Category: Development

We live in a world of instant gratification that drives innovation and the adoption of new technology across healthcare. Consumers expect ease of use and zero lag time while accomplishing a goal in a few simple steps. When it works, it’s a wonderful thing, and when it doesn’t, it can ruin your day. Therefore, designing and building a beautiful and forward-thinking website is just half of the work. The other half is determining where it will all sit, digitally speaking. In this article, we will review three of the most common and widely used content management systems in healthcare. 

Content management systems for healthcare 

A CMS or content management system is a system that allows you to create, manage, build, and customize the digital experience for an end-user. There are a vast amount of options, however, we’ll focus on the three largest players in the healthcare space and hit a few important highlights and pitfalls of each. 

Picking the right content management systems for your healthcare system is incredibly important. Information needs to be secure, fast to obtain, and hospitals need the ability to manage a CMS with scale while having the confidence that it will not crash. The consequences of a poorly chosen or implemented CMS can be catastrophic to an organization, especially one in an industry as important as healthcare. Especially since we’ve seen a dramatic increase in cyberattacks over the years, in fact, incidents rose 42% in 2020 alone.

If you’re refreshing your consumer digital experience and looking to update your current CMS or move to a new one, this should help.

Open and closed source CMS

Before we go much further, we should talk about the differences between a “closed-source” and “open-source” CMS. With open-source you have a lot more flexibility in everything from pricing to coding. Open-source is “free” for anyone to use and comes with a large community of users and developers constantly working to create and improve the platform and the plugins that come with it. This can lead to a very powerful and robust solution (when done correctly) for almost any website but can also lead to security and vulnerability issues since there are so many moving parts and constant changes. 

All the above is the opposite of closed-source, which does not have an open community and coding options. With this comes increased security but also larger fees and pricing associated with implementing and managing this kind of CMS, since you’re relying heavily on the CMS creators. 

There are pros and cons to each. The main takeaway is that whichever route you choose when done right, will certainly have its benefits. 

So, with that, let’s get into three of the most popular content management systems for healthcare organizations out there. 

WordPress CMS

We will start with the largest and most recognized CMS; WordPress. WordPress holds a whopping 43% market share of all websites on the internet. Yeah, they’re big.

WordPress is an open-sourced CMS that started as a popular blogging platform but has quickly evolved into a leader in the space. Many small, medium, and large (enterprise) sized websites are hosted on WordPress. Its flexible and customizable features are a huge plus for this CMS.

With plugins, community and developer support, and plenty of use cases and documentation to support your needs, it is usually the first choice for a developer team. It’s customizable, SEO-friendly, flexible, scalable, and offers great levels of personalization. It can be very secure, but can often take a bit more leg work. 

Pros and cons of WordPress

In addition to the above, WordPress offers other benefits worthwhile mentioning:

• It is pretty easy to set up and start working with. 
• Has a lower cost of ownership and setup.
• There are thousands of themes and plugins to choose from so that you find the perfect solution for your team’s needs.
• It’s relatively easy to deploy your changes and enhancements as needed.
• Is a powerful and modern editor experience when using Gutenberg.
• There are options for automatic updates to help with plugin management.

While there are plenty of reasons why WordPress is ideal to use, there are a handful of “cons” with using this platform.

• Security risks are heightened when using a large and open-source CMS. With so many features and plugins, it’s hard to always keep up with updates and minimize risk. For an enterprise site built on WordPress, this could be a full-time job. 
• WordPress is typically not used on very high-traffic websites. Don’t get me wrong here, they still are to some degree, but we see this being used less and less on your enterprise-level architectures, mainly due to management and security needs. 
• Finding the best modules for your implementation can be challenging and often the best ones are not free, so additional costs can add up.

Drupal CMS

Drupal is another very popular and robust option for websites of all sizes. It is another popular open-source platform that prides itself on having what they claim is the best experience of any CMS out there. It’s around 20 years old and the current newest version is Drupal 9. 

*Tip: If your team is still on Drupal 7, you’ll lose community support in November 2022. Learn why you should upgrade to Drupal 9 now.*

Drupal holds a much smaller market share of websites, but that shouldn’t deter an organization from migrating over. With its robust offerings, all geared at a great web experience, it’s easy to see why Drupal is chosen for many enterprise builds. It shares the same features as WordPress as well and most CMS’ we talk about all have those by default. Drupal also has some great aftermarket support from companies, like Acquia, and they are able to add a lot to an already-solid system, making it a great choice for large, heavily-trafficked websites. 

Pros and cons of Drupal

Drupal “pros:”

• Offers custom content types/capabilities that are more flexible compared to other CMS like WordPress.
• Comes with advanced security features out-of-the-box, which makes it a perfect choice for security-conscious businesses. 
• Built with scalability and performance in mind. The platform is capable of handling massive traffic spikes. 
• Drupal core comes with multilingual support out-of-the-box, and you do not need any additional integrations or modules for the same.
• You can have more control over access and user permissions. Its built-in access control system allows you to create custom user roles with different permissions. This feature can be highly beneficial for enterprises where access control can be a major issue.
• Many consider Drupal’s system to be more flexible than other CMS platforms. This makes the content organization much easier. You can group your content together in various configurations.

