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Drupal and the Future of Healthcare


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Achieve Internet VP of Operations Marc Hermsmeyer and Dexcom Inc., Senior Marketing Manager Tom Hall speak about technology solutions for the Healthcare Industry using Open Source software, such as …

Achieve Internet VP of Operations Marc Hermsmeyer and Dexcom Inc., Senior Marketing Manager Tom Hall speak about technology solutions for the Healthcare Industry using Open Source software, such as Drupal.
The Government is forcing technology innovation within the Healthcare industry yet there are very few solutions out there that are tailored for the specific requirements and needs of the Healthcare market. In past experiences with Dexcom and other Healthcare clients Achieve has leveraged the power of Drupal to create powerful solutions that drive patient outcomes, improve workflows, and remain compliant with rigorous regulatory requirements.
This presentation shines a light on the technology needs of the Healthcare market and how Drupal can meet those needs.

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  • These are typical pains that the patient is experiencing in their interactions with Healthcare.
  • Poor communication between Doctors as well as lack of interaction between patient and physicians are partly to blame for the bloated costs and poor level of care. Inefficiencies from cumbersome proceduresPoor communication from redundant workflow Lack of interoperability between platformsDelay in accounts receivable Trouble accessing patient medical information Low patient engagementInsecure technology platforms
  • Certain offices have different applications for each component of the processDifferent scheduling appBilling appMessaging Etc$17 saved every time practice can handle a billing query online rather then by phone$7 saved for every appointment scheduled online12,000 phone calls averted a month!re-direct over 100 hours each month from paperwork and phone calls to providing better customer service and patient carePhysician offices have a number of cumbersome workflow procedures. The inefficiencies cost the practice money and time and take away from the care they can provide for their patientsThese inefficiencies and challenges translate into poor customer service and a lack of patient care, which is obviously not the intended consequence of Healthcare.
  • Government forces are causing poor decisions on technology solutions.
  • Affordable Care Act: Commonly called Obama care, the Affordable Care Act is a US Federal statute signed into law by President Obama in March of 2010. Represents the most significant government expansion of and regulatory overhaul of the US Healthcare System. It’s aimed at increasing the rate of health insurance coverage for Americans and reducing the overall cost of healthcare. It provides a number of mechanisms to employers and individuals in order to increase coverage rates. Additional reforms are aim to improve healthcare outcomes and streamline the delivery of health care in the US. HITECH Act: Set meaningful use of interoperable EHR adoption in the health system as a critical national goal and incentivized EHR adoption. Meaninful Use: Physicians are incentivized to drive adoption of EHRs by receiving incentive payments. 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 EHR stimulus money the HITECH Act requires doctors to show meaningful use of EHS and technology The Goal: Improve care coordination, reduce healthcare disparities, engage patients and their families.
  • By mandating the use of Electronic Health Records (EHR) and establishing an initiative for better system wide communication through the use of technologyEHRs and Patient Portals will satisfy 3 of the 10 core criteria laid out in Stage 2 Meaningful UseMeaningful Use requires a level of interaction from the patient in order for the physician to qualify for the government creditThe Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.Patient portals will satisfy 2 of 20 core criteria from Stage 1 of Meaningful Use, and 2 of 10 elective criteria of which physicians need to satisfy 5 electives to qualifyPortals will satisfy 3 of the criteria laid out in Stage 2 of Meaningful UseMeaningful Use, American Recovery and Reinvestment Act and specifically the HITECH Act are still works in progress and the final outcome is still unknown, what is known however:Penalties for not participating begin in 2015, with a 1% reduction in Medicare payments up to 5%This is essentially a mandate from the government for portals: patient engagement is one of the governments health care prioritiesMU is becoming a driver of automation: Stage 2 will require patient action along with patient engagementRequiring a measurement of patient use ensures that physicians will promote the availability and access to electronic recordsUnder the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.
