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Technology and Sleep Therapy

How did Cape Medical Supply build such a fast-growing sleep therapy program?

HME provider Garry Sheehan is president and CEO of Cape Medical Supply and chairman of the board of the Home Medical and Services Association of New England. His company has built a very strong sleep therapy program, which grew from being 33 percent of the business in 2012 to 55 percent by the end of 2015. Sheehan says his company’s success is based on hard work, a significant investment in technology and pushing their operating system — supplied by Brightree — to increase sales and patient satisfaction.

Sheehan recently presented at an HME Business Magazine webinar, “Accelerate Your Sleep Therapy Practice,” where he discussed new efficiencies and generating better outcomes for sleep therapy and patient resupply.

The key, says Sheehan, is having the technology to monitor each step of the business and the infrastructure to make integral changes.

“We want to know this data inside and out, forward and backward,” says Sheehan. “We want to understand how well our program is performing. We look at everything from demand measurements, which include incoming referrals and setups. We look at our compliance rate, which is a key indicator for how well we are performing, and look at how much value we are adding in our compliance team function.”

Bottom line: You need to measure, he says. And no matter what sleep business you are in, it is essential to have a blend of patient satisfaction scores, patient measurement, financial measurements, and demand capacity measurements to tell you how your business is performing. Sheehan measures 21 sleep key performance indicators. They included PAP setups, five-year restarts, IVR orders, overall supply NI, active templates, and clinic setup percentage.

“Providers have to understand their sleep therapy practice from end to end and have visibility into performance from the moment a referral hits their system through when a patient is actively reordering supplies,” he says. “What are your cycle times, throughputs, bottlenecks and volume challenges? If you cannot report regularly on these elements and report them back to healthcare professionals and payors, sooner or later you will be left behind. The ability to leverage data for decision making and growth is an essential element of being a modern, innovative provider, and something referral partners and payors will rightly come to expect.”

Sheehan says that sleep therapy has four phases of PAP therapy execution, which are all supported by data collection and measurement. They are Intake, Setup, Compliance and Replenishment.

Intake includes data entry, qualification, PA and scheduling. Sheehan says the majority of their referrals come in via fax, so Cape Medical’s intake is receiving the fax, qualifying the order, and the outreach back to the physician or lab partner. Sheehan says that about 50 percent of the referrals they receive have insufficient information for them to immediately proceed with the order. Common problems include not having the correct face-to-face notes or prescriptions that are inaccurate.

Setup includes the quality of patient interaction, fit of supply, accuracy of settings and quality of support materials. Patient satisfaction scores are tallied. Questions that Sheehan’s team answers during setup include:

  • How strong are educational materials?
  • How positive is the interaction between the clinician and the patient?
  • How comfortable are patients with the device?
  • How well does the mask fit?

“We are fighting from behind on Day 1 when we are getting a high percentage of referrals that don’t have the required information,” Sheehan says. “Our motto is ‘we do the right things the right way’ and that’s the painful way as well. We often hear that the company up the street doesn’t require certain things and we politely walk them through Medicare regulations, showing them that we do the right thing.”

Compliance includes patient outreach, coaching and intervention. “We use a lot of the automation provided with Brightree, where it can display work queues for us for patients that require intervention,” Sheehan says. “You want to use as much automation as you can. You want to use as much management by exception. If 50 percent is a baseline with no intervention, then if you can drive another 30 percent of compliance, you really want to be focusing on that 30 percent and not on the 50 percent who use it religiously or the 20 percent who say they tried it and will never wear the mask again. You need to use the data to know which patients are at risk and who has a good chance using coaching to get through compliance, and help them receive the true benefit of their therapy.”

Replenishment includes outreach, omnichannel, and patient experience. Sheehan offers these tips on resupply:

  • Excellence on intake creates incentive for repeat referrals
  • High compliance rates deliver strong throughput
  • Excellence in resupply can, independent of those factors, create patient volume growth
  • Leverage tools, automation, and data analysis to expand the program

Sheehan says that regardless of your technology partner, you likely will have to account for work that falls outside your automated processes and systems. “We have an electronic fax solution we are using so that’s where the majority of these referrals are slotted in. They are tracked and moved through a folder architecture so we know what is a new referral, new supply patient, etc. It’s really a work queue to make sure the info that comes in outside the system gets inside the system.”

This article originally appeared in the May 2016 issue of HME Business.

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