Drupal “cons:”

• Setting up with Drupal is not as easy as WordPress and you will need to rely on a Drupal developer who understands the system and complexities to get it up and running smoothly while continuing to manage it.
• Like WordPress, Drupal has plugins that will need to be updated and supported on a regular basis.
• Finding the best modules for your implementation can be challenging and often the best ones are not free, so additional costs can come with a Drupal implementation.
• With older versions of Drupal, like Drupal 7, not all of the newest and better features are available like what can be used with the latest version.

Sitecore CMS

Sitecore is a closed-source CMS that is used by enterprise-level organizations. It focuses on a solid all-around digital experience. With Sitecore you’ll likely be choosing between four main products (Sitecore Experience Commerce, Sitecore Experience Manager, Sitecore Experience Platform, and Sitecore Content Hub) to get your site up and running. Each of those products has its purpose based on your industry which means Sitecore can cater to many market segments. 

Sitecore has established itself as one of the more secure platforms since it is closed-source and doesn’t offer an open door for outside developers and companies to come in and create modules, features, plugins, etc. 

Pros and cons of Sitecore

Sitecore “pros:”

• As stated above, Sitecore comes out of the box with a high level of security since it is locked down pretty tightly. 
• The various product offerings of Sitecore make it scalable and customizable for organizations of various types.
• Sitecore has a really strong content editing interface out of the box. 
• Unlike some other open-source platforms, Sitecore comes with many sought after features by default, like personalization, analytics, segmentation, and more. 

Sitecore “cons:”

• Being a custom closed-source platform, changes and enhancements will often take time and become costly. 
• Speaking of costs, Sitecore is not a cheap CMS out of the gate and requires some steep licensing fees to get started. 
• When managing your site and backend you will often have to rely on Sitecore’s team of developers to help, which can add time and additional costs. 

Modea’s take on healthcare CMS

When looking for a well-suited CMS, the process begins with taking a deep dive to fully understand the needs of your organization and what will be required to keep your website, and customers, happy. We often assist our clients in selecting a CMS based on many factors such as:

• Size and capability of a team
• Who will be managing the system 
• Any specific, unique needs
• How often the site will receive updates
• Total traffic to the site

The above and so much more are included in what we call our “Discovery Phase” and it’s a crucial part of any digital transformation. You can’t build a house without a solid foundation, and a website and digital front piece are no different here. 

We recently stated in our “4 Lessons on Digital Transformation” article that mobile is the next critical platform. And although it is still early in the adoption curve, we see that many healthcare systems are taking control of their mobile patient experience, just like our clients at Ballad Health who recently built an EHR-integrated mobile app.

Our seasoned experience in the digital and mobile app space has allowed us to work with clients like UHS, Carilion Clinic, and Footmaxx to deliver apps used by thousands of users each day. Our data-driven approach and monitoring have allowed us to learn a great deal about what worked, what can be improved, and mistakes to avoid; which we’ll cover today.

If your team is considering building an EHR-integrated mobile app these 3 tips will be essential to your success. Learn from us, cut down on your go-to-market timeline, and launch a stellar all-in-one mobile app for your patients!

Tip #1: Submit to the app stores early

Trust us, it’s not as easy as it sounds, but don’t be discouraged, with the right information on what to expect you’ll be able to launch your app in time for your deadline. 

#1 We suggest that ahead of time you become familiar with the requirements and process for submitting your app. This in itself is pretty simple.

#2 Apple can be challenging when trying to quickly get through the steps of approval. Meaning that they will most likely suggest recommendations for fixes before you can publish your app. We highly suggest adding buffer time to your launch and prepare for fixes. We did not have this same experience with Google, approval was simple.

#3 Communicate with your executive team (client-side) and provide education around what the approval process looks like. This way, everyone is on board with why Apple requires iterations prior to approval.

Pro-tip: your app does not have to be live before you submit it for a review with Apple.

Tip #2: Plan your measurement strategy

Pulling consumer data out of Apple or Google app stores is a hard and manual process. In addition, there are not many metrics that either store will provide, so do not expect to receive a cornucopia of consumer data without much work.

#1 Think about what data you’ll want in advance and create a strategy for how to obtain it. Do not wait until launch to think through your measurement plan.

Our Analytics team uses Firebase Analytics for many mobile apps and manually created events based on KPIs and specific questions we needed to answer post-launch. This takes time, so if you’d like to track higher-level metrics to explain engagement, do not wait until launch to create, test, and implement a plan.

Tip #3: Get aligned with MyChart

Part I: Authentication is complicated

Whether you’re using Epic MyChart, Cerner HealtheLife, or any other EMR with the corresponding patient portal, do as much testing as you can when leveraging authentication.

#1 Start testing as early as possible to mitigate crashes

There are many complexities with authentication and highly suggest that your team starts testing functionality as soon as possible. Do not assume that what you set up will work; test, test, and test again.

Part II: Be familiar with MyChart’s release cadence 

Before you start building the app, become very familiar with MyChart’s (or your EMR of choice) release cadence. Otherwise, you’ll be joyfully unaware of upcoming releases and there is a large possibility that your app’s features will break… resulting in more work for you and your team.

