Industry specific cover image Oracle Healthcare Consumer Solutions: Provider Retail and Disease Management Mary Kilmer, NA Executive Director, Healthcare

Industry specific cover image

Oracle Healthcare Consumer Solutions: Provider Retail and Disease Management

Mary Kilmer, NA Executive Director, Healthcare IBU April 2009

Copyright ©2009, Oracle. All rights reserved. Oracle Healthcare Confidential 2

Oracle Healthcare Mission

Leveraging the power and resources of a top 5 global healthcare care company to empower you to deliver:

• Operational efficiency and game changing productivity

• Collaboration and communication across the healthcare community

• Empowered associates

• Information management and analytics with real-time information that promote improvement in outcomes

• Reaching beyond the artificial boundaries in promoting wellness and safety

• Providing a holistic healthcare experience for each patient’s needs and personalizes their care


Our Client’s Critical Business Issues

• Challenged to improve loyalty and satisfaction with patients, medical staff and employees

• Inability to develop new sources of revenue

• Struggling to reduce cost of healthcare delivery especially for chronic disease

• Challenged to embrace the rise in healthcare consumerism

• Fragmented consumer delivery value chain

• Improve the patient experience


Its All About The Relationship

“The quality of the ongoing relationship between the

hospital and its patients (and medical staff) is far and away the dominant determinant of success.”

Gartner


What is the Patient Experience for Healthcare?

Healthcare organizations develop successful high-value, relationships and deliver superior service and more effective experience to their physician, patient, and community constituents

Establish a patient centered, collaborative, personal experience where knowledge and care can support the patient, the family,the community, the medical staff

Establish the provider as the trusted source of all healthcare support


Why Now?

• Rise in consumerism, demand for a partnership in care

• Increase use of internet and call center

• More effective technology

• Entrants of new “providers”

• Need to capture new revenues with predictable streams

• Recognition that this new business needs a retail focus


Survey Says:Patients want to Connect


What Consumers Say They Want From HospitalsAligns With “Retail” StrategiesQuality – Convenience – Lower Cost - Empowerment

•Easy access to care

•More support from trusted provider

•Coordinated treatment

•Better health education access

•Price & Quality information transparency

•Multiple communication pathways

•More collaborative disease management


Providers Are Challenged to Capture Revenues to Stay Viable

Average Revenue Breakdown of Retail Pharmacies ‘07

Prescription Drugs67%

OTC Medications and Personal care

10%

Health & Beauty aids5%

General Merchandise and

Other18%

Source: Freedonia Healthcare Market Overview 2008, Public Retail Pharmacy corporation annual reports


... Studies Show Quality & Costs Impacts from Improved Discharge Planning & Care Coordination

Sources: “Educating Patients Before They Leave the Hospital Reduces Readmissions, Emergency Department Visits, and Saves Money”, AHRQ press release – Feb. 2009.

“Community Benefit Strategies for a Changing Economy”, Jeni Williams, HFM Magazine, Feb. 2009


Why Oracle?

• World class order to cash and retail solution

• Market leading CRM and Order Management and Fulfillment

• Investment in functionality

• Investment and commitment in healthcare industry

• Successful solution managing mail order pharmacy for last 7 years

• Experience in the retail and payor space

• Experience in provider market


Thinking outside the box!


Investment in Healthcare

Oracle FY 2005

Oracle FY 2006 Oracle FY 2007


Accuracy

Scalability

Security

BusinessIntelligence

Oracle Healthcare Consumer Solutions

•Collaborative tracking, interaction and education

•Clinical Pathway Post Discharge

•Document and communicate online

•Workflow alerts

•Outcomes improved, readmissions reduced, satisfaction increased

•Mail Order pharmacy and DME delivery direct to consumers or to regional locations

•CRM, ERP and Analytics Solution

•Marketing, Sales, Interaction Center, and Service

•Supply Chain and Financials

•Pre-Built Analytics

•Interactive tools to assess patients complaints•Determine right venue •Referrals•Online FAQ and help desk•Reduce cost•Improve quality•Improve satisfaction

• Utilizing the Oracle Pharmacy solution • Broaden their value chain by offering supplies, meals, prescriptions, DMEs, etc.•Multiple channels•Interactive TV•POS•Web Store

Disease Management

Retail

Pharmacy

Nurse Triage Retail


Provider Retail


Insight Review of 550 Bed Hospital


Oracle Insight Review of Healthcare Retail Opportunity

Oracle Healthcare conducted an Insight review assessing the Healthcare Retail opportunities for a 550 bed, $300M in revenue community hospital.

.


