Interoperability -- One on one with Chris Kinard

IT systems are getting connected across healthcare. LifeH2H's Kinard gives an provider's-eye view on how it will impact and benefit HME businesses.

Chris Kinard, vice president of corporate system development for LifeH2H, a South Carolina DME and respiratory supply company established in 1995, says he has been working in the HME industry since age 14. He speaks as an advocate and educator at various state association meetings, customer conferences and Medtrade. He also sits on the Medtrade Education Advisory Board. Recently, HME magazine talked with Kinard about the importance of HMEs achieving IT interoperability.

HME Business: As healthcare in general looks to better connect care providers so that they work in concert, share data, etc., what is the state of HME software and information technology interoperability?

Chris Kinard: Interoperability in a formal sense is somewhat new to HME providers and is often dismissed as unattainable and/or irrelevant to the daily delivery of care. However, at its core, IT interoperability is the single success factor in the complete, compliant delivery of post-acute patient care and outcomes management.

In an industry where reimbursement is largely controlled by regulations and third-party coverage guidelines, provider focus and large amounts of resources are primarily dedicated to billing platforms that can simply adjudicate claims and manage denials, regardless of referral origination or disposition. As a result, HME providers assume responsibility for making sense of the orders and medical documentation produced by fragmented healthcare systems, methodologies and practices. The byproduct is a workflow that is both uncontrollable and unpredictable, thus compromising quality delivery of care and reducing the potential for reimbursement.

As the healthcare continuum shift continues, HME providers and IT vendors are beginning to collaborate more around the efficient delivery of quality care, which defines interoperability far beyond IT infrastructure.

What has been LifeH2H’s experience with software and IT interoperability?

IT development and system integration (interoperability) is at the core of the growth strategy for LifeH2H. We have leveraged software solutions and IT systems to invert the HME referral process, requiring complete, compliant order sets prior to delivery. Our solutions begin with health system integration at the EMR/medical record level, where we obtain electronic order sets and comprehensive medical documentation needed to provide and bill for products and services. As part of our commitment to compliance, we work with the health system to develop and implement the electronic order sets and outline supporting medical need as required in the local coverage determinations. Working in partnership with the hospital, we simultaneously secure physician authorization, coordinate care, and expedite discharge. Additionally, we consolidate order details and authorizations for inclusion in the patient’s medical record.

Like most providers, we utilize various industry software solutions to manage processes, patients, insurance claims, and patient outcomes. Although some interfaces exist to connect these systems, the only way for us to comprehensively manage and automate the order flow process, while controlling the patient experience, was to develop our own intelligence platform called, Segue Solutions. Segue is a single-source solution that connects healthcare, payer, vendor and provider systems and coordinates care in the hospital to home space. Using industry standard communication protocols or custom connections, orders are processed electronically and patient information is shared automatically with the systems and individuals involved in the delivery, billing and follow-up of patient care. Segue ensures the information is formatted to specification so the exchange of information can be fully automated. Additionally, rules management functionality promotes coverage compliance and order accuracy.

How are your company and patients benefiting from interoperability?

Connecting healthcare systems and integrating workflow processes enables us to place the patient back in the center of care. Transparency and accountability in the order process ensures the right product or service is delivered to the patient in a timely and effective manner. Simultaneously, information is efficiently shared across business platforms for compliant and timely claims billing.

Post-delivery, Segue delivers patient therapy information to LifeTouch, the patient outcomes management division of LifeH2H. Care Coaches use the health information to engage patients, measure prescribed therapy compliance, and monitor changes and trends in their condition. This information is aggregated and delivered to the physician for optimal care plan development and the prevention of hospital readmissions. In partnership with the HME provider and the health system, LifeTouch consistently demonstrates improved outcomes and lower readmissions through on-demand reports and interactive dashboard metrics.

Where would you like to see interoperability go? What functions are not offered that you would like to see?

Looking ahead, I believe the HME industry needs to collectively pursue representation at the global healthcare interoperability level. Continued support of the HIMMS initiative or through the CommonWell Alliance, we own the responsibility of detailing the significance of our role as providers in care and demonstration of successful patient outcomes management that comes from integrated IT systems.

What are your top reasons for HME providers to consider using software and IT functions that have interoperability?

  • Efficiency through automation
  • Accuracy
  • Compliance
  • Transparency
  • Accountability
  • Demonstration of outcomes
  • Monetization of impact

The industry and the healthcare continuum as a whole is changing all around us. In order to remain relevant, HME providers must leverage integrated technology solutions in the delivery of quality care.

This article originally appeared in the August 2017 issue of HME Business.

About the Author

Joseph Duffy is a freelance writer and marketing consultant, and a regular contributor to HME Business. He can be reached via e-mail at joe@prooferati.com.

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