Industry Specific Cover Image: Oracle Healthcare Consumer Solutions: Provider Retail and Disease Management

Industry specific cover image
Oracle Healthcare Consumer Solutions: Provider Retail and

Disease Management
Mary Kilmer, NA Executive Director, Healthcare IBU

April 2009
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
Copyright ©2009, Oracle. All rights

reserved. Oracle Healthcare Confidential 2
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 Hospitals
Aligns With “Retail” Strategies
Quality – 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
General
Merchandise and
Other
18%
Health & Beauty
aids
5%
OTC Medications
and Personal care
Prescription Drugs
10%
67%
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

Oracle Healthcare Consumer Solutions
•Collaborative tracking, •Mail Order

pharmacy and DME
interaction and
delivery direct to
education consumers or to
•Clinical Pathway Post regional locations
Discharge •CRM, ERP and
•Document and Disease Analytics Solution
communicate online Management Pharmacy •Marketing, Sales,
Interaction Center,
•Workflow alerts and Service
Scalability
•Outcomes improved, •Supply Chain and
readmissions reduced, Financials
satisfaction increased
•Pre-Built Analytics
Security Accuracy
• Utilizing the Oracle
•Interactive tools to Pharmacy solution
assess patients Business • Broaden their
Nurse Triage Intelligence Retail value chain by
complaints
•Determine right venue offering supplies,
•Referrals meals,
•Online FAQ and help prescriptions,
desk DMEs, etc.
•Reduce cost •Multiple channels
•Improve quality •Interactive TV
•Improve satisfaction Retail •POS
•Web Store

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

Extremely Conservative Estimates Used
We used lower anticipated business capture rates & margin estimates than
both industry & patient survey data prove are likely
% Capture
Product / 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%

Detailed Opportunity Summary Example: Women’s Health Services
New Products / Services Annual Revenues Gross Margins

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
Total Annual Revenue Potential $ 2.0 – 4.6 M $0.95 – 1.5 M
Reimbursable = $0.7-1.7 M Non-Reimbursable = $1.2 -2.3 M Home Service Related = $0.6 -.08 M
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.

Executive Summary - Key Findings for Hospital
 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

OHCS Retail Footprint:Order-To-Cash Flow
Customer Relationship
Disease Supply Chain Management Financials
Applications Management
Order managed and fulfilled Order paid for
Mgt Order placed
Channels Telephony eMail Web Mobile Fax
SOA Suite
Shared
Components
Task Manager
Business Intelligence/Reporting
Analytics

reserved. Oracle Healthcare Confidential
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 Who Is it for?

• Health Screening • Patients
• Health Education • Families
• Health Coordination • Communities
• Health Choices • Providers
• Health Support in and out of the • Payors
Hospital • Provinces
• States
• Countries

Why Focus on Chronic Conditions?
As of 2006, patients with chronic conditions accounted for:
83% of US healthcare spending
81% of inpatient stays
91% of prescriptions
76% of physician visits
98% of home healthcare visits

Why Focus on Disease Management?
Chronic •Cost of CDM in the US 2008 -$1.3 Trillion with and

Disease estimated increase to $4.2 Trillion in 2023
Management
•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 •Frequent readmissions

Disease
Management •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

Oracle is Invested in Supporting Chronic Disease Management
Chronic Health Connected

Disease Awareness Healthcare
Management and
Prevention
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

OHCS Retail Footprint:Order-To-Cash Flow
Customer Relationship
Disease Supply Chain Management Financials
Applications Management
Order managed and fulfilled Order paid for
Mgt Order placed
Channels Telephony eMail Web Mobile Fax
SOA Suite
Shared
Components
Task Manager
Business Intelligence/Reporting
Analytics

reserved. Oracle Healthcare Confidential
OHCS: DM Solution Footprint
• OHCS: Disease Management

– Siebel Interaction Center
• Web
• Email
Disease
• Call Center
Management
• Smart Scripting
– Siebel Marketing
– iLearning
– Oracle Technology

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


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Industry specific cover image

Oracle Healthcare Consumer Solutions: Provider Retail and

Mary Kilmer, NA Executive Director, Healthcare IBU

Leveraging the power and resources of a top 5 global healthcare care

• Collaboration and communication across the healthcare community

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

• Reaching beyond the artificial boundaries in promoting wellness and safety

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

Copyright ©2009, Oracle. All rights

• 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

Copyright ©2009, Oracle. All rights

“The quality of the ongoing relationship between the

Copyright ©2009, Oracle. All rights

Healthcare organizations develop successful high-value, relationships

Establish a patient centered, collaborative, personal experience where

Establish the provider as the trusted source of all healthcare support

Copyright ©2009, Oracle. All rights

• 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

Copyright ©2009, Oracle. All rights

Copyright ©2009, Oracle. All rights

•Easy access to care

•More support from trusted provider

•Better health education access

•Price & Quality information transparency

•Multiple communication pathways

•More collaborative disease management

Copyright ©2009, Oracle. All rights

Average Revenue Breakdown of Retail Pharmacies ‘07

Copyright ©2009, Oracle. All rights

Copyright ©2009, Oracle. All rights

• World class order to cash and retail solution

• Market leading CRM and Order Management and Fulfillment

• 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

Copyright ©2009, Oracle. All rights

Copyright ©2009, Oracle. All rights

Oracle FY 2005 Oracle FY 2006 Oracle FY 2007

Copyright ©2009, Oracle. All rights

•Collaborative tracking, •Mail Order

Copyright ©2009, Oracle. All rights

Copyright ©2009, Oracle. All rights

Copyright ©2009, Oracle. All rights

Oracle Healthcare conducted an Insight review assessing the

Copyright ©2009, Oracle. All rights

• Discharge-related DME, pharmacy and other services “bundled” to

Copyright ©2009, Oracle. All rights

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

• Preferences for communication & information exchange lend strongly to