Federal regulations mandate that medical device companies provide a private discussion forum for users of the devices. Accuray was one of the first to provide such a forum – creating AERO to enable users to privately discussion treatments using Accuray’s non-invasive robotic radiology systems – before it was mandated. With a goal of improving patient outcomes, the site had grown to more than just the forums. It had become a hub of information and resources in radio-oncology.

Marker Seven got the opportunity to evolve this trendsetting platform into something truly unique.

Working for over a year with Accuray to update and maintain the original AERO site, we were familiar with the site’s growing pains. Built in Expression Engine, we’d shown interest in rebuilding it in Drupal to bring it into the Accuray digital family and to facilitate easier sharing of content between the sites. But as the AERO community was somewhat new, the Accuray team was still figuring out what content they wanted to create, share, and curate.

Then Varian launched OncoPeer and everything changed.

As with other confidential communities, it was password protected and impossible to get a look at but from the press the site garnered, it was clear that the user interface was more attractive and modern looking than AERO. With a roughly $1M price tag before training and maintenance costs, any non-invasive radiology system is a significant investment for hospitals. Though each has its differences, a helpful and supportive community platform can be a big selling point. The heat was on now to reimagine AERO. 

Many of the site’s problems could be traced to the way content was (dis)organized. 

As the community grew, so did the demand for new types of content. Accuray administrators didn’t always know where it should go and so kept adding sections. The structure became sprawling and disorganized. Users navigated directly to the only known peer-driven section, the forums, and bypassed the rest of the site which created a need to “advertise” new sections on the homepage.

The first step was to develop an intuitive architecture that would accommodate current and future content.

With a wealth of content unique to the AERO community as well as announcements and resources pulled in from other sources, making it a hub of information for non-invasive radiosurgery would require a killer user experience. Rather than organize content by type or even by subject, we organized it around intention and purpose. That way, the site could grow organically and content would always fit and be intuitively found. We also wanted to use the new structure to invite users to create and contribute content such as case studies and presentations. 

We created a public-facing version of the site that allows users to browse and preview the types of content available.

As a private community, hospital administrators and physicians who are considering TomoTherapy or CyberKnife didn’t originally have access to the site and couldn’t evaluate its value. Without exposing sensitive information, we previewed peer-driven data and discussions, Accuray-curated presentations and support, and announcements and publications from across the industry. The previews also helped bolster latent membership, enticing qualified users to join or login by showing them the types of content they were missing.

Next, we developed a personalized and customizable experience. 

From our interviews with Accuray stakeholders, we knew they wanted to drive user-generated content, curate panels, and provide a lot of downloadable and video content. To do so, we needed to make it easy to upload, tag, and share content, and integrate it with what users were there for. 

Serving a diverse group of users including administrators, physicists and clinicians, as well as covering a wide range of treatment specialties also meant that users needed to quickly get at the information relevant to them. We built the new AERO experience on a Drupal 8 platform which allowed us to add multi-level search and filtering functionality to allow users to quickly and easily customize their experience. Giving the site a left-side navigation with at-a-glance icons gave the site the easy feel of a social network while keeping important information at the users’ fingertips. 

Before recommending Drupal 8 to the client, we had to make sure it was the right choice. 

The client’s understanding of how the existing site worked was limited, yet they were attached to much of its functionality. We found out exactly what they liked and wanted to keep but, in many cases, adding the functionality to help sort, format, and present content, also simplified their internal processes. In deciding which version of Drupal to use, we took a long look at the available options. Drupal 7 is a well-established, mature framework, with a wealth of existing resources available. Drupal 8, on the other hand, represented the future of Drupal. Having been through a number of major Drupal releases, we were well aware of the challenges involved in building on the leading edge of the development cycle, but felt that the benefits of Drupal 8 outweighed the challenges that decision might bring. 

Doing a complicated build on a new platform had its challenges. 

One of the great strengths of Drupal as a platform is the breadth and depth of the documentation, both for the core application and user-contributed modules. But compared to Drupal 7, the documentation for Drupal 8 was still incomplete or missing outright and there were relatively few implementation samples to look at. A lot of this had to do with the fact that this version was a significant rewrite, leveraging the well-established Symfony PHP framework, a go-to for enterprise with its high code quality, best practices for development, and a strong support community, at its core. Rather than rewrite previous releases procedural request handling and other in-application functionality, Drupal 8 leverages Symfony’s existing, object-oriented components, for improved performance and extensibility. On the front-end, Drupal 8’s shift to Twig for templating provides a fast, secure, and flexible templating engine that isn’t Drupal specific, expanding the pool of developers and extensions. 

Like so many projects, this one kicked off with a sudden and aggressive timeframe. 

Fortunately, we were well acquainted with the existing site, and were able to anticipate many of the challenges to complete the project on time and on budget. The day we launched, our client was already wanting to create an event but didn’t have time for training. We’d customized the admin interface, already much improved with Drupal 8, so the client felt comfortable using it on her own. She set up a prostate cancer group and everything relevant to that group was automatically pulled in from past events, presentations, and the forums. Hitting the ground running was huge bonus for our client.