Products & Technology

Shaping Your Super Staff

In a world of declining reimbursement, providers are striving to get the most of their 'human capital.' Software can help.

HME Super StaffProviders have many assets — their inventory, their delivery resources, their capital, and the other elements of their businesses — but it’s safe to say their most crucial asset is the staff that makes their business possible. From deliveries to clinical care to billing to claims to sales, the men and women that work and manage an HME provider’s day-to-day activities are the lifeblood of the business.

But in an era of bloodthirsty Medicare reimbursement cuts, providers must make some very difficult decisions when it comes to their staffing. No one wants layoffs — neither the employees, nor management — but even when tough choices must be made providers face an even less savory dilemma: how do they accomplish more with a smaller team?

Regardless of why a provider has to engage in layoffs, they still must serve the same patients, coordinate with the same referral partners, and somehow provide the same level and range of care. Moreover, they will more than likely have to accomplish all that while also trying to expand their businesses into entirely new territory, such as retail sales, in order to compensate for their lost reimbursement revenue.

What they need are super staffs — teams of multi-faceted, multi-talented individuals that can take on new tasks and responsibilities and smoothly shift from one business focus to another. But that’s a very tall order to fill for already overbooked provider teams. Even the best employee in the world needs some help.

Enter information technology. HME providers’ software systems and resources can offer a plethora of tools to help them track team performance, identify problems, set goals, and fine tune staff efficiency to ensure that everyone on the team is performing like a super hero.

The University of Michigan Health System has five homecare services business units that employ approximately 500 full-time employees, 140 of which fall under its DME provider, Mediquip, says James Shurlow, Director HME Services. The Health System began working with manual processes, before starting a multi-year review process to review various software packages.

Implementation began in 2002, with different systems for different business units (the HME provider went with Fastrack). And then the productivity followed. One key improvement was striving to become a paperless operation, which Shurlow says was a significant staff efficiency gain. From there, the provider has branched off into various ways of using software to fine-tune staff performance.

“We’re pretty metrics-driven,” he says. “For example, we monitor CPAP set-ups and then CPAP set-ups per staff member. We monitor the number of phone calls coming into our CPAP group — total calls, wait time — as well as by individual staff member. For our respiratory therapists we monitor total number of clinical visits, total number of miles driven, total number of clinical patients.”

The list goes on. The call center team gets monitored in various ways, the distribution team gets monitored along various lines, and so forth. That said, there is significant room to grow, according to Shurlow.

“As an industry, we are way behind the rest of the world when it comes to technology,” says Shurlow, who’s been in the business for 37 years.

He relates a story in which General Motors consulted with the University of Michigan Health System to determine ways it could drive down healthcare costs, a key area of overhead for the auto manufacturer. That resulted in a subsequent discussion concerning how GM could show the provider how to reduce its costs.

“So General Motors introduced us to the whole ‘lean’ concept,” he says, referring to the management concept of driving wasteful processes out of a business. “… Lean, of course, ties right into our software system.”

For example, Shurlow says the provide is currently engaged in a project to survey how fully each area of the business is utilizing its software to gain efficiency, or additional ways the software could be used to rive additional effectiveness and value. So far, they’ve identified approximately 75 different ways to make additional efficiency gains, he says.

And that effort to sharpen staff efficiency and flexibility will continue, Shurlow says. The stakes are simply too high.

“The fact remains with the reimbursement cuts and competitive bidding, if we don’t find — very rapidly — ways to become more efficient, then we will no longer be in business,” he explains. “The competitive bid rates are a huge cut, but the other payors aren’t just standing on the sidelines; they’re going to be implementing cuts down to those levels as rapidly as they can. So we’re going to either cease to exist, or find a better way of doing things.”

Staff Management Offerings

We surveyed the various software providers offering IT solutions in the home medical equipment space to see what staff management tools, features and capabilities their systems incorporated. Here’s a round of the various offerings available on the market:

AnkotaAnkota HDM for HME (Healthcare Delivery Management Software)

Ankota, Inc.
(800) 909-9866

Years in business: 4
Number of installed systems: 500+ health care providers use the Ankota Care Coordination Network, including HME providers.
Type of System: A hosted, web-based/Cloud/SaaS system; mobile features also support use of tablets, smartphones, telephony (IVR), etc. while offline.
Programming languages and database environments: The software uses the ASP.NET development environment and is primarily developed in the language C#

Staff management capabilities: Ankota’s technology is mainly used by many types of post acute providers including HME to plan, coordinate, and manage deliveries, and it’s staff management capabilities are related to that. The system’s scheduling & resource optimization imports delivery tickets from your order entry system, then assures optimal use of your delivery personnel and vehicles. The solution always considers care plan requirements, skills/certifications, availability, proximity and even patient or caregiver preferences when scheduling. Point-of-care documentation is electronic and updated in real time using tablets or telephony (IVR). Planning and routing features help caregivers provide more services and make more deliveries each day at lower costs, as well as travel fewer miles. Providers can use the system to manage caregiver and technicians’ schedules, oversee dispatch, monitor on time delivery and rate caregiver/technician performance. Track expenses, miles traveled and on-time performance of staff. Integrated GPS and asset management solutions available through preferred partners.

