The Orchidée project (Organization of a Network of Hospitals Involved in Epidemiological Surveillance and Emergency Response), coordinated by Santé publique France, aims to establish a multi-thematic epidemiological surveillance system based on data from all departments of the hospitals participating in the network. The network covers all regions of mainland France as well as the French Antilles. On October 9, 2024, the Orchidée project’s kick-off meeting was held at the Agency’s offices, with approximately 100 participants representing the Consortium’s members.

Real-time surveillance: a critical issue highlighted by the COVID-19 pandemic

The French health authorities’ response to the COVID-19 pandemic has demonstrated the importance of daily monitoring of the dynamics of an emerging phenomenon to better control its spread among the population. Making these indicators available as open data at sub-municipal geographic levels also allows for a better understanding of the dynamics of epidemics. Today, while the epidemiological surveillance conducted by Santé publique France relies on a multi-source system that integrates data from emergency departments, it is important—to obtain a comprehensive view—to supplement this hospital-based surveillance with data on conventional hospitalizations or other departments (particularly intensive care).

Orchidée will fill a gap in the current surveillance system in France by providing real-time insights into the health situation in major French hospitals regarding morbidity and/or mortality for a range of conditions. It will also enable preparation for future exceptional health situations, particularly the emergence of new viruses that could impose a significant burden in terms of morbidity and/or mortality in hospitals.

An innovative project leveraging hospital data warehouses

The data collected as part of patient care within healthcare facilities and other institutions is extensive and holds significant potential for research, innovation, and the improvement of healthcare systems and epidemiology. The development of hospital health data warehouses enables the consolidation and organization of this data, thereby facilitating its use.

Until now, surveillance development strategies have relied either on adapting existing software or on building a new information system. Today, the Orchidée project is based on the concept of secondary use of health data via hospital health data warehouses (HHDWs) to improve epidemiological surveillance in hospitals. An HHDW collects and structures medical information on patients visiting a healthcare facility within a single database.

For the first time in France, hospital surveillance will be based on existing data, stored in hospital data warehouses, on a national scale, for a range of conditions. Orchidée will provide a detailed view of the dynamics of epidemics and enable a response to exceptional health situations. Furthermore, Orchidée’s federated model is innovative in that it relies on a network of hospitals, each of which will generate epidemiological indicators.

There are numerous advantages to relying on the principle of secondary data use by integrating with hospital data warehouses. First, it maximizes the value of existing, highly informative data; reduces the burden on the healthcare system by avoiding new data entries; and ensures the quality of the indicators.

This model must be scaled up to strengthen national, regional, and European capacities to monitor diseases and leverage the health data reported daily by hospitals.

A project addressing both national and European health challenges

Gaining a real-time view of health trends at the European level is one of the key objectives of the European Centre for Disease Prevention and Control (ECDC), which has been coordinating an epidemiological surveillance network for over 15 years. Without a significant improvement in existing surveillance infrastructure, European Union member states risk facing challenges similar to those observed at the start of the COVID-19 pandemic. Thus, the ECDC and the World Health Organization Regional Office agree on the urgency of developing and maintaining integrated surveillance systems for COVID-19, influenza, and potentially other respiratory viral infections (such as RSV or new viral diseases of public health concern) within the European Union. This justifies a number of coordinated actions by the European Commission to help Member States strengthen their surveillance systems.