Medicine for the Whole Person

Medicine for the Whole Person

Orion gathers data to make diagnosis more precise

By Kenneth LaFave

For years, patients thought their doctors had all the information they needed: age, weight, medical history and medications.

They were wrong.

“Doctors have access to only about 10% of the information they need to make an accurate diagnosis,” says David Bennett, executive vice president of Airpark-based health management company, Orion Health.

Individuals differ so radically from one to another that particulars like DNA make an important difference in diagnosing or determining the best treatment.

What can be done to change this?

Orion calls its answer Precision Medicine. It consists of assembling and crunching data to represent a patient in every aspect of his or her life.

“In a nutshell, what we go to market with is a platform that can collect data from many sources. All the hospitals submit their data to Orion. A platform called Rhapsody integrates everything into one database,” Bennett says.

“The technology is fantastic.”

Bennett has nurtured the Orion company from a small office 4½ years ago to this year’s opening of its new development center in Scottsdale. Orion intends to hire more than 500 employees at an average base wage of $88,000 per year.

Instead of a patient’s information consisting of data from only one or two sources, Orion streams it from unlimited sources. Not only such physical information as DNA, but lifestyle factors show up as well.

“Orion really wants to find the right answer,” Bennett says. “The doctor knows your blood type and whether you have diabetes or high blood pressure. But what about social factors? Do you live alone? People who live alone tend to be in hospitals more often. Do you participate in social media? People who engage in a lot of social media tend more toward depression.”

It’s medical data that represents the whole person, not just 10%. Just how much of a difference can be made with complete as against incomplete data is illustrated in the case of someone close to Bennett: his son, Carter.

“About a decade ago, Carter was diagnosed with cystic fibrosis (CF). He had a host of physical problems, like lung infections due to mucous build-up and issues like pancreas blockages. He made monthly visits to the ED and had regular sinus surgeries. In his eighth grade year alone, he was hospitalized for three consecutive weeks while his lungs underwent a thorough cleaning. Every year, his lung function went down.”

Complicating CF is the fact that it exists in no less than 1,200 variations, and treatment can differ from one another. Carter belonged to a 4% group within the community of CF sufferers.

“We were in the CF Clinic at Phoenix Children’s Hospital, and we told Carter’s doctor that we were very excited about a new drug that was meant for his mutation of the disease. There are actually new drugs created for specific genome mutations.”

Based on the data at hand, the doctor dismissed the new drug as ineffective for Carter. But when Bennett produced “about a hundred pages” of intensive additional data, the doctor reviewed it—and reversed his opinion.

“This is a game changer,” the doctor says of the data.

Today, Carter is 19, off to college on his own, breathing well without surgeries and, as his father puts it, “now he has a shot to outlive me.”

Carter’s doctor was, Bennett emphasizes, “a great doctor.”

“But he didn’t have the tools to analyze my son and get him on a life-saving medicine until those pages were produced. It’s trial and error for most doctors. In the future, payers (insurance companies) and providers (physicians) will be able to rely on technology that synthesizes and analyzes the data, and utilize it in the right context at the right time.”

Doctors with less than complete data are sometimes forced to prescribe drugs on a trial-and-error basis. Statins, for example, work on only 30% of the population. And there are people for whom Ibuprofen has no effect. Such things used to be part of the hit-and-miss of medicine. With Orion’s help, they will soon belong to the past.

Orion houses the data for 100 million people worldwide. The public company, based in New Zealand, was headquartered in Boston until 2012, when it moved to Scottsdale Airpark. While that may sound like a random move, it was a cautionary one. The lack of tornadoes, hurricanes and other natural disasters in Arizona make it a prime destination for businesses that rely on data storage.

“We may keep our data on a cloud, but there still has to be a building somewhere,” Bennett says.

Bennett points out that when Hurricane Katrina hit New Orleans in 2005, an untold amount of data was lost. That can’t happen where the greatest danger to storage is the air-conditioning going out.

In addition to making diagnosis more precise, Orion’s data crunching can help reduce cost.

“You can drive down cost by using this technology to address social determinates. One of our clients in South Carolina had what they called ‘frequent fliers’—60 patients who were making over 1,000 visits to Emergency in a single year. It turned out that some of these people just needed medicine and couldn’t get to the pharmacy to buy it. So the company worked with the ambulance company to set up a triage service in the ambulance to track what the patient needed. If it was just medicine, that became a matter of a $3 co-pay instead of a $2,500 ED visit.”

Accumulating data is a never-ending quest at Orion, where 30 percent of annual revenue goes back into research.

For Bennett, who came over to Orion from his own Scottsdale software integration business, building out the company is more than business.

“It’s a mission. For me, that’s what it is. I want to help these doctors and patients in making decisions about what will help them. To do this work, you really need focus at the mission level, because it’s going to change health care for the better and make a difference in people’s lives. How many other people get that opportunity?”