Primary Service Lines Studied :These areas were agreed on with senior management at the outset of the project

• Discharge-related DME, pharmacy and other services “bundled” to increase revenues & patient satisfaction in the following areas:

– OB/GYN– Oncology– Psychiatric – E.D. – Cardiology– Sleep Lab

• Retail / Out-Patient Pharmacy– Potential for re-fill & “smart-switch” business related to discharges– Related OTC business– Employee prescription service– Possible pharmacies in MOB’s or other remote locations– Other

• Expanded Gift Shop products & services– Existing gift shop– Greatly expanded web offerings – Additional retail shops


Patients were Surveyed to Validate Patient/Consumer Receptivity & Interaction Preferences for the Contemplated Services

• The great majority of patients indicated they would use these services – if offered:• 84% said they’d purchase DME/HME items if offered

• 84% said they’d purchase discharge medications if offered

• 75% said they were comfortable ordering via in-room interactive TV devices

• 66% said they’d order refills of medications initially purchased at discharge

• Patients view hospital as a trusted source of medical information, second only to their physician!

• Preferences for communication & information exchange lend strongly to anticipated program execution plans


% CaptureProduct / Service of Available Business Assumed Gross Margins

Industry Hosp Pts. We Used Industry We Used

DME & Daily Living Products 60% 84% 40-70% 50% 25 – 35%

Discharge Medications 60% 84% 30-70% 24% 22%

Refills on above 40% 66% 35-50% 10-20% 7%

Employee Medications 80% 60% 10% 7%

Extremely Conservative Estimates UsedWe used lower anticipated business capture rates & margin estimates than

both industry & patient survey data prove are likely


Related DME/HME sales $0.9 – 1.5 M $0.6 – 0.9 M

- Breast pumps/rentals, bras, diapers, 15% bottle feeder items (Note current pump sales/rentals only 320/yr. – vs. 34000 total!)

Related Pharmacy sales $0.5 – 1.9 M $0.05 – 0.15 M

- Percoset, Lanolin, “Easy Switch Conversion”

Other products & services $0.6 – 1.2 M $0.3 – 0.5 M- Specialty formula, car seats, Baby Registry Services

Reimbursable = $0.7-1.7 M Non-Reimbursable = $1.2 -2.3 M Home Service Related = $0.6 -.08 M

Detailed Opportunity Summary Example: Women’s Health Services

Key enablers:

• End-to-end re-design of communication & coordination activities with physicians & patients

• Clinical system integration to trigger appropriate workflows based on diagnosis, procedural, or other drivers.

• Standardized discharge order sets for target groups, with physician buy-in.

• Modified nursing discharge procedures to accommodate.

• Potential use of interactive TV offerings to enable easy patient education & ordering.

• Proposed retail system components to manage orders, fulfillment, billing, collections, reporting, etc.

Dependencies:

• Gaining physician support outside core advisory group.

• Additional retail & education space

• Coordination of “sales” efforts at all touch points.

• Related “Discharge” pharmacy dependencies.

Total Annual Revenue Potential $ 2.0 – 4.6 M $0.95 – 1.5 M

New Products / Services Annual Revenues Gross Margins


Increase annual revenues of $21 to 40 M per year, with margins ~$8.1M (additional $20-30M in areas we didn’t study)

Extrapolated to Health System level, between $500M and $1B annually

Most attractive areas to start will be additional DME sales in Women’s services, Pulmonary, Cardiology, Sleep Lab and E.R. –

Discharge pharmacy sales is next most attractive opportunity

These new services will also satisfaction

Enhance hospital comprehensive patient care & service innovation

Executive Summary - Key Findings for Hospital

Copyright ©2009, Oracle. All rights reserved. Oracle Healthcare Confidential

OHCS Retail Footprint:Order-To-Cash Flow

Disease Mgt

Supply Chain ManagementOrder managed and fulfilled

Customer Relationship ManagementOrder placed

eMail WebTelephony Mobile Fax

FinancialsOrder paid for

Channels

Task Manager

SharedComponents

AnalyticsBusiness Intelligence/Reporting

Applications

SOA Suite


The Right “Retail” Strategy Can Bring Multiple Positive Outcomes

• New revenues with higher margins

• Improved patient care & wellness

• Improved patient satisfaction and physician

• Lower total cost of care

• Building of “Brand” loyalty

• Reduced operating costs

• Improved disease management


Oracle Healthcare Consumer Solution

• Supports: the ordering and fulfillment of – Pure retail

– eCommerce gift shop

– Pharmaceuticals, discharge and refill

– DME discharge and refill

• Also supports:

– Disease Management

– Marketing and Branding

– Loyalty


Multiple Channels Can Deliver the Message

• Personal Content Delivery Tool

• Interactive TV

• Patient Concierge

• Discharge Planner/Nurse

• Fax

• Call Center

• Email

• Portal

• Paper/Mail


Nurse Concierge is one way hospitals can utilize OHCS


Nurse Concierge can offer personalized discharge support


Nurse is assigned patient and provided physician directed prescription and supply recommendations


Interactive Medication Education


Medication Ordering Support


Disease Management Program Invitation


Hospital’s eCommerce Website


Patient Sees the Ease of Use and Ordering


One-Click Ordering


Disease Management


Disease Management

What is DM• Health Screening

• Health Education

• Health Coordination

• Health Choices

• Health Support in and out of the Hospital

Who Is it for?• Patients

• Families

• Communities

• Providers

• Payors

• Provinces

• States

• Countries


Why Focus on Chronic Conditions?

81% of inpatient stays

83% of US healthcare spending

91% of prescriptions

76% of physician visits

98% of home healthcare visits

As of 2006, patients with chronic conditions accounted for:


Why Focus on Disease Management?

Chronic Disease

Management

•Cost of CDM in the US 2008 -$1.3 Trillion with and estimated increase to $4.2 Trillion in 2023

•80 Million people have multiple CDs

•Canada’s annual spend for CDM is over $80 Billion

•CD accounts for 44% of the population but 78% of all healthcare expenditures

•CHF the number three admission due to lack of coordination of care at home


What is the Cost of Chronic Disease?

Chronic Disease

Management

•Frequent readmissions

•Burden on patient who has to manage complicated treatments and medications on their own

•CHF the number three admission due to lack of coordination of care at home

•Burden on family and healthcare system


Health Awareness

and Prevention

Connected Healthcare

Oracle is Invested in Supporting Chronic Disease Management

Chronic Disease

Management

OHCS: CDM Solution


Implications for Clinical Quality

• OHCS supports Disease Management initiatives to help push the clinical pathways post discharge or after initial diagnosis

–Channel for provider/patient/caregiver collaboration with access for patient interaction thru portal, email, phone etc.• i.e.Daily glucose check with workflow based on tolerances to

physicians• i.e. track daily weight of CHF patients

–Supports more directly the treatment plan with direct control of medication, meals, DMEs, services

–Meals for CHF patients–Supports pathway management thru Online Learning tool to support

compliance• Comprehensive analytics and reporting to track and improve patient and

aggregate clinical outcomes


The Right Consumer/Disease Management Strategy Can Bring Multiple Positive Outcomes

• Improved patient care & wellness

• Improved patient satisfaction and physician

• Improved support to patient and family

• Closer relationship between provider and patient


• Improved health awareness and prevention

• Health prevention and population screening

Copyright ©2009, Oracle. All rights reserved. Oracle Healthcare Confidential

OHCS Retail Footprint:Order-To-Cash Flow

Disease Mgt

Supply Chain ManagementOrder managed and fulfilled

Customer Relationship ManagementOrder placed

eMail WebTelephony Mobile Fax

FinancialsOrder paid for

Channels

Task Manager

SharedComponents

AnalyticsBusiness Intelligence/Reporting

Applications

SOA Suite


OHCS: DM Solution Footprint

• OHCS: Disease Management

–Siebel Interaction Center

• Web

• Email

• Call Center

• Smart Scripting

–Siebel Marketing

– iLearning

–Oracle Technology

Disease Management


Oracle Disease Management

• Utilizing CRM Interaction Center and learning to establish a more collaborative relationship between Patients and Providers and between the care team

– Programmatic approach to Disease Management thru Marketing and Interaction Center

• Call Center

• Email

• FAQ

• Portal support

• Learning

• Expansion of outreach


Oracle Disease Management

• Chronic Disease Management

– Diabetes

• Classes

• Glucose communication

• Education

• Meals, pharma, DMEs, etc support

• Call Center support

• FAQ online

• Email

• Communities


In conclusion


Our Client’s Critical Business Issues

• Challenged to improve loyalty and satisfaction with patients, medical staff and employees

• Inability to develop new sources of revenue

• Struggling to reduce cost of healthcare delivery especially for chronic disease

• Challenged to embrace the rise in healthcare consumerism

• Fragmented consumer delivery value chain

• Improve the patient experience


OHCS is the Only Solution That Will Bring Results and Build the Relationship

• New revenues with higher margins

• Improved patient care, disease management, & wellness

• Improved satisfaction and experience


• Building of “Brand” loyalty

• Reduced operating costs

Documents

Industry specific cover image Oracle Healthcare Consumer Solutions: Provider Retail and Disease Management Mary Kilmer, NA Executive Director, Healthcare