Orange Healthcare CEO Elie Lobel discusses the importance of digitalization to the healthcare industry, major challenges, and the tremendous work that has already been done in the e-health regulatory field both in France and internationally.
Could you give us a brief introduction to Orange Healthcare? What are the milestones and achievements since its establishment in 2007 and its recent turn into a dedicated subsidiary of Orange Business Services?
The world is turning digital and so is the health sector.
2016 was a significant year for Orange Healthcare; since 2007 it has been a business unit and we have now turned Orange Healthcare into a full subsidiary of Orange Business Services with a focus on the B2B consumer segment and e-health. We are providing connectivity and high level IT services for healthcare data to the pharma industry, medical devices manufacturers, hundreds of hospitals, international NGOs, ministries of health around the world etc.
As recently appointed CEO, I needed to understand Orange as a complex business. I myself, have been working in the e-health business for 15 years— ten years in start-up companies and for the last five years with ASIP Santé, the French e-health government agency. The vast experience I gained at ASIP Santé contributes towards my strong understanding of the existing regulatory framework.
The world is turning digital and so is the health sector; however, it needs to gain momentum in comparison to other industries. Despite this, there are quite a few good reasons for the process to take longer. The major reason is obviously the heavily regulated health market; if you introduce innovative digital concepts, regulation needs time to adapt to new developments. Change is a very difficult and long process!
Secondly, taking into account the special lifecycle requirements and regulations surrounding gathered health data, one needs to consider that technical aspects also change rapidly. From a technical standpoint, the first step is to build databases and ensure security of sensitive information. The latter takes time and care, thereby making adaptation to a digital environment in healthcare much slower. Back in 2007, Orange was the pioneer in implementing digital trends in the sector. One of our first findings was that prior to introducing innovation to such a conservative and highly regulated market environment, it is essential to make sure that new developments actually work in practice.
The health care industry is highly complex. To digitalize information, concepts need to be thoroughly structured so the information can be manipulated and built into algorithms—knowledge itself is difficult to conceptualize! In the scientific environment to conceptualize knowledge you use ontology which means mapping concepts and the relationships between them. If used correctly, this will limit the number of concepts to a few thousands, and rarely more than ten thousands. In comparison, health concepts start from several thousands and to be comprehensive you are left with almost a million. This is why digitalization in the healthcare industry takes more time and it simply cannot be compared to any other industry.
Digitalization in the healthcare industry takes more time and it simply cannot be compared to any other industry.
You were appointed to this position three months ago. What have been your main priorities so far?
Firstly, I needed to map and understand the Orange Healthcare business as well as the global Orange operations. I have always strived to bring the best technology to the healthcare sector and now I’m aiming to bring the best of Orange technology to the healthcare sector. For the past two months I have been mapping priorities for the business and now there are four clearly defined pillars to address.
Firstly, Orange has always worked closely with several hundred French and international hospitals and clinics and we want to develop these relationships further. Secondly, we aim to develop a more dynamic way of operating in sectors such as pharma and medtech. Thirdly, we want to broaden our cooperation with various insurers. The fourth pillar is related to our telecommunications business as we are helping to overcome the communication challenges experienced by doctors and patients in undeveloped markets such as Africa. We use B2C models to implement mobile health solutions but we are hoping to shift to B2B2C in those markets so that patients can get access to these services at no out of the pocket cost. Therefore, we are strongly focusing on international institutions as well.
Can you give us an overview of the scope of your activities?
Orange as a business manages ten million objects worldwide and, naturally, has a broad knowledge of best-practices in management and business operations. Although the health sector conveys specific challenges, we can still leverage this knowledge and expertise thus providing the best technology to our partners. Orange Healthcare provides the tools necessary to capture the data from medical devices, manage it, transfer it, and host it in a secure manner for further meaningful analysis. One of the main focuses of Orange is hosting medical data aligning with specific regulations. France is a pioneer in this field; the regulatory environment surrounding data hosting services is highly sophisticated and provides a clear framework to operate in—so much so that the EU legislation to be implemented in 2018 follows the French example. The european regulation may be complex, yet it offers a greater level of harmonization on the international level thus benefiting all stakeholders.
We are the one of the leading companies in the hospital and clinic segment with several hundred satisfied and loyal customers! Currently, we are seeking opportunities to expand into other areas, specifically into pharma and medtech sectors where we already have some significant partnerships with for example LivaNova, Weinmann, Sanofi, and Baxalta to name just a few.
