f.
Trainers
g. Service team
h. Systems Admin
i.
DBA
2. Environments must be available for installation of the software, specified and provisioned to
match the scale of roll out and likely message volume, storage requirements and concurrent
access requirements. Indicative environment specifications will be provided to the Customer by
Orion Health to support this activity
3. Access to systems must be granted from remote user
4. Any arrangements with third party suppliers
5. Procurement of Microsoft or Oracle database licenses (where applicable)
6. Information feeds or extracts
7. For context launching, the technical mechanism of passing and receiving credentials
Indicative Customer Responsibilities (Will be ratified at time of call off)
The following lists some of the Customer obligations which, if fulfilled, will enable the successful
delivery of the Orion Health software:
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Staff – The customer is expected to provide adequate staff for the project and allow Orion
Health access to these staff for the purpose of delivering the software.
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Governance – Any governance associated with decision making is the responsibility of the
customer and a clear governance structure, including a Change Control Board, should be put in
place to mitigate the risk of delays due to delays in decision making. The customer is
responsible for reviewing and approving the deliverables within agreed timescale including
design documents, test plans and acceptance criteria.
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Testing – The customer will work with Orion Health to test the solution. This includes
preparing test scripts and providing anonymised test data.
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Infrastructure – The customer is responsible for ensuring they have provided adequate
infrastructure to support the solution including network infrastructure to the hosted
environment and end-user devices.
SubContractor(s)
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Third Party Organisations / Source Systems – The customer is expected to manage any
necessary arrangements with third party organisations / source systems to support the
development of information feeds.
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End-user Training – Orion Health will provide Train-the-Trainer training for customer staff.
The customer is expected to support Orion Health in the delivery of training including
producing a training plan and making resources available for training.
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First Line Support – The customer will provide first line support to appropriate triage issues
including suitably qualified and trained staff. Support staff will provide data to the Orion
Health help desk in order to resolve the issue. Orion Health provides technical training for
support staff.
No key sub-contractors identified.
Pricing Information
Implementation Charges
Service Charges
£1,136,979 excl VAT for professional services fees to configure the software
procured in the Service Charges section
Charge Description
Unit Price (excl VAT);
License & Support Band 1 Tariff
£909.79 per user assuming 1000 users
License & Support Band 2 Tariff
£528.89 per user assuming 2500 users
License & Support Band 3 Tariff
£360.29 per user assuming 5000 users
Exit Charges
Invoicing Terms
Invoicing for the Implementation Charges and the License element of the Service
Charges will be based upon the following principles.



Payment Terms
Discounts
Resource Based Pricing
Invoicing will be milestone-based, against the milestones agreed with the
Customer in the implementation plan.
Such milestones may, indicatively, include: completion of planning and
design; installation of license keys; completion of interface build,
completion of configuration build, entry to user acceptance testing, exit
from user acceptance testing, go-live, completion of post go-live
implementation support.
The proportion of the charges applied to each milestone will be
commensurate with the work performed and delivery of tangible work
products.
The Support element of the Service Charges will be apportioned from go-live, and
the charges will be payable in arrears.
Volume discount applied, please see tariff charges above
Resources are available on T&M rates according to the rate card below:
Role
PMO Analyst
Test Analyst
Systems Engineer
Business Analyst
Implementation Consultant
Technology Specialist
Trainer
Test Manager
Senior Implementation Consultant
Senior Technology Specialist
Daily Rate (£) excluding VAT
and expenses
£550
£650
£700
£850
£850
£850
£850
£950
£950
£950
PMO Leader
Project Manager
Database Administrator
Programme Manager
Project Director
Technical Services Manager
Solution Architect
Clinical Consultant
Professional Services Group Director
Other Pricing Information
£1,000
£1,000
£1,000
£1,100
£1,200
£1,200
£1,200
£1,200
£1,400
Implementation assumes:
10 feeds – 4 simple, 4 medium, 2 complex
Messages are assumed to be in HL7v2 format
MiG service available
4 roles, 4 tailored view system
No backloading (bulk loading of historical data)
Reuse of existing privacy model
3 environments
2 pathways, intermediate complexity
2 context links
8 month deployment assumed
Pricing is for install & configuration services only.
Pricing does not include Hardware, Network, Database or any 3rd party system
costs, such as 3rd party interface costs or MiG service costs, or triage and
remediation of issues with any of these components.
Service Pricing:
Tariff 1 – minimum purchase 1000 units (registered users) for 1 year. Ongoing
year on year maintenance charge would be agreed based on volume of units
purchased.
Tariff 2 – minimum purchase 2500 units (registered users) for 1 year. Ongoing
year on year maintenance charge would be agreed based on volume of units
purchased.
Tariff 3 – minimum purchase 5000 units (registered users)for 1 year. Ongoing year
on year maintenance charge would be agreed based on volume of units purchased.
For EMPI, up to 1M UID’s are available in this pricing model.
Service pricing includes 3rd level break-fix support on Orion Health standard SLA
as described above.