DIABCO: HIPAA Billing SystemsAR-Express

DIABCO – Healthcare Software Solutions
(800) 864-6210

Years in business: 30
Number of installed systems: (not available)
Type of System: AR-Express stand-alone server based system for Multi User’s or ARXLite for the single user
Software programming languages and database environments used: Microsoft Windows 8, Server 2008, MSQL 2008, .net, VB, VFP
Staff management capabilities: Using the system management assigns an ID and password to each user. AR-EXPRESS uses that ID not only for security purposes but also to track users in AR-EXPRESS. For example, the Activity dialog reached from the Admin Menu shows when a user logs on and off AR-EXPRESS and where the user goes while in AR-EXPRESS. The Audit Trail dialog shows any data changes the user makes. AR-EXPRESS Productivity Tracking provides a management tool that tracks a user’s entry into and exiting from AR-EXPRESS; menu option selections; and related dialog selections. Providers can use the information on the Activity dialog if questions arise regarding a user’s activity in AR-EXPRESS. The Activity dialog lets you view each user’s activity records. AR-EXPRESS Audit Trail is built into the AR-EXPRESS dialogs to tracks users field data changes; record additions; and record deletions. The Audit Trail dialog lets management view each user’s audit trail records and to monitor data changes in AR-EXPRESS.


Brightree, LLC.
(888) 598-7797

Years in business: 11
Number of installed systems: 2,500
Type of System: A hosted, web-based/SAAS system
Programming languages and database environments:
Built using Microsoft’s .NET framework and MS SQL Server for its database environment.
Staff management capabilities: Brightree offers three broad sets of staff management
capabilities in the form of workflow and rules management; reporting and analytics; and the BrightSALES automation tool. Under workflow and rules, Brightree features an advanced Rules Engine and (new in Spring 2013) Custom Rules capabilities so that providers can configure their own payor- and product-specific rules and assign related tasks to the right staff in automated workflows. The Rules Engine drives tasks to Work Lists and Group Profiles that enable providers to assign the right staff to “manage by exception.” For example, this directs staff to address unconfirmed sales orders promptly. Looking at reporting and analytics, the Brightree Executive Dashboard features capabilities to monitor and trend employee performance on sales order confirmation times, time to process CMNs, and more. Flexible ad hoc reporting can be used in a variety of ways to better manage employee performance. BrightSALES, Brightree’s sales force automation tool, unites the billing and sales/marketing operations into one system to streamline activities such as referral source management, contact management, and scheduling of appointments. Your entire staff, including your marketing reps, can collaborate fluidly via Brightree’s notes, tasks, and reminders. And because BrightSALES is part of the Brightree platform, any updates you make to a referral source are done once. There’s no more re-entering key contact information or activities into multiple systems.

MediwareCaretinuum, HomeCareNet, Ascend, MestaMed, Pharmed

Mediware Information Systems, Inc.
(888) 633-4927

Years in business: 42
Number of installed systems: not provided
Type of System: A stand-alone system installed on-site, and a hosted system that uses special client software
Programming languages and database environments: Mediware software uses Microsoft.NET, Microsoft SQL DB, and C#
Staff management capabilities: Analysis can be done through custom reports of HME order entry by customer service rep. For A/R, collectors and status can be assigned to claim to allow for A/R Collection analysis. Tools and tracking systems within the software allow for productivity tracking and process and content management and reporting to increase efficiency, determine bottlenecks, and optimize performance.


Definitive Homecare Solutions
(866) 277-4876

Years in business: 19
Number of installed systems: 1,200
Type of System: A stand-alone system installed on-site
Programming languages and database environments: SQL, Visual Foxpro, .Net, C#
Staff management capabilities: The CPR+ system provider HME business managers unlimited access to the systems data, which allows for custom reports to be run to track team member and department productivity. To help guide staff, CPR+ supports efficient workflows through the use of pre-defined workflow queues to help manage an order through its lifecycle.

