Forrest Direct Pay

Background

Dr. Brian Forrest earned national attention for pioneering a Direct Pay, low-overhead practice that improves patient care while financially benefitting both doctor and patient. He had been teaching other doctors how to set up and run their own successful direct pay medical practice in one-on-one, day-long sessions. Needless to say this approach limited his ability to meet the growing demand from doctors looking to implement his approach.

Dr. Forrest needed an application that turned the on-site educational visit into an interactive online educational resource for interested physicians.

The key features:

1. The ability for doctors to purchase membership in order to access Dr. Forrest's intellectual property
2. Multi-level user access permissions
3. Secure video streaming
4. A Practice Transition Calculator which guides doctors by making predictions and recommendations based on variables they input

Starting with a lean mindset

Following the lean startup methodology, we sought to leverage proven existing technologies in order to reduce time spent writing software from scratch. Knowing that the Drupal content management system was equipped with robust member management and multi-level content protection, we chose to leverage Drupal and its corresponding community of modules to handle most of the basic functionality of the site. This allowed us to get off the ground quickly with minimal expenditure and start putting ideas to the test.

Managing members and protecting access

Security - the chief concern

Our task was to build a website that enabled Dr. Forrest to share his intellectual property and be fairly compensated for this service. Putting his wealth of knowledge online would facilitate that exchange, but if implemented without security in mind it could cost him thousands in lost revenue. Therefore we made protecting access to content our chief concern throughout the development process.

Multiple user types

Content needed to be easily viewable by those who had purchased access, while being inaccessible to those who had not. We accomplished this by building sets of user privileges and tying them to purchasable membership levels. Though they evolved over the life of the project, the membership levels we eventually settled upon were:

• Anonymous - Guests on the site. Access would be restricted to information about the site and some teaser content.
• Free subscription - Can access a bit more teaser content
• Basic member - Purchase required. Can access content helpful in determining whether or not to pursue starting a direct pay practice.
• Full-access member - Upgrade required. Can access all content and documents necessary for starting and running their own practice.
• Seed practice member - Purchase required. Can see same content as Full-access member plus some additional advantages.

Securing video

A set of video talks, together spanning several hours, were to take the place of the in-person meeting Dr. Forrest had been holding with interested doctors. As such, hosting and streaming video was crucial to the success of the site.

Setting up a video host.

We needed a video host that was reliable and fast, one that could host several hours worth of high-quality video, could handle the demands of a few initial doctors while being able to seamlessly transition to handling the demands of the hundreds (or thousands) of doctors we hoped to have eventually, and that would allow us to restrict access to different sets of videos depending on membership level.

Leveraging Viddler

At first, Amazon S3 seemed to be the logical choice for hosting and streaming content. Indeed, as it harnesses Amazon's impressive resources, S3 is one of the most dependable and affordable methods of serving files. However, it lacked the ability to restrict access to different sets of files.

Ultimately we created an account with the commercial video hosting site, Viddler. Upon request the team at Viddler provided us with a custom code for secure video embedding. As an established commercial host, Viddler has the resources to support seamless video streaming to hundreds of docs at once. This keeps the burden off our own servers providing a better site experience.

Building an online community

Dr. Forrest wanted doctors to be able to discuss and ask questions about the topics covered in each video. The natural choice for facilitating these discussions was to set up a forum. However the challenge was to build a forum that would recognize membership level and hide topics from unqualified members. With some advanced configuration, we were able to find a drupal forum module that worked with our access control settings. Unqualified users simply get a friendly message about needing to purchase or upgrade when trying to access forum topics above their level, while full-access members can browse everything.

Building the Practice Transition Calculator

Engaging the user with visual cues and dynamic feedback

The calculator is designed to simulate the one-on-one interaction between a doctor and Dr. Forrest that would occur in a consulting session. As such we built into the calculator a good deal of interactivity.

With a click, contextual help expands below the current field set with explanations and advice. Certain options require selecting a balance between two percentages. For these we implemented sliders for a more intuitive user experience. When a calculation is run, feedback is produced based on the data entered. Color-coded messages alert the user to potential problems with their proposed practice transition plan highlighting the values that would need to change to create a more reasonable plan.

Purchasing and billing

Our system required several different types of transactions each with corresponding changes to a user's privileges. We leveraged drupal modules and a subscription billing service to give users the ability to:

1. Buy a membership - The user's credit card is billed and his account is automatically granted privileges on the site.
2. Upgrade/Downgrade a membership - The user either purchases an upgrade or chooses to downgrade and his account privileges are automatically changed to reflect his new status
3. Pay at once or over time - The user can choose to pay their membership fee in monthly installments or in a one-time fee up front.

Additionally we granted Dr. Forrest the ability to offer discount codes and promotions. These options provided us with flexibility as the membership concept evolved through the project.