This document provides an overview of a presentation about harnessing open source and Drupal to drive outcomes in healthcare. The agenda includes discussing Achieve, the current state of US healthcare, trends in healthcare technology, the value of open source, how Drupal can help, and a Dexcom case study. It discusses challenges in the healthcare industry and how technology like patient portals, electronic health records, and open source platforms can help address issues like interoperability, workflow automation, and patient engagement.

1. Launch with Confidence!
Harnessing the Power of Open
Source & Drupal to Drive
Outcomes in Healthcare
4/16/13

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
4/16/13

3. About Achieve
legal name
Achieve Internet"
founded
1998"
headquarters
1767 Grand Avenue, Suite #2 | San Diego, CA 92109 | U.S.A."
leadership
Ron Huber, Chief Executive Officer"
Achieve leverages best in class open source web application and development experience and tools to create
mission
optimized platforms for enterprise clients. "
core values
Meticulous Coding | Transparent Work Flow | Robust Performance"
Achieve specializes in the architecture and planning phases of large-scale enterprise projects for Fortune 500
services
Companies. Services include: Application Development, Integrated Communications, Globalization, Infrastructure
and Deployment, and Mobility and End-User Services. "
clients
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. "
partnerships
Acquia (Enterprise Partner), Drupal Association, Neue Creative Group, Kluge Interactive "
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4. Key Clients: Media & Entertainment
clients!
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5. Key Clients
clients!
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6. About Me
• Marc Hermsmeyer
• VP, Operations at
Achieve Internet
• 14+ years experience
in Internet software
and online media
• Enjoys surfing,
backpacking & fishing
LinkedIn: www.linkedin.com/in/marchermsmeyer/"
Twitter: @MHermsmeyer"
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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
Frost and
Sullivan
• Increasing population size
Research"
Demographics
• Ageing population that are living longer
Disease • Increase in life style induced diseases
Patterns
• Increase in chronic diseases
• Health is valued more today
Consumer • Patients are acting more like consumers
Behavior
when deciding on care
• Incentives for Electronic Healthcare Platforms
Government • Mandate for patient engagement and
Pressure
interaction
§ h"p://www.slideshare.net/FrostandSullivan/health-­‐informa9on-­‐technologies-­‐market-­‐trends
4/16/13

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
4/16/13

12. Industry Wide Challenges
These challenges have plagued many other
industries in the past, from Media, Publishing
and Manufacturing, beyond….
§ Interoperability
§ Integration
§ Workflow automation
§ User experience
§ Billing
§ Performance
§ Scalability
§ Communication
§ Patient engagement
§ Mobile solutions
4/16/13

13. Hasty Decisions
Physician satisfaction with their current
technology solution
Black Book Rankings on Top
Ranking EMRs "
Satisfied
Undecided
Dissatisfied
§ h"p://www.blackbookrankings.com/healthcare/
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14. Where is Healthcare Headed?
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15. Where is Healthcare Headed?
Government Mandate to Leverage Technology
Financial Incentives
Will Cause Healthcare
Affordable Care Act Adoption Rates to
Soar
HITECH Act
§ Electronic Health
Records (EHR)
§ Practice Management
Tools
Meaningful Use
§ Patient Portals
§ Personal Health Records
4/16/13

16. Affordable Care Act & Meaningful Use
“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.” "
HealthIT.gov and CMS.gov"
$63,750!
amount healthcare professionals will be able to receive per eligible
professional within their practice that implements an EHR under
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/
4/16/13

17. Missing the Mark on Meaningful Use
160000
HealthIT.gov HIT Adoption Rates"
140000
120000
100000
80000
60000
40000
20000
0
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
§ h"p://dashboard.healthit.gov/HITAdop9on/?view=0
4/16/13

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
• 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
4/16/13

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
• h"p://www.healthdatamanagement.com/issues/18_3/will-­‐pa9ent-­‐portals-­‐open-­‐the-­‐door-­‐to-­‐be"er-­‐care-­‐39853-­‐1.html
4/16/13

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
• h"p://healthcare.intuit.com/portal/docs/pa9ent-­‐portals-­‐mu-­‐whitepaper.pdf
4/16/13

21. How Can Technology Help?
Leveraging the power of technology will help to lower costs and
create engaging care solutions:
§ 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
4/16/13

22. 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
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23. The Value of Open Source and Drupal
• 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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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
Primary Mobile Social Email Community Video
site
application
FB/Twitter
campaign
site
portal
Measurement and reporting
Drupal
Marketing
Commerce Social Media CRM Analytics
automation
4/16/13

27. Security Management – The DOD
“Continuous and broad
peer review, enabled by
public available source
code, supports software
David M. Wennergren
reliability and security
Department of Defense CIO
efforts”
4/16/13

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
4/16/13

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
4/16/13

30. Dexcom, Inc. – An (Oracle) Integration Case Study
• 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.
• Medical device company that
distributes glucose monitoring • Achieve built a series of custom modules that
systems
integrated multiple sources of data into one seamless
• Third Party Integration: Oracle platform, including a number of proprietary client
Legacy System
information:
• Custom Built Modules to lock • Insurance verification
secure client data behind firewall
• Purchasing and frequency limits based on client insurance
• HIPAA Compliant
and co-pays
• Mobile optimized: Responsive • Product specifications
web design technology used
4/16/13

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
4/16/13

32. Drupal – Freedom and Flexibility
No Lock-in Simplified Digital Experiences
Open SaaS model offers Lowest solution TCO
freedom to move your customers and the fastest learning curve
digital experiences to any
amongst developers
and Digital Marketers.
Mature Cloud Model
Unmatched Innovation Leverage mature, optimized
Accelerate innovation from idea cloud deployment models and
to experience at web speed across offers operational models to map
any channel or device.
spending plans to successes.
Unified Platform Best of Breed
Create unforgettable customer Empower the business to mix and
experiences by leveraging a match sales and marketing tools in
unified platform for content, a string of pearls approach
community, and commerce.
for maximum business impact
4/16/13

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
4/16/13

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
4/16/13

35. Why Drupal Rocks – A Snapshot!
Drupal Rocks!
§ Cost!
Drupal Rocks!
§ Scalability and Time to Market
§ Platform Integration
§ Community Capabilities
§ Drupal Talent…everywhere!
4/16/13

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
4/16/13

37. Thank You
Marc Hermsmeyer!
§ VP, Operations
§ marc.hermsmeyer@achieveinternet.com
§ 800.618.8777
4/16/13

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
4/16/13

40. Backup Slides
References
4/16/13

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.!
!
§ hp://en.wikipedia.org/wiki/HITECH_ACT
4/16/13

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=/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
4/16/13

43. The Achieve Process
4/16/13