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.

1. Launch with Confidence
Harnessing the Power of Open
Source & Drupal to Drive
Outcomes in Healthcare
5/16/2013

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&A
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3. 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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4. Key Clients: Media & Entertainment
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clients

5. Key Clients
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clients

6. 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

7. Three Key Focuses
1. Current state of
Healthcare
2. Developing Trends
in Technology
3. Future Drupal
Considerations
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8. Healthcare – An Individual Perspective
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9. 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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10. Changing Landscape for Healthcare
• Increasing population size
• Ageing population that are living longerDemographics
• 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
 http://www.slideshare.net/FrostandSullivan/health-information-technologies-market-trends
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Frost and
Sullivan
Research

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, 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
5/16/2013

12. 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….

13. Hasty Decisions
Satisfied Undecided Dissatisfied
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Physician satisfaction with their current
technology solution
 http://www.blackbookrankings.com/healthcare/
Black Book Rankings on Top
Ranking EMRs

14. Where is Healthcare Headed?
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15. 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

16. Affordable Care Act & Meaningful Use
 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/
“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

17. 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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 http://dashboard.healthit.gov/HITAdoption/?view=0

18. 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. http://www.healthdatamanagement.com/issues/18_3/will-patient-portals-
open-the-door-to-better-care-39853-1.html

19. 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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• http://www.healthdatamanagement.com/issues/18_3/will-patient-portals-open-the-door-to-better-care-39853-1.html

20. 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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• http://healthcare.intuit.com/portal/docs/patient-portals-mu-whitepaper.pdf

21.  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:

22. Patient Portals – Feature Ranking
Feature Rank 1-5 (1= lowest; 5 = highest)
Integration 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
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23. • 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

24. 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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25. Workflow Automation
• Content creator / editor
workbench
• Review, approval, publishing
workflows
• Change reviewing
• Content versioning
• Role-based interface &
permissions
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26. Integration with Best-of-Breed Tools
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Primary
site
Mobile
application
Social
FB/Twitter
Community
site
Video
portal
Email
campaign
Drupal
Measurement and reporting
Commerce Social Media
Marketing
automation
CRM Analytics

27. 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”

28. 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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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 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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30. • 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

31. 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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32. 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.

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 solutions
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34. 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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35. 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!

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 Engagement
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37. Thank You
5/16/2013
Marc Hermsmeyer
 VP, Operations
 marc.hermsmeyer@achieveinternet.com
 800.618.8777

38. 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: info@achieveinternet.com
 Twitter.com/achieveinternet
 http://www.facebook.com/pages/Achieve-Internet/7335128391
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39. Q & A
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40. Backup Slides
References
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41. 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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 http://en.wikipedia.org/wiki/HITECH_ACT

42. 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=/ehrincentiveprogr
ams/
• 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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43. The Achieve Process
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