  • Primary Care Providers Using EHR and Meeting Meaningful UsePPCP = Progress for Primary Care Providers
  • Receive Government CreditMeaningful Use mandates the implementation of technology amongst physician, practices, and hospitalsMeet requirements through a fully integrated platform of solutions made possible with Drupal.Engage your patients beyond the threshold necessary to meet requirementsDrupal has the ability to integrate with multiple API platformsDrupal’s extensibility allows for custom module creationWhy use 10 different platforms? Drupal can tie them into one elegant solution, including:Connect with your customers through simple messaging functions that can reduce call time Get your staff off the phone and focused on the patientEmail Engagement: Mail Chimp, ConstantContact, iContact
  • Integration with video and multi-mediaSecure messaging capabilities both internally and externallyCentral repository for shared files Single sign on functionality
  • Everything needed to better manage personal care in one easy to use and convenient platform.
  • Transcript

    • 1. Launch with ConfidenceHarnessing the Power of OpenSource & Drupal to DriveOutcomes in Healthcare5/16/2013
    • 2. 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&A5/16/2013
    • 3. About Achievelegal namefoundedheadquartersleadershipmissioncore valuesservicesclientspartnershipsAchieve Internet19981767 Grand Avenue, Suite #2 | San Diego, CA 92109 | U.S.A.Ron Huber, Chief Executive OfficerAchieve leverages best in class open source web application and development experience and tools to createoptimized platforms for enterprise clients.Meticulous Coding | Transparent Work Flow | Robust PerformanceAchieve specializes in the architecture and planning phases of large-scale enterprise projects for Fortune 500Companies. Services include: Application Development, Integrated Communications, Globalization, Infrastructureand 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 suchas: U.S. Chamber of Commerce, Dexcom, Inc., Experian, Hunter Industries, and Amerigroup.Acquia (Enterprise Partner), Drupal Association, Neue Creative Group, Kluge Interactive5/16/2013
    • 4. Key Clients: Media & Entertainment5/16/2013clients
    • 5. Key Clients5/16/2013clients
    • 6. About Me• Marc Hermsmeyer• VP, Operations atAchieve Internet• 14+ years experiencein Internet softwareand online media• Enjoys surfing,backpacking & fishing5/16/2013LinkedIn: @MHermsmeyer
    • 7. Three Key Focuses1. Current state ofHealthcare2. Developing Trendsin Technology3. Future DrupalConsiderations5/16/2013
    • 8. Healthcare – An Individual Perspective5/16/2013
    • 9. Healthcare – An Individual Perspective• When was the last time you went to theDoctor’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.5/16/2013
    • 10. Changing Landscape for Healthcare• Increasing population size• Ageing population that are living longerDemographics• Increase in life style induced diseases• Increase in chronic diseasesDiseasePatterns• Health is valued more today• Patients are acting more like consumers whendeciding on careConsumerBehavior• Incentives for Electronic Healthcare Platforms• Mandate for patient engagement andinteractionGovernmentPressure andSullivanResearch
    • 11. 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, lifeexpectancy and infant mortality rate Americans are spending 17% of GDP onHealthcare costs 21 – 40% of Healthcare spend is wasteddue to inefficiencies in workflow» Dr. James LaBelle, CMO Scripps Health Dr. James LaBelle, Chief Medical Officer and Senior Vice President at Scripps Health5/16/2013
    • 12. Industry Wide Challenges Interoperability Integration Workflow automation User experience Billing Performance Scalability Communication Patient engagement Mobile solutions5/16/2013These challenges have plagued many otherindustries in the past, from Media, Publishingand Manufacturing, beyond….