Fastrack Healthcare SystemsFastrack HME Enterprise System

Fastrack Healthcare Systems Inc.
(800) 520-2325

Years in business: 20
Number of installed systems: 1,315
Type of System: A stand-alone system installed on-site, or a hosted (Cloud) system using special client software
Programming languages and database environments: Microsoft SQL
Staff management capabilities: The Fastrack ScoreBoard displays user definable key indicators showing productivity by each team member within their department including billing, cash posting, etc. and the Executive Dashboard provides key business indicators at a glance. Fastrack’s Workflow Management tool provides the ongoing status of required documentation and all orders so that managers can see the elapsed time between order stages and respond accordingly. Fastrack provides a Task Manager that allows for the assigning of responsibilities to one or more staff members with follow-up capabilities.

MedAct SoftwareMedAct Software

MedAct Software
(800) 326-0314

Years in business: 25
Number of installed systems: 600
Type of System: Fully integrated HME business management system deployed on-site, Hosted in the cloud, and SaaS.
Programming languages and database environments: MedAct Software Client/Server Edition is a Windows based system utilizing a SQL based RDB.
Staff management capabilities: To help management stay on top of team performance, a real-time graphical dashboard, with core executive and management data, such as aging detail and aging summary data, sales data, current day delivery and pickup totals, along with claim pending submissions, voided submissions, and denials data measured in dollar amounts. Also, sales reports show which items are selling the most, which salesperson is generating the most sales and the source of the most referrals.

MedFORCEMedFORCE Scan, D&R Manager, WorkFLOW

MedFORCE Technologies Inc.

Years in business: 10
Number of installed systems: (not available)
Type of System: A stand-alone system installed on-site, and a hosted, web-based/SAAS system
Programming languages and database environments: Software is designed in Delphi and SQL SERVER database to securely store data. The Web-based application is written in
Staff management capabilities: The system is a business process management tool to manage all workflow and processes within the business. MedFORCE helps ensure consistent processes, monitor and manage performance and productivity and improve efficiency of the organization, and works in conjunction with the billing software of a provider’s choice. In that regard, the system helps providers map workflow processes within MedFORCE to help ensure consistent staff performance as well as provide the tools to monitor and manage productivity.


Noble House
(800) 749-6700

Years in business: since 1989
Number of systems installed: (not available)
Type of System: A stand-alone system installed on-site
Programming languages and database environments: Delphi with SQL database running under Windows or Linux.
Staff management capabilities: Noble*Direct’s management reports include various staff-focused reports, such as commissions monthly by salesperson; products sold by salespersons; products sold this period month versus last month (or last year, etc.); sales by category (i.e., respiratory, wheelchairs, CPAP, etc.); accounts receivable; sales by primary insurance co. on a monthly, quarterly, or yearly basis; sales by secondary insurance company again monthly, quarterly yearly. Noble*Direct also includes a complete audit trail, so that if anything is changed, the time and the user is noted. Likewise the system incorporates a full transaction detail report. Also, to help management clearly and easily review this data, Noble*Direct displays the information in graphs, in a color-coded and time-stamped fashion. Last, Noble*Direct can produce customized reports on any piece of data recorded in the system.


(800) 231-7776

Years in business: 35
Number of installed systems: 1,050
Type of System: A stand-alone system installed on-site, a hosted, web-based/SAAS system, or a hosted system, but uses special client software
Programming languages and database environments: Proprietary
Staff management capabilities: The system includes activity by unique user ID and provides security, accountability and performance reporting.

TIMS SoftwareTIMS Software

Computers Unlimited
(406) 255-9500

Years in business: 35
Number of installed systems: (not available)
Type of System: On-premise system or a cloud based system
Software programming languages and database environments: Microsoft .Net and SQL server
Staff management capabilities: TIMS’ patient intake process delivers critical HME workflow needed to improve both operating efficiencies and the provider’s CSR performance — all while providing management with simple ways to track and measure productivity and distribute workloads, giving staff more time to care for patients.

TITAN, Reimbursement PRO, WebScan PROTITAN, Reimbursement PRO and WebScan PRO

(866) 885-2974

Years in business: 12
Number of installed systems: 1,200 installs
Type of System: A hosted, web-based/SAAS system
Programming languages and database environments: Software applications are built in .NET/C#, Java, and JavaScript. Database environments are Microsoft SQL Server.
Staff management capabilities: Reimbursement PRO’s workflow tools enable staff members to quickly and efficiently prosecute denials while its monitoring tools enable management to organize the billing staff to most effectively handle the workload. TITAN provides management and staff with the ability to monitor performance in real time while comparing themselves to their peers. That comparative context gives management the knowledge of how well, or how poorly, their staff is performing compared to their peers.

This article originally appeared in the May 2013 issue of HME Business.


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