#1 Know if the features you’re leveraging will be updated and when

Save some time now and look at your EMR’s release calendar. Luckily Epic is very upfront about what they have in store so we could plan accordingly.

Want to learn more?

Check out the full recording from our recent webinar with Ballad: How to Build an EHR-Integrated Mobile App or download the quick and easy-to-read PDF version.

What does upgrading your Drupal platform have to do with cybersecurity at your healthcare system? 

Everything. 

Nefarious actors like hackers are experts at exploiting weaknesses in unsupported content management systems.

Making sure you have the most up-to-date version of Drupal (or any other CMS) is one key step you can take to minimize security risks. Without security updates and support, your website is vulnerable.

This is especially true for healthcare organizations and health systems that use Drupal 7 or 8. This means you haven’t yet migrated to Drupal 9, which was released in June of 2020.

Here’s why this matters now: Drupal is ending community support for Drupal 7 in November 2022. Community support for Drupal 8 will end in November 2021.

Those looming dates might instill fear in healthcare organizations, especially considering the move from Drupal 7 requires a rebuild. But the benefits are worth it. 

Not only will you have access to the latest security updates and support, but Drupal 9’s new features can also make running your health organization’s website easier and smoother.

Make the Big Leap and upgrade from Drupal 7 to 8 or 9

Drupal calls the move away from 7 “the last big migration.” Drupal 8 was essentially a reinvention of Drupal, with fundamental changes in how your content is stored. 

This means that your content can’t just drop in, as it might with other updates. You have to set up a migration and map to the new way of doing things. The good news is that once your health system makes this last big migration, it will be far easier to make major updates in the future.

Two things to keep in mind:

• If you’re coming from 7, you have options: Use 8 as a step to 9, or go right to 9. (We have a health system client currently on 7 that we’re moving to 9.)
• If you’ve already rebuilt for 8, upgrading to 9 will be far less involved. (We have several clients on 8 who we’re moving to 9.)

What Healthcare Organizations Will Appreciate About Upgrading to Drupal 9

Drupal has incorporated some popular community modules into 9, which makes it even more out-of-the-box. That’s important for digital teams inside healthcare organizations who have a lot on their plate—especially right now in the era of COVID-19.

Compared to Drupal 7, Drupal 9 features the same structured content-based system that’s easy to work with. Here are a few things we’ve noticed about Drupal 9 that may be especially beneficial for healthcare organizations

A strong layout builder

Hospital websites have many types of pages, such as specialties, conditions, treatments, locations, and visitor information—all built around components that web teams need to be able to customize. Drupal 9 features a visual design tool that lets you easily build layouts, reuse blocks, and customize the different parts of the page.

Better media library

Video is an increasingly important content element for health systems. It provides a way to authentically communicate patient stories or explain conditions. With Drupal 9, you’ll have the ability to embed remote content such as YouTube and Vimeo videos. There’s also a Media Library module, so you can easily add media assets.

Better page view performance

There’s a strong correlation between page load time and bounce rate for healthcare organizations. The BigPipe module increases page view performance by sending the main “content” area of a page even if sidebars or other pieces of content are still being generated.

Front-end and back-end developer improvements

Drupal 9 has HTML5, additional helper libraries, accessibility enhancements, and enhanced base themes that front-end developers will appreciate. On the back end, there’s better integration with third-party services, which many health organizations rely on.

How Hospitals Can Prepare to Migrate to Drupal 8 or 9

Healthcare organizations still on 7 might be using modules that weren’t ported over to either 8 or 9. That’s one of the biggest watch-out areas we’ve encountered so far.

You’ll need to take an audit of every module your current website is using. For any modules you want to keep, make sure there is a compatible version for 8 and 9. If there isn’t, you’ll need to search for a replacement. 

We’ve found that this is a pain point for hospitals. But with the right planning, you can keep all the functionality you need—and usually gain functionality.

If you’re moving from 7, it’s a good opportunity to redesign, especially if you’re considering making informational architecture changes. You’re essentially re-platforming, so it makes sense to revisit the look and feel of your site, as well as how well it performs and meets users’ needs.

Healthcare is a rapidly evolving industry, and patients are increasingly consumer-minded. They value convenience, clarity, and transparency. They want their healthcare web experience to be as straightforward as booking on Airbnb. 

If your website is behind in meeting these expectations, the move to Drupal 8 or 9 is the perfect time to align with the latest best practices for healthcare website design.

What About Upgrading from Drupal 8 to 9?

Drupal calls moving from 8 to 9 “the easiest major upgrade in a decade” and we agree. Drupal 9 was mostly built in Drupal 8, so it will be very familiar.

You’ll still want to make sure that your hosting environment is compatible with what Drupal 9 requires. Also, make sure your codebase doesn’t use deprecated APIs. There are tools you can use to identify deprecated APIs in your codebase and fix them. 

Since support for 8 ends this year, it’s critical to make the move to 9 as soon as you’re able.

Modea is here to help healthcare organizations create the best web experience possible for consumers.

Have questions about upgrading or migrating to Drupal? We’re happy to help.