    • 13. Hasty DecisionsSatisfied Undecided Dissatisfied5/16/2013Physician satisfaction with their currenttechnology solution Book Rankings on TopRanking EMRs
    • 14. Where is Healthcare Headed?5/16/2013
    • 15. Where is Healthcare Headed?5/16/2013Affordable Care ActHITECH ActMeaningful UseGovernment Mandate to Leverage TechnologyFinancial IncentivesWill Cause HealthcareAdoption Rates toSoar Electronic HealthRecords (EHR) Practice ManagementTools Patient Portals Personal Health Records
    • 16. Affordable Care Act & Meaningful Use“To meet the requirements of Meaningful Use Stage 2, health careproviders need to more actively engage patients by providing themwith the capability to electronically view, download, and transmitrelevant information from their provider’s electronic health records.”5/16/2013$63,750amount healthcare professionals will be able to receive per eligibleprofessional within their practice that implements an EHR underMeaningful and
    • 17. Missing the Mark on Meaningful Use020000400006000080000100000120000140000160000Number of Primary Care Providers EnrolledNumber of Primary Care Providers Live on EHRNumber of Primary Care Providers Demonstrating Meaningful UseEnrollment Goal, HIT Adoption Rates5/16/2013
    • 18. New Wave of Healthcare TechnologyPatient Portals:―It’s going to be a cost of doing business. Youwouldn’t consider not having a phonesystem, and the generations that are comingup are going to think it’s ridiculous not to beable to communicate via computer.‖--Elizabeth Boehm, Forester Research5/16/2013• Elizabeth Boehm, Forester Research and Experia Health.
    • 19. Benefit of Patient Portals• $0.63 cents saved… Every time practice does not have tomail lab results• $17 saved… Every time practice can handle a billingquery online rather then by phone• $7 saved… For every appointment scheduled online• 25% reduction in patients… Who need to come in for afollow 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 eachmonth from paperwork and phone calls to providingbetter customer service and patient care5/16/2013•
    • 20. Patients Want Portals• 94% of patients in one survey rated easy access to their ownmedical records as either important or very important• 75% of patients want their physicians to provide onlineservices to do the following:• Schedule appointments• Get test results• Access medical records• Exchange email• 81% would schedule their own appointment via a secure website and fill out medical/registration forms online prior to visit5/16/2013•
    • 21.  Connectivity/Interoperability Accessible patient records and testresults 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 solutions5/16/2013How Can Technology Help?Leveraging the power of technology will help to lower costs andcreate engaging care solutions:
    • 22. Patient Portals – Feature RankingFeature Rank 1-5 (1= lowest; 5 = highest)Integration w/ EHR 5RX Refills 5Secure Messaging 5Lab/Test Results 5Referrals 4Online Medical Forms 4Access to Medical Info 3.5Billing 3Scheduling 3Mobile (Responsive) 3E-Visits 2Community Building (Social/Forums) 2Support 25/16/2013
    • 23. • PatientEngagement…BestSolved with Drupal Robust platform withnumerous modules forcustomization Extensible and designed toaccommodate numerouschanges Out of the box functionality5/16/2013The Value of Open Source and Drupal
    • 24. Drupal Specific SolutionsWorkflow Automation +… Configuration Approval Auditing3rd Party Integration +… Single Sign-on (SSO) Consume 3rd Party Data BI IntegrationSecurity … Access User Management Password Policies= Enhanced Customer and Patient Interaction Engage the patient and meet Meaningful Use goals5/16/2013
    • 25. Workflow Automation• Content creator / editorworkbench• Review, approval, publishingworkflows• Change reviewing• Content versioning• Role-based interface &permissions5/16/2013
    • 26. Integration with Best-of-Breed Tools5/16/2013PrimarysiteMobileapplicationSocialFB/TwitterCommunitysiteVideoportalEmailcampaignDrupalMeasurement and reportingCommerce Social MediaMarketingautomationCRM Analytics
    • 27. Security Management – The DOD5/16/2013David M. WennergrenDepartment of Defense CIO“Continuous and broadpeer review, enabled bypublic available sourcecode, supports softwarereliability and securityefforts”
    • 28. Tom Hall, Dexcom, Inc.• Senior Marketing Manager forDexcom, Inc.• Manages short and long termdigital strategies includingwebsite development and agencypartnerships• Focused on scaling Dexcom’sonline presencethrough, SEO, and socialnetworks, to increase inboundtraffic, and to grow customer base5/16/2013
    • 29. 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 OracleLegacy system• Platform had to be an intuitive e-commerce solution Result• Fully HIPAA compliant site that allowed patients access to theirrecords and diabetes devices in an elegant mobile platform• Decreased administration work to expedite order process• Expanded sales channel online for customers to order5/16/2013
    • 30. • Achieve teamed up with Acquia to build, host andsupport an e-commerce site that gave patients aquick, easy, and secure method for re-ordering theirglucose monitoring systems.• Critical client data was locked within Dexcom’s Oraclesystem.• Achieve built a series of custom modules thatintegrated multiple sources of data into one seamlessplatform, including a number of proprietary clientinformation:• Insurance verification• Purchasing and frequency limits based on clientinsurance and co-pays• Product specifications• Medical device company thatdistributes glucose monitoringsystems• Third Party Integration: OracleLegacy System• Custom Built Modules to locksecure client data behind firewall• HIPAA Compliant• Mobile optimized: Responsiveweb design technology used5/16/2013Dexcom, Inc. – An (Oracle) Integration Case Study
    • 31. A Positive Outlook• Open Source Technology Has AlreadyAlleviated These Same Pains in OtherIndustries Fully integrated with all third party APIs Engaging platform Seamless billing solutions Scheduling solution for front office automation Secure websites exceeding industry standards5/16/2013
    • 32. Drupal – Freedom and Flexibility5/16/2013No Lock-inOpen SaaS model offersfreedom to move your customersdigital experiences to anyUnmatched InnovationAccelerate innovation from ideato experience at web speed acrossany channel or device.Best of BreedEmpower the business to mixand match sales and marketingtools in a "string of pearls"approach for maximumbusiness impactUnified PlatformCreate unforgettable customerexperiences by leveraging aunified platform forcontent, community, and commerce.Mature Cloud ModelLeverage mature, optimizedcloud deployment models andoffers operational models to mapspending plans to successes.Simplified Digital ExperiencesLowest solution TCOand the fastest learning curveamongst developersand Digital Marketers.
    • 33. 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 solutions5/16/2013
    • 34. Achieve’s Drupal DevelopmentAchieve has dedicated thousands of hours developing themost complex Drupal solutions specializing in: Workflow• Elegant back-end solutions that have simplified the most complexeditorial workflow• Track-able content editing and deployment process for HIPAAcompliance Integration• Platforms that access critical client data behind firewalls lockedwithin secure legacy systems Infrastructure Services• Achieve builds rock-solid HIPAA compliant server configurations Security• Rigorous security audits5/16/2013
    • 35. Drupal Rocks!5/16/2013Why Drupal Rocks – A Snapshot! Cost! Scalability and Time to Market Platform Integration Community Capabilities Drupal Talent…everywhere!Drupal Rocks!
    • 36. 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 Engagement5/16/2013
    • 37. Thank You5/16/2013Marc Hermsmeyer VP, Operations 800.618.8777
    • 38. Connect with AchieveIf you have any further questions or would like to get in touch withAchieve you can do so through the following channels:• Email:
    • 39. Q & A5/16/2013
    • 40. Backup SlidesReferences5/16/2013
    • 41. HITECH Act SummaryThe Health Information Technology for Economic and Clinical Health Act, abbreviated HITECHAct, was enacted under the American Recovery and Reinvestment Act of 2009. Under theHITECH Act, the United States Department of Health and Human Services is spending $25.9billion 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 healthrecords.‖Electronic Health Records (EHR)The HITECH Act set meaningful use of interoperable EHR adoption in the health care system asa critical national goal and incentivized EHR adoption. The "goal is not adoption alone butmeaningful use of EHRs — that is, their use by providers to achieve significant improvementsin care.‖Title IV of the act promises maximum incentive payments for Medicaid to those who adopt anduse "certified EHRs" of $63,750 over 6 years beginning in 2011. Eligible professionals mustbegin receiving payments by 2016 to qualify for the program. For Medicare the maximumpayments are $44,000 over 5 years. Doctors who do not adopt an EHR by 2015 will be penalized1% of Medicare payments, increasing to 3% over 3 years. In order to receive the EHR stimulusmoney, 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.5/16/2013
    • 42. References• Dr. James LaBelle, Chief Medical Officer and Senior Vice President at Scripps Health••••••••••
    • 43. The Achieve Process5/16/2013