Launch with Confidence Harnessing the Power of Open Source & Drupal to Drive Outcomes in Healthcare 4/16/13
May 19, 2015
Launch with Confidence!
Harnessing the Power of Open Source & Drupal to Drive Outcomes in Healthcare 4/16/13
Agenda • About Achieve
• Current State of U.S. Healthcare
• Where is Healthcare Headed?
• The Value of Open Source
• How Can Drupal Help?
• Case Study Quick Look: Dexcom, Inc.
• How to Harness Open Source for Healthcare Outcomes
• Summary
• Q&A
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About Achieve legal name
founded
headquarters
leadership
mission
core values
services
clients
partnerships
Achieve Internet"
1998"
1767 Grand Avenue, Suite #2 | San Diego, CA 92109 | U.S.A."
Ron Huber, Chief Executive Officer"
Achieve leverages best in class open source web application and development experience and tools to create optimized platforms for enterprise clients. "
Meticulous Coding | Transparent Work Flow | Robust Performance"
Achieve specializes in the architecture and planning phases of large-scale enterprise projects for Fortune 500 Companies. Services include: Application Development, Integrated Communications, Globalization, Infrastructure and Deployment, and Mobility and End-User Services. "
Achieve has worked with some of the most recognizable names in the Media and Entertainment Industry: Sony, NBC Universal, MTV, and Fast Company. Achieve has also worked with numerous enterprise corporations such as: U.S. Chamber of Commerce, Dexcom, Inc., Experian, Hunter Industries, and Amerigroup. "
Acquia (Enterprise Partner), Drupal Association, Neue Creative Group, Kluge Interactive "
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Key Clients: Media & Entertainment
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clients!
Key Clients
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clients!
About Me
• Marc Hermsmeyer • VP, Operations at
Achieve Internet
• 14+ years experience in Internet software and online media
• Enjoys surfing, backpacking & fishing
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LinkedIn: www.linkedin.com/in/marchermsmeyer/"Twitter: @MHermsmeyer"
Three Key Focuses
1. Current state of Healthcare
2. Developing Trends in Technology
3. Future Drupal Considerations
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Healthcare – An Individual Perspective
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Healthcare – An Individual Perspective
• When was the last time you went to the Doctor’s office or the Emergency Room? § How did you schedule the appointment? § How much paperwork did you have to fill out?
§ How did you pay for the service?
§ How would you rate your experience? • You are not alone. • Most people are just as frustrated.
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Changing Landscape for Healthcare
• Increasing population size • Ageing population that are living longer Demographics
• Increase in life style induced diseases • Increase in chronic diseases
Disease Patterns
• Health is valued more today • Patients are acting more like consumers
when deciding on care Consumer Behavior
• Incentives for Electronic Healthcare Platforms • Mandate for patient engagement and
interaction Government
Pressure
§ h"p://www.slideshare.net/FrostandSullivan/health-‐informa9on-‐technologies-‐market-‐trends
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Frost and Sullivan Research"
Current State of Healthcare Industry
• $2 Trillion spent a year in the U.S. § Most expensive system in the world • Ranks poorly in leading indicators including, life
expectancy and infant mortality rate
§ Americans are spending 17% of GDP on Healthcare costs
§ 21 – 40% of Healthcare spend is wasted due to inefficiencies in workflow » Dr. James LaBelle, CMO Scripps Health
§ Dr. James LaBelle, Chief Medical Officer and Senior Vice President at Scripps Health
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Industry Wide Challenges
§ Interoperability § Integration § Workflow automation § User experience § Billing § Performance § Scalability § Communication § Patient engagement § Mobile solutions
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These challenges have plagued many other industries in the past, from Media, Publishing
and Manufacturing, beyond….
Hasty Decisions
Satisfied Undecided Dissatisfied
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Physician satisfaction with their current technology solution
§ h"p://www.blackbookrankings.com/healthcare/
Black Book Rankings on Top Ranking EMRs "
Where is Healthcare Headed?
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Where is Healthcare Headed?
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Affordable Care Act
HITECH Act
Meaningful Use
Government Mandate to Leverage Technology
Financial Incentives Will Cause Healthcare Adoption Rates to Soar § Electronic Health
Records (EHR) § Practice Management
Tools § Patient Portals § Personal Health Records
Affordable Care Act & Meaningful Use
§ h"p://www.healthit.gov/buzz-‐blog/meaningful-‐use/pa9ent-‐engagement-‐objec9ves-‐meaningful-‐stage-‐2/ § h"p://www.cms.gov/Regula9ons-‐and-‐Guidance/Legisla9on/EHRIncen9vePrograms/index.html?redirect=/ehrincen9veprograms/
“To meet the requirements of Meaningful Use Stage 2, health care providers need to more actively engage patients by providing them with the capability to electronically view, download, and transmit relevant information from their provider’s electronic health records.” "
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$63,750!amount healthcare professionals will be able to receive per eligible
professional within their practice that implements an EHR under Meaningful Use "
HealthIT.gov and CMS.gov"
Missing the Mark on Meaningful Use
0
20000
40000
60000
80000
100000
120000
140000
160000
Number of Primary Care Providers Enrolled Number of Primary Care Providers Live on EHR Number of Primary Care Providers Demonstrating Meaningful Use Enrollment Goal, PPCPs
HealthIT.gov HIT Adoption Rates"
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§ h"p://dashboard.healthit.gov/HITAdop9on/?view=0
New Wave of Healthcare Technology
Patient Portals:
“It’s going to be a cost of doing business. You wouldn’t consider not having a phone system, and the generations that are coming up are going to think it’s ridiculous not to be able to communicate via computer.”
--Elizabeth Boehm, Forester Research
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• Elizabeth Boehm, Forester Research and Experia Health. h"p://www.healthdatamanagement.com/issues/18_3/will-‐pa9ent-‐portals-‐open-‐the-‐door-‐to-‐be"er-‐care-‐39853-‐1.html
Benefit of Patient Portals • $0.63 cents saved… Every time practice does not have to
mail lab results • $17 saved… Every time practice can handle a billing
query online rather then by phone • $7 saved… For every appointment scheduled online • 25% reduction in patients… Who need to come in for a
follow up (keeps insurance costs down) due to e-consults and messaging capabilities of portal
• 12,000 phone calls averted a month! • Allows certain practices to re-direct over 100 hours each
month from paperwork and phone calls to providing better customer service and patient care
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• h"p://www.healthdatamanagement.com/issues/18_3/will-‐pa9ent-‐portals-‐open-‐the-‐door-‐to-‐be"er-‐care-‐39853-‐1.html
Patients Want Portals
• 94% of patients in one survey rated easy access to their own medical records as either important or very important
• 75% of patients want their physicians to provide online services to do the following:
• Schedule appointments • Get test results
• Access medical records
• Exchange email
• 81% would schedule their own appointment via a secure web site and fill out medical/registration forms online prior to visit
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• h"p://healthcare.intuit.com/portal/docs/pa9ent-‐portals-‐mu-‐whitepaper.pdf
§ Connectivity/Interoperability § Accessible patient records and test
results § Integration with multiple platforms § Role-based security § Customizable workflow management § Medical form submission § Referral capability § Rx refills requests § Internal and external messaging § Intuitive scheduling § Billing functionality § Mobile solutions
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How Can Technology Help? Leveraging the power of technology will help to lower costs and
create engaging care solutions:
Patient Portals – Feature Ranking Feature Rank 1-‐5 (1= lowest; 5 = highest)
Integra9on w/ EHR 5
RX Refills 5
Secure Messaging 5
Lab/Test Results 5
Referrals 4
Online Medical Forms 4
Access to Medical Info 3.5
Billing 3
Scheduling 3
Mobile (Responsive) 3
E-‐Visits 2
Community Building (Social/Forums) 2
Support 2 4/16/13
• Patient Engagement…Best Solved with Drupal § Robust platform with
numerous modules for customization
§ Extensible and designed to accommodate numerous changes
§ Out of the box functionality
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The Value of Open Source and Drupal
Drupal Specific Solutions Workflow Automation +…
§ Configuration § Approval § Auditing
3rd Party Integration +… § Single Sign-on (SSO) § Consume 3rd Party Data § BI Integration
Security … § Access § User Management § Password Policies
= Enhanced Customer and Patient Interaction § Engage the patient and meet Meaningful Use goals
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Workflow Automation
• Content creator / editor
workbench
• Review, approval, publishing
workflows
• Change reviewing
• Content versioning
• Role-based interface &
permissions
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Integration with Best-of-Breed Tools
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Primary
site Mobile
application Social
FB/Twitter Community
site Videoportal
Email campaign
Drupal Measurement and reporting
Commerce Social Media Marketing automation CRM Analytics
Security Management – The DOD
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David M. Wennergren Department of Defense CIO
“Continuous and broad peer review, enabled by public available source code, supports software reliability and security efforts”
Tom Hall, Dexcom, Inc.
• Senior Marketing Manager for Dexcom, Inc.
• Manages short and long term digital strategies including website development and agency partnerships
• Focused on scaling Dexcom’s online presence through, SEO, and social networks, to increase inbound traffic, and to grow customer base
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Dexcom, Inc. – Workflow Automation
• Dexcom, Inc (NASDAQ: DXCM) § Issue • Needed to expand sales channels online
• The solution had to access crucial client data stored behind Oracle Legacy system
• Platform had to be an intuitive e-commerce solution
§ Result • Fully HIPAA compliant site that allowed patients access to their
records and diabetes devices in an elegant mobile platform
• Decreased administration work to expedite order process • Expanded sales channel online for customers to order
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• Achieve teamed up with Acquia to build, host and support an e-commerce site that gave patients a quick, easy, and secure method for re-ordering their glucose monitoring systems.
• Critical client data was locked within Dexcom’s Oracle system.
• Achieve built a series of custom modules that integrated multiple sources of data into one seamless platform, including a number of proprietary client information:
• Insurance verification • Purchasing and frequency limits based on client insurance
and co-pays • Product specifications
• Medical device company that distributes glucose monitoring systems
• Third Party Integration: Oracle Legacy System
• Custom Built Modules to lock secure client data behind firewall
• HIPAA Compliant • Mobile optimized: Responsive
web design technology used
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Dexcom, Inc. – An (Oracle) Integration Case Study
A Positive Outlook
• Open Source Technology Has Already Alleviated These Same Pains in Other Industries § Fully integrated with all third party APIs
§ Engaging platform
§ Seamless billing solutions
§ Scheduling solution for front office automation
§ Secure websites exceeding industry standards
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Drupal – Freedom and Flexibility
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No Lock-in Open SaaS model offers
freedom to move your customers digital experiences to any
Unmatched Innovation Accelerate innovation from idea to experience at web speed across
any channel or device.
Best of Breed Empower the business to mix and match sales and marketing tools in a "string of pearls" approach for maximum business impact
Unified Platform Create unforgettable customer
experiences by leveraging a unified platform for content,
community, and commerce.
Mature Cloud Model Leverage mature, optimized cloud deployment models and
offers operational models to map spending plans to successes.
Simplified Digital Experiences Lowest solution TCO ���
and the fastest learning curve amongst developers ���
and Digital Marketers.
Drupal Will Redefine Patient Engagement
• A Single-Sign on (SSO) web-based portal • Access to all medical records and test results • Convenient web-based scheduling • Medical web-forms • Integration with EHRs • Online billing and payment options • E-visit capabilities • Online requests: referrals and prescription refills • Mobile and responsive web solutions
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Achieve’s Drupal Development Achieve has dedicated thousands of hours developing the most complex Drupal solutions specializing in:
§ Workflow • Elegant back-end solutions that have simplified the most complex
editorial workflow • Track-able content editing and deployment process for HIPAA
compliance § Integration • Platforms that access critical client data behind firewalls locked
within secure legacy systems § Infrastructure Services • Achieve builds rock-solid HIPAA compliant server configurations
§ Security • Rigorous security audits
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Drupal Rocks!
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Why Drupal Rocks – A Snapshot!
§ Cost!
§ Scalability and Time to Market
§ Platform Integration
§ Community Capabilities
§ Drupal Talent…everywhere!
Drupal Rocks!
Key Takeaways
• U.S. Healthcare system is not getting the job done § Overpriced
§ Under Performing
• Healthcare landscape is changing § Patients are acting more like consumers
• Government has mandated the use of technology § Technology adoption rates will begin to rapidly increase
§ Choice of technology solution needs to be calculated
• Drupal is the choice solution for Patient Engagement 4/16/13
Connect with Achieve If you have any further questions or would like to get in touch with
Achieve you can do so through the following channels:
• Email: [email protected]
§ Twitter.com/achieveinternet
§ http://www.facebook.com/pages/Achieve-Internet/7335128391
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Q & A
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Backup Slides
References
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HITECH Act Summary The Health Information Technology for Economic and Clinical Health Act, abbreviated HITECH Act, was enacted under the American Recovery and Reinvestment Act of 2009. Under the HITECH Act, the United States Department of Health and Human Services is spending $25.9 billion to promote and expand the adoption of health information technology. The inclusion of "as much as $36.5 billion in spending to create a nationwide network ofelectronic health records.” ! !
Electronic Health Records (EHR)!The HITECH Act set meaningful use of interoperable EHR adoption in the health care system as a critical national goal and incentivized EHR adoption. The "goal is not adoption alone but 'meaningful use' of EHRs — that is, their use by providers to achieve significant improvements in care.”!Title IV of the act promises maximum incentive payments for Medicaid to those who adopt and use "certified EHRs" of $63,750 over 6 years beginning in 2011. Eligible professionals must begin receiving payments by 2016 to qualify for the program. For Medicare the maximum payments are $44,000 over 5 years. Doctors who do not adopt an EHR by 2015 will be penalized 1% of Medicare payments, increasing to 3% over 3 years. In order to receive the EHR stimulus money, the HITECH act (ARRA) requires doctors to show "meaningful use" of an EHR system. As of June 2010, there are no penalty provisions for Medicaid.!!
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§ h"p://en.wikipedia.org/wiki/HITECH_ACT
References • Dr. James LaBelle, Chief Medical Officer and Senior Vice President at Scripps Health • http://www.blackbookrankings.com/healthcare/ • http://dashboard.healthit.gov/HITAdoption/?view=0 • http://www.healthit.gov/buzz-blog/meaningful-use/patient-engagement-objectives-
meaningful-stage-2/ • http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/
index.html?redirect=/ehrincentiveprograms/ • http://www.slideshare.net/FrostandSullivan/health-information-technologies-market-
trends • http://dashboard.healthit.gov/HITAdoption/?view=0 • http://www.healthit.gov/providers-professionals/benefits-electronic-health-records-
ehrs • http://healthcare.intuit.com/portal/docs/patient-portals-mu-whitepaper.pdf • http://www.healthdatamanagement.com/issues/18_3/will-patient-portals-open-the-
door-to-better-care-39853-1.html • http://en.wikipedia.org/wiki/HITECH_ACT
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The Achieve Process
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