You have been accredited by the Ministry of Health to host personal data. Can you elaborate on this accreditation ?
Orange is the first telecommunications company which has been given this accreditation to host health data. The requirements are not only related to security but also include qualitative assessments of the management and financial capacities to be able to hold data in a technically secure way for 20 years or more. Patient data needs to be protected and, as the company storing it, we have to showcase said capacities to manage the whole lifecycle of the data. Thus, many international companies want to use French-based hosting services for further implementation into their European affiliates. France perfectly illustrates how a country gains a competitive advantage by anticipating innovation and adjusting their regulatory framework accordingly.
Orange is the first telecommunications company which has been given this accreditation to host health data.
Most recently, we’ve expanded our reach by partnering with Harmonie Mutuelle, one of the largest insurers in France that covers several million people. The first stage of the partnership involves providing isolated and elderly people with an innovative teleassistance technology called ‘Live Intercom’ in their homes. It enables swift communication between the assistance platform and patients; in case of emergency the patient can press the button to send an emergency signal. Live Intercom uses an Orange SIM card to transmit the signal and is at the same time a telephone and a gateway for communicating devices; for Orange, this is the first step towards manufacturing revolutionary devices. This is also the kick-off for transferring the technology of these communicating devices into other areas of daily emergency response systems. For instance, the ‘Live Intercom’ is already linked to the fire detector and water leak detector. We’re continuously focusing our efforts on innovation in order to expand the usages; the possibilities are endless! For example, we are working to combine passive and active captors to help monitor elderly people daily behavior, by learning their daily habits with artificial intelligence which has the capacity to recognize any unnatural behavior. If this happens, the artificial intelligence sends notifications to caregivers who can call and intervene in case help is necessary. Having such a system at home makes it safer for the elderly people and their family, contributes towards the whole healthcare system, as well as citizen empowerment and public health.
Would it be safe to say that healthcare by algorithms is now supplanting traditional healthcare?
It is about enhanced patient centricity, providing more options and finding better solutions for the benefit of the patients. Indeed, this is very ambitious, however, I find great similarities to when outpatient care replaced certain aspects of inpatient care – it will happen and we simply need time to become accustomed to this new reality.
Big data in pharma is significantly reshaping the healthcare environment at large, attracting recent entrants such as technology giants Google and Microsoft. Some healthcare providers view these as potential partners, others as threats. Where does Orange fit in the healthcare space?
Once again, when we talk about healthcare data we need to understand the sensitivity of the subject and that it can’t be compared to any other type of information. One of the challenges IT-technology companies face when entering the health sector is the level of privacy which they’re able to provide. Typically, these big companies use their users’ data for profit purposes, hence why their business model doesn’t necessarily fit the segment. Orange has signed an extensive code of conduct to ensure privacy and limit the use of the data to contribute towards the public health system. Our business is built on strong values; we do not gather data for one purpose and then manipulate it for another purpose. Orange has expertise as a service provider in the field of health and we play an important role in ensuring that the healthcare provided to patients is of high quality.
When we talk about healthcare data we need to understand the sensitivity of the subject and that it can’t be compared to any other type of information.
Is Orange the company that will bring the traditional healthcare and new world technology together?
Orange is definitely the accelerator in this field, we provide capable technologies and align to regulations on an EU level. Therefore, Orange can definitely bring different actors together and naturally assumes the role of an efficient safeguard in the digital world of the health sector.
What final message would you like to share to our audience?
One of the key subjects in the field of health is interoperability, which means ensuring that different objects can easily communicate between each other. In addition, interoperability also ensures that data is kept safe but also accessible for legitimate health users through the established interface. Orange has been strongly involved in standardization of organizations in the health IT area together with other groups in the field such as Continua Health Alliance which provides interoperability standards, devices, and data for the industry. In 2015 we developed a project called ‘mHealth Grand Tour,’ a bike tour for patients with type one and two diabetes that started in Brussels and finished in Geneva, a distance of over 1,500 km. The Tour is aimed at promoting physical activity and highlighting the benefits of remote monitoring and medical coaching of diabetic patients as part of a personalized support program. Orange implemented a robust technology framework surrounding the event which provided a secure real-time data flow throughout!