open source health_acquia_final_v2_20130415

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

Thank You

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Marc Hermsmeyer!§ VP, Operations"

§ marc.hermsmeyer@achieveinternet.com"§ 800.618.8